Professor Camilla Carroll

Summary

ENT Educational programme for primary care and audiology: This programme is a fit for purpose 'ENT Educational Programme', for GPs, practice nurses and audiologists, to be delivered on an annual basis, during the academic year, September to June, with CPD accreditation and an audit component. The programme is a competency-based educational model utilising adult learning theories, with a focus on skills transfer in a situated learning environment. Employing such an approach towards ENT education for primary care practitioners and audiologists is time efficient, but still provides the opportunity for hands-on learning and formal assessment, factors that are considered important for upskilling practitioners for clinical practice. The programme consists of a series of interactive lectures, practical skills workshops, ENT practice guidelines and an annual competency assessment. Benefits for ENT Out -Patient Services: The ultimate aim of this integrated care programme is to develop a national network of credentialed primary care practicitoners, empowered to deliver an adult ear suctioning service for common ear conditions in a local setting. The patient maintains their connection with their primary care provider and this re-directed delivery of care would have a significant impact on reducing the demand for ENT OPD services, freeing-up the hospital based ENT surgeon to see, treat and manage patients with more complex conditions.

Funding Agency

HSE

Project Type

Educational project

Person Months

24

Summary

Summary What it means to be a Surgeon in 21st century Ireland, is an increasingly difficult question to answer (McCulloch, 2006). Societal expectation is rapidly changing and favours the surgeon patient relationship to be one of collaboration, rather than dictation. Current trends in healthcare systems are changing the traditional way by which the surgeon interacts with the patient (Gruen et al., 2003). Today's surgeon is a trusted member of a healthcare professional team, that works together to deliver safe and effective care to the patient (Evetts, 2014). The continued pace of technological change requires the surgeon to commit to lifelong learning with ongoing mastery of new operative skills. Assessment by the regulatory bodies, which govern surgical practice being an increasing part of modern surgical practice (Taylor, 2011). However, despite all the changes in 21st century practice, the concept of professionalism remains constant (Shapiro et al., 2015). Professionalism is at the heart of being a good doctor and is central to the surgeon's contract with society (Brennan and Monson, 2014). The Irish Medical Council, the regulatory body in Ireland, has recently deployed three pillars of professionalism, namely partnership, practice and performance as a schematic to illustrate ways in which specific principles and values can form the basis of good professionalism (IMC). I have had the opportunity to interview five senior Irish surgeons and explore their reflections on what "Surgical Professionalism" means to them, both in an Irish context and within the IMC Professionalism Framework. This study presents the thematic analysis of their reflections. The study design is based on the qualitative analysis of the 5 semi - structured interviews, carried out with the senior Irish surgeons. Data extracts from the interviews were coded and emergent themes were formulated, using thematic analysis methodology. Five distinct themes emerged from the data. The themes were doctor-patient relationship, the regulatory body, education and training , surgical teams and emotional well-being. Data extracts illustrating these themes are presented in the text. The epistemological insight gained from these emergent themes may help to shape the future education, training and practice of Irish Surgeons.

Programme

MEdSurgEd

Project Type

Qualitative Research

Person Months

24

Summary

An anatomical and physiological analysis of the reconstructed pharynx was carried out in patients who had undergone a total laryngectomy for squamous cell carcinoma.(SCC) The purpose of the review was to evaluate the function of the pharyngoesophageal segment following surgical ablation and the development of oesophageal speech. The study participants were males (N=10) who had a laryngectomy performed for SCC. The pharyngoesophageal segment (POS) was evaluated in each participant using 2 direct and 2 indirect methodologies. The methodologies utilised were EMG sampling of the POS, manometry of the POS, 24hr ambulatory ph., recording and video-fluoroscopic assessment of the reconstructed pharynx. This study demonstrated that the anatomical reconstruction of the POS determined it's physiological function post-operatively. This in turn had a significant impact on the development and quality of oesophageal speech following laryngectomy.

Funding Agency

none

Programme

BSc Anatomy UCD

Project Type

Clinical evaluation of patients who had undergone laryngectomy for SCC

Person Months

12

Summary

This research evaluated skeletal muscle flap pathophysiology. I focused on methods of improving the viability and function of dynamic muscle flaps for use in the clinical setting. This involved the use of the angiogenic growth factors PDGF and bFGF and ischaemic preconditioning in large and small animal models. The results of this research demonstrated that (I). Muscle flap survival was augmented through the application of PDGF in the hairless mouse Latissimus Dorsi Muscle (LDM) model. (II). Muscle flap perfusion and function was augmented through the application of bFGF in the canine LDM model. (Ill). lschaemic preconditioning of skeletal muscle augmented survival in rat LDM model.

Funding Agency

Research grant of $56,461 awarded by the Jewish Hospital Research Foundation Louisville KY USA

Programme

MD awarded by research submission UCD

Project Type

Basic science and animal models

Person Months

24

Summary

Working Group on Bullying and Harassment in Medical Education and Practice The organisational culture of the HSE is one, which must not tolerate bullying or harassment in the workplace. However, NCHDs continue to report bullying, when they are surveyed on this topic. The IMC 2014 - 2016 national trainee experience surveys have identified a consistent level of trainees experiencing bullying and harassment in the workplace. In 2016, 36% of trainees reported being the victim of bullying and harassment in their post. 50% of trainees reported witnessing someone else being the victim of bullying and harassment and 44% had experienced undermining behaviours. The IMC concluded in 2016, that "bullying is endemic in our culture". Similar studies carried out by the British Medical Association in 2016 found, that 20% of trainee doctors in the UK reported experiencing bullying and harassment in the workplace in the past year. To address this issue, the HSE and the IMO have established a collaborative short-life working group to evaluate interventions aimed at changing workplace attitudes towards bullying. Lessons learned from NHS interventions, which have resulted in a "zero tolerance culture" towards workplace bullying will be reviewed, as part of this groups evaluation of bullying changing attitudes. The committee members broadly reflect the stakeholders responsible for the delivery of NCHD training and workplace environment. The group is jointly chaired by Rosarii Mannion (HSE National Director of HR) and Anthony Owens (IMO Director of Industrial Relations). The other committee members include Camilla Carroll RCSI (Postgraduate Forum for Medical Education Prepresentative), Anthony O'Connor RCPI, Martin McCormack, COA, Eva O'Reilly National Lead NCHD and representatives from National HR and National Doctors Training & Planning.

Funding Agency

HSE

Programme

National Programme to address workplace bullying and harassment in the HSE.

Project Type

Qualitative Research

Person Months

12