ACPs in ED

In this special episode Senior ACP James Pratt joined the podcast to talk about Advanced Clinical Practitioners in ED.  This is a topic he's talked about before at various conferences and meetings.  At EM2C 2018 he started his talk rather impressively:

James and Jamie talk about:

• What is an ACP and what their job role entails
• James' own career and the development of the ACP team at the QMC Nottingham
• What the Nottingham ACP course consists of and the course entry criteria
• Issues in the development of the ACP team and how these were approached
• Potential areas of future development

There's an emphasis on the education and time required to create the ACP service and how this is not a short term solution to staffing issues but rather a long term investment in our staff

For more information on the ACP course at the University of Nottingham you can visit the course page here

For more information on Advanced Clinical Practitioner Educators you can visit the Association of Advanced Clinical Practitioner Educators website here

We're looking make more podcasts on advanced practice in the future so please get in touch with any suggestions!

P Cubed (How to do a Presentation) - #wewillgiveDREEAMpresentations

In a previous blog post I've already sung the praises of Ross Fisher and the p cubed approach to presentations.

In this live recording at the latest DREEAM educators' meeting I talk a bit more about p cubed, how to present information in a way that's not just nice to look but has science behind it.

Here are the slides.  As ever just click to scroll through them.

Topics covered:

• Why bullet points are bad (irony)
• How to storyboard - spark points and lightning slides
• The science of presentations - cognitive overload, the three second rule, the rule of thirds and dual coding
• How to present data

Here is the Take Visually for this episode: 

I hope you enjoy this talk and feel inspired.  That's the purpose of this talk and as a team at DREEAM we have made a Twitter pledge #wewillgiveDREEAMpresentations.

For more information on learning theories (and why it's wrong to think about 'types' of learners) check out Learning Scientists.

Good luck telling people of the amazing things you've seen.

                 - Jamie

FOAMed Lessons from Jurassic Park for Emergency Medicine

The other week I watched Jurassic Park being played in Wollaton Park (otherwise known as Bruce Wayne's house).  Maybe it's a reflection of how sad I am but I couldn't help but think of Emergency Medicine and FOAMed as I watched this amazing masterpiece of a film.  If you haven't watched it now is the chance to stop reading and watch it.  You won't be disappointed.  

In the scene featuring the Brachiosaurus (see above) the characters are open mouthed and in awe.  It's easy to be in awe of Emergency Medicine, especially as you first start, perhaps even intimidated.  But there are lessons from this film which can help us as we tackle this majestic speciality. 

Embrace education and listen

In the film Lex is nearly eaten by a Tyrannosaurus Rex until Dr Alan Grant tells her to stay still as it won't be able to see her (rubbish but I never said this film was a documentary).  She stays still and isn't eaten.  Donald Gennaro and Ian Malcolm do move and one is eaten and the other is severely injured.  The lesson: listen to your seniors and follow advice especially when faced by a T-Rex or the Triple-A-asaurus.

Educate, don't terrify

In the book by Michael Crichton (who also wrote E.R.) - again read the book if you haven't - Alan Grant loves kids (makes sense as kids love dinosaurs).  In the film he hates kids at the beginning before going on a story arc where he loves them.  In this early scene he decides to teach a child to respect dinosaurs by terrifying him.  The result?  One scared child who I'm sure didn't go on to love dinosaurs.  We have to inspire as educators not terrify.  Those who teach through fear are dinosaurs.  Figuratively.  

Don't let the little things take you down

The books 'Jurassic Park' and 'Lost World' and the film 'Lost World Jurassic Park' feature small dinosaurs (Procompsognathus in the books, Compsognathus in the film).  Whilst little and innocent looking these dinosaurs work together to kill much larger humans.  There's a lesson there that if we ignore the small things (not checking bloods, not doing our at work assessments) they can get together and take us down.  Don't let them.

Just because you could doesn't mean you should

An important ethics lesson here for all doctors and researchers regardless of speciality.  ''First do no harm'.'

Keep it simple... 

In the film 'Jurassic World' Ingen decide that as the public are now bored of dinosaurs (as if) to make a new dinosaur the Indominus Rex by mixing the DNA of a T-Rex, Velociraptor, tree frog and, oddly, cuttlefish.  The result is a terrifying problem of their own making with multiple traits including, strangely in a creature designed for public display, the ability to camouflage.  It's easy in Emergency Medicine to create problems either in our decision making, attitude, human factors...the list goes on.  Keep it simple.

...and get help

The Indominus Rex is ultimately only taken down by a tag team effort between Rexy and Blue the Velociraptor with the Mosasaur providing the coup de grâce.  Make sure you work as a team.  Work on your team work skills.  We can then tackle even the biggest problem.  

Importance of CPR

A vital skill we all should learn and encourage.  No, his technique is not great but at least Dr Grant gives it a try and Tim lives.  And it's still better than James Bond's effort in Casino Royale...

Life er finds a way

This classic line from Dr Ian Malcolm sums up everything really.  But in the Emergency Department we have to accept there are some things out of our control.  There will always be more patients to see.  We can't save everyone.  We see people at their worst everyday in an environment that shocks people who are new to it.  Whilst we should always seek to improve we should also appreciate the sheer amazing job we already do.  And accept that sometimes there are somethings we can't change.  

There we have it.  Lessons from Jurassic Park for the Emergency Department.  I'm off to watch Jurassic Park again.  Hopefully if we follow these lessons we too can make it on the helicopter home...