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.

Serving Multiple Masters: Exploring HRD in the Context of Third Sector Partnerships for Public Service Delivery

Organisations in the Non-Profit and Voluntary (NPV) sector increasingly face challenging and uncertain times with an increasing shift from public grant funding towards contract funding. As a result many of these changes employees in such organisations have often found themselves working more closely under contract with colleagues in public sector organisations in order to provide public services. Using a multiple case study methodology and in-depth interviewing of a range of stakeholders form two large Northern Irish based Non Profit Organisations in the social care sector, the purpose of this research was to
investigate HRD and people management issues and how a turbulent environment can affect how organisations approach HRD strategy and implementation.

The research identifies the importance placed upon NPOs adopting HRD strategies and addressing the development of unique and specialised skills in order to claw back power within the relationships they serve with statutory funding bodies. However this research also notes that the manner in which HRD and its associated issues are considered within NPOs can have an impact on the loyalty and commitment of the workforce which serves them. What is of concern is that the context for the delivery of public services under contract is putting increasing strain on NPOs and this has been felt markedly by their respective workforces, and unless strong values-led leadership and managerial practice is in
place in NPOs, the voluntary-centred ethos of those who work in the sector may be significantly damaged.