A 'Learning conversation' as a style of feedback.

This article was migrated. The article was marked as recommended. This paper explores the history behind the introduction and use of a 'learning conversation' as a mechanism of providing effective feedback to students on resuscitation courses. The authors hope the use of this style of feedback may useful in many other contexts to provide authentic feedback. The central aim of a learning conversation is to promote and support greater self-awareness of the individual student in order to develop competence and team leadership through critical inquiry ( Harri-Augstein & Thomas 1991). Learning, particularly in the context of resuscitation is demonstrated by the utilisation of "planned experience which brings about a change of behaviour" and the process is facilitated by feedback whether during skills teaching, in workshops or in simulation. The learning conversation uses empathic, active respectful listening and discussion shared between a small group of participants, facilitated by an instructor to ensure that key learning emerges from this process duly informing future practice and behaviours. A mnemonic has been developed to facilitate acquisition of the skills involved in this feedback. Faculty also require feedback to fully develop their feedback skills but once established the process makes both faculty and students share their feelings, frustrations and learning in a very positive learning climate. The learning conversation has been in use in resuscitation courses for almost six years and the authors feel there is a wealth of literature available to support this approach which can be usefully applied to facilitate learning in many small group teaching settings and the process of delivering a Learning conversation is detailed within the paper.

The constructive use of images in medical teaching: a literature review.

This literature review illustrates the various ways images are used in teaching and the evidence appertaining to it and advice regarding permissions and use. Four databases were searched, 23 papers were retained out of 135 abstracts found for the study. Images are frequently used to motivate an audience to listen to a lecture or to note key medical findings. Images can promote observation skills when linked with learning outcomes, but the timing and relevance of the images is important - it appears they must be congruent with the dialogue. Student reflection can be encouraged by asking students to actually draw their own impressions of a course as an integral part of course feedback. Careful structured use of images improve attention, cognition, reflection and possibly memory retention.

Rhabdomyolysis in MDMA intoxication: a rapid and underestimated killer. "Clean" Ecstasy, a safe party drug?

BACKGROUND: Ecstasy is a popular drug among young adults. It is often thought to be safe. The dose of methylenedioxymethamphetamine (MDMA) in a tablet of Ecstasy varies greatly, and there is also a difference in individual response to a dose of MDMA. OBJECTIVES: To increase the awareness of potential mortality in MDMA use. CASE REPORT: We report the case of a patient with a lethal intoxication after pure MDMA intoxication. The serum toxicology screening showed an elevated level of MDMA (1.5 mg/L) but no other amphetamines or other drugs. CONCLUSIONS: The cause of death was a rapidly evolving hyperkalemia due to rhabdomyolysis. There is still a need to educate the public about the dangers of this so-called "safe" party drug.

Human factors in resuscitation teaching.

INTRODUCTION: There is an increasing interest in human factors within the healthcare environment reflecting the understanding of their impact on safety. The aim of this paper is to explore how human factors might be taught on resuscitation courses, and improve course outcomes in terms of improved mortality and morbidity for patients. The delivery of human factors training is important and this review explores the work that has been delivered already and areas for future research and teaching. METHOD: Medline was searched using MESH terms Resuscitation as a Major concept and Patient or Leadership as core terms. The abstracts were read and 25 full length articles reviewed. RESULTS: Critical incident reporting has shown four recurring problems: lack of organisation at an arrest, lack of equipment, non functioning equipment, and obstructions preventing good care. Of these, the first relates directly to the concept of human factors. Team dynamics for both team membership and leadership, management of stress, conflict and the role of debriefing are highlighted. Possible strategies for teaching them are discussed. CONCLUSIONS: Four strategies for improving human factors training are discussed: team dynamics (including team membership and leadership behaviour), the influence of stress, debriefing, and conflict within teams. This review illustrates how human factor training might be integrated further into life support training without jeopardising the core content and lengthening the courses.