Category: Community

Posts by Jano Klimas about community, collaboration, charity and social welfare.

Irish Network of Medical Educators (#INMED2014): The 7th Annual Scientific Meeting

A network of volunteers for all interested in medical education on the island of Ireland met in Belfast yesterday. The network’s aim is to improve education. Network’s vision:

“The Network seeks to enhance medical education on the island of Ireland by bringing together individuals and organisations with an interest in and responsibilities in medical and healthcare education in a National Medical Education Network.”

The 2014 conference theme was creating supportive learning environments. See figure 1 below.

This year, the programme extended over two half-days and a full day between them.
The Wednesday half day offered five pre-conference workshops: Maximising clinical education opportunities, Researching clinical workplaces, Identifying trainees in difficulty, Overcoming obstacles to reflective practice, and Mixed methods research. As of Tuesday, February 18 (8am), there were 152 names on the delegate list. Of those, 7 were marked as judges, 4 as chairs, and 4 as chair/judge – a transparent practice rather unusual at conferences.

Thursday was the main day of the conference. It started with the usual welcomes and opening addresses in a packed room. In fact, delegates who came late stood in the back of the room, because there were no free seats left.

Two keynotes attracted most delegates, Prof Billet from Australia and Prof McAvoy from Britain. Prof Billet’s lecture was pre-recorded and projected on a large screen, because he was in Geneva at the time of conference. He explained meaning of important education terms, such as curriculum or apprenticeship. In simple words, he talked about learning by doing, but his theory-heavy talk with big words was difficult to follow in some places, as reported by delegates. The organizers helped the audience by pausing the video, interacting with the audience, and letting 20 seconds of silence for free-flow thinking

Doctors in difficulty and the re-mediators were discussed by Prof McAvoy (shown in Figure 2). Her talk reminded us that doctors are people too. Most are motivated, they’re not burned out. The reasons for their underperformance are subject of McAvoy’s research: professional, personal, physical health (e.g., high blood pressure), or mental health problems; the group identified 18% of cognitive problems among doctors, and in one case recommended psychiatric assessment which ended doctor’s career. Comprehensive assessment of underperforming doctors is critical – if you’re not getting the diagnosis right, the treatment won’t be effective. Following the assessment, absolute clarity of feedback is paramount for performance improvement.

Figure 2. Professor McAvoy

An hour and a half before the lunch, the delegates viewed 77 research and education posters. Judges assessed the posters allowing 3 minutes for presenters’ speech plus a couple of question.

Lunchtime provided opportunities for meeting the experts. After lunch, the delegates scattered into 5 workshops: i. student narratives (n= 6), ii. clinical ethics (n= 15), iii. emotional intelligence (n= 12), iv. organizational culture (n= 13), and v. emotions (n= 16). The numbers of delegates who attended workshops but did not put their names on the list are not included. Students led the mental health session from 4-5PM. The day finished with traditional AGM, drinks and dinner.

Friday half day concluded the conference with four sessions including research presentations, keynote speech by Prof Dornan from Netherlands, and hot topics in medical education. Read more about the conference here: www.inmed.ie

Is it easier to recruit participants in space? Ten years of Cochrane and Mike Clarke in Ireland

Tenth annual Cochrane in Ireland conference“From evidence to clinical guidelines” took place on 24 January 2014 at School of Nursing& Human Sciences, Dublin City University.

The 7-hours programme kicked off with a welcome by Professor John Costello, Executive Dean of the Faculty of Science and Health, Dublin City University, followed by the National Clinical Effectiveness Agenda of Dr Kathleen MacLellan, Director National Clinical Effectiveness Committee, Department of Health, Dublin.

Figure 1 Yellow arrow card
Mike Clarke’s (Professor & Director of MRC Methodology Hub, Queen’s University Belfast) random thoughts about randomised trials covered some of the more unusual things people have studied. There are approximately 25000 new randomised trials every year, leading to around 700 000 trials registered in CENTRAL Cochrane database. From this overwhelming amount of evidence, Dr Clarke cherry-picked the most unusual, controversial and interesting trials. His presentation started by distributing yellow-arrow cards to delegates in anticipation of active engagement (See figure 1).

Figure 2 Votes and Mike Clarke
Dr Clarke’s random thoughts started with sweets as tip boosters and continued through gamgee hats to lipsticks, restaurants and vegetables, organ music, citruses, chocolate and space trials – a truly spectacular collection. We all voted on Clarke’s provoking questions about these trials (shown in figure 2): did sweets increase, decrease or unchanged the size of the tip? Does smiley face make more difference in tips size than a hand-written thank you? How beneficial is doodling while working or phone-calling? Mike encouraged us to relate each of these entertaining questions to bigger dilemmas about trials, for example, who is in charge of interpreting whether an intervention works? Or, do we believe something because it was published? Ending on a positive note, Clarke presented trials that were conducted on astronauts in the international space station. The drop-out rate was 0 because they had nowhere to go?

Help, I’m stuck.

After a brief tea and coffee break, the participants dispersed into three parallel sessions (N=25:12:7). Dr Clarke’s session was most popular. Traditionally, Mike uses the power and knowledge of a group of people at his workshops that might have some problems with their Cochrane reviews, but collectively have the knowledge to solve them. The list of participants’ questions that he wrote on the white board at the session start was left with only 2-3 questions unanswered. The group disciplines were mutually helpful – psychology, general practice, nursing or information science, experienced reviewers and Cochrane’s novices.
Two other sessions happened in parallel with Clarke’s workshop. Drs O’Rourke & O’Toole covered practicalities of generating clinical guidelines for cancer treatment in Ireland. Dr Matthews, HRB Cochrane Fellow and Senior Lecturer, School of Nursing & Human Sciences, Dublin City University, helped delegates with issues around starting Cochrane reviews.

Lunch was in the campus canteen – each delegate got a €10 voucher. The atmosphere in the canteen was conducive to contact making; we sat by long tables surrounded by students.

The afternoon programme included 2 lectures by Susan Smith and Anne Matthews, and a conclusion by Dr Teresa Maguire – Head of the population science and health services research at the Health Research Board in Ireland. Dr Matthews corroborated on her experience of doing a review on morning sicknessand being a Cochrane fellow – it’s for life, not just for the 2-year fellowship. Dr Smith is a Professor of general practice at Royal College of Surgeons in Ireland who has done 9 Cochrane reviews. Her rich experiences from these reviews were especially useful for those interested in multimorbidity.

Alcohol: poets’ love affair

Spoken word events often take place in bars. Poets who perform at and attend these events are over the legal limit for drinking. But what if an underage poet wants to join them? Their chances to avoid the alcohol culture are grim.

Poetry slam at Accent’s drink-free venue


Young talented poets are forced to perform in alcohol temples. There, they listen to the established artists talking about their drinking. They watch older poets drink one beer after another, which is nothing new in the poetry art. Poetry has a long-established love affair with alcohol, not only in Ireland. For example, W. B. Yeats, an Irish poet and playwright, would have had experiences with the drinking culture. Perhaps they contributed to his Drinking Song:

“Wine comes in at the mouth
And love comes in at the eye;
That’s all we shall know for truth
Before we grow old and die.
I lift the glass to my mouth,
I look at you, and I sigh.”
Being open about alcohol is good – we live in an alcohol-soaked society after all. Denial and silence doesn’t work. Harm reduction approaches to drug use works. Adolescence is a period of experimentation which includes drugs and other risky behaviors. Parents of teen poets could use, for example, Marsha Rosenbaum’s Safety First reality based approach. This approach helps teenagers to make responsible decisions by honest, science-based information, encouraging moderation, understanding consequences and putting safety first.
In addition to education, drink-free venues for arts and poetry events should be promoted. For example, Accents Coffee & Tea Lounge is an alcohol-free place in Dublin City centre. It was created by Anna Young as a cozy environment for people to meet and as an alternative to a pub. Before they opened, there weren’t many places where you could buy coffee late at night in Dublin. It is the only café in Dublin opened till 11 pm. Accents is the home to two poetry events, a poetry slam competition on the first Sunday of the month (See picture), and A-Musing gig, Stand-up comedy and poetry night on the last Sunday of every month.
I hope that there will be more venues like this for aspiring poets. In the meantime, support a poet by “buying him or her beer”.

Christmas 2013 on the Dog Islands, a.k.a. Canaries

The Canary Islands were not named after canaries, the exotic birds, but dogs.  The original Latin name means Island of the Dogs. The dog islands were my home for Christmas this year.
 

Getting there  

The flight was delayed by 30 minutes. We spent another half an hour stuck on the runway, waiting for our slot. The weather was grim as it could be and it didn’t seem to change for the day. But nobody cared about it. Nobody ran back and forth through the airport hall; no curses no complaints. It was going to be only better after this – nothing could spoil the expectation.

We’re going to canaries. It’s clear to all of us that this is not a business trip. It’s not a family trip either. It’s sun holiday. We are going to sunbathe on Christmas.

The cheerful atmosphere dominated streets of Las Palmas. Little squares filled with spectators of evening concerts. Choirs took turns in catholic churches. Fireworks entertained families in the streets. And yet, the city gave little sign of getting ready for Christmas. Decorations were sparse and advertisements kept to minimum. The horrors of western-type consumerist brainwashing spared the small town. Christmas were coming, but slowly and quietly… mostly showing in the faces of happy people.

 
Our second lodging, on the Tenerife island, was cheap – a pension located on the ground floor of an outskirts apartment complex. As we were checking in, a young girl stood by the glass front door. She waited there for a while with a sponge cake in her hands and a soft orange sweater over her shoulders. Her clothes didn’t give away much, but her face and hands looked strangely familiar. I’ve seen many of those in my previous job, as a needle exchange worker.
Our host didn’t hurry to open the door. She waited. When he finally got to answer the door, she asked something in Spanish. He said no quietly. He was a very polite man. When he finished his talk about local attractions, we went out for a cup of tea. There they were. The orange woman and her companion – boyfriend perhaps – noticed us.
“Finish habitacion?”
I didn’t know what he asked. My wife answered in English, “No we just came”.
He sat back to his girl and they both looked sad. What bothered them? Perhaps this pension was their last chance to get a bed for tonight. The invisible barrier that separated our worlds felt close. I was on the good side today, but I could’ve been on their side tomorrow.
 

Speak Spanish, we’re in Canaries

German was the norm in Tenerife. Hikers on the Teide volcano greeted us with “Hallo” instead of the local “Ola”. Volcanic dust was everywhere. The monotonous, dry country brought back old folk song titles, ashes to ashes – dust to dust. All we are is dust in the wind. Pondering these sad truths couldn’t be easier than here. Admiring the mountainous landscape lifted all my heavy feelings away. “Traum” – a fellow hiker said. She’s right; the mountains looked like dreams to me too.
Back on the Gran Canaria Island, we bicycled on the last day of our holidays. Starved by the physical exercise, we looked at the Spanish menu card in a Santa Catalinian restaurant. Unlike most places, they didn’t have English translation and when we tried to order, we found out why. We asked about the first option on the list – Pechuga. The waiter answered in Spanish which we didn’t understand. A nearby customer tried to help in French with no success. Noticing his efforts, the waiter demanded Spanish:
“Speak Spanish, we’re in Canaries” to which we responded with confused looks and growing impatience.
Unable to find an easier equivalent for Pechuga, the waiter gripped her breasts and said again:
“Pechuga”
We didn’t get it, until she brought the chicken breast dish to our table, but Pechuga has now a prominent place in my small Spanish vocabulary.

Enslaved by the Annual Symposium of the Society for the Study of Addiction 2013

The term Addiction comes from the Latin “enslaved by”. For two days, we became slaves of addiction conferring, once again, at the SSA conference in York, UK. Here’re my perceptions from this scientific slavery.
 

De-normalisation

Alcohol is so widespread in our community that abstinence is almost abnormal, argued one of the conference delegates. It’s hard to disagree with that. Recovery is helped by achieving a sense of normality about abstinence or lowered use. Professor Robert West took this issue even further and talked about denormalising use (check out his blog). Looking at the issue from multiple angles, he warned about the potential negative consequences of stigmatising use. Stigmatisation can backfire by increasing healthcare costs for people who not only use, but also have to deal with the stigmatisation and its negative effects. It seems that normalising safer use or normalising quitting is the way to go. My point about negative effects of stigmatisation reinforces the belief (supported by evidence) held by many harm reductionists that balanced information about drugs is the best form of primary prevention.
 

Skeltergate coffee

The most useful part of the conference for me was the opportunity to talk to colleagues at my, post-doctoral, level. I met the first friend before the conference, in a coffee place – Skeltergate. Skeltergate is a small cafeteria really close to the conference hotel. My friend waited there for me with a research paper in one hand and a pencil in the other. He definitely made the best use of his time. He and my second friend, who lives in London, are emerging researchers who recently relocated because of work. Both have a very busy working schedule, which includes working at 4 AM before breakfast, or after 11 PM when kids go to bed. I asked one of them how many hours per week he worked and he replied that working time is not a meaningful variable in academia. In another words, productive researchers work all the time.
 

Don’t stop working

Checking email is not work, it’s a compulsion. True to this statement, most people checked their inboxes during the conference lectures. Others did so in the cafeteria. Some people did not read their emails when they were out of office and enjoyed the opportunities of talking to other delegates. The academia did not manage to enslave all.
 

Always keep searching for the water pump

Before the conference, my PI suggested reading a bit about John Snow (1813 –1858) – an English doctor and a pioneer of anaesthesia and medical hygiene. Being the father of modern epidemiology, he traced the source of a cholera outbreak in Soho, London, in 1854. The outbreak was long, had too many victims, and no one know what kept it going. Dr Snow found the poisoned water pump, which everybody drank from, and shut it down. The figure below shows his memorial plaque at the Park Inn.

Tweeting

In contrast to the high prevalence of personal computers, the SSA Twitter banter was quiet again. Maybe it’s because there’s no official #hashtag for the SSA conference. Some people use the whole title (see figure below), while others tried to establish the #SSA2013 hashtag. This tag was used in 5 tweets only. What’s more, it’s being used as a hashtag for Space Situational Awareness 2013 conference, which was in London the weekend after SSA.

 

Check out also the blog about the conference by Sally Marlow