Dr Adrian Boyle, Consultant Emergency Physician and Caldicott Guardian at Addenbrookes Hospital in Cambridge, and Chair of the Quality Emergency Care Committee at the Royal College of Emergency Medicine, reflects on the practical application of our revised guidance – Confidentiality: reporting gunshot and knife wounds (2017).
The GMC guidelines on confidentiality have recently changed. This is a potentially fraught area for doctors who treat victims of intentional injury. Research has consistently shown that doctors care for many assault victims who the police are simply unaware of, despite the severity of injury. Over 70% of assaults treated at emergency departments are never recorded by the police [i].
Patients may have many reasons for not disclosing their assault to the police. They may be too frightened of reprisals, they may not want their own behaviour scrutinised and they may make a judgement call that the police won’t take action. Wherever possible…
There are weeks in science when even your successes feel like a failure.
That is, if you’re lucky. If you’re unlucky there will be months of it. The criticisms will stretch out before you and though they may be paired with encouragements, you’ll only see the words:
“We’re sorry to say your application was unsuccessful”
“We cannot recommend this paper for publication”
“This was interesting but I didn’t quite understand this bit . . .”
We think the praise is there to soften the blow, because it’s how we pull our own punches when we’re trying to help.
You’ll be scored on your teaching, or on a job application, or a grant proposal . . . 3/5 they’ll say and instead of concentrating on the 3 points you got, you’ll stare at the 2 you didn’t. You’ll be given feedback on a paper and you’ll gloss over “this is interesting” and jump straight to “I disagree with this conclusion”. They’ll tell you they wanted a range of subjects on offer, you’ll hear “you weren’t good enough”.
Sometimes you might think about leaving, working for an NGO, or industry, and you’ll wonder if you’re weak, if you just can’t hack it. Maybe, sometimes, in the dark of night, you might even think that about your friends who got out, but I guarantee you won’t think it for long because you know it’s not true.
You were awesome when you stopped what you were doing to explain that thing to your colleague. You were awesome when you pulled a bunch of slides together and stood up to talk about thing no one in that room had done. You were awesome when you listened to their opinions. You were awesome when you cried because it hurt and you were awesome when you were able to shrug it off and you were awesome when you reined in your training and left good feedback for the next person.
You are awesome, and you will continue to inspire awe in me no matter what you do.
I’ve been on Twitter since April 2011 — nearly six years. A few weeks ago, for the first time, something I tweeted broke the thousand-retweets barrier. And I am really unhappy about it. For two reasons.
First, it’s not my own content — it’s a screen-shot of Table 1 from Edwards and Roy (2017):
And second, it’s so darned depressing.
The problem is a well-known one, and indeed one we have discussed here before: as soon as you try to measure how well people are doing, they will switch to optimising for whatever you’re measuring, rather than putting their best efforts into actually doing good work.
In fact, this phenomenon is so very well known and understood that it’s been given at least three different names by different people:
Goodhart’s Law is most succinct: “When a measure becomes a target, it ceases to be a good measure.”
If you’re a lecturer and you think your student has plagiarised something the way to deal with it is:
1) Put the work through a plagiarism checking service, e.g. TurnItIn, which is capable of recognising sequences other than words
2) If TurnItIn flags the work up as plagiarised check – because TurnItIn is way too sensitive and usually it’s a grammatical error
3) Inform the student what plagiarism is, showing them in the work the examples and show how they can quote without falling afoul of plagiarism – students must be able to change their work for the better after receiving feedback.
4) ??? profit from the improved education of your students?
My name is Tiffany Martínez. As a McNair Fellow and student scholar, I’ve presented at national conferences in San Francisco, San Diego, and Miami. I have crafted a critical reflection piece that was published in a peer-reviewed journal managed by the Pell Institute for the Study of Higher Education and Council for Opportunity in Education. I have consistently juggled at least two jobs and maintained the status of a full-time student and Dean’s list recipient since my first year at Suffolk University. I have used this past summer to supervise a teen girls empower program and craft a thirty page intensive research project funded by the federal government. As a first generation college student, first generation U.S. citizen, and aspiring professor I have confronted a number of obstacles in order to earn every accomplishment and award I have accumulated. In the face of struggle, I have persevered and continuously produced…
Quick – what’s the difference between parliament and government?
If, like me, this question makes you mimic a quizzical puppy – imagine sitting in one of the beautiful meeting rooms in the Scottish Parliament while this is Q.1 in our pop quiz introduction to the Academic Engagement with Parliament workshop.
Thankfully none of the other scientists were leaping up in their chairs to answer either!
Yesterday I had the very good fortune to attend a brilliant workshop run by SPICe (a part of Scottish Parliament responsible for research briefings and information). The aim of the workshop was to get academics engaging more with the parliament and the policy making process.
The answer, by the way, is that the government runs the country and the parliament serves the country by holding the government to account. It’s a remarkably simple answer that I hope was buried somewhere in the back of my brain but just an example of one of the ways I realised how poor I am at policy-engagement!
One of my big take home messages from yesterday was that Parliament does desperately want to engage with us, but we academics tend to wait in our ivory tower for somebody to come calling at its base. I often accuse the public of not seeking out scientific information when they have a question so imagine my shame (In Glaswegian parlance: it gie me a right riddie) when I realised I’m just as guilty of this when it comes to engaging with policy.
Transparency is important for the Scottish Parliament and their Bills are all available at each stage, with many calls for feedback throughout the process. The government also declares its plan for the year and any bills it will propose at regular intervals (usually September). Why do I never check this to see if there’s anything our team should be feeding into?
And it’s impossible to visit the Scottish Parliament without talking about how beautiful it is. It’s a truly amazing building, designed to reinforce the ideals of transparency and accountability for the people.
Whether quirk of architectural psychology or just the joy of having actually learned something, I came away from yesterday feeling inspired and enthusiastic about policy in a way I haven’t felt since my PhD days.
Imagine that you are about to board a long haul flight on a Sunday morning and you read in your copy of The Telegraph that the airline runs on a skeleton staff at the weekend and as a result your aeroplane is much more likely to crash.
Most people would cancel the trip, or rebook with a different carrier. The consequence for people with no option but to fly would be a very uncomfortable journey. The increase in stress and anxiety for nervous passengers could be very significant.
And the newspapers publishing this sort of allegation had better be confident that it is true. You can be sure the airline will use the full weight of the law to sue for reputational damage and loss of income if there is doubt about the veracity of the story.
Patients admitted on a Sunday were more likely to die over the next thirty days than a similar cohort of admissions on Wednesday- the ratio was 1.16 and the result significant, suggesting a true result of increased deaths by 16%
94% of these ‘admissions’ were emergencies
34% of deaths occurred within three days of admission
You are actually less likely to die if you are IN hospital on the weekend – the Sunday to Wednesday ratio here is 0.92, or 8% LESS likely. As the authors also conclude, this…
A while ago, I posted the comic Up Goer Five, an annotated blueprint of the Saturn V rocket with all the parts described using only the thousand most common English words.
Today, I’m excited to announce that I’m publishing a collection of large-format (9″x13″) Up Goer Five-style blueprints. The book is full of detailed diagrams of interesting objects, along with explanations of what all the parts are and how they work.
The titles, labels, and descriptions are all written using only the thousand most common English words. Since this book explains things, I’ve called it Thing Explainer.
The diagrams in Thing Explainer cover all kinds of neat stuff—including computer buildings (datacenters), the flat rocks we live on (tectonic plates), the stuff you use to steer a plane (airliner cockpit controls), and the little bags of water you’re made of (cells).
Thing Explainer will be published by Houghton Mifflin Harcourt on November 24th. You can preorder it now (Amazon, Barnes & Noble