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10 - Portfolios
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- By Larissa Ryan, ST4 Old Age Psychiatry, Oxford Deanery, Berkshire Healthcare NHS Foundation Trust, Clare Oakley, Clinical Research Worker, St Andrew's Academic Centre, Institute of Psychiatry, King's College London
- Edited by Amit Malik, Dinesh Bhugra, Andrew Brittlebank
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- Book:
- Workplace-Based Assessments in Psychiatry
- Published online:
- 01 January 2018
- Print publication:
- 01 June 2011, pp 108-121
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Summary
This chapter discusses the use of portfolio learning generally, and more specifically its applications in psychiatry. It focuses on the use of portfolios in specialist training in psychiatry, but also their use in revalidation. The chapter considers what portfolio learning is, and the advantages and disadvantages of this method. The models that have previously been established for a portfolio framework will be discussed and we will evaluate the e-portfolio format. Finally, we will explain the recent process of developing the Royal College of Psychiatrists’ Portfolio Online platform, and look ahead to the future developments in this area.
What is a portfolio?
Portfolios have been in use for many years in a wide variety of fields, but more recently they have been applied in the training of health professionals. They have become a feature of many undergraduate medical curricula, and feature as part of postgraduate specialist training for all the major medical specialties. A portfolio has been simply defined by Mathers et al (1999) as ‘a collection of evidence maintained and presented for a specific purpose’. A more detailed description is that portfolios should include ‘a documentation of learning, an articulation of what has been learned and a reflective account of the events documented or personal reflection’ (Snadden & Thomas, 1998a). The second definition highlights the difference between a professional portfolio, which is used only to present examples of work or to list achievements, and a learning portfolio, which includes a record of educational experience but also contains reflection on this, and planning for future learning.
An important feature of learning portfolios is that they rely on, and encourage, self-directed learning, which is a key feature of adult learning. Kolb's learning cycle (Fig. 10.1) describes a process where concrete experience leads to reflection, which leads to conceptualisation and learning from the experience, which leads to further experimentation with trying out new knowledge, which then results in further experience (Kolb, 1984).
74 - Anticholinesterase inhibitors: monitoring of cardiac side-effects
- from VII - Treatment
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- By Larissa Ryan, Berkshire Healthcare NHS Foundation Trust
- Edited by Clare Oakley, Floriana Coccia, Neil Masson, Iain McKinnon, Meinou Simmons
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- Book:
- 101 Recipes for Audit in Psychiatry
- Published online:
- 02 January 2018
- Print publication:
- 01 March 2011, pp 179-180
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Summary
Setting
This audit is designed to be carried out within the setting of an out-patient memory clinic in old age psychiatry.
Background
Acetylcholinesterase inhibitors are licensed and widely used for the treatment of dementia. There is a potential for cardiac side-effects from these medications, particularly in the elderly population. This is due to their cholinergic effect, acting to slow the heart rate down by enhancing vagal activity. This bradycardiac effect has led to concerns about serious arrhythmias or heart block, but could also lead to pre-syncope due to a slow pulse. Dizziness leading to falls in older people could have serious consequences, such as fractures or intracranial bleeds. Rowland et al (2007) addressed this issue of cardiac complications in a review of randomised controlled trials of the three cholinesterase inhibitors, and recommended that a minimal level of cardiac monitoring is suitable.
Standards
Standards were taken from a protocol suggested by Rowland et al (2007) and were as follows:
ᐅ All patients considered for treatment with cholinesterase inhibitors in the memory clinic should have a symptom enquiry and pulse check at baseline.
ᐅ All patients currently on treatment with cholinesterase inhibitors in the memory clinic should have a symptom enquiry and pulse check at each 6-monthly follow-up visit.
Method
Data collection
A report was generated showing all patients seen in a memory clinic over a defined period. This could be obtained from a computer system or clinic records. Patients were included in the audit only if they were currently receiving treatment with cholinesterase inhibitors, or were due to start such treatment. The medical notes for these patients were then obtained and analysed.
For all patients already on a cholinesterase inhibitor (and those due to start treatment with one), the presence in the notes of the following was recorded:
ᐅ demographic details
ᐅ presence or absence of any pre-existing cardiac disease
ᐅ previous treatment with a rate-altering medication, other than cholinesterase inhibitors
ᐅ the presence or absence of symptoms of dizziness, syncope, falls or ‘funny turns’
ᐅ a pulse rate check.
In addition, for patients already on a cholinesterase inhibitor, the notes were checked for documentation of which medication they were on, its dose and duration of treatment.
Contributors
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- By R. J. Aitken, Gokhan Akkoyunlu, David F. Albertini, Christiani A. Amorim, R. A. Anderson, Baris Ata, Pedro N. Barri, Mohamed A. Bedaiwy, Rosita Bergström, Veronica Bianchi, Montserrat Boada, Paolo Boffetta, Andrea Borini, Karina Braga Ribeiro, Peter R. Brinsden, Ralph L. Brinster, Jason G. Bromer, A. L. Caplan, Chian Ri-Cheng, Ina N. Cholst, A. Ciobanu, Megan Clowse, Ana Cobo, Susannah C. Copland, John K. Critser, B. J. Curry, Giuseppe Del Priore, M. De Vos, Marie-Madeleine Dolmans, Javier Domingo, Jacques Donnez, David H. Edgar, Nanette R. Elster, Carol Fabian, Gregory M. Fahy, Tommaso Falcone, Debra Friedman, Jill P. Ginsberg, Debra A. Gook, Julie R. Gralow, Elizabeth Grill, Sebastien Gouy, Xu Han, Lisa M. Harlan-Williams, Outi Hovatta MD, Wayland Hsiao, Zhongwei Huang, E. Isachenko, V. Isachenko, Roy A. Jensen, I. I. Katkov, S. Samuel Kim, Jennifer Klemp, Larissa A. Korde, R. Kreienberg, Srinivasan Krishnamurthy, Juergen Liebermann, J. Ryan Martin, Elizabeth A. McGee, Marie McLaughlin, P. Mathevet, D. Meirow, Philippe Morice, Steven F. Mullen, Kutluk Oktay, Pasquale Patrizio, Antonio Pellicer, Pinki K. Prasad, Kenny A. Rodriguez-Wallberg, Erin Rohde, Allison B. Rosen, Zev Rosenwaks, María Sánchez, R. Sanchez, Glenn L. Schattman, Peter N. Schlegel, Einat Shalom-Paz, Lonnie D. Shea, Gunapala Shetty, Jill Simmons, Carrie A. Smith, J. Smitz, Miquel Solé, Jean Squifflet, Shane R. Stecklein, Jerome F. Strauss, David J. Tagler, Seang Lin Tan, Evelyn E. Telfer, Sreedhar Thirumala, Michael J. Tucker, Catherine Uzan, Anne Van Langendonckt, Anna Veiga, W. H. B. Wallace, Wenjia Wang, Brent Waters, Dagan Wells, Teresa K. Woodruff, Erik Woods, Christine Wyns
- Edited by Jacques Donnez, Université Catholique de Louvain, Belgium, S. Samuel Kim, University of Kansas
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- Book:
- Principles and Practice of Fertility Preservation
- Published online:
- 04 February 2011
- Print publication:
- 03 February 2011, pp x-xiv
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