The clinical teacher
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Emergency department (ED) handovers are arguably more complex than handovers in the ward environment. This is because of an unpredictable patient load, fluctuations in acuity, compressed time frames and the undifferentiated or undiagnosed nature of clinical problems. In order to ensure safe, relevant and accurate handovers, we have implemented a novel multiprofessional model. The model ensures that staff groups communicate, interact and learn together. In this study we investigated the effectiveness and usefulness of this new morning handover structure at St Thomas' Hospital, a busy teaching hospital in London, UK. ⋯ Our unique morning handover structure ensures patient safety, as well as the appropriate transfer of information and responsibility to all involved with the care of patients in the ED. It offers the opportunity for multiprofessional learning, encourages teamwork and improves operational processes within the ED.
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Burnout is a state of mental and physical exhaustion related to work or care-giving activities. Distress during medical school can lead to burnout, with significant consequences, particularly if burnout continues into residency and beyond. The authors reviewed literature pertaining to medical student burnout, its prevalence, and its relationship to personal, environmental, demographic and psychiatric factors. We ultimately offer some suggestions to address and potentially ameliorate the current dilemma posed by burnout during medical education. ⋯ Burnout is a prominent force challenging medical students' well-being, with concerning implications for the continuation of burnout into residency and beyond. To address this highly prevalent condition, educators must first develop greater awareness and understanding of burnout, as well as of the factors that lead to its development. Interventions focusing on generating wellness during medical training are highly recommended.
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Ward rounds are complex clinical activities, and are an integral part of hospital life. Failures in care can have a direct consequence on patient safety. Recently, simulation ward rounds have allowed medical students and junior doctors to practise their skills in a safe environment, yet there is no commonly accepted and taught framework on how to conduct a ward round. ⋯ Clinical checklists have become integral to improving patient outcomes, and Dr Caldwell's checklist could be used to improve patient safety while they are in-patients. The Considerative Checklist could be a vital tool in teaching this skill to students and junior doctors, but further qualitative and quantitative research is required to investigate whether using the checklist improves student performance, learning and engagement on the wards, and whether this improves patient outcomes.