History taking and clinical examination skills from a stoma nurse’s perspective

Comprehensive history-taking and clinical examination skills are examples of role development for a stoma care nurse specialist. Comprehensive history-taking is a thorough exploration of a patient's presenting complaint and the gathering of subjective information, while clinical examination is the gathering of objective information from a head-to-toe assessment or a focused assessment of a particular body system. This paper demonstrates the application of comprehensive history-taking and gastrointestinal clinical examination skills by the stoma care nurse in a clinical community setting, and explores their advantages and disadvantages in stoma care practice.

Learning fluid prescription skills: why is it so challenging?

IIt is well recognised that medical students and junior doctors find fluid prescription a challenging topic. This study was designed to gain a greater understanding of the experiences that medical students face related to learning about fluid prescribing. Methods: A qualitative approach, using focus groups, was employed in this research. Final-year medical students in academic year 2011-12 at Queen's University Belfast were invited to participate during their 'Assistantship' placement in March 2012. Discussions in focus groups, consisting of between six and eight students, were recorded and transcribed verbatim. The research team, consisting of three separate investigators, conducted thematic analysis independently. A final consensus regarding emerging themes was reached by discussion within the whole research team. Medical students and junior doctors find fluid prescription a challenging topic Results: Five prominent themes emerged: 'Teaching experience: a disruptive variation'; 'Curricular disconnections'; 'The driving test: Theory-practice transformation'; 'Role modelling: which standard to aspire to?'; and finally 'Reconciling the perceived risk'. Discussion: This re search provided insights into medical students' opinions of the teaching practices and learning experiences related to fluid prescribing. The learning of prescribing skills is complex andcontextual. In the development of such skills, medical students are often exposed to conflicting educational experiences that challenge the novicelearner in making judgements on best prescribing practice. This study adds to the body of evidence that fluid prescription is a difficult topic, and has generated a number of multifaceted and strategic recommendations to potentially improve fluid prescription teaching.

Spectres of Shakespeare:Ong Keng Sen’s Search: Hamlet and the Intercultural Myth

Arguably, the myth of Shakespeare is a myth of universality. Much has been written about the dramatic, thematic and ‘humanistic’ transference of Shakespeare’s works: their permeability, transcendence of cultures and histories, geographies and temporalities. Located within this debate is a belief that this universality, among other dominating factors, is founded upon the power and poeticism of Shakespeare’s language. Subsequently, if we acknowledge Frank Kermode’s assertion that “the life of the plays is the language” and “the secret (of Shakespeare’s works) is in the detail,” what then becomes of this myth of universality, and how is Shakespeare’s language ‘transferred’ across cultures? In Asian intercultural adaptations, language becomes the primary site of confrontation as issues of semantic accuracy and poetic affiliation abound. Often, the language of the text is replaced with a cultural equivalent or reconceived with other languages of the stage – song and dance, movement and music; metaphor and imagery consequently find new voices. Yet if myth is, as Roland Barthes propounds, a second-order semiotic system that is predicated upon the already constituted sign, here being language, and myth is parasitical on language, what happens to the myth of Shakespeare in these cultural re-articulations? Wherein lies the ‘universality’? Or is ‘universality’ all that it is – an insubstantial (mythical) pageant? Using Ong Keng Sen’s Search Hamlet (2002), this paper would examine the transference of myth and / as language in intercultural Shakespeares. If, as Barthes argues, myths are to be understood as metalanguages that adumbrate social hegemonies, intercultural imaginings of Shakespeare can be said to expose the hollow myth of universality yet in a paradoxical double-bind reify and reinstate this self-same myth.