Clinical Conversations

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

This week Dr Jonathan Bardgett discusses how to manage patients with a red hot painful swollen foot with Dr Callum Mutch. Jonathan and Callum discuss diagnostics, treatment and examples of different case presentations. Dr Mutch is an infection doctor working in Edinburgh with his time split between the microbiology lab and the infectious diseases ward. He has recently undertaken a medical education fellowship focusing on Simulation Based Mastery Learning and Digital Education. Outside of work he is the co-host of the Infectious Diseases Insight of Two Specialists (ID:IOTS) podcast. Disclaimer: Please always refer to the most up-to-date local antimicrobial guidelines -- Useful Links-- NICE guideline [NG141]: Cellulitis and erysipelas: antimicrobial prescribing - https://www.nice.org.uk/guidance/NG141 Sullivan T, de Barra E. Diagnosis and management of cellulitis. Clin Med (Lond). 2018 Mar;18(2):160-163. - doi: https://doi.org/10.7861/clinmedicine.18-2-160 MicroGuide App: https://apps.apple.com/gb/app/microguide/id447171786 / https://play.google.com/store/apps/details?id=com.xancu.utreat&pli=1 NHS Scotland Antimicrobial Companion app: https://www.antimicrobialcompanion.scot/ Shorter is better - https://www.bradspellberg.com/shorter-is-better NG141 Summary of the Evidence on Antibiotic prophylaxis for the prevention of recurrent cellulitis and erysipelas - https://www.nice.org.uk/guidance/ng141/chapter/Summary-of-the-evidence#antibiotic-prophylaxis-for-the-prevention-of-recurrent-cellulitis-and-erysipelas Differentials: Lipodermatosclerosis - https://cks.nice.org.uk/topics/venous-eczema-lipodermatosclerosis/, DVT NICE guideline NG158 - https://www.nice.org.uk/guidance/NG158 Fernando SM, Tran A, Cheng W, Rochwerg B, Kyeremanteng K, Seely AJE, Inaba K, Perry JJ. Necrotizing Soft Tissue Infection: Diagnostic Accuracy of Physical Examination, Imaging, and LRINEC Score: A Systematic Review and Meta-Analysis. Ann Surg. 2019 Jan;269(1):58-65. - doi: https://doi.org/10.1097/sla.0000000000002774 Infectious diseases tag on Education Portal - https://learning.rcpe.ac.uk/tag/index.php?tc=1&tag=Infectious%20Diseases ID:IOTS podcast - https://idiotspodcasting.buzzsprout.com/ (https://idiotspodcasting.buzzsprout.com/1782416/9227705-6-skin-and-soft-tissue-infection and https://idiotspodcasting.buzzsprout.com/1782416/9227743-7-necrotising-fasciitis) Recording Date: 28 June 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 episode Dr Marilena Giannoudi discusses the approach to patients with peripheral neuropathy with Dr Louise Davidson. Dr Davidson first covers the basic anatomy and function of the peripheral nervous system and describes lower motor neurone signs. They discuss different peripheral neuropathy presentations and types. Dr Davidson emphasises the importance of a thorough history before moving on to examination, testing/investigations, and management. Dr Louise Davidson is a Consultant Neurologist based in Edinburgh. Dr Davidson works full time for the National Health Service with interests in epilepsy, general neurology and botulinum toxin for dystonia. Dr Davidson was awarded an MD degree following her research into the diagnostics of Sporadic Creutzfeldt-Jakob Disease. During her general neurology practice, Dr Davidson has managed a number of different cases of peripheral neuropathy and has previously discussed the topic at college meetings and at general medical grand round meetings. Dr Davidson is also actively involved in medical education and is the current local programme lead for neurology training. Dr Marilena Giannoudi is a cardiology registrar based in Leeds. She is a member of the Trainees and Members’ Committee, a Fellow of the Higher Education Academy, and is currently undertaking a PhD. -- Related content -- RCPE Fellows & Members can explore neurology content on the Education Portal: https://learning.rcpe.ac.uk/tag/index.php?tc=1&tag=Neurology Recording date: 26 June 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 episode Drs Dáire O'Shea and Sarah Clifford discuss what the acute medic needs to know about HIV (human immunodeficiency virus) with Dr Jonny Bardgett, including the patient journey following diagnosis, opportunistic infections, advances in diagnosis and management, treatment side effects, and use of PrEP (pre-exposure prophylaxis) and PEP (post-exposure prophylaxis) to reduce transmission and acquisition of HIV. Dr Sarah Clifford recently completed training in Infectious Diseases and General Medicine, and is currently working as an acting consultant in the Regional Infectious Diseases Unit at the Western General Hospital in Edinburgh. Clinical interests include HIV medicine and tropical medicine. Dr Clifford is a graduate of the Liverpool School of Tropical Medicine & Hygiene, and the Gorgas Course in Tropical Medicine (Lima, Peru). Dr Dáire O'Shea is a Consultant Physician in Infectious Disease at the Regional Infectious Diseases Unit Edinburgh and Honorary Clinical Senior Lecturer at University of Edinburgh. He is a graduate of Trinity College Dublin, Ireland and undertook Internal Medicine and specialist Infectious Diseases Training in Ireland. In 2011 Dr O'Shea was awarded a Transplant Infectious Diseases fellowship with the Alberta Transplant Institute in Canada continuing to take on a position with the Infectious Diseases Academic Faculty of the University of Alberta. In 2014 he took up his current position in Edinburgh. Subspecialist interests include infection in immunocompromised hosts, in particular infection post transplantation; HIV medicine, and Viral hepatitis. Research interests focus on immunopathogenesis and immune determinants of infection outcomes. -- Link -- HIV drug interactions https://www.hiv-druginteractions.org/ Recording date: 31 May 2023 Sound issues: We apologise for some lower quality audio in this episode. -- 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 Libby Sampey interviews Dr Catriona Kyle about adrenal insufficiency and steroid replacement. They discuss the different types of adrenal insufficiency and relevant physiology before exploring recognition, investigations and diagnosis, and links to other autoimmune diseases. They go on to discuss management including ‘sick day rules’, and patient follow-up. Dr Catriona Kyle is a Consultant Endocrinologist at the Western General Hospital in Edinburgh, and has a PhD in steroid physiology from the University of Edinburgh. Dr Libby Sampey is a member of RCPE’s Trainees and Members’ Committee podcast team and a Foundation Year Doctor. -- Links -- Society for Endocrinology - Adrenal Crisis Information https://www.endocrinology.org/clinical-practice/clinical-guidance/adrenal-crisis/ Diagnosis and Treatment of Primary Adrenal Insufficiency: An Endocrine Society Clinical Practice Guideline (Bornstein et al., 2016) https://doi.org/10.1210/jc.2015-1710 Society for Endocrinology https://www.endocrinology.org/ Recording date: 8 June 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

Today Dr Marilena Giannoudi discusses treating diabetic patients on the wards with Dr Evgenia Foteinopoulou. Dr Evgenia Foteinopoulou is a Consultant in Endocrinology & Diabetes at NHS Lothian with a special interest in Diabetic Nephropathy and Diabetes classification. Dr Foteinopoulou is also involved in Undergraduate and Postgraduate medical teaching. Dr Marilena Giannoudi is the T&MC Podcast Lead and Vice-Chair for Careers and Communications, and a clinical academic trainee in cardiology in Yorkshire and Humber. Recording Date: 21 April 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

This week Dr Marilena Giannoudi interviews Professor Mahmood Adil on data, how it can be used in healthcare and what opportunities are available for healthcare workers interested in medical data. Professor Adil has over 25 years of medical, public health, executive management and policy experience and delivered on key senior positions in the UK & USA including; Medical Director (Public Health Scotland), National Quality & Efficiency Advisor (Department of Health, England), Visiting Faculty (Yale School of Public Health). He has been responsible for national health intelligence and health protection functions and helped to improve quality/patient outcomes, reduce cost and innovate health care services for populations in the UK and internationally. Dr Marilena Giannoudi is the T&MC Podcast Lead and Vice-Chair for Careers and Communications, and a clinical academic trainee in cardiology in Yorkshire and Humber. Recording Date: 24 February 2023 -- Useful Links -- TOPOL - https://topol.hee.nhs.uk/ TOPOL Digital Fellowships - https://topol.hee.nhs.uk/digital-fellowships/ FCI - https://fci.org.uk/ FutureLearn Course: Data for Health & Care - https://www.futurelearn.com/courses/data-for-health-and-care Florence Nightingale Foundation Digital Fellowships - https://florence-nightingale-foundation.org.uk/academy/digital-fellowships/ NHSE elfh Hub - https://portal.e-lfh.org.uk/ EDRIS - https://www.isdscotland.org/products-and-services/edris/ NHS Digital - https://digital.nhs.uk/data -- 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 Libby Sampey interviews Ian Lee on impromptu teaching on the medical ward. Ian discusses the importance in facilitating teaching on the wards and how to recognise and overcome challenges, as both educators and learners, to provide good quality training in a clinical setting. Ian Lee is a Lecturer in Medical Education and Senior Fellow of the Higher Education Academy who works mainly on the University of Edinburgh's Clinical Educator Programme. With a background in nursing, Ian's past clinical teaching includes; teaching resuscitation and clinical skills; ALS instruction; roles in simulation based education and of course supporting medical and nursing students on clinical placement in patient facing clinical settings which is what forms the basis of today's Clinical Conversation. Now in full time academia, Ian continues to share his experiences of working with learners in clinical settings and augments this with evidence from the literature as well as insights developed from hosting workshops on similar topics. Recording Date: 31 March 2023 --Useful Links-- Clinical Educator Programme website - https://www.clinicaleducator.org/en-gb/ A five-step "microskills" model of clinical teaching, by Neher et al. (1992) - https://pubmed.ncbi.nlm.nih.gov/1496899/ Teaching That Counts: The One-Minute Preceptor Model from CanadiEM - https://canadiem.org/teaching-that-counts-the-one-minute-preceptor-model/ SNAPPS: a learner-centered model for outpatient education, by Wolpaw, Wolpaw & Papp (2003) - https://doi.org/10.1097/00001888-200309000-00010 Learning and teaching in the clinical environment, by Spencer (2003) - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1125480/ -- 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 Sampey discusses with Dr Gurney what QI is. Why it is beneficial in a healthcare setting. How it affects patient outcomes and helps to deliver patient centred care. Dr Gurney is Lecturer on MSc Clinical Education at the University of Edinburgh & Co-leader of a 40 credit course on Quality Improvement in relation to Clinical Education within the MSc. Additionally she clinically works in medicine of the elderly and acute medicine. Recording Date: 23 Feb 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

This week Dr Kat Ralston discusses the concept of civility with Dr Catherine Stretton. They reflect on their own personal experiences and explore the evidence on the impact incivility has on our ability to do our jobs effectively. They discuss recognising the factors that can lead to incivility, explore strategies to challenge incivility with compassion and consider how we can influence our workplace culture to improve patient safety. Kat is a Specialist Trainee in Geriatric and General Medicine and a Medical Education Fellow, currently working in Edinburgh. Cath is a Consultant Anaesthetist in St. John's Hospital, Livingston. Alongside her clinical work, she is very interested in staff experience and how this translates into to the quality of healthcare that our teams deliver to our patients. She is also interested in utilising Quality Improvement science to achieve excellence in these two areas, so both patients and staff get the best possible experience from our healthcare system. --Useful Links-- Civility saves lives website - https://www.civilitysaveslives.com/ The Price of Incivility by Christine Porath and Christine Pearson (2013) in Harvard Business Review - https://hbr.org/2013/01/the-price-of-incivility The Impact of Rudeness on Medical Team Performance: A Randomized Trial – Riskin, Erez et al. (2015) - https://doi.org/10.1542/peds.2015-1385 Exposure to incivility hinders clinical performance in a simulated operative crisis – Katz et al. (2019) - http://dx.doi.org/10.1136/bmjqs-2019-009598 Paul Stretton’s Twitter - (@psquantumsafety) The ‘just culture’: why it is not just, and how it could be – Stretton (2020) - https://doi.org/10.12968/bjhc.2020.0058 -- 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 Jonathan Bardgett interviews Dr Ganesh Arunagirinathan about hyponatraemia. They discuss the importance of recognising hyponatraemia and how to manage patients presenting at the front door. Dr Arunagirinathan is a Consultant Physician in Diabetes & Endocrinology in Edinburgh. Recording Date: 12 December 2022 -- Follow us -- https://www.instagram.com/rcpedintrainees https://twitter.com/RCPEdinTrainees -- Upcoming RCPE Events -- https://events.rcpe.ac.uk/ Feedback: cme@rcpe.ac.uk