Clinical Conversations

In this episode of Clinical Conversations, Dr Kat Ralston chats with Dr Alan Japp about heart failure with reduced ejection fraction. They discuss an approach to clinical assessment, share top tips for diuresis and explore the four pillars of heart failure therapy. Dr Alan Japp is a Consultant Cardiologist at the Edinburgh Royal Infirmary and St John's Hospital, Livingston. He is also the Clinical Lead for Heart Failure in NHS Lothian and the Local Principal Investigator for DAPA HF and IRONMAN clinical trials. Dr Kat Ralston is a geriatric medicine registrar in Edinburgh. She is also the Education Co-Vice Chair and the joint Podcast Lead for the RCPE Trainee & Members' Committee (T&MC). Recording date: 16 October 2024 -- Useful links -- European Society of Cardiology Heart Failure Guidelines (2023 focused update) : https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines/Focused-Update-on-Heart-Failure-Guidelines -- Follow us -- https://www.instagram.com/rcpedintrainees https://twitter.com/RCPEdinTrainees -- Upcoming RCPE events -- https://events.rcpe.ac.uk/ -- Become an RCPE Member -- https://www.rcpe.ac.uk/membership/join-college Feedback: cme@rcpe.ac.uk

In this episode, Dr Marilena Giannoudi speaks with Dr Sarah Schoeman about the genitourinary medicine (GUM) clinic. Dr Schoeman discusses the prevalence of sexually transmitted infections, provides non-GUM specialists tips on how to ask a patient's sexual health and describes some interesting cases from her clinical experience. Dr Sarah Schoeman is a GUM Consultant in Leeds based at the Leeds Teaching Hospitals Trust. She is also Clinical Lead for the Leeds Teaching Hospitals Trust HIV service. She is currently co-Chair of the GUM SAC alongside Dr Andy Williams and together they represent the GUM SAC on the BASHH board. In addition Sarah is a current clinical member of the HIV CRG, Clinical Lead for the West Yorkshire HIV Network, Clinical Lead for the Leeds Fast Tack Cities project, a BASHH Sexual Health Dermatology SIG member and BSSVD council member. Dr Marilena Giannoudi is a cardiology registrar based in Leeds. She is Co-Chair of the Trainees and Members’ Committee (T&MC), a Fellow of the Higher Education Academy, and is currently undertaking a PhD. Recording Date: 3 October 2024 -- Useful Links -- LoveGUM - https://lovegum.bashh.org Get involved in GUM - https://padlet.com/stashh1/get-involved-in-gum-kz9569d4dbswatyz -- Follow us -- https://www.instagram.com/rcpedintrainees https://twitter.com/RCPEdinTrainees -- Upcoming RCPE events -- https://events.rcpe.ac.uk/ -- Become an RCPE Member -- https://www.rcpe.ac.uk/membership/join-college Feedback: cme@rcpe.ac.uk

For Sepsis Awareness Month, Dr Marilena Giannoudi speaks with Dr Ron Daniels about sepsis. They discuss the causes, investigation, management, and prevention of sepsis. Topics include the Sepsis 6 and escalation of care, use of blood cultures, septic shock, and post-sepsis syndrome. Dr Ron Daniels is an NHS Consultant in Intensive Care, based at University Hospitals Birmingham, U.K. He’s also Founder and Chief Executive of the UK Sepsis Trust and Vice-President of the Global Sepsis Alliance. In 2016 he was awarded the British Empire Medal for services to patients. Ron’s expertise lies in translational medicine and leadership. He leads the team driving dissemination of the Sepsis 6 treatment pathway and is part of the team responsible for much of the policy and media engagement around sepsis in the U.K. and elsewhere, including as a core member of the team securing the adoption of the 2017 Resolution on Sepsis by the World Health Organization (WHO). At home, Ron’s worked with the NHS over the last 9 years to ensure that by 2019, in England, more than 80% of patients presenting with suspected sepsis were receiving appropriate antimicrobials rapidly. He is now leading a team working with His Majesty’s Government to once again drive sepsis improvement work in the post pandemic era. He’s ever mindful of the perceived conflict, and the synergies and need for collaboration, with the antimicrobial stewardship agenda. Dr Marilena Giannoudi is a clinical academic trainee in cardiology in the Yorkshire and Humber region. Her current interests include heart failure, endothelial dysfunction, and medical education. She is a Fellow of the Higher Education Academy and is currently pursuing a PhD. Dr Giannoudi is passionate about ensuring that trainees' voices are heard and that educational opportunities are available to foster confidence and independence throughout their training. She has developed core medical training (now IMT) teaching programs in hospitals across her deanery. Additionally, she uses her position on the local junior doctor body to advocate for and implement necessary changes. -- Links -- The UK Sepsis Trust's Clinical Tools - https://sepsistrust.org/healthcare-professionals/clinical-tools/ NICE guidelines on suspected sepsis - https://www.nice.org.uk/guidance/NG51 Global Sepsis Alliance - https://globalsepsisalliance.org/ -- Choose RCPE as your College of Entry for PACES -- We encourage you to sit PACES with our College. We have a friendly and experienced examinations team who expertly support candidates, and we deliver PACES at centres across the UK. Select RCPE as your College of Entry when applying online through your My MRCP(UK) online account. Recording date: 11 September 2024 -- Follow us -- https://www.instagram.com/rcpedintrainees https://twitter.com/RCPEdinTrainees -- Upcoming RCPE events -- https://events.rcpe.ac.uk/ -- Become an RCPE Member -- https://www.rcpe.ac.uk/membership/join-college Feedback: cme@rcpe.ac.uk

In this episode, Professor Eylem Levelt and Dr Marilena Giannoudi discuss the early stages of cardiometabolic disease, its asymptomatic challenges, and key risk factors. They cover how junior doctors can protect at-risk patients and the prevalence of diabetes and weight issues among those diagnosed. Reflecting on trends over the past decades, they share insights into improving patient outcomes. Looking ahead, they discuss reducing heart failure and managing conditions like obesity-related heart disease. Prof Levelt offers practical advice for junior doctors on identifying and managing at-risk patients. Prof Eylem Levelt is an academic cardiologist with a specialist interest in cardiovascular imaging and diabetic heart disease. Dr Marilena Giannoudi is a cardiology registrar based in Leeds. She is Co-Chair of the Trainees and Members’ Committee, a Fellow of the Higher Education Academy, and is currently undertaking a PhD. --Links-- For clinicians: European Society of Cardiology (ESC) Clinical Practice Guidelines: https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines/CVD-and-Diabetes-Guidelines American College of Cardiology (ACC) Guidelines: https://www.acc.org/Guidelines For patients: British Heart Foundation (BHF): https://www.bhf.org.uk --Related listening-- Inherited Cardiac Conditions, Clinical Conversations https://podcasts.rcpe.ac.uk/show/clinical-conversations/inherited-cardiac-conditions-3-june-2024/ Women in Cardiology [Re-release], Career Conversations https://podcasts.rcpe.ac.uk/show/career-conversations/women-in-cardiology-re-release-8-march-2024/ Medical Specialties - Clinical Genetics, Career Conversations https://podcasts.rcpe.ac.uk/show/career-conversations/medical-specialties-clinical-genetics-07-jun-2023/ Demystifying PACES - Cardiovascular [Station 3], Career Conversations https://podcasts.rcpe.ac.uk/show/career-conversations/demystifying-paces-cardiovascular-station-3-29-jan-2024/ Movement Medicine, Career Conversations https://podcasts.rcpe.ac.uk/show/clinical-conversations/movement-medicine-03-apr-2023/ Follow Professor Levelt on X @EylemLevelt Recording date: 25 June 2024 -- Follow us -- www.instagram.com/rcpedintrainees twitter.com/RCPEdinTrainees -- Upcoming RCPE Events -- events.rcpe.ac.uk/ Feedback: cme@rcpe.ac.uk

This week Dr Ben Warner interviews Professor Tom Fardon on the topic of asthma. Through a case study, Prof Fardon discusses how to assess and treat a severe exacerbation of asthma and what needs to be considered when discharging patients. Tom and Ben also discuss diagnosing asthma and the treatments available to patients. Professor Fardon is a Consultant Respiratory Physician at NHS Tayside and Honorary Professor at the University of Dundee. They are also Clinical Lead for the Scottish Government's Respiratory Specialty Delivery Group. Dr Ben Warner is a Respiratory Medicine Specialty Registrar with clinical and academic experience of global public health. He is currently undertaking a PhD in multimorbidity in Malawi as part of the Wellcome-funded Multimorbidity PhD Programme for Health Professionals with the University of Glasgow. --Useful Links-- Current NICE guideline on Asthma: Diagnosis, monitoring and chronic asthma management - https://www.nice.org.uk/guidance/ng80 Current BTS/SIGN British Guideline on the Management of Asthma - https://www.brit-thoracic.org.uk/quality-improvement/guidelines/asthma/ Upcoming SIGN updates - https://www.sign.ac.uk/our-guidelines/british-guideline-on-the-management-of-asthma/ BTS Clinical Statement on the medical management of inpatients with tobacco dependency - https://thorax.bmj.com/content/79/Suppl_1/3 Treatable traits approach in asthma - https://treatabletraits.org.au/wp-content/uploads/2022/02/MJA-TT-Case-Final.pdf Environmental impact of inhalers toolkit produced by ‘Greener Practice' - https://www.greenerpractice.co.uk/high-quality-and-low-carbon-asthma-care/ Greener Practice guide on reducing the carbon footprint of inhalers - https://s40639.pcdn.co/wp-content/uploads/Reducing-Carbon-Footprint-of-Inhaler-Prescribing-v3.3.2.pdf National Review of Asthma Deaths (NRAD) - https://www.hqip.org.uk/resource/asthma-deaths-nrad-report-2014/ British Thoracic Society asthma attack care bundle - https://www.brit-thoracic.org.uk/quality-improvement/clinical-resources/asthma/bts-asthma-care-bundles/ Asthma exacerbations and sputum eosinophil counts: a randomised controlled trial - https://doi.org/10.1016/S0140-6736(02)11679-5 Clinical remission in severe asthma with biologic therapy: an analysis from the UK Severe Asthma Registry - https://erj.ersjournals.com/content/62/6/2300819 Low Dose Inhaled Budesonide and Formoterol in Mild Persistent Asthma - https://doi.org/10.1164/ajrccm.164.8.2104102 Recording date: 22 May 2024 -- Follow us -- https://www.instagram.com/rcpedintrainees https://twitter.com/RCPEdinTrainees -- Upcoming RCPE Events -- https://events.rcpe.ac.uk/ Feedback: cme@rcpe.ac.uk

In this brief episode, Dr Marilena Giannoudi, Co-Chair of the Trainees and Members’ Committee, gives an overview of the Royal College of Physicians of Edinburgh's podcasts relevant to doctors-in-training. These include: this podcast, 'Clinical Conversations'; 'Career Conversations' including the new 'Demystifying PACES' series; and the Recently Appointed Consultants' Committee's podcast, 'Consultant Conversations', relevant to senior trainees. All RCPE podcasts can be found at https://podcasts.rcpe.ac.uk/ The 'Demystifying PACES' podcast series can be found at https://podcasts.rcpe.ac.uk/show/career-conversations/category/paces/ Recording date: 23 January 2024 -- Follow us -- https://www.instagram.com/rcpedintrainees https://twitter.com/RCPEdinTrainees -- Upcoming RCPE Events -- https://events.rcpe.ac.uk/ -- Become a Member -- https://www.rcpe.ac.uk/membership/join-college Feedback: cme@rcpe.ac.uk

What happens at the Inherited Cardiac Conditions clinic? In this episode, Dr Marilena Giannoudi and Dr Anshu Sengupta discuss Inherited Cardiac Conditions (ICCs) and the ICC clinic, including who makes up this multi-disciplinary team. They discuss the approach to patients with ICCs covering investigations and management including guideline-led treatment, monitoring, risk assessment and exercise advice. Dr Anshu Sengupta is a Consultant Cardiologist in the Yorkshire Heart Centre, specialising in investigating and managing patients and families with ICCs. He has a specialist interest and training in heart failure and cardiac magnetic resonance imaging. Dr Marilena Giannoudi is a cardiology registrar based in Leeds. She is Co-Chair of the Trainees and Members’ Committee, a Fellow of the Higher Education Academy, and is currently undertaking a PhD. -- Useful links -- For clinicians: - European Society of Cardiology (ESC) Cardiomyopathy Guidelines: https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines/Cardiomyopathy-Guidelines - American College of Cardiology (ACC) Guidelines: https://www.acc.org/Guidelines For patients: - British Heart Foundation (BHF): https://www.bhf.org.uk - Cardiomyopathy UK: https://www.cardiomyopathy.org/ - Arrhythmia Alliance: https://heartrhythmalliance.org/aa/uk/ -- Related listening -- Women in Cardiology [Re-release], Career Conversations https://podcasts.rcpe.ac.uk/show/career-conversations/women-in-cardiology-re-release-8-march-2024/ Medical Specialties - Clinical Genetics, Career Conversations https://podcasts.rcpe.ac.uk/show/career-conversations/medical-specialties-clinical-genetics-07-jun-2023/ Demystifying PACES - Cardiovascular [Station 3], Career Conversations https://podcasts.rcpe.ac.uk/show/career-conversations/demystifying-paces-cardiovascular-station-3-29-jan-2024/ Movement Medicine, Career Conversations https://podcasts.rcpe.ac.uk/show/clinical-conversations/movement-medicine-03-apr-2023/ Recording date: 22 May 2024 -- Follow us -- https://www.instagram.com/rcpedintrainees https://twitter.com/RCPEdinTrainees -- Upcoming RCPE Events -- https://events.rcpe.ac.uk/ Feedback: cme@rcpe.ac.uk

In this episode, Dr Kat Ralston chats to Dr Matt Lambert about hyperacute stroke. They discuss a targeted approach to first assessment, including how to utilise your team effectively in a time-pressured environment. They explore the evidence behind different treatment options and share practical tips on thrombolysis and thrombectomy. Dr Lambert is a consultant in Stroke and Medicine for the Elderly in NHS Tayside and was clinical lead for stroke in Tayside from 2016 until 2023. During this time they led a significant reorganisation of stroke services which led to significant improvements in the delivery of stroke care as measured by the Scottish Stroke Care Audit and laid the foundations for introducing a mechanical thrombectomy service for acute stroke in Tayside. They have an interest in quality improvement and completed the Scottish Quality and Safety Fellowship. Since late 2023 Dr Lambert has been the Stroke Specialty Advisor to the CMO and National Clinical lead for Stroke in Scotland. Dr Kat Ralston is a Geriatric Medicine Registrar and member of the RCPE Trainees and Members’ Committee, currently working in Edinburgh. -- Useful Links -- NIHSS training - https://www.ninds.nih.gov/health-information/public-education/know-stroke/health-professionals National Clinical Guideline for Stroke for the UK and Ireland - https://www.strokeguideline.org/ Endovascular thrombectomy after large-vessel ischaemic stroke: a meta-analysis of individual patient data from five randomised trials - https://doi.org/10.1016/s0140-6736(16)00163-x Recording Date: 11 March 2024 -- Follow us -- https://www.instagram.com/rcpedintrainees https://twitter.com/RCPEdinTrainees -- Upcoming RCPE Events -- https://events.rcpe.ac.uk/ Feedback: cme@rcpe.ac.uk

In this episode Dr Ben Warner discusses multimorbidity, also known as multiple long-term conditions, with Professor Frances Mair. They discuss what multimorbidity is, how the concept differs from frailty and how the burden of treatment and health inequalities impact patients with multiple long-term conditions. Professor Frances Mair is the Norie Miller Professor of General Practice, Head of General Practice and Primary Care, and Director of a Wellcome funded Multimorbidity PhD Programme for Health Professionals at the University of Glasgow. She co-leads the NHS Research Scotland Primary Care Network, promoting research activity in primary care and is a member of the MRC Clinical Academic Research Partnerships Panel. Professor Mair is also an International Advisor to the Norwegian Primary Care Research Network and the Australian Translating Research Outcomes into the Primary Health Interface (TROPHI) Scientific Advisory Group as well as acting as a Visiting Professor at the University of Melbourne, Australia. Dr Ben Warner is a Respiratory Medicine Specialty Registrar with clinical and academic experience of global public health, having completed the LSHTM’s East African Diploma in Tropical Medicine and then worked for 18 months in rural South Africa. He is currently undertaking a PhD in multimorbidity in Malawi as part of the Wellcome-funded Multimorbidity PhD Programme for Health Professionals with the University of Glasgow. Recording date: 20 February 2024 -- Useful Links -- https://www.bmj.com/content/339/bmj.b2803 https://www.nice.org.uk/guidance/ng56 https://doi.org/10.1016/S0140-6736(12)60240-2 https://www.gla.ac.uk/colleges/mvls/graduateschool/multimorbidity/ https://www.gla.ac.uk/schools/healthwellbeing/staff/francesmair/ -- Follow us -- https://www.instagram.com/rcpedintrainees https://twitter.com/RCPEdinTrainees -- Upcoming RCPE Events -- https://events.rcpe.ac.uk/ Feedback: cme@rcpe.ac.uk

In this episode, Dr Marilena Giannoudi and Dr Vidhya Nair discuss orthogeriatrics, including frailty and fragility fractures, osteoporosis, and falls risk assessment, and the importance of a multi-disciplinary (MDT) team throughout patient care. Dr Vidhya Nair graduated from Newcastle University in 2002 and moved down to Leeds in 2003. Dr Nair became a Consultant in Elderly Medicine specialising in Orthogeriatrics in 2011 and worked in Pinderfields General Hospital on a dedicated hip fracture unit. Since 2015 Dr Nair has worked as a Consultant in Leeds Teaching Hospitals. Dr Nair's current role is as the Clinical Lead for Orthogeriatrics based at Leeds General Infirmary, providing orthogeriatric input onto orthopaedic wards and the Major Trauma Unit. Dr Marilena Giannoudi is a cardiology registrar based in Leeds. She is Co-Chair of the Trainees and Members’ Committee, a Fellow of the Higher Education Academy, and is currently undertaking a PhD. -- Useful links -- Frailty for the Non-Specialist - 'Clinical Conversations' podcast https://podcasts.rcpe.ac.uk/show/clinical-conversations/frailty-for-the-non-specialist-11-mar-2024/ National Osteoporosis Guideline Group (NOGG) https://www.nogg.org.uk FRAX® tool - Fracture Risk Assessment Tool https://frax.shef.ac.uk/FRAX/ (and see https://www.fraxplus.org/) Recording date: 15 February 2024 -- Follow us -- https://www.instagram.com/rcpedintrainees https://twitter.com/RCPEdinTrainees -- Upcoming RCPE Events -- https://events.rcpe.ac.uk/ Feedback: cme@rcpe.ac.uk

In this episode, Dr Kat Ralston chats with Dr Emma Phillips about clinical debriefing. They talk about what clinical debriefing is (and isn’t) and why we should be incorporating this into our everyday work. They explore when and how to facilitate a clinical debrief and share tips on how we can embed clinical debriefing into our practice. Dr Phillips is an Anaesthetic Registrar working in South-East Scotland. She completed a simulation fellowship at Scottish Simulation Center in 2018 and maintains active role in simulation based education. Dr Phillips completed a Master's in 2022 with a dissertation examining attributes and evidence for use of clinical debriefing tools. She has also published and presented on a number of topics including non-technical skills in simulation, clinical debriefing, educational innovations and airway management. Dr Kat Ralston is a Geriatric Medicine Registrar and member of the RCPE Trainees and Members’ Committee, currently working in Edinburgh. -- Useful Links -- Kolbe M, Schmutz S, Seelandt J C, Eppich W J, Schmutz J B. Team debriefings in healthcare: aligning intention and impact BMJ 2021; 374 :n2042 - https://doi.org/10.1136/bmj.n2042 Phillips EC, Smith SE, Tallentire V, et al. Systematic review of clinical debriefing tools: attributes and evidence for use BMJ Quality & Safety Published Online First: 28 March 2023. - https://doi.org/10.1136/bmjqs-2022-015464 Petrosoniak A, Gabriel J, Purdy E. Stop asking if it works, start making it happen: exploring barriers to clinical event debriefing in the ED. CJEM. 2022;24(7):673-674. - https://doi.org/10.1007/s43678-022-00396-9 Walker CA, McGregor L, Taylor C, Robinson S. STOP5: a hot debrief model for resuscitation cases in the emergency department. Clin Exp Emerg Med. 2020;7(4):259-266. - https://doi.org/10.15441/ceem.19.086 Wolfe et al. (2014) Interdisciplinary ICU Cardiac Arrest Debriefing Improves Survival Outcomes - https://doi.org/10.1097/CCM.0000000000000327 Rose & Cheng (2018) Charge nurse facilitated clinical debriefing in the emergency department - https://www.cambridge.org/core/journals/canadian-journal-of-emergency-medicine/article/charge-nurse-facilitated-clinical-debriefing-in-the-emergency-department/CC224433937ACBA849491A66EBC9593D Ralston et al. (2024) Overcoming barriers to clinical event debriefing through simulation - https://doi.org/10.1111/medu.15359 Recording Date: 16 February 2024 -- Follow us -- https://www.instagram.com/rcpedintrainees https://twitter.com/RCPEdinTrainees -- Upcoming RCPE Events -- https://events.rcpe.ac.uk/ Feedback: cme@rcpe.ac.uk

In this episode, released to coincide with World TB Day 2024, Dr Ben Warner discusses pulmonary tuberculosis (TB) with Dr David Connell. Dr David Connell first explains his personal interest in TB. They then discuss pulmonary TB in depth, including: epidemiology; pathogenesis, immune response, and transmission (a 'lymphatic disease with respiratory spread'); how TB presents and differential diagnoses; latent TB infection and reactivation; and management including the importance of the multidisciplinary team (MDT) and the role of public health in contact tracing and the end goal of elimination. Dr David Connell completed higher specialist training in Respiratory and General Internal Medicine in North-West London including at St.Mary’s Hospital, where he completed a PhD in the immunology of Tuberculosis, before becoming a Consultant at Ninewells Hospital in 2017 where he has a specialist interest in Complex Pulmonary Infections and TB. He is Co-Chair of the Scottish Health Protection Tuberculosis Network and is a Clinical Service Advisor to the BTS MDR-TB Advice Service. Dr Ben Warner is a Respiratory Medicine Specialty Registrar with clinical and academic experience of global public health, having completed the LSHTM’s East African Diploma in Tropical Medicine and then worked for 18 months in rural South Africa, where he encountered the sharp end of the global TB pandemic. He is currently undertaking a PhD in multimorbidity in Malawi as part of the Wellcome-funded Multimorbidity PhD Programme for Health Professionals fellow with the University of Glasgow. Recording date: 1 March 2024 -- Follow us -- https://www.instagram.com/rcpedintrainees https://twitter.com/RCPEdinTrainees -- Upcoming RCPE Events -- https://events.rcpe.ac.uk/ Feedback: cme@rcpe.ac.uk

This week Dr Marilena Giannoudi focuses on the topic of Frailty with Dr Sean Ninan. They discuss recognising frailty, the different ways to measure the severity of frailty and the importance of adapting treatment for frail patients. Dr Sean Ninan is a Consultant Geriatrician and Clinical Lead for Dementia and Delirium at Leeds Teaching Hospitals NHS Trust. Dr Ninan is also Course Director of Leeds Frailty Education. Dr Marilena Giannoudi is a cardiology registrar based in Leeds. She is Co-Chair of the Trainees and Members’ Committee, a Fellow of the Higher Education Academy, and is currently undertaking a PhD. Recording Date: 04 December 2023 -- Useful Links -- CGA Toolkit - https://www.cgakit.com/frailty CGA in Primary Care Settings - https://www.bgs.org.uk/cgatoolkit GIRFT Geriatric Medicine - https://gettingitrightfirsttime.co.uk/medical_specialties/geriatric-medicine/ Rapid Delirium Test - https://www.the4at.com Clinical Frailty Scale - https://www.dal.ca/sites/gmr/our-tools/clinical-frailty-scale.html -- Follow us -- https://www.instagram.com/rcpedintrainees https://twitter.com/RCPEdinTrainees -- Upcoming RCPE Events -- https://events.rcpe.ac.uk/ Feedback: cme@rcpe.ac.uk

This week, Dr Kat Ralston takes a fresh look at the geriatric giants with Dr Clare Bostock. They explore frailty syndromes using the “5M’s” approach (matters most, mind, mobility, medications, and multi-complexity) and discuss the importance of a detective mindset to make the diagnosis. They share practical tips on the assessment and management of patients with frailty at the front door. Clare Bostock is a consultant geriatrician at NHS Grampian. Her areas of special interest include acute assessment, polypharmacy, falls, and quality improvement. She works in the geriatric assessment unit at Aberdeen Royal Infirmary. The geriatric medicine team at ARI started daily reviews of older people with frailty in the Acute Medical Admissions area in July 2022. She spent nearly 3 years working in the hospital at home team alongside acute work at ARI, and now works in ARI and at an intermediate care facility at Rosewell House. Dr Kat Ralston is a Geriatric Medicine Registrar and member of the RCPE Trainees and Members’ Committee, currently working in Edinburgh. --Useful Links-- Managing multiple medicines- https://rightdecisions.scot.nhs.uk/polypharmacy-guidance/ British Geriatrics Society Frailty module - https://www.bgs.org.uk/elearning/2023-frailty-identification-and-interventions Clinical Frailty Scale - https://www.bgs.org.uk/sites/default/files/content/attachment/2018-07-05/rockwood_cfs.pdf Think Delirium Toolkit-https://learn.nes.nhs.scot/2442/rrheal/education-networks/rural-teams-education-network/think-delirium-improving-the-care-for-older-people-delirium-toolkit The Geriatric 5M’s - https://agsjournals.onlinelibrary.wiley.com/doi/10.1111/jgs.14979 Silver Book II – Geriatric Syndromes (British Geriatrics Society) - https://www.bgs.org.uk/resources/silver-book-ii-geriatric-syndromes ACB Calculator - https://www.acbcalc.com/ Managing Multiple Medicines: Anticholinergics Recommendations - https://rightdecisions.scot.nhs.uk/polypharmacy-guidance/hot-topics/anticholinergics/ Top Tips for Clinical Frailty Scale - https://www.dal.ca/sites/gmr/our-tools/clinical-frailty-scale/cfs-guidance.html -- Follow us -- https://www.instagram.com/rcpedintrainees https://twitter.com/RCPEdinTrainees -- Upcoming RCPE Events -- https://events.rcpe.ac.uk/ Feedback: cme@rcpe.ac.uk

In this episode, Dr Kat Ralston talks to Dr Sam Hopkins about growth mindset. They talk about what growth and fixed mindsets are, and why thinking about your mindset is critical to successful learning and development as doctors. They discuss practical tips on ways to influence your mindset and the mindset of others around you, including effective ways to seek and give feedback and the power of role-modelling that failure is not only normal but an essential part of growth as a doctor. Sam Hopkins is a Specialty Trainee in Medical Oncology at the Edinburgh Cancer Centre and a Senior Medical Education Fellow for the Medical Education Directorate, NHS Lothian. She is also an Honorary Clinical Fellow at the University of Edinburgh. Her research interests are growth mindset, specifically how to increase trainee adoption of a growth mindset in the clinical learning environment, and innovative simulation methodology, such as her novel table top simulation board game. She is Canadian of origin and her passions include cooking, positive psychology and yoga. Dr Kat Ralston is a Geriatric Medicine Registrar and member of the RCPE Trainees and Members’ Committee, currently working in Edinburgh. -- Useful Links -- Carol Dweck TED talk "Developing a Growth Mindset" - https://www.youtube.com/watch?v=hiiEeMN7vbQ Hopkins SR, Rae VI, Smith SE, Meldrum S, Tallentire VR. From safety net to trampoline: elevating learning with growth mindset in healthcare simulation. Advances in Simulation. 2023 Nov 10;8(1):26. - https://link.springer.com/article/10.1186/s41077-023-00264-1 Hopkins SR, Rae VI, Smith SE, Mutch CP, Oliver N, Tallentire VR. Growing a growth mindset: a tabletop simulation board game. International Journal of Healthcare Simulation. 2023 Jul 10(null):1-3. - https://www.ijohs.com/article/doi/10.54531/cjfe6207?q= Dweck CS, Leggett EL. A social-cognitive approach to motivation and personality. Psychological review. 1988 Apr;95(2):256. - https://psycnet.apa.org/record/1988-29536-001 Yeager DS, Dweck CS. What can be learned from growth mindset controversies?. American psychologist. 2020 Dec;75(9):1269. - https://psycnet.apa.org/record/2020-99903-019 Wolcott MD, McLaughlin JE, Hann A, Miklavec A, Beck Dallaghan GL, Rhoney DH, Zomorodi M. A review to characterise and map the growth mindset theory in health professions education. Medical Education. 2021 Apr;55(4):430-40. - https://asmepublications.onlinelibrary.wiley.com/doi/abs/10.1111/medu.14381 Recording date: 23 November 2023 -- Follow us -- https://www.instagram.com/rcpedintrainees https://twitter.com/RCPEdinTrainees -- Upcoming RCPE Events -- https://events.rcpe.ac.uk/ Feedback: cme@rcpe.ac.uk

In this brief episode, Dr Marilena Giannoudi, Co-Chair of the Trainees and Members’ Committee, gives an overview of the Royal College of Physicians of Edinburgh's podcasts relevant to doctors-in-training. These include: this podcast, 'Clinical Conversations'; 'Career Conversations' including the new 'Demystifying PACES' series; and the Recently Appointed Consultants' Committee's podcast, 'Consultant Conversations', relevant to senior trainees. All RCPE podcasts can be found at https://podcasts.rcpe.ac.uk/ The 'Demystifying PACES' podcast series can be found at https://podcasts.rcpe.ac.uk/show/career-conversations/category/paces/ Recording date: 23 January 2024 -- Follow us -- https://www.instagram.com/rcpedintrainees https://twitter.com/RCPEdinTrainees -- Upcoming RCPE Events -- https://events.rcpe.ac.uk/ -- Become a Member -- https://www.rcpe.ac.uk/membership/join-college Feedback: cme@rcpe.ac.uk

In the second of two episodes on Long COVID, Dr Hannah Preston discusses Long COVID and ME/CFS (Myalgic Encephalomyelitis / Chronic Fatigue Syndrome) with Dr Binita Kane. Long COVID, also known as Post-Covid Syndrome, is further explored. Dr Preston and Kane discuss Postural Tachycardia Syndrome (PoTS), immune dysregulation, Mast Cell Activation Syndrome (MCAS), the impact of Long COVID on women's and men's health, investigations, emerging research and treatments, and the importance of listening to your patient. Dr Binita Kane is a Consultant respiratory physician in Manchester. She has worked on the frontline of the pandemic since 2020 and set up the first COVID virtual ward model in the UK and has advised nationally on the role of virtual wards across England. In January 2021, Dr Kane’s 10 year old daughter developed COVID and subsequently Long COVID. This has led her on an international search for answers, culminating in her becoming a campaigner, researcher, patient advocate, champion for the Long COVID Kids charity and now a specialist Long COVID physician. Dr Kane is a member of the World Health Network Long COVID Executive Committee, Independent SAGE and a campaigner for clean air. Dr Hannah Preston is a Renal Registrar in Edinburgh and RCPE Trainees and Members' Committee (T&MC) Co-Chair. Listen to Part 1: https://podcasts.rcpe.ac.uk/show/clinical-conversations/long-covid-part-1-27-nov-2023/ -- Links -- PoTS UK: https://www.potsuk.org Standing up to PoTS: https://www.standinguptopots.org/videos-about-pots Visible app - Visible Health https://www.makevisible.com BMJ Long COVID - an update for primary care (2022): https://www.bmj.com/content/378/bmj-2022-072117 Nature review article: Long COVID, major findings, mechanisms and recommendations: https://www.nature.com/articles/s41579-022-00846-2 Review article: Long COVID pathophysiological factors and abnormalities of coagulation https://pubmed.ncbi.nlm.nih.gov/37080828/ Dr Kane's YouTube channel 'The Long COVID Clinic - What you CAN do' in partnership with The Long COVID Support Charity: https://www.youtube.com/@LCCWYCD Gez Medinger YouTube channel - interviews with the world's leading Long COVID researchers and more: https://www.youtube.com/channel/UCln_SCEd4JiGkHIUZd1VlXw The World Health Network - Long COVID resources, bringing together knowledge from across the world: https://whn.global/long-covid/ Long COVID Kids Charity - resources for children and families affected by Long COVID: https://www.longcovidkids.org World Physio Long COVID resources - international repository of resources regarding safe rehabilitation approaches: https://world.physio/covid-19-information-hub/long-covid -- Related RCPE content -- For RCPE's COVID-19 content, see https://learning.rcpe.ac.uk/tag/index.php?tc=1&tag=COVID-19&ta=2&excl=1 Recording date: 26 November 2023 -- Follow us -- https://www.instagram.com/rcpedintrainees https://twitter.com/RCPEdinTrainees -- Upcoming RCPE Events -- https://events.rcpe.ac.uk/ Feedback: cme@rcpe.ac.uk

In the first of two episodes on Long COVID, Dr Hannah Preston discusses Long COVID and ME/CFS (Myalgic Encephalomyelitis / Chronic Fatigue Syndrome) with Dr Binita Kane. Long COVID, also known as Post-Covid Syndrome, is explored in depth, including prevalence, risk factors, symptoms and impact, pathophysiology, and management. Dr Kane also busts some common myths about Long COVID. Dr Binita Kane is a Consultant respiratory physician in Manchester. She has worked on the frontline of the pandemic since 2020 and set up the first COVID virtual ward model in the UK and has advised nationally on the role of virtual wards across England. In January 2021, Dr Kane’s 10 year old daughter developed COVID and subsequently Long COVID. This has led her on an international search for answers, culminating in her becoming a campaigner, researcher, patient advocate, champion for the Long COVID Kids charity and now a specialist Long COVID physician. Dr Kane is a member of the World Health Network Long COVID Executive Committee, Independent SAGE and a campaigner for clean air. Dr Hannah Preston is a Renal Registrar in Edinburgh and RCPE Trainees and Members' Committee (T&MC) Co-Chair. -- Links -- BMJ Long COVID - an update for primary care (2022): https://www.bmj.com/content/378/bmj-2022-072117 Nature review article: Long COVID, major findings, mechanisms and recommendations: https://www.nature.com/articles/s41579-022-00846-2 Review article: Long COVID pathophysiological factors and abnormalities of coagulation https://pubmed.ncbi.nlm.nih.gov/37080828/ Dr Kane's YouTube channel 'The Long COVID Clinic - What you CAN do' in partnership with The Long COVID Support Charity: https://www.youtube.com/@LCCWYCD Gez Medinger YouTube channel - interviews with the world's leading Long COVID researchers and more: https://www.youtube.com/channel/UCln_SCEd4JiGkHIUZd1VlXw The World Health Network - Long COVID resources, bringing together knowledge from across the world: https://whn.global/long-covid/ Long COVID Kids Charity - resources for children and families affected by Long COVID: https://www.longcovidkids.org World Physio Long COVID resources - international repository of resources regarding safe rehabilitation approaches: https://world.physio/covid-19-information-hub/long-covid -- Related RCPE content -- For RCPE's COVID-19 content, see https://learning.rcpe.ac.uk/tag/index.php?tc=1&tag=COVID-19&ta=2&excl=1 Recording date: 16 October 2023 -- Follow us -- https://www.instagram.com/rcpedintrainees https://twitter.com/RCPEdinTrainees -- Upcoming RCPE Events -- https://events.rcpe.ac.uk/ Feedback: cme@rcpe.ac.uk

Dr Kat Ralston and Dr Sarah Bartlett discuss free e-learning on the '10 things a doctor can do to combat climate change' initiative from the Royal College of Physicians of Edinburgh's College Advisory Forum on the Environment (CAFE). This initiative has featured in The BMJ, the College's journal JRCPE and in Scotland's Chief Medical Officer's Annual Report. Dr Sarah Bartlett is Co-Chair of RCPE's CAFE with Dr Marion Slater, and Registrar in Geriatric Medicine, General Internal Medicine and Stroke in Edinburgh. Dr Kat Ralston is a Geriatric Medicine Registrar and member of the RCPE Trainees and Members’ Committee, currently working in Edinburgh. -- Links -- CAFE '10 things...' e-learning https://learning.rcpe.ac.uk/10things Last podcast episode: Sustainability - be lazy to save the planet https://podcasts.rcpe.ac.uk/show/clinical-conversations/sustainability-be-lazy-to-save-the-planet-30-oct-2023/ CAFE '10 things...' in The BMJ https://doi.org/10.1136/bmj.o2650 CAFE '10 things...' in JRCPE https://doi.org/10.1177/14782715231158878 CAFE '10 things...' in CMO Annual Report (page 56) https://www.gov.scot/publications/realistic-medicine-doing-right-thing-cmo-annual-report-2022-2023/ -- Related content -- RCPE Fellows & Members can explore planetary health content on the Education Portal: https://learning.rcpe.ac.uk/tag/index.php?tc=1&tag=Planetary%20Health&ta=2&excl=1 Recording dates: 23 August 2023 (Dr Bartlett) and 3 November 2023 (Dr Ralston) -- Follow us -- https://www.instagram.com/rcpedintrainees https://twitter.com/RCPEdinTrainees -- Upcoming RCPE Events -- https://events.rcpe.ac.uk/ Feedback: cme@rcpe.ac.uk

This week Dr Kat Ralston discusses sustainability in healthcare with Dr Shauna Golden. They explore why striving for individual perfection isn't the answer, and discuss the importance of using your sphere of influence to drive change. They share practical tips on how you can improve sustainability where you work, including projects that are 'win-win' - saving the planet, saving money and improving staff and patient experience. Dr Shauna Golden has a background in Emergency Medicine and was the first Medical Education Fellow in Sustainability in NHS Lothian. She studied and trained in Ireland, became interested in the climate crisis while working in Australia, and thereafter completed a Masters in Global Health Policy at The University of Edinburgh. Dr Kat Ralston is a Geriatric Medicine Registrar and member of the RCPE Trainees and Members’ Committee, currently working in Edinburgh. -- Links -- Sustainable QI https://www.susqi.org/ Sustainable QI specialties https://sustainablehealthcare.org.uk/what-we-do/sustainable-specialties Mary Robinson podcast https://www.mothersofinvention.online/ NHS Scotland Strategy https://www.gov.scot/publications/nhs-scotland-climate-emergency-sustainability-strategy-2022-2026/ NHS Lothian Climate Challenge Grants https://nhslothiancharity.org/apply-for-funding/climate-challenge-grants/ Charing Cross Quality Improvement project https://www.england.nhs.uk/greenernhs/whats-already-happening/reducing-unnecessary-cannulation-at-charing-cross-hospital/ Centre of sustainable healthcare https://sustainablehealthcare.org.uk -- Related content -- RCPE Fellows & Members can explore planetary health content on the Education Portal: https://learning.rcpe.ac.uk/tag/index.php?tc=1&tag=Planetary%20Health&ta=2&excl=1 Recording date: 6 July 2023 -- Follow us -- https://www.instagram.com/rcpedintrainees https://twitter.com/RCPEdinTrainees -- Upcoming RCPE Events -- https://events.rcpe.ac.uk/ Feedback: cme@rcpe.ac.uk