Publications

Silicosis due to artificial stone (AS) has emerged over the last decade as an increasing global issue. We report the first eight UK cases. All were men; median age was 34 years (range 27–56) and median stone dust exposure was 12.5 years (range 4–40) but in 4 cases was 4–8 years. One is deceased; two were referred for lung transplant assessment. All cases were dry cutting and polishing AS worktops with inadequate safety measures. Clinical features of silicosis can closely mimic sarcoidosis.

Rationale

There is an aspiration to retain increasing numbers of older workers in employment, and strategies to achieve this need to make provision for the increasing prevalence of chronic diseases with age. There is a consistent body of cross-sectional evidence that suggests that patients with chronic obstructive pulmonary disease are more likely to have adverse employment outcomes.

Objectives

We report the findings of the first longitudinal study of this issue.

Methods

We designed, implemented and evaluated a near-peer simulation training programme teaching diagnostic and therapeutic abdominal paracentesis to core medical trainees (CMTs). We taught diagnostic and therapeutic abdominal paracentesis to 77 north-west London CMTs over 8 training days over 4 years, 2015 to 2019. The programme was optimised by use of plan, do, study, act (PDSA) cycles and the content was evaluated by anonymous pre- and post-course questionnaires.

We are delighted to introduce an issue of FHJ in which we have focused our minds, and hopefully those of our readers, on the ever-present activity of all clinicians (and humans) – learning. This is such a wide topic, so we have considered a number of different dimensions with the confidence that these will stimulate interest, debate and discussion. Firstly, we have considered the important issue of learning to speak up in our workplaces.

Occupational exposures are a common and preventable cause of lung disease. About one in six cases of chronic obstructive pulmonary disease (COPD) and asthma worldwide are related to work.

When we conceived of the theme of ‘learning well’ for the June 2020 issue of FHJ, it is safe to say that the world was a different place. Our thinking around how to utilise education as a method of promoting improved self-care, wellbeing and belonging within a stretched healthcare system was based on current cultural philosophies of civility, preventing moral injury and burnout, and ensuring that healthcare professionals could be empowered – through autonomy and competence – to learn without blame from even the most challenging of situations.

The General Medical Council (GMC) national trainee survey (NTS) monitors junior doctor training experience annually, which is then used by organisations such as Health Education England to inform quality management. Its validity as an assessment of the learning environment to drive improvement is frequently questioned; currently there are no published evidence-based studies to demonstrate its impact. To explore the effects of the GMC survey, we carried out a retrospective cohort study using publicly available GMC NTS survey data.