Use of standardised patients in optometry training.

: The ability to articulate clinical findings to patients through effective communication is a key skill in all health-care professions.: Unannounced standardised patients (SPs) are successful in measuring quality of clinical care provided by qualified optometrists but have not been used in optometry training. Final-year undergraduate optometry students examine members of the public during primary care clinics observed by visiting clinical tutors (VCTs) who provide individualised feedback, highlighting areas for improvement.

Expertise in physiological breech birth: A mixed-methods study.

Background: The safety of vaginal breech birth depends on the expertise of birth attendants, yet the meaning of "expertise" remains unclear and subjectively defined. The objective of this study was to define expertise and the roles experts may play in expanding access to this service.

Methods: We performed an integrative analysis of two strands of data concerning expertise in physiological breech birth, including the following: survey data from a Delphi study involving 26 very experienced clinicians (mean experience = 135 breech births) and 2 service user representatives, and interviews from a grounded theory study of 14 clinicians more moderately experienced with physiological methods (5-30 upright breech births).

Deliberate acquisition of competence in physiological breech birth: A grounded theory study.

Problem: Research suggests that the skill and experience of the attendant significantly affect the outcomes of vaginal breech births, yet practitioner experience levels are minimal within many contemporary maternity care systems.

Background: Due to minimal experience and cultural resistance, few practitioners offer vaginal breech birth, and many practice guidelines and training programmes recommend delivery techniques requiring supine maternal position. Fewer practitioners have skills to support physiological breech birth, involving active maternal movement and choice of birthing position, including upright postures such as kneeling, standing, squatting, or on a birth stool.

Effectiveness of vaginal breech birth training strategies: An integrative review of the literature.

Background: The safety of vaginal breech birth depends on the skill of the attendant. The objective of this review was to identify, synthesize, and report the findings of evaluated breech birth training strategies.

Methods: A systematic search of the following on-line databases: Medline, CINAHL Plus, PsychINFO, EBM Reviews/Cochrane Library, EMBASE, Maternity and Infant Care, and Pubmed, using a structured search strategy.

Principles of physiological breech birth practice: A Delphi study.

Objective: to establish a multi-professional consensus on shared principles underlying the practice of physiological breech birth.

Design: three-round Delphi e-survey.

Setting: multi-national.

Standards for maternity care professionals attending planned upright breech births: A Delphi study.

Objective: to establish a consensus of opinion on standards of competence for professionals attending upright breech births.

Design: a three-round Delphi e-survey.

Setting: multinational.

What should we assess in practice?

Aim: This article reports on a PhD study and follow up work undertaken to review and develop a tool for assessment of practice.

Background: The assessment of practice in nursing and midwifery education and, other health professions has been the source of concern, criticism and research for a number of years with the conclusion that it might not be possible to develop an assessment tool that could encompass all aspects of professional practice.

Methods: A qualitative evaluation study was undertaken using the naturalistic method of inquiry.

Technology alleviates bed management woes.

Advances in bed occupancy management abound, thanks to new technology.

Move care to a higher level with emergency systems.

Consider using emergency department information systems to improve patient care in your facility.