Internal medicine journal
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Internal medicine journal · Nov 2021
Development of teaching, mentoring and supervision skills for basic training registrars - a frustrated apprenticeship?
Teaching, mentoring and supervision (TMS) are fundamental skills with a specific commitment within the Royal Australasian College of Physicians professional practice framework. The new basic training standards include 'use of appropriate educational techniques to facilitate the learning of peers, junior colleagues and other health professionals and to provide supervision for junior colleagues' but it is unclear how basic physician trainees and equivalent grade doctors (hereinafter 'registrars') will provide, learn or develop TMS skills. ⋯ Registrars are expected to teach, mentor and supervise junior colleagues but experience a 'frustrated apprenticeship': formal training is minimal and informal training is dependent on variable role models, opportunities and systematic support. Registrars feel unprepared and lack confidence despite wanting to succeed in this domain. Suggestions for improvement include baseline formal training, purposeful role modelling by seniors and equitable promotion of TMS opportunities.
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Internal medicine journal · Nov 2021
Consensus guidelines for optimising antifungal drug delivery and monitoring to avoid toxicity and improve outcomes in patients with haematological malignancy and haemopoietic stem cell transplant recipients, 2021.
Antifungal agents can have complex dosing and the potential for drug interaction, both of which can lead to subtherapeutic antifungal drug concentrations and poorer clinical outcomes for patients with haematological malignancy and haemopoietic stem cell transplant recipients. Antifungal agents can also be associated with significant toxicities when drug concentrations are too high. ⋯ These guidelines provide recommendations on antifungal drug monitoring and TDM-guided dosing adjustment for selected antifungal agents, and include suggested resources for identifying and analysing antifungal drug interactions. Recommended competencies for optimal interpretation of antifungal TDM and dose recommendations are also provided.