This chapter explores ways of reducing the risk of SARS-CoV-2 transmission to women and staff within gynaecology outpatient clinics. The likely routes of transmission are discussed, namely via droplets, aerosols and fomites. Using the 'hierarchy of control' categories, elimination, substitution, engineering, administration and personal protective equipment (PPE), practical strategies for modifying virus exposure are presented. The management of specific clinical conditions are reviewed based upon advice prepared by the Specialist Societies in conjunction with each other and the Royal College of Obstetricians and Gynaecologists. The need to maintain at least a minimal level of gynaecological services is recognised and that this should provide safe, equitable and effective care. Ways of reducing clinic attendance are discussed with the substitution of face-to-face with remote consultations and when this is relevant. Current recommendations for ambulatory procedures, including colposcopy and hysteroscopy, are considered so that best use is made of reduced resources.
Background/context Traditionally, medical training has predominantly involved a ‘learning by doing’ approach, but over the last 20 years, the use of simulation as a form of undergraduate and postgraduate education has significantly increased. Techniques are increasing in sophistication, and some studies have shown simulation to be more effective for trainees to become competent in their clinical skills than the traditional approach. The future aim of the Royal College of Paediatrics and Child Health (RCPCH) is to create a national simulation programme focusing on the RCPCH curriculum. It would therefore be beneficial for medical students to also have access to simulation training. With this in mind, Dr Pawley and Dr Fidler instigated simulation training at the Royal Alexandra Children’s Hospital (RACH) from 2012 for junior doctors and 2013 for 5th year medical students. This is the first service evaluation of both medical students and trainees to determine if they feel simulation training is beneficial and relevant, and how they feel it could be improved. Knowledge of providers’ attitudes to simulation was also looked at. Methodology 5 different questionnaires were created, containing quantitative and qualitative questions. They were distributed via paper feedback forms at the weekly simulation sessions and via Survey Monkey (an online data collection tool). Results/outcomes Confidence levels increased in all groups after having attended the simulation sessions and all groups thought that simulation was an ‘effective’ way of learning (using a 5 point likert scale). The majority of participants would prefer to provide feedback via paper feedback questionnaires as opposed to Survey Monkey. Conclusions and recommendations The simulation sessions run at the RACH are well received and found to be beneficial and relevant by participants. Using the feedback provided, it would be helpful to amend the sessions so that they map the curriculum more effectively. References Grant DJ, Marriage SC. Training using medical simulation. Archives of Disease in Childhood 2012;97(3):255–9 Kory PD, Eisen LA, Adachi M, et al. Initial airway management skills of senior residents simulation training compared with traditional training. Chest Journal 2007;132(6):1927–31 Aggarwal R, Ward J, Balasundaram I, et al. Proving the effectiveness of virtual reality simulation for training in laparoscopic surgery. Annals of surgery 2007;246(5):771–9 Schendel S, Montgomery K, Sorokin A, Lionetti G. A surgical simulator for planning and performing repair of cleft lips. Journal of Cranio-Maxillofacial Surgery 2005;33(4):223–8
Social prescriptions are increasingly being integrated into the medical curriculum -whether that be prescribing physical exercise for heart disease or a book group for depression. This is unknown territory for many medical students (and indeed doctors) with the risks and benefits being largely uncharted. Medical schools today adopt a holistic approach to medicine, teaching students to consider the whole patient rather than just their disease and encouraging shared decision making between doctor and patient. Social prescribing goes hand in hand with this, and so will undoubtedly become increasingly popular in the future despite conflicting evidence. For these reasons, it is important for medical students to understand exactly what social prescribing is and how it can potentially benefit their future patients.
How to support patients in making informed decisions about their treatment options
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