Clinical Governance/Academia Questions Flashcards
What clinical question in obstetrics and gynaecology wold you like to see answered in the next 5 yrs
The pathogenic mechanism of Endometriosis
Why??
- Significant impact on people/economy/population
- 11.4% of women affected by age 44 (RANZOCG endorsement guidelines)
- $9.3 Billion in 2017 in costs (Therapy/sick days, etc)
- Disabiling condition that affects women at all stages in their lives, leading to chronic pain/infertility and metal health issues - Gold standard treatment risky and not that effective
Laparoscopy + medical suppression whilst effective for some individuals has significant downsides
- requires Hormonal suppression -> Can’t be used for everyone, can’t concieve
- Laparoscopy carries significant risk
Well defined pathogenic mechanism may allow for more targeted therapy and reduce affect of endorsement on out population and create safer treatments
What are the qualities of a good teacher
- Communication
- Enthusiastic & Engaging
- Knows their students and how to best connect with them
What is the role of Evidence based medicine in clinical care
- Improving Patient outcomes
- EBM provides clinicians with a lense through which to appraise the care they offer patients and offer them the best care that is available to them
- - Avenues of research
- Evidence based medicine provides people with a structure through which to pose hypothesis and aim to answer clinical questions. that can occur on an international level such as the many landmark trials that RANZCOG that identified, as well as on a much small scale involved unit audits and other small research projects - Keeps clinicians accountable
- Clinicians that work in comparable environments with comparable patient population and available resources and held accountable to use evidence based medicine.
On rural rotation you are told that is it normal for trainees to do a lot of C/S because it is safer for new trainees to overcall situations. a few weeks later you note the C/S is close to 40%. What are you thoughts on this/ how would you approach this
- Trainee education and competence
- This situation doesn’t describe adequate training
- Trainees should be supported to make the best decision for the patients in line with best clinical practice, as they one day will go on to become the leader in this area
2 Women centred care
- A Caesarean section rate can be used as an indicator of unit performance within O&G
- Importance to consider/listen to what women actually want
- If the majority of women are wanting VD -> we are not delivering them the best care they deserve
On rural rotation you are told that is it normal for trainees to do a lot of C/S because it is safer for new trainees to overcall situations. a few weeks later you note the C/S is close to 40%. What are you thoughts on this/ how would you approach this
- Trainee education and competence
- This situation doesn’t describe adequate training
- Trainees should be supported to make the best decision for the patients in line with best clinical practice, as they one day will go on to become the leader in this area - C/S rate of 40%
- What are the contributing factors to this
- Consultants/Trainees/Clinical environments/Patient demographics/paediatric cover/Patient choice
- Clearly this rate is higher that other hospitals but without adequate understanding of why it is difficult to judge
What methods of teaching do you know
- Didactic lecture based
- Old fashioned, useful in certain situations even engaged audience and engaging lecturer - Simulation of practical skill
- Becoming more usable/importance with improving technology and a lack of surgical experience for junior doctors - Real world supervision of practical skill
- Excellent hands on learning but teacher needs to be effective in using opportunity and student needs to be ready to learn - Case based discussion
- Useful small group methods of teaching, takes bract concepts and makes it real world - One on one mentoring
- Personalised teaching specific to person strengths and weaknesses - Teleconference learning
- Evolving form of education
Clinical handover is an essential part of good clinical practice, and a high-risk area for patient safety. What is your understanding of clinical handover, and how do we ensure this is being undertaken at a high standard within our hospitals?
- Understanding of handover
- Essential part of clinical care where the information and care of patients are handed over
- Occurs in many forms. End/start of shift handover, but also in notes in patient file + post-operative notes
How do we ensure high quality handover
- Structured ISBAR format -> evidence shows it improved care
- Protected time for doctors 30 mins either side
- multi-disciplinary involvement
- Consultant led handover
- Special care during labour and with locums
