Listen – Look – Locate: An approach to the febrile child #tipsfornewdocs

The first Wednesday of August in the UK represents an exciting time for a cohort of newly qualified junior doctors who start their medical careers. For those commencing in Paediatrics and Emergency Medicine, or starting these specialties for the first time, the prospect of managing young potentially unwell children can be daunting.

Having to assess the “febrile’ child often results in a drain of colour from even the most confident of junior doctors. This quick presentation is centred specifically around assessing the febrile child and contains a few experiential and evidence based tips.  It is not a comprehensive guide to history taking or examination – please watch #Paedstips you won’t find in books How to examine children, and look at the resources via Seeing kids is child’s play at St.Emlyn’s  for further detail.

If you need a framework to start with though – go no further than Listen, Look and Locate:

 

What I learnt this week: The importance of being part of a team (Sir Bradley Wiggins says so!) #WILTW

This is the eleventh #WILTW post

Hours after winning a silver medal at the Commonwealth Games Sir Bradley Wiggins gave the following interview to the BBC:

http://www.bbc.co.uk/sport/0/commonwealth-games/28477534

It was a honest account of what the team had achieved in Glasgow. He also noted that he had struggled with the “not-so-niceties” of the highly competitive nature of the Tour-de-France. What stood out for me was his comment about looking forward to returning to being part of a true team. The team pursuit is dependant on everyone, not just a one highly skilled individual.

Emergency Medicine is very similar. When it gets very busy, with large patient volumes and high acuities every health care professional plays a vital part in ensuring patient safety and a quality experience for all. It is that collaborative experience that makes emergency medicine such a fun place to work. I can try and see as many patients as possible but without the health care assistant, nurse, ward clerk and manager all playing their roles it will be a deeply unsatisfying experience. Even during the busiest periods, a quick joke and a smile between members of staff makes a huge difference.

We are one Team

So I’m with Bradley – while the individual reward may be worthwhile in the short term nothing beats a team effort…

What did you learn this week? #WILTW

What I learnt this week: Learning not to be as busy as a “Backson” #WILTW

This is the tenth #WILTW post

On the long journey to and from our holiday in Wales our girls were entertained with an iPad playing a variety of disney films and Peppa Pig episodes. One of their favourite films is Winnie the Pooh ( 2011)

It features a catchy song about the Backson

Owl:         Christopher Robin has been captured!
[all]:        What?
Owl:        By a creature called “The Backson.”
[all gasp]
All:          Captured by the Backson!
Tiger:     What’s a Backson?

Owl:       A horrible creature! Malicious!
Tiger:     You don’t say.
Owl:       Ferocious!
Tiger:     Fero… ?! Ooh!
Owl:       And worst of all, terribly busy.

(I suspect you’ll find it impossible not to sing along after you have listened a couple a times)

I used to take pride in the fact that I was always busy. A badge of honour almost. Having spent a week away from work and being able to properly relax I realise I have no less work to do now than I did before I left (and probably more). However I am now infinitely more chilled and less stressed about my to-do list.  While I’m unlikely to completely change all my working habits I am going to try an hold on to the image of the ‘terribly busy’ Backson to remind me of the importance of a good holiday 🙂

Beach View

 

What did you learn this week? #WILTW

 

 

What I learnt this week: Feel the fear and do it anyway #WILTW

The ninth #WILTW post

I recently visited the Wellcome Trust exhibition: “an idiosyncratic A to Z of the human condition“. I thoroughly recommend it as, not only is it free, but it does really get you thinking about different mindsets and idiologies. I was struck by this particular exhibit

dustbin

I would not generally think of myself as someone who is afraid to do things but it was interesting that I thought of many fears I would like to put in the bin. My transition to being a consultant has generated a great deal of self-reflection and I hope self-efficacy (thanks to Helen Bevan for highlighting the difference)

selfefficacy

 

Actually there are many things I have been afraid to do – but by not recognising them as fears I have not challenged them. Hoping the rubbish bin approach will help me be more honest in future!

What did you learn this week? #WILTW

Evaluating Education

Many thanks to the SMACC team for releasing my #SMACCGold talk: Evaluating Education. The background story can be found here

The publication related to the 7I Framework can be found here

Video

Damian Roland – Evaluating Education from Social Media and Critical Care on Vimeo.

Slides:

Audio: link here

Just who or what am I evaluating? Learning from #SMACCGold

Many thanks to the St.Emlyn’s team for the idea for blogging on the background to SMACCGold talks..

Very rarely do I get an e-mail that makes me instantly smile but receiving a request from Chris Nickson to speak at #SMACCGold was one of those occasions. I felt in someways like an imposter but also, if I am honest, some degree of validation. The input and impact of the smacc team into the #FOAMed community is something I am hugely respectful of. Surely, whatever the reasons for my invite, it must have meant some of the things I had been blogging/publishing on were being well received? (If I lack insight in this regard please be kind with feedback….!)

Regardless of my initial surprise though, how to go about constructing a SMACCesque talk that could possibly come even close to Victoria Brazil’s or Cliff Reid’s? I’d like to share a mistake I made early in the development of my talk. I do this firstly because I try to be a reflective learner but also because it has had quite a profound effect on me. The big mistake was that I spent far too long thinking the talk was about me rather than a talk about evaluating education. Obviously the talk wasn’t about ‘me‘ but I had noticed from the previous SMACC that people talked about Levitan’s “airway” or Weingart’s “resuscitation”. What could I bring to the talk that would encapsulate the essence of me? I was partly relieved to hear both Victoria Brail and Simon Carley say they had had weeks of sleepless nights before their talks due to their own internal pressures to perform well. This I suspect was a measure of anxiety to maintain high standards not because they were interested in showing off prowess of their subject. Ultimately once I realised the material could speak for itself, and I just needed to be an effective conduit, things started falling into shape.

To be clear that I don’t think I only made one mistake (!) other errors I made were embarrassingly predictable:

Changing material at the eleventh hour – don’t do this. None of the last minute changes I made in the conference centre lobby on the day of may talk added anything useful. In fact they just resulted in me forgetting to say things that would have been beneficial information!

Not practicing what you preach – specifically to practice, practice and practice and then practice again (preferably in front of someone else)

The talk itself was based on my PhD work and my experiences with trying to bridge the chasm between educational theory and the clinician with an interest but no such background. I am a firm believer in the power of face validity – therefore educational models need creating which are well researched but also easy to explain to those not interested in complex theorem. Given one of my research interests is validity in medical education this all starts to get a bit ‘meta’. I wrestled for some time with putting a run of slides in explaining different types of validity. I went for this in the end, also choosing to deliberately include a ‘bad slide’. I had been emboldened to do this  after trying the same in the education workshop (particularly Chris Nickson mouthing ‘so glad he said that!’ when I explained that the slide I was showing was intentionally dreadful)

One of the challenges in medical education is the interplay between the educator and the subject of the ‘education’. What is the impact of a great speaker in terms of knowledge acquisition? Knowing the importance of this effect weighed heavily on me. Reflections after the event have resulted in a very critical evaluation of myself as a speaker but if I have learnt anything from the experience it is this self-evaluation is a useful process. Fascinating this didn’t occur to me at the time…

 

Tips on chairing webexes and conference calls

Inspired by this tweet I set about collating some of my experiences of conference calls and webexes.

I recommend watching this video first to set the scene

The summary of my video cast is distilled into these six points

1. Practicalities – a reminder of difference between calls that are simply multi-person phone conversations and those that are facilitated online conversations including ability to see presentations and documents.

2. Preparation – as with all meetings setting an agenda is key but also remember to confirm functionality of dial-in numbers.

3. Participants – be aware of the ‘newbie’ and provide as much pre-event advice as possible.

4. Procedures – be as clear as possible about the structure of meeting at the outset.

5. Punctuality – you may need to more directive than is normal as this is an environment where body language is impossible to read.

6. Pitfalls – make sure everyone is muted –  but remind them to unmute when speaking!

I recorded in one take so it’s not amazingly fluid but I would really welcome feedback on all the points I have missed!

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