Clinical Conversations

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

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This podcast is from the Trainees & Members' Committee (T&MC) of the Royal College of Physicians of Edinburgh (RCPE).

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

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This podcast is from the Trainees & Members' Committee (T&MC) of the Royal College of Physicians of Edinburgh (RCPE).

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/

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This podcast is from the Trainees & Members' Committee (T&MC) of the Royal College of Physicians of Edinburgh (RCPE).

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

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This podcast is from the Trainees & Members' Committee (T&MC) of the Royal College of Physicians of Edinburgh (RCPE).

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

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This podcast is from the Trainees & Members' Committee (T&MC) of the Royal College of Physicians of Edinburgh (RCPE).

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

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This podcast is from the Trainees & Members' Committee (T&MC) of the Royal College of Physicians of Edinburgh (RCPE).

In this episode, Edward Foo discusses spontaneous bleeding presentations and their identification and management with Dr Andrew Page.

Dr Andrew Page is a Consultant Haematologist with a special interest in bleeding and thrombotic disorders at the Royal Infirmary of Edinburgh, and Director of the Edinburgh Haemophilia Centre. Before training as a medic, he worked in basic scientific research in the field of genetics. This continues to inform his clinical interests, and Dr Page is also the Clinical Lead of the Scottish Bleeding and Platelet Disorders Genetic Diagnostic Service.

Edward Foo is a medical student at the University of Edinburgh and Student Observer of the RCPE Trainees and Members' Committee (T&MC).

--- Notes for the listener ---

At c. 10.55, Dr Page discusses European licensing for gene therapy in haemophilia B. The situation has changed since recording (13/12/2022), and gene therapy in haemophilia B now has conditional authorisation in Europe: https://www.ema.europa.eu/en/news/first-gene-therapy-treat-haemophilia-b

At c. 24.23, Dr Page discusses reversal of warfarin. Dr Page mentions Beriplex, which is the brand of prothrombin complex concentrate (PCC) used in NHS Lothian, where Dr Page works. However, it should be noted that other brands are available and Beriplex is just being given as an example. Other brands can be found in the BNF: https://bnf.nice.org.uk/drugs/dried-prothrombin-complex/medicinal-forms/

--- Link ---

The ISTH Bleeding Assessment Tool is available from:

https://www.isth.org/page/reference_tools

Recording date: 13 December 2022

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This podcast is from the Trainees & Members' Committee (T&MC) of the Royal College of Physicians of Edinburgh (RCPE).

In this episode, Dr Marilena Giannoudi discusses the role of the 'first fit' clinic and seizure diagnosis and management with Dr Richard Davenport.

Dr Richard Davenport has been a Consultant Neurologist since 1999. While very much a general neurologist, he undertakes NHS first seizure, movement disorder and MND clinics, and has particular interests in education and training. Dr Davenport became President of the Association of British Neurologists (ABN) in May 2023. Outside of neurology, Dr Davenport enjoys cycling.

Dr Marilena Giannoudi is the T&MC Podcast Lead and Vice-Chair for Careers and Communications.

-- Link --

https://www.gov.uk/epilepsy-and-driving

Recording date: 24 January 2023

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This podcast is from the Trainees & Members' Committee (T&MC) of the Royal College of Physicians of Edinburgh (RCPE).

This week Dr Jonny Bardgett discusses Guillain–Barré syndrome (GBS) with Dr Gavin Langlands. Topics include; what GBS is, when to suspect GBS and diagnose, when to start treatment and escalate and the prognosis and rehabilitation of patients.

Dr Gavin Langlands is in their penultimate year of neurology Registrar training at the Institute of Neurological Sciences, Glasgow in the West of Scotland, with a developing interest in neuromuscular disorders.

Recording Date: 07 December 2022

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This podcast is from the Trainees & Members' Committee (T&MC) of the Royal College of Physicians of Edinburgh (RCPE).

Dr Jonathan Bardgett talks with Dr Zoë Fritz about treatment escalation plans and the ReSPECT process, contextualised with patient case vignettes.

Dr Zoë Fritz is a Wellcome fellow in Society and Ethics, and a Consultant Physician in Acute Medicine at Addenbrooke’s Hospital, Cambridge. Her research is focused on identifying areas of clinical practice that raise ethical questions and applying rigorous empirical and ethical analysis to explore the issues and find effective solutions. This applied clinical ethics research allows her to translate ethical analysis into improving healthcare experience and outcomes.

-- Links --

ReSPECT - https://www.resus.org.uk/respect

REDMAP - https://www.spict.org.uk/red-map/

Recording date: 26 October 2022

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This podcast is from the Trainees & Members' Committee (T&MC) of the Royal College of Physicians of Edinburgh (RCPE).