PTH-44 Figure 1Baseline data 2018 - 2019 (pre-p ndemic)[Figure omitted. See PDF]Abstract PTH-44 Figure 2Post PDSA 1, in progress April 2021 onwards[Figure omitted. See PDF]Abstract PTH-44 Figure 3Rates of endoscopy within 24 hours (%)[Figure omitted. See PDF]Abstract PTH-44 Figure 4Median length of stay (days)[Figure omitted. See PDF]Abstract PTH-44 Figure 5Mortality rates within 28 days of AUGIB (%)[Figure omitted. See PDF]ConclusionsUHMBT data and national data were comparable, with ample room to improve the Morecambe Bay AUGIB service and therefore outcomes for our patients in line with BSG recommendations. It is too early following PDSA 1 interventions to draw any meaningful conclusions from the data. However, a positive result appears achievable with improvements ongoing via further quarterly PDSA cycles throughout the remainder of the year. The authors look forward to presenting these results with the wider BSG community towards the end of 2021. The impact of the Covid-19 Pandemic will also be included in the final data and presentation.ReferencesSiau, Keith, et al. ‘British Society of Gastroenterology (BSG)-led multisociety consensus care bundle for the early clinical management of acute upper gastrointestinal bleeding.’ Frontline gastroenterology 11.4 (2020): 311-323 https://www.bsg.org.uk/wp-content/uploads/2019/11/flgastro-2019-101395.pdfMcPherson, S. J., et al. ‘Gastrointestinal haemorrhage: time to get control.’ London, UK: National Confidential Enquiry into Patient Outcome and Death (2015). https://www.ncepod.org.uk/2015report1/downloads/TimeToGetControlFullReport.pdf

Background Teaching, mentoring and supervision (TMS) are fundamental skills with a specific commitment within the Royal Australasian College of Physicians professional practice framework. The new basic training standards include 'use of appropriate educational techniques to facilitate the learning of peers, junior colleagues and other health professionals and to provide supervision for junior colleagues' but it is unclear how basic physician trainees and equivalent grade doctors (hereinafter 'registrars') will provide, learn or develop TMS skills. Aims To explore how registrars provide, learn and develop TMS skills. Methods Mixed methods approach. New Zealand registrars were invited to participate in anonymous survey regarding TMS experiences and learning. Focus groups explored skill acquisition and development more deeply. Results A total of 121 registrars from 16 District Health Boards responded. Registrars supervise two juniors daily (range 0-4+). Fewer than 1:4 have formal training in TMS skills. Free text and focus group themes include: informal development by observing role models plus personal experience of giving and receiving TMS, inequitable access to development opportunities and formal training, barriers include workload and unsupportive learning cultures. Some registrars lack confidence in delivering TMS. Conclusions Registrars are expected to teach, mentor and supervise junior colleagues but experience a 'frustrated apprenticeship': formal training is minimal and informal training is dependent on variable role models, opportunities and systematic support. Registrars feel unprepared and lack confidence despite wanting to succeed in this domain. Suggestions for improvement include baseline formal training, purposeful role modelling by seniors and equitable promotion of TMS opportunities.

Developing professional identity is a vital part of health professionals' education. In Auckland four tertiary institutions have partnered to run an interprofessional simulation training course called Urgent and Immediate Patient Care Week (UIPCW) which is compulsory for Year Five medical, Year Four pharmacy, Year Three paramedicine and Year Three nursing students. We sought to understand student experiences of UIPCW and how those experiences informed student ideas about professional identity and their emergent practice as health professionals within multidisciplinary teams. In 2018, we commenced ethnographic research involving participant observation, field notes, interviews, photography and observational ethnographic film. A total of 115 students participated in this research. The emergent findings concern the potentially transformative learning opportunity presented within high fidelity multi-disciplinary simulations for students to develop their professional identity in relation to peers from other professions. Our work also exposes the heightened anxiety and stress which can be experienced by students in such interdisciplinary simulations. Student experience suggests this is due to a range of factors including students having to perform in front of peers and staff in such simulation scenarios when their own professional identity and capabilities are still in emergent stages. Staff-led simulation debriefs form a critical success factor for transformative learning to be able to occur in any such simulations so that students can reflect on, and move beyond, the emotion and uncertainty of such experiences to develop future-focused concepts of professional identity and strategies to support effective interprofessional teamwork.

(1) Background: The purpose of this systematic review was to appraise the empirical evidence and refereed literature pertaining to medical students and the integration of mindfulness and physical exercise regimens. (2) Methods: A systematic review protocol was implemented. Five databases were utilised to survey the salient literature. (3) Results: The initial search identified 353 potentially relevant articles. After comprehensively reviewing the initial catchment using several analytical phases, 17 articles were considered for the final review. The final review indicated that the research was mainly conducted in the USA with some research originating from Europe, Canada, Jamaica, and India. In addition, a range of research designs were applied to measure or discuss the efficacy of the integrated intervention. (4) Conclusions: This systematic review demonstrated that when mindfulness and physical exercises are integrated there are likely to be positive health outcomes for medical students.