One medical school's experience of sustaining general practice teaching in the time of COVID-19.

Challenges have been encountered in maintaining the Western Sydney University general practice program but effective strategies have been adopted to manage the impact of COVID-19.

Glimpses into the transition world: New graduate nurses' written reflections.

BACKGROUND: This study was born out of our reflections as educators responsible for helping new graduate nurses transition into their first year of professional practice through a formal education programme. Finding ourselves wondering about many of the questions the students raised with us, we set about looking more closely at what could be gleaned from the students' experience, captured in their written work over the course of a year. OBJECTIVES: To identify the challenges and learning experiences revealed in reflective assignments written by new graduate nurses undertaking a postgraduate course as part of their transition to registered nurse practice. STUDY DESIGN, SETTING AND PARTICIPANTS: Data consisted of the written work of two cohorts of students who had completed a postgraduate university course as part of their transition to new graduate practice in New Zealand. Fifty four reflective essays completed by twenty seven participating students were collected and their contents analysed thematically. RESULTS: Five key themes were identified. The students' reflections noted individual attributes - personal and professional strengths and weaknesses; professional behaviour - actions such as engaging help and support, advocating for patients' needs and safety and putting their own feelings aside; situational challenges such as communication difficulties, both systemic and interpersonal, and the pressure of competing demands. Students also identified rewards - results they experienced such as achieving the nursing outcomes they desired, and commented on reflection as a useful tool. CONCLUSIONS: The findings shed light on the experiences of new graduates, and how they fare through this critical phase of career development. Challenges relating to the emotional labour of nursing work are particularly evident. In addition the reflective essay is shown to be a powerful tool for assisting both new graduate nurses and their lecturers to reflect on the learning opportunities inherent in current clinical practice environments.

Use of the Ages and Stages Questionnaire to predict outcome after hypoxic-ischaemic encephalopathy in the neonate.

BACKGROUND: Infants who suffer hypoxic-ischaemic encephalopathy (HIE) at birth are at increased risk of developmental disability. In this at-risk population, reliable, inexpensive and early identification of those children who are likely to require formal developmental assessment and intervention is needed. AIM: To evaluate the ability of the Ages and Stages Questionnaire (ASQ) to detect developmentally delayed children in an Australian population of infants who suffered HIE at birth. METHODS: Fifty-five children who survived HIE were followed until 12-14 months of age. Test characteristics were calculated to examine the ability of the ASQ to appropriately identify developmentally delayed infants against this study's 'gold standard': the Bayley Scales of Infant Development II. RESULTS: Comparing the ASQ with the Bayley Scales of Infant Development II, the questionnaire had the following test characteristics: sensitivity 92%, specificity 95%, positive predictive value 92%, negative predictive value 95% when used to detect severe developmental delay; and sensitivity 67%, specificity 93%, positive predictive value 92%, negative predictive value 68% when used to detect both severe and mild developmental delay. However, the ASQ used at standard cut-offs failed to detect any of the children with mild delay. CONCLUSIONS: The ASQ is extremely effective for the detection of severe developmental delay in children who have suffered HIE at birth. Its capacity to identify those with milder delay is limited. The ability of the test to detect only those with severe developmental delay means that the ASQ is of little value as a screening tool in this population.