ideas Flashcards
Tell Us About Yourself
Clinical:
- FY2 doctor, currently in orthogeriatric medicine before moving onto final placement in paediatrics
Personal:
- Enjoys reading, cooking, and travelling
- Practices mindfulness to manage stress and maintain mental health.
-I have thoroughly enjoyed my experiences in paediatrics so far. This year I was awarded the RCPCH Foundation Doctor Prize for my commitment to the specialty. I am extremely proud of this achievement and feel it is an accumulatyion of all of my hard work. Experiences such as volunteering in the university play team, completing a student selected neonatal placements where I conducted research into neonatal intubation premedication – this was published which was a huge academic achievement. This was also presented as a poster at an RCPCH conference. As the leader of the Asthma Innovation Research branch at Imperial College I designed and led teaching for primary school children, including organising volunteers and schools. The purpose of the teaching was to raise asthma awareness in young children, both about symptoms and management (including how to correctly use inhalers). I communicated with primary schools, designed, and delivered interactive teaching on asthma and its management, followed by a Q&A. I organised volunteers to also deliver this teaching. Raising asthma awareness is important because the promotion of health education at an early age will improve current and future health outcomes.
During my emergency department rotation in foundation year 1 I organised to spend one day a week working in the paediatric emergency department. I picked up practical skills such as taking bloods and examining children. I also learnt about common paediatric presentations and the initial management of emergency conditions, I learnt to anticipate when to escalate to seniors. Since starting foundation year 2, I have completed a taster in paediatrics in which I had the opportunity to see the safeguarding team in action.
Additionally, I completed my VR simulation level 3 children’s safeguarding training and online level 3 children’s safeguarding. I attended paediatric immediate life support training and simulated leading paediatric cardiac arrest scenarios.. I attended RCPCH workshops to explore different paediatric sub-specialties.
I am committed to advancing paediatric care through teaching, research, audit, and practice.
why paediatrics
Passionate about improving children’s health outcomes and having a lifelong impact on children and their families, helping them grow into healthy adults, promoting health early to create a healthier society.
Supportive and collaborative teams. Fun, kind, and compassionate colleagues make paediatrics a pleasure to work in.
While peers may feel apprehensive about working with children, I feel energised and rewarded by the opportunity. Paediatric ED experience: Reinforced my passion as the most enjoyable and fulfilling days.
Focus for family-centred care, collaborating with parents and carers to achieve the best outcomes for children.
Enjoy the unique challenges and variety in paediatrics, from treating newborns to young adults.
What Did You Do During Medical School/Foundation to Explore Paediatrics?
Early Experiences:
Volunteered on the play team:
Developed communication skills to engage with children and their carers.
paediatric placement and student selected Neonatal placement:
Gained hands-on experience, including assisting with resuscitations.
Inspired academic contribution as the first author of a paper on neonatal intubation premedication.
Poster research at the RCPCH conference and published in Early Human Development.
Elective in neonatal medicine and in paeds st Lucia : Solidified my passion for paediatrics and highlighted global inequalities.
Led a branch of Asthma Innovation Research:
Taught asthma management in primary schools.
Fostered an interest in early health promotion and education.
Foundation: arranged to do 1 day a week in paeds ed, taster week in paeds including running a clinic with a consultant present. level 3 safeguarding and PILs training.
who inspired you the most
Recently, I have been deeply inspired by the consultant paediatrician in emergency medicine at my hospital. She embodies the qualities of an exceptional paediatrician, including empathy, outstanding communication skills, and adaptability. Her fantastic support, teaching and her ability to ensure smooth teamwork are remarkable. She handles concerned parents with confidence and brings a calming presence to stressful situations. Her professionalism and dedication make her a true role model, and I aspire to emulate her qualities in my own career.
what are you most proud of in your portfolio?
RCPCH Foundation Prize: reflecting dedication to paediatrics
Leading Asthma Awareness Course: Designed and delivered educational sessions to primary school children, promoting early health education and awareness of asthma management.
Neonatal Research Paper: Authored a study on neonatal intubation premedication practices, which was published in Early Human Development and presented at the RCPCH conference 2022.
what suits you to the role
Clinical Skills:
- Skilled at managing acutely unwell patients efficiently and safely.
- Proficient in anticipating and solving problems effectively and escalating when necessary.
Passion and Motivation:
- Deeply committed to improving future health outcomes for children.
- Find working with children and their families incredibly rewarding.
Teamwork and Collaboration:
- Strong member of MDT that values clear open communication
Dedication to Paediatrics:
- Proven commitment through experiences, training, and academic contributions.
- Awarded the RCPCH Foundation Doctors’ Prize for dedication to the specialty.
Where have you shown commitment to paediatrics?
Awarded the RCPCH Foundation Doctor Prize for dedication to paediatrics.
organised Weekly shifts in the paediatric A&E during my emergency medicine placement. Developed skills in blood-taking, examination, and managing common paediatric emergencies.
Completed a taster week in general paediatrics, including running a clinic and seeing safeguarding in practice.
Neonatal placements: Gained practical skills and inspired academic contributions.
Organised weekly shifts in the paediatric ED during FY1:
Academic and Research Contributions:
Published research on neonatal intubation premedication, created a poster to be presented at RCPCH conference.
Led asthma education projects in university.
Committed to advancing paediatric care through research, audits, and clinical practice.
Completed VR Simulation Level 3 Children’s Safeguarding Training and online Level 3 safeguarding.
Attended RCPCH workshops to explore various paediatric sub-specialties.
Completed Paediatric Immediate Life Support (PILS) training, simulating leadership in cardiac arrest scenarios.
What are the qualities of a good paediatrician? Do you have those qualities?
Compassion and Empathy:
Understands children’s fears and families’ anxieties, building trust and holistic care.
Excellent Communication Skills:
Explains medical issues clearly to children and carers, using age-appropriate language.
Adaptability:
Adjusts to children’s diverse ages, temperaments, and developmental stages.
Teamwork:
Collaborates effectively with families, healthcare professionals, and multidisciplinary teams.
Advocacy for Children:
Acts in children’s best interests, particularly in safeguarding or inequity challenges.
What will be the biggest challenge in this post for you?
Parental Expectations:
Parents often have high expectations for their children’s care, especially in difficult or uncertain situations.
To address this, I focus on clear, compassionate communication, explaining the situation, treatment options, and expected outcomes.
I provide a supportive space for parents to ask questions and express concerns, which helps manage expectations and build trust.
Staying Up to Date with Changes in Guidelines/Evidence-Based Medicine:
Paediatrics is a rapidly evolving field, with frequent updates in clinical guidelines and evidence-based practices.
To stay current, I commit to continuous learning by reading journals, attending conferences, and engaging in formal educational opportunities.
I collaborate with my team to discuss the latest research and guidelines, ensuring we provide the most up-to-date care.
Emotional Strain:
Sick children and their families can be emotionally taxing, particularly in critical or end-of-life care scenarios.
I manage this by practicing self-care (e.g., mindfulness) and debriefing with colleagues and mentors after challenging cases.
I also engage in team meetings and peer discussions to ensure emotional resilience and seek support.
What skills or personal attributes do you possess that will make you a good trainee in this specialty?
Hardworking and Motivated:
Actively reflect on my practice to identify areas for improvement.
Strong Communication Skills:
able to Remain calm and focused when managing acutely unwell patients.
Able to adapt to dynamic, high-pressure clinical environments.
Prioritise effectively in busy environments to ensure timely and safe patient care.
Driven by a strong passion for paediatrics and delivering family-centered care.
Committed to learning, growing, and improving the care I provide.
Tell us about any teaching experiences or presentations you have done. Describe and reflect on your involvement in clinical education.
Asthma Innovation Research Branch (Medical School):
Led teaching for primary school children on asthma awareness, including symptoms and inhaler use.
Organised and coordinated volunteers and schools, ensuring smooth logistics.
Delivered interactive teaching, followed by a Q&A session to promote health education at an early age, aiming to improve both current and future health outcomes.
Foundation Doctor Teaching:
Conducted bedside teaching, 1:1 mentoring, and lecture-style teaching with junior colleagues and medical students. gained feedback and adapted teaching.
Future Teaching Plans:
Excited to lead virtual on-call sessions with final-year medical students starting in February, which will provide an opportunity to enhance clinical teaching.
Reflection:
Enjoys being involved in clinical education, with a focus on delivering practical, engaging, and valuable learning experiences.
Recognises the importance of health education in improving patient outcomes and supporting the next generation of healthcare professionals.
Where do you see yourself in 3-5 years time?
I would like to have Completed the MRCPCH exams and Gained a solid foundation in general paediatrics.
Involved in QIPs, audits, and research to contribute to paediatric care.
Explored and finalized choice of sub-specialty training.
Maintaining a healthy work-life balance.
How do you organise your workload?
Prioritise tasks based on urgency and importance. Address acutely unwell patients and time-sensitive tasks first.
Use task lists to structure the day and stay organised.
Group similar tasks together for efficiency
Work with the team to delegate tasks appropriately.
Seek support when needed to manage the workload effectively.
Stay prepared for unexpected emergencies while managing routine tasks.
Ensure time-sensitive tasks, such as discharge summaries, are completed on time.
What are your hobbies? How do they influence your medical practice?
I regularly exercise to maintain both physical and mental well-being. This helps me stay focused, manage stress, and remain resilient in a demanding medical career.
I spend time outdoors to clear my mind and gain perspective
I enjoy reading, particularly topics related to medicine and personal development. recently finished the first breath - an incredible book recommended in the RCPCH milestones magazine. combines authors experiences of neonatal medicine and the ethical dilemas faced by healthcare professionals.
These hobbies support a healthy work-life balance, boost resilience, and ensure I remain engaged and passionate in my medical career.
How do you manage stress at work?
proactively Prioritise tasks and stay organised to prevent feeling overwhelmed.
speak with team for support, promoting teamwork and open communication in challenging situations.
Outside of Work Regular exercise, mindfulness, and spending time with family and friends to unwind.
Reflect regularly on difficult situations, seek feedback and mentorship to learn and improve.
What skills do you need to improve?
Currently working on improving my teaching abilities by leading virtual on-call teaching sessions for final-year students. will regularly ask for feedback and adapt sessions accordingly
Focused on enhancing my paediatric knowledge during my upcoming paediatric placement in April and study for Foundations of Practice and Theory and Science exams during this time to increase knowledge before hopefully starting as a trainee.
Commitment to professional development
Committed to contributing to children’s healthcare through research, audit, and clinical practice.
Awarded the RCPCH Foundation Doctors’ Prize for my commitment to paediatrics.
Organised to spend one day a week in the paediatric emergency department.
Gained practical skills such as taking bloods and examining children. Learned about common paediatric presentations and initial management of emergency conditions.
Completed VR simulation level 3 and online level 3 children’s safeguarding training. Attended paediatric immediate life support training and simulated leading paediatric cardiac arrest scenarios.
Attended RCPCH workshops to explore different paediatric sub-specialties.
Completed a taster week in paediatrics, observing the safeguarding team in action and leading a clinic.
What are the rewards working as a paediatrician
Job Satisfaction: positively impacting children’s health and well-being.
real potential to have an impact on a child’s life.
Work in a supportive, multidisciplinary team fostering a collaborative work culture.
The dynamic nature of paediatrics, with varied cases and opportunities for ongoing learning. Experience working with children of all ages, from babies to young adults.
Fulfilment from Helping Children:
Every day brings new challenges and opportunities to improve health outcomes for children, making the work incredibly fulfilling.
What are the challenges working as a paediatrician
Parental Expectations:
Managing demanding parental expectations, especially when families are anxious or uncertain about their child’s condition.
Staying Updated:
Keeping up with the latest research and guidelines in paediatrics to ensure the highest standard of care, which can be challenging due to the field’s fast-evolving nature.
Emotional Strain:
Dealing with complex and sensitive situations, including life-limiting illnesses, which can be emotionally challenging.
Challenges of paediatrics and how you address them
Parental Expectations:
Parents often have high expectations for their children’s care, especially in difficult or uncertain situations.
To address this, I focus on clear, compassionate communication, explaining the situation, treatment options, and expected outcomes.
I provide a supportive space for parents to ask questions and express concerns, which helps manage expectations and build trust.
Staying Up to Date with Changes in Guidelines/Evidence-Based Medicine:
Paediatrics is a rapidly evolving field, with frequent updates in clinical guidelines and evidence-based practices.
To stay current, I commit to continuous learning by reading journals, attending conferences, and engaging in formal educational opportunities.
I collaborate with my team to discuss the latest research and guidelines, ensuring we provide the most up-to-date care.
Emotional Strain:
Sick children and their families can be emotionally taxing, particularly in critical or end-of-life care scenarios.
I manage this by practicing self-care (e.g., mindfulness) and debriefing with colleagues and mentors after challenging cases.
I also engage in team meetings and peer discussions to ensure emotional resilience and seek support.
What motivates you to give your greatest effort?
I believe every patient deserves the best possible care.
Motivated by my own personal experience of caring for my mother during her cancer diagnosis.
First hand insight into strengths and shortcomings of healthcare interactions.
Inspired to treat every patient with the compassion, respect, and care I would want for my own family.
How have you coped with managing a work-life balance?
I have learned to set clear boundaries between work and personal time, ensuring I prioritise my well-being.
Outside of work, I engage in activities that help me relax, such as reading, cooking, and spending time outdoors.
I practice mindfulness, which helps me stay grounded and manage stress effectively.
I ensure that I make time for family and friends, which helps me maintain my wellbeing through my support system.
At work, I manage my time by staying organised and asking for help when needed, ensuring I stay focused and efficient.
What coping strategies do you use?
Mindfulness and Meditation: helps me stay calm and focused.
I prioritise physical activity, such as going for walks or engaging in sports, which improve my mood.
Effective time management is crucial; I organise tasks, break them down into manageable steps, and ask for support when needed.
I make sure to schedule regular downtime to spend with family and friends, which helps me to recharge and maintain a positive work-life balance.
Why should we recruit you rather than any other candidate?
Whilst working in the paediatric emergency department I developed the ability to recognise acutely unwell children and prioritise them appropriately. I gained experience managing common presentations such as head injuries by clerking, examining and formulating management plans. I learnt to escalate to seniors when needed, ensuring patient safety.
Involved in paediatric QIP and
research on neonatal premedication practices published in Early Human Development.
Empathy and Communication Skills:
awarded the RCPCH foundation doctors prize for my commitment to the specialty.
Drive and Passion for Paediatrics:
make me an excellent candidate for your team.
How do you keep your skills up-to-date?
I attend workshops and conferences, such as those organised by the RCPCH, to stay updated on advancements in paediatrics.
I regularly read BMJ, RCPCH Milestones Magazine, and clinical guidelines to ensure my knowledge is evidence-based.
I pursue hands-on learning during placements and training, including simulation-based sessions and multidisciplinary team discussions.
After difficult clinical experiences, I engage in self-reflection to assess my strengths and areas for improvement.
I stay engaged with emerging evidence through research and audit projects, contributing to my growth as a clinician.
organisation example
- Coordinated with schools to schedule multiple asthma awareness teaching sessions. coordinated with volunteer students to teach them the lesson materials and session plans which i had prepared.
- Communicated effectively with school staff to ensure smooth delivery of sessions.
- Balanced organisation with delivering impactful and engaging teaching.
- Developed time management and leadership skills through the process.
teamwork example
Worked closely with new FY1 doctors during my urology rotation.
Supervised their day-to-day tasks, encouraging them to seek advice when needed.
Helped them build confidence in clinical skills.
Supported them when the workload was challenging by breaking down tasks and providing guidance.
Fostered a positive learning environment and offered feedback on presentations.
Advised them on navigating their first post and their professional development.
Highlighted the importance of teamwork, mentorship, and creating a supportive atmosphere in the MDT.
Give an example of a situation where you showed leadership.
Leading asthma innovation research teaching
Involved in leading Paediatric cardiac arrest scenarios during paediatric Immediate Life Support (PILS) training.
Managed teamwork in high-stress situation and ensured clear communication and coordination.
Recognised for approachability, which helps create a safe and supportive environment for the multidisciplinary team (MDT) to work effectively.
Completed leadership programs like the Edward Jenner Level 0 and 1 and the Enhance ‘Contextual Leadership’ module, which significantly boosted clinical confidence.
Awarded Foundation Leadership Merit for commitment to leadership training and development.
Impact:
These leadership experiences have reinforced the importance of good communication, teamwork, and approachability in leading teams during critical moments, as well as in everyday clinical settings. Passionate about further developing leadership skills further as a paediatrician.
resilience example
During the flu season this year, I managed multiple critically unwell patients, many of whom were nearing the end of their lives.
It was emotionally and physically demanding, as I moving between providing end-of-life care, supporting grieving families, and caring for other unwell patients.
Each conversation with families required empathy and clarity, ensuring they felt supported during such a difficult time.
I maintained my focus and composure, Reflecting on these experiences, it highlighted the value of self-care and debriefing to sustain resilience in challenging circumstances.
Example working in MDT and supervising others
Worked closely with new FY1 doctors during my urology rotation.
Supervised their day-to-day tasks, encouraging them to seek advice when needed.
Helped them build confidence in clinical skills.
Supported them when the workload was challenging by breaking down tasks and providing guidance.
Fostered a positive learning environment and offered feedback on presentations.
Advised them on navigating their first post and their professional development.
Highlighted the importance of teamwork, mentorship, and creating a supportive atmosphere in the MDT.
How do you Manage time?
Prioritise tasks based on urgency and importance. Address acutely unwell patients and time-sensitive tasks first.
Use task lists to structure the day and stay organised.
Group similar tasks together for efficiency
Work with the team to delegate tasks appropriately.
Seek support when needed to manage the workload effectively.
Stay prepared for unexpected emergencies while managing routine tasks.
Ensure time-sensitive tasks, such as discharge summaries, are completed on time.
What is the training programme?
RCPCH Progress+ Curriculum: Competency-based framework for paediatric training from ST1 to ST7.
11 Key Domains: Clinical care, communication, professionalism, leadership, education, management, QI, research, personal development, system-based practice.
Workplace-Based Assessments: Mini-CEX, case-based discussions, PDPs, and ePortfolios.
Emphasis: Child-centered care, continuous professional development, and acquiring necessary skills for high-quality care.
Why this training programme over others?
Structured Pathway: Clear, well-organised training journey. General paediatrics and then more specialised
Comprehensive Curriculum: Covers a broad range of clinical skills and knowledge.
Broad Clinical Exposure: Provides diverse hands-on learning opportunities.
Strong Support System: Mentorship and continuous professional development.
Child-Centered Care: Focus on improving outcomes for children.
Example of audit/QIP
QIP in Paediatric A&E: Led a QIP on NICE guidelines for UTI diagnosis and management in children under 16.
Reviewed 1000+ patient notes for diagnosis, management, and follow-up.
Compared current practice with gold standards and identified the need for changes.
Presented findings at A&E governance and urology audit meetings.
Completed a PDSA cycle leading to changes in practice
developing a microbiology sample database and implemented a dipstick interpretation flowchart.
Ensured adherence to NICE guidelines and improved patient care.
Is undertaking QIP/Audit an important part of today’s healthcare model?
QIP and audits are essential for ensuring safe, effective, and evidence-based care in paediatrics.
Audits identify gaps in current practices, highlighting areas for improvement.
QIPs implement and sustain improvements, focusing on patient safety, resource optimisation, and adherence to clinical guidelines.
Audits and QIPs foster teamwork, learning, and innovation.
They directly enhance outcomes for patients
Describe your experience of the audit process? What did you gain from your audit experience?
QIP in Paediatric A&E: Led a QIP on NICE guidelines for UTI diagnosis and management in children under 16.
Reviewed 1000+ patient notes for diagnosis, management, and follow-up.
Compared current practice with gold standards and identified the need for changes.
Presented findings at A&E governance and urology audit meetings.
Completed a PDSA cycle leading to practical changes, like developing a microbiology sample database and implementing a dipstick interpretation flowchart.
Ensured adherence to NICE guidelines and improved patient care.
Audit on MSU Collection and Surgical Prophylaxis: Reviewed 100 patient notes on operations, pre-operative care, and antibiotic usage. Identified gaps, specifically in pre-operative MSU culture rates. Shared findings in urology audit meeting and recommendations to improve practices and align with best standards.
What I Gained:
Experience in data collection, analysis, and identifying areas for improvement.
Improved understanding of the audit process and how to drive practical changes in clinical settings.
Tell me about clinical governance? Has clinical governance improved patient safety?
Clinical Governance: A framework that ensures healthcare organisations are accountable for maintaining and improving care quality. It involves:
Risk Management:
Audits and Quality Improvement:
Continuous Learning:
Impact on Patient Safety:
Proactive Risk Identification:
Error Reporting:
Evidence-Based Practices:
Programs like GIRFT:
Conclusion: Clinical governance has greatly improved patient safety by fostering collaboration, reducing errors, and driving evidence-based practices.
What is evidence -based medicine? Tell us about the different levels of evidence available?
Evidence-Based Medicine (EBM):
Integrates the best available research evidence, clinical expertise, and patient values.
Aims to ensure treatments are effective, safe, and patient-centered.
Involves using current research to guide healthcare decisions and improve patient outcomes.
Levels of Evidence (from strongest to weakest):
Systematic Reviews and Meta-Analyses:
Randomised Controlled Trials (RCTs):
Cohort Studies:
Case-Control Studies:
Cross-Sectional Studies:
Case Reports:
Expert Opinion:
Conclusion: EBM uses the most reliable evidence to guide clinical decision-making, promoting informed and high-quality care.
Tell us about your research experience?
first authored a paper focused on premedication practices for neonatal endotracheal intubation and less invasive surfactant administration across UK NHS Trusts.
Published in Early Human Development after being presented at the 2022 RCPCH conference as a poster.
This research experience reinforced my passion for paediatrics and highlighted the importance of contributing to the field through research to improve clinical practices.
Neoprint findings
Wide variability in first-line premedication for endotracheal intubation could be addressed through consensus guidelines
Divisive views on LISA premedication practices necessitate further research via a randomized controlled trial.
Is undertaking research an important part of today’s healthcare model?
Advancement in Medical Knowledge and guidelines
Research drives new treatments, refines existing protocols, and identifies best practices.
Contributes to evidence-based practice, enhancing patient safety and efficiency.
Research informs policy-making and helps personalise care based on individual needs.
Tell us about a recent paper you have read
Study Title: Procalcitonin-guided duration of antibiotic treatment in children hospitalised with confirmed or suspected bacterial infection in the UK (BATCH)
Study Design: two-arm, individually randomised, controlled trial.
Key Findings:
Investigated whether procalcitonin-guided therapy could safely reduce the duration of intravenous antibiotics in children with suspected or confirmed bacterial infections.
Compared procalcitonin (a bacterial infection biomarker) with C-reactive protein (CRP) for treatment decisions.
No significant difference in intravenous antibiotic duration between the procalcitonin-guided group and usual care group.
Safety outcomes were similar across groups.
Conclusion: procalcitonin testing does not provide additional benefits for reducing treatment duration or improving safety outcomes.
What makes you a good team player? Give an example of a recent situation where you played an important role in a team.
Supportive: I prioritise helping colleagues and fostering a positive team environment.
Teaching: I actively share knowledge and enjoy teaching to enhance team skills.
Communication: I ensure open, clear, and respectful communication to maintain effective collaboration.
Give an example of conflict you have experienced in the workplace and how this was resolved.
Encountered a difficult and confrontational patient’s son who frequently shouted at staff, questioned competencies, and insisted he knew the diagnosis.
His behaviour was distressing to the patient, worsening her compliance and increasing her belief that we were not trying to help her.
Resolution Approach:
Remained professional and focused on de-escalating interactions with the son while maintaining care for the patient.
Escalated to my consultant, ensuring I reported the ongoing behavior.
Family Meeting:
Consultant arranged a family meeting with senior staff and hospital management to address the situation.
Clear boundaries were established, including reducing direct contact between the son and junior staff, and a potential hospital ban was communicated if his bullying continued.
Outcome:
The situation improved, allowing staff to focus on providing effective patient care while reducing distress for the patient.
This experience emphasised the importance of teamwork, clear communication, and escalating issues appropriately to protect both patients and staff.
Is undertaking clinical education an important part of today’s healthcare model?
Yes, absolutely – clinical education is crucial in today’s healthcare model.
Training Future Doctors:
Ensuring Safe, High-Quality Care:
Supporting Professional Growth:
Improving Healthcare Outcomes:
Discuss any new teaching methods that you are aware of? What teaching methods do you know. Which do you prefer, and why?
Aligning Teaching to Learners’ Perspective:
Focus on what the learners need to know and tailor the content to their individual learning needs. Build on knowledge.
Acknowledging the importance of adapting teaching to different learner perspectives ensures the material is relevant and engaging.
Feedback-Driven Learning:
Regularly seek feedback from learners and incorporate it into future teaching sessions, ensuring that the content is effective and meeting their needs.
Stretching Knowledge:
challenges learners to think beyond their current understanding, encouraging critical thinking and deeper learning.
pushing learners to expand their knowledge.
Preferred Teaching Methods:
I prefer methods that actively engage learners, such as bedside teaching and interactive discussions, as these foster critical thinking and help learners apply theory to practice.
Your consultants mentions something to a patient that you believe to be wrong, how do you react?
Prioritise Respectful and Tactful Approach: maintain professionalism and avoid conflict.
Understand the Context:
Make sure I fully understand the context before reacting to avoid misjudging the situation. Consider the possibility that there may be factors I am unaware of.
Private Discussion:
Privately approach the consultant and frame my concern as a request for clarification. For example: “I thought the recommendation for [specific issue] was [correct information]; could we confirm together?”
Support in Correcting the Information:
If an error is confirmed, I would help the consultant correct the information transparently with the patient to maintain trust and ensure the correct message is communicated.
Reflect and Learn:
Reflect on the situation, both for clinical learning and decision-making improvement, ensuring that I gain insight and improve my approach for future encounters.
This approach maintains professionalism while promoting team collaboration and ensuring patient trust is upheld.
Tell us about a NICE guideline that has related to a specialty that you have been working in?
The NICE guideline NG103 on Delirium: prevention, diagnosis, and management outlines key recommendations for managing delirium in adults. Below are the main points:
- Prevention of Delirium
Identify at-Risk Individuals: Screen for risk factors such as age >65 years, cognitive impairment, severe illness, or hip fracture.
Address Modifiable Risk Factors:
Ensure good hydration and nutrition.
Manage pain effectively.
Minimise the use of unnecessary medications, particularly sedatives and anticholinergics.
Optimise sensory input, such as providing glasses or hearing aids.
Encourage mobility and sleep hygiene.
- Diagnosis of Delirium
Use clinical observation and cognitive tests, such as the 4AT tool, to assess for delirium. Look for:
Acute onset and fluctuating course.
Inattention.
Disorganised thinking.
Altered level of consciousness.
- Management of Delirium
Non-Pharmacological Interventions:
Reorient the patient by providing clocks, calendars, and familiar items.
Ensure a calm, well-lit, and quiet environment.
Encourage family or caregiver involvement.
Pharmacological Interventions: Only consider medication if the patient is severely distressed or at risk of harming themselves or others.
Use low-dose haloperidol or lorazepam as a short-term option, except in cases of Parkinson’s disease or Lewy body dementia, where antipsychotics should be avoided.
- Monitoring and Follow-Up
Regularly reassess the patient to ensure delirium symptoms are resolving.
Identify and treat underlying causes, such as infections, metabolic imbalances, or drug toxicity.
