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Advanced Trainees (advanced + trainee)
Selected AbstractsEvaluation of emergency medicine trainees' ability to use transport equipmentEMERGENCY MEDICINE AUSTRALASIA, Issue 3 2009Manoj Samuel Abstract Objective: To assess the skills of advanced emergency medicine trainees in the use of commonly used transport equipment and to determine what teaching has been undertaken and what level of confidence trainees have in their ability to use the equipment tested. Methods: This is a prospective multicentre observational study examining equipment use. Three pieces of equipment were examined: the infusion pump, defibrillator-monitor and transport ventilator. A questionnaire and a series of practical tasks were used. Advanced trainees from Victorian ED were enrolled as participants. Outcomes included proportion of participants able to perform all tasks successfully, subjective registrar confidence with use of equipment and departmental training practices. Eleven ED were represented, covering metropolitan tertiary, metropolitan peripheral and regional hospitals. Results: There were 47 participants enrolled in the study. The range of advanced training years of participants was 1,5+. Of the 47 participants, 39 (83%; 95% CI 72.2,93.7%) had been involved as medical escorts. Eighteen participants (38.3%; 95% CI 24.4,52.2%) described some form of teaching for equipment use. The median level of confidence of participants (on a 5-point scale) was 4 (25,75% interquartile range 3,4), which correlates with a moderate degree of confidence. Of 47 participants, 7 (14.9%; 95% CI 4.7,25.1%) rated themselves as not confident or somewhat under-confident (i.e. 1 or 2 on the scale). Of 47, 12 passed overall (25.5%; 95% CI 13.1,38%) and 8 completely failed (17.0%; 95% CI 6.3,27.8%) the skill testing. Conclusion: When tested in isolation, there appears to be deficits in the equipment skills of advanced ED trainees who are expected to be proficient in transport medicine. [source] Survey of surgical skills of RANZCOG traineesAUSTRALIAN AND NEW ZEALAND JOURNAL OF OBSTETRICS AND GYNAECOLOGY, Issue 1 2009Andreas OBERMAIR Background: In Australia, the Integrated Training Program (ITP) of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) offers training in obstetrics and gynaecology. There is anecdotal concern among trainees and Fellows that the surgical component of training is inadequate, with new specialists lacking the confidence and competence to perform many ,standard' surgical procedures. These concerns have not previously been quantified in Australia and New Zealand. Aim: To determine trainees' subjective competence and confidence with surgical procedures and trainees' satisfaction with their surgical training. Methods: All 430 active RANZCOG trainees and 108 Fellows elevated within the previous two years were invited to complete a self-administered questionnaire (65% response rate), which assessed details of procedures performed and confidence to perform them; satisfaction with the surgical training; and perceived teaching ability of the supervising consultants. Results: Those in ITP year 6 rated their confidence high (, 4 of 5) for procedures performed very frequently, but lower for other procedures. No procedure regarding the management of complications reached a confidence score of , 4. Teaching abilities were rated best for obstetric procedures, with 54% rating their consultants' teaching ability as ,excellent'; but for laparoscopic procedures and procedures dealing with complications, 21.2% and 23.4% of respondents rated their consultants' teaching ability as ,poor', respectively. Conclusions: Advanced trainees lacked confidence in a range of surgical procedures; and possible weaker areas were identified in the teaching experience of trainers. These limitations must be addressed by medical educators and training program coordinators. [source] Operative experience in the Victorian general surgical training programmeANZ JOURNAL OF SURGERY, Issue 12 2003Kenneth Wong Background: The Royal Australasian College of Surgeons recommends minimum operative and endoscopy training requirements for advanced trainees in general surgery. This study examines the influences of trainee seniority, geographical location of surgical rotation, and surgeons' remuneration arrangements on the operative and endoscopy experiences of general surgical trainees in Victoria. Methods: Trainee log books covering two 6-month training periods in the year 2001 were analysed for depth and breadth of reported operative and endoscopy experience. Results: A total of 81 trainee log books was reviewed. Senior trainees were significantly more likely to have a higher primary operator experience. Total operative caseload and primary operator experience, in terms of major operative cases, were greater in rural rotations. Endoscopy experience was significantly greater in rural rotations. Operative exposure to gynaecological, laparoscopic, orthopaedic, paediatric and plastic surgical procedures was significantly greater in rural rotations. Surgeons' remuneration arrangements were not significantly related to trainee operative experience. Conclusions: Rural surgical rotations enhance the depth and breadth of operative experience of Victorian general surgical registrars, allowing greater exposure to subspecialty surgical procedures. [source] Anticoagulation prophylaxis for central venous catheter-associated thrombosis in cancer patients: An Australian perspectiveASIA-PACIFIC JOURNAL OF CLINICAL ONCOLOGY, Issue 1 2008Suzanne KOSMIDER Abstract Background: The use of indwelling central venous catheters (CVC) for chemotherapy delivery is essential for people receiving therapies by protracted venous infusion and for patients with difficult venous access. Complications include infection and catheter-related thrombosis. Strategies have been suggested to prevent catheter-related thrombosis, however, there is no clear consensus on how to proceed. Guidelines recommend against the use of prophylactic anticoagulation in adult patients with solid organ malignancies and an indwelling CVC. We investigated the practice of Australian medical oncologists. Methods: A written questionnaire was mailed to all members of the Medical Oncology Group of Australia assessing practices of prophylactic anticoagulation in adult patients with solid organ malignancies and CVC. Results: Responses were obtained from 141 (55%) medical oncologists and from 40 advanced trainees. Ten percent (n = 4) of oncology trainees and 18.4% (n = 26) of medical oncologists routinely administered anticoagulants to patients with a CVC without a previous history of line-related thrombus. The most common strategy employed (73% of those using anticoagulation) was to recommend 1 mg of warfarin. Conclusions: The results demonstrate that a significant number of patients in Australia receive routine anticoagulation, the most popular strategy being the use of low-dose warfarin. Based on our results there is a clear need for further education regarding the lack of supporting data and the potential harm that may ensue. [source] |