Training in and assessment of the procedural skills required to perform peripheral nerve blockade

The training and ongoing education of medical practitioners has undergone major changes in an incremental fashion over the past 15 years. These changes have been driven by patient safety, educational, economic and legislative/regulatory factors. In the near future, training in procedural skills will undergo a paradigm shift to proficiency based progression with associated requirements for competence-based programmes, valid, reliable assessment tools and simulation technology. Before training begins, the learning outcomes require clear definition; any form of assessment applied should include measurement of these outcomes. Currently training in a procedural skill often takes place on an ad hoc basis. The number of attempts necessary to attain a defined degree of proficiency varies from procedure to procedure. Convincing evidence exists that simulation training helps trainees to acquire skills more efficiently rather than relying on opportunities in their clinical practice. Simulation provides a safe, stress free environment for trainees for skill acquisition, generalization and transfer via deliberate practice. The work described in this thesis contributes to a greater understanding of how medical procedures can be performed more safely and effectively through education. The effect of feedback, provided to novices in a standardized setting on a bench model, based on knowledge of performance was associated with an increase in the speed of skill acquisition and a decrease in error rate during initial learning. The timing of feedback was also associated with effective learning of skill. A marked attrition of skills (independent of the type of feedback provided) was demonstrable 24 hrs after they have first been learned. Using the principles of feedback as described above, when studying the effect of an intense training program on novices of varied years of experience in anaesthesia (i.e. the present training programmes / courses of an intense training day for one or more procedures). There was a marked attrition of skill at 24 hours with a significant correlation with increasing years of experience; there also appeared to be an inverse relationship between years of experience in anaesthesia and performance. The greater the number of years of practice experience, the longer it required a learner to acquire a new skill. The findings of the studies described in this thesis may have important implications for the trainers, trainees and training bodies in the design and implementation of training courses and the formats of delivery of changing curricula. Both curricula and training modalities will need to take account of characteristics of individual learners and the dynamic nature of procedural healthcare.

Effectiveness of Depression-Suicidal Behaviour Gatekeeper training among police officers in three European regions: outcomes of the Optimising Suicide Prevention Programmes and their Implementation in Europe (OSPI-Europe) study

Background: Gatekeeper training for community facilitators, to identify and respond to those at risk of suicide, forms an important part of multi-level community-based suicide prevention programmes. Aims: This study examined the effects of gatekeeper training on attitudes, knowledge and confidence of police officers in dealing with persons at risk of suicide. Methods: A total of 828 police officers across three European regions participated in a 4-hour training programme which addressed the epidemiology of depression and suicidal behaviour, symptoms of depression, warning signs and risk factors associated with suicidal behaviour, motivating help-seeking behaviour, dealing with acute suicidal crisis and informing bereaved relatives. Participants completed internationally validated questionnaires assessing stigmatising attitudes, knowledge about depression and confidence in dealing with suicidal persons pre- and post-training. Results: There were significant differences among countries in terms of previous exposure to suicidal persons and extent of previous training. Post-training evaluation demonstrated significant improvements in stigmatising attitudes, knowledge and confidence in all three countries. Conclusion: The consistently positive effects of gatekeeper training of police officers across different regions support inclusion of this type of training as a fundamental part of multi-level community-based suicide prevention programmes and roll-out, nationally and internationally.

Equal citizenship for a new society? An analysis of training and employment opportunities for republican ex-prisoners in Belfast

Previous research evidence appears to suggest that while they suffer from similiar socio-economic problems to the wider nationalist community, the problems for republican ex-prisoners seem to be on a greater scale. The primary objective of this research was to investigate the current obstacles facing republication ex-prisoners in training and employment and to make proposals for change.

ENVIRON 2011: 21st Irish Environmental Researchers Colloquium

The theme of this year’s colloquium is “Towards 2020: Environmental challenges and opportunities for the next decade” which reflects the many environmental targets that have been set for the year 2020 in areas of climate change, renewable energy, water protection and biodiversity. In relation to the latter, we are delighted to have Professor Michael Depledge (Former Chairman of UK Science Advisory Committee on the Environment & Climate Change) at ENVIRON 2011 to deliver the colloquium keynote address on “Health and the Value of Nature”. The colloquium plenary session has a number of high profile speakers who will address the colloquium theme of environmental challenges and opportunities for the next decade including Professor John Sweeney (NUI Maynooth), Ms Laura Burke (Director of EPA’s Office of Climate, Licensing Research and Resource Use) and Mr John Mullins (CEO of Bord Gais). The research programme has 95 oral presentations and 60 poster presentations in the themes of water quality, energy and climate change, marine and coastal research, environmental management, environmental technologies, environment and health, and biodiversity and ecosystems. In addition, for the first year, poster presenters have the opportunity to make a 1 minute oral presentation on their poster during the oral sessions in the relevant theme. The 2011 colloquium also sees an increase the number of workshops and seminars accompanying the programme with an emphasis on training and development for postgraduates in the environmental area. We are particularly pleased to have a link with the Environment Graduate Programme in the “Ocean Studies Workshop” which illustrates how the ENVIRON colloquium can support and benefit from the various graduate programmes currently being developed within Universities. Finally ENVIRON 2011 and the UCC 2011 Law and the Environment symposium have been deliberately scheduled together at the same time and location to allow delegates from both conferences to benefit from each other’s programmes.