Parasuicide and general practice: a pilot study

General Practitioners from Cork City and its environs were sent a questionnaire regarding their experience of parasuicide in the previous twelve months. Replies were received from 133 of the 185 GPs. 189 individuals, accounting for 212 episodes of parasuicide, were seen by 78 doctors, indicating a lower level of repetition than that found in hospital-referred cases. Almost a third of doctors saw no cases, just over one fifth saw one episode and the same proportion dealt with two. A small number of general practitioners saw many cases. Regarding management, 128 (60%) were referred to Casualty, 31 of whom were also referred for psychiatric care. Thirty percent were referred directly for psychiatric care. While only fourteen were retained within general practice without referral, 40% of the GPs felt that, ideally, acts of parasuicide should be retained with more specialised advice being obtained. Furthermore, 88.1% believed that management of parasuicide should form part of an integral part of post-graduate or continued general practitioner medical training. Clearly, GPs are willing to play a more active role in the management of parasuicide.

Black Femininity through the White Speculum: The Implications of Medicosocialism and the Disproportionate Regulation of Black Women’s Reproductive Autonomy

At the crux of health disparities for women of color lies a history of maltreatment based on racial difference from their white counterparts. It is their non-whiteness that limits their access to the ideologies of “woman” and “femininity” within dominant culture. As the result of this difference, the impact of the birth control movement varied among women based on race. This project explores how the ideology attributed to the black female body limited black women’s access to “womanhood” within dominant culture, and analyzes the manners in which their reproductive autonomy was compromised as the result of changes to that ideology through time. This project operates under the hypothesis that black women’s access to certain aspects of femininity such as domesticity and motherhood reflected their roles in slave society, that black women’s reproductive value was based on the value of black children within slave culture, and that both of these factors dictated the manner in which their reproductive autonomy was managed by health professionals. Black people’s worth as a free labor force within dominant culture diminished when the Reconstruction Amendments were added to the constitution and slavery was deemed unconstitutional—resulting in the paradigmatic shift from the promotion of black fertility to its recession. America’s transition to the medicosocial regulation of black fertility through Eugenics, the role of the black elite in the movement, and the negative impact of this agenda on the reproductive autonomy of black women from low socioeconomic backgrounds are enlisted as support. The paper goes on to draw connections between post-slavery ideology of black femininity and modern-day medicosocial occurrences within clinical settings in order to advocate for increased bias training for medical professionals as a means of combating current health disparities. It concludes with the possibility that this improvement in medical training could persuade people of color to seek out medical intervention at earlier stages of illness and obtain regular check-ups by actively countering physicians’ past transgressions against them.

La carpeta de aprendizaje y la evaluación entre iguales de los estudiantes. Resultados de una innovación docente en los estudios universitarios de las artes

Students reflect more on their learning in course subjects when they participate in managing their teaching–learning environment. As a form of guided participation, peer assessment serves the following purposes: (a) it improves the student’s understanding of previously established learning objectives; (b) it is a powerful metacognitive tool; (c) it transfers to the student part of the responsibility for assessing learning, which means deciding which learning activities are important and choosing the degree of effort a course subject will require; (d) it emphasizes the collective aspect of the nature of knowledge; and (e) the educational benefits derived from peer assessment clearly justify the efforts required to implement activities. This paper reports on the relative merits of a learning portfolio compiled during fine arts-related studies in which peer assessment played an important role. The researchers analyzed the student work load and the final marks students received for compulsory art subjects. They conclude that the use of a closed learning portfolio with a well-structured, sequential and analytical design can have a positive effect on student learning and that, although implementing peer assessment may be complex and students need to become familiar with it, its use is not only feasible but recommendable.

Étude exploratoire auprès de médecins des effets perçus d’une formation corps / esprit fondée sur les pratiques du Sensible

Résumé: Les pratiques du Sensible sont des pratiques d’accompagnement formatives et soignantes. Elles permettent d’apprendre comment l’expérience du corps et de son mouvement interne conduit au développement de la conscience et de la présence à soi ainsi qu’à l’autre, des qualités enviables pour des professionnelles et professionnels de la relation d’aide du secteur de la santé. Dans ces pratiques, le corps joue un rôle central à travers quatre types d’intervention : la thérapie manuelle, la gymnastique sensorielle, l’introspection sensorielle et l’entretien verbal à propos de l’expérience corporelle. Selon Large (2009), une qualité de présence particulière se construit chez les participantes et le participant aux pratiques du Sensible. Selon lui, ceux-ci se rapprochent de leur intériorité, parviennent à verbaliser à autrui ce qu’ils ressentent et en arrivent à poser des actions qui expriment ce qu’ils deviennent. Large (2009) constate qu’ils acquièrent de la stabilité, de l’adaptabilité et de l’autonomie. À la fois plus affirmatifs, ils gagnent aussi en proximité à l’autre. Bois (2007) note un changement de représentation lié aux idées, aux valeurs, à l’image de soi et au rapport perceptif à soi. Une chercheure et des chercheurs constatent un changement de conception de la santé (Duval, 2010; Laemmlin-Cencig et Humpich, 2009). À notre connaissance, il n’y a pas eu d’étude antérieure concernant l’influence des pratiques du Sensible auprès de médecins. Nous avons exploré, le cas échéant, comment une formation aux pratiques du Sensible, suivie par des médecins, a modifié leur rapport à leur corps, à leur propre santé, à leur conception de la santé, à la qualité de leur présence à eux-mêmes, aux autres professionnelles et professionnels et aux patientes et patients. Des entretiens semi-structurés d’une durée de 90 à 105 minutes ont été effectués auprès de six médecins français (cinq femmes et un homme) ayant été formés aux pratiques du Sensible entre 2005 et 2012. Deux types d’entretiens à visée compréhensive (Kaufmann, 2011) et d’explicitation (Vermersch, 2010; 2012) ont été réalisés. Des informations ont aussi été recueillies sur la formation et les activités professionnelles des participantes et du participant. Deux démarches d’analyse ont été utilisées, entre autres pour vérifier la cohérence des résultats et augmenter la rigueur de notre projet. Notre première démarche d’analyse a été conçue à partir de deux méthodes : au départ avec l’analyse thématique et par la suite une analyse avec les catégories conceptualisantes afin de déboucher sur une théorisation ancrée. La deuxième démarche d’analyse a consisté à créer une liste de vingt-six phénomènes présents pour la majorité des entretiens suite à des discussions tenues avec notre équipe de direction. Selon nos résultats, suite à la formation aux pratiques du Sensible, les cinq participantes témoignent d’une plus grande proximité et attention à leur corps et d’une meilleure écoute de celui-ci. Cet ancrage corporel de leur présence les informe davantage sur leur mode de vie et d’existence. Il en ressort ainsi des prises de conscience importantes grâce auxquelles les participantes font des choix nouveaux pour une vie plus cohérente et recentrée sur leur intériorité. Par le fait même, elles récupèrent leur pouvoir sur leur vie comme sur leur santé. En outre, parmi les six médecins, quatre ont modifié leur conception de la santé. Celle-ci s’est en effet élargie pour inclure de nouveaux éléments, dont la qualité du rapport à soi et l’accordage entre le corps et la pensée. Le corps semble être une voie souterraine à partir de laquelle se sont réalisées des transformations dans la personne, comme si le corps devenait une interface ayant des effets sur plusieurs facettes de la personne. Ces transformations semblent avoir une influence sur la manière dont celle-ci exerce sa profession, comme si un savoir-être renouvelé de la personne transformait son savoir-faire au sein de sa pratique. Au plan de la qualité de la présence aux autres, il est rapporté que les relations professionnelles se sont améliorées pour la majorité des participantes. Des transformations personnelles semblent avoir eu des effets sur leurs relations professionnelles. Par exemple, tous témoignent d’une meilleure qualité de présence et de disponibilité aux patientes et patients. La plupart signalent l’apprentissage d’une juste distance thérapeutique et, en même temps, d’une relation plus singulière avec chaque patiente et patient. Nous constatons par notre analyse que la relation aux patientes et patients est modifiée aux plans de la communication, du toucher et de l’écoute. Le parcours de formation des étudiantes et étudiants en médecine semble créer des conditions favorisant l’épuisement (Brazeau, Schroeder, Rovi et Boyd, 2010; Colombat, Altmeyer, Barruel, Bauchetet, Blanchard, Colombat et al., 2011; Ishak, Nikravesh, Lederer, Perry, Ogunyemi et Bernstein, 2013; Llera et Durante, 2014; Rodrigues, Albiges et Blanchard, 2012). Certaines interventions de type corps / esprit semblent pouvoir minimiser cet impact (Elder, Rakel, Heitkemper, Hustedde, Harazduk, Gerik et al., 2007; Hewson, Copeland, Mascha, Arrigain, Topol et Fox, 2006; Irving, Park-Saltzman, Fitzpatrick, Dobkin, Chen et Hutchinson, 2014; Maclaughlin, Wang, Noone, Liu, Harazduk, Lumpkin et al., 2011; Motz, Graves, Gross, Saunders, Amri, Harazduk et al., 2012; Rosenzweig, Reibel, Greeson, Brainard et Hojat, 2003; Saunders, Tractenberg, Chaterji, Amri, Harazduk, Gordon et al., 2007). Notre recherche démontre chez nos participantes et notre participant que la formation aux pratiques du Sensible leur a permis de faire plusieurs gains pour leur propre santé. Il semble qu’en amont des apprentissages liés à la profession médicale, une qualité de savoir-être puisse solidifier la personne, ses apprentissages et sa future pratique médicale. Les étudiantes et étudiants en médecine seraient ainsi mieux outillés pour traverser ce cursus de formation exigent et épuisant. Il serait intéressant de reprendre la recherche auprès d’un plus grand nombre de médecins ou d’étudiantes et étudiants en médecine afin d’y observer les éléments de théorisation répétitifs inclus dans la théorisation ancrée de notre étude exploratoire. Ainsi, selon les résultats, il serait alors plus aisé de promouvoir l’apprentissage expérientiel d’approches de type corps / esprit (dont les PS) dans les cursus universitaires en médecine.

Education and training of medical physicists in south East Asia: Accomplishments and challenges

John Cameron has made significant contributions to the field of Medical Physics. His contributions encompassed research and development, technical developments and education. He had a particular interest in the education of medical physicists in developing countries. Structured clinical training is also an essential component of the professional development of a medical physicist. This paper considers aspects of the clinical training and education of medical physicists in South-East Asia and the challenges facing the profession in the region if it is to keep pace with the rapid increase in the amount and technical complexity of medical physics infrastructure in the region.

A 3D virtual medical imaging suite : bridging the academic-clinical training boundary

Aims The Medical Imaging Training Immersive Environment (MITIE) system is a recently developed virtual reality (VR) platform that allows students to practice a range of medical imaging techniques. The aim of this pilot study was to harvest user feedback about the educational value of the application and inform future pedagogical development. This presentation explores the use of this technology for skills training and blurring the boundaries between academic learning and clinical skills training. Background MITIE is a 3D VR environment that allows students to manipulate a patient and radiographic equipment in order to produce a VR-generated image for comparison with a gold standard. As with VR initiatives in other health disciplines (1-6) the software mimics clinical practice as much as possible and uses 3D technology to enhance immersion and realism. The software was developed by the Medical Imaging Course Team at a provider University with funding from a Health Workforce Australia “Simulated Learning Environments” grant. Methods Over 80 students undertaking the Bachelor of Medical Imaging Course were randomised to receive practical experience with either MITIE or radiographic equipment in the medical radiation laboratory. Student feedback about the educational value of the software was collected and performance with an assessed setup was measured for both groups for comparison. Ethical approval for the project was provided by the university ethics panel. Results This presentation provides qualitative analysis of student perceptions relating to satisfaction, usability and educational value as well as comparative quantitative performance data. Students reported high levels of satisfaction and both feedback and assessment results confirmed the application’s significance as a pre-clinical training tool. There was a clear emerging theme that MITIE could be a useful learning tool that students could access to consolidate their clinical learning, either during their academic timetables or their clinical placement. Conclusion Student feedback and performance data indicate that MITIE has a valuable role to play in the clinical skills training for medical imaging students both in the academic and the clinical environment. Future work will establish a framework for an appropriate supporting pedagogy that can cross the boundary between the two environments. This project was possible due to funding made available by Health Workforce Australia.

The development and evaluation of a medical imaging training immersive environment

Introduction A novel realistic 3D virtual reality (VR) application has been developed to allow medical imaging students at Queensland University of Technology to practice radiographic techniques independently outside the usual radiography laboratory. Methods A flexible agile development methodology was used to create the software rapidly and effectively. A 3D gaming environment and realistic models were used to engender presence in the software while tutor-determined gold standards enabled students to compare their performance and learn in a problem-based learning pedagogy. Results Students reported high levels of satisfaction and perceived value and the software enabled up to 40 concurrent users to prepare for clinical practice. Student feedback also indicated that they found 3D to be of limited value in the desktop version compared to the usual 2D approach. A randomised comparison between groups receiving software-based and traditional practice measured performance in a formative role play with real equipment. The results of this work indicated superior performance with the equipment for the VR trained students (P = 0.0366) and confirmed the value of VR for enhancing 3D equipment-based problem-solving skills. Conclusions Students practising projection techniques virtually performed better at role play assessments than students practising in a traditional radiography laboratory only. The application particularly helped with 3D equipment configuration, suggesting that teaching 3D problem solving is an ideal use of such medical equipment simulators. Ongoing development work aims to establish the role of VR software in preparing students for clinical practice with a range of medical imaging equipment.

Blended learning in medical imaging pre-clinical skills training – does it work?

Undergraduate Medical Imaging (MI)students at QUT attend their first clinical placement towards the end of semester two. Students undertake two (pre)clinical skills development units – one theory and one practical. Students gain good contextual and theoretical knowledge during these units via a blended learning model with multiple learning methods employed. Students attend theory lectures, practical sessions, tutorial sessions in both a simulated and virtual environment and also attend pre-clinical scenario based tutorial sessions. The aim of this project is to evaluate the use of blended learning in the context of 1st year Medical Imaging Radiographic Technique and its effectiveness in preparing students for their first clinical experience. It is hoped that the multiple teaching methods employed within the pre-clinical training unit at QUT builds students clinical skills prior to the real situation. A quantitative approach will be taken, evaluating via pre and post clinical placement surveys. This data will be correlated with data gained in the previous year on the effectiveness of this training approach prior to clinical placement. In 2014 59 students were surveyed prior to their clinical placement demonstrated positive benefits of using a variety of learning tools to enhance their learning. 98.31%(n=58)of students agreed or strongly agreed that the theory lectures were a useful tool to enhance their learning. This was followed closely by 97% (n=57) of the students realising the value of performing role-play simulation prior to clinical placement. Tutorial engagement was considered useful for 93.22% (n=55) whilst 88.14% (n=52) reasoned that the x-raying of phantoms in the simulated radiographic laboratory was beneficial. Self-directed learning yielded 86.44% (n=51). The virtual reality simulation software was valuable for 72.41% (n=42) of the students. Of the 4 students that disagreed or strongly disagreed with the usefulness of any tool they strongly agreed to the usefulness of a minimum of one other learning tool. The impact of the blended learning model to meet diverse student needs continues to be positive with students engaging in most offerings. Students largely prefer pre -clinical scenario based practical and tutorial sessions where 'real-world’ situations are discussed.