Coda Change

Technology is good for learning‚ information and even wisdom at our fingertips, tech like simulation and virtual reality is cool. And technology really hit its straps with social and collaborative learning. But technology is bad‚ distracting, and multi-tasking impairs learning, our health can suffer, and good technology can be badly applied (eg PowerPoint as a "crime against connection" in presentations). Some technology is expensive without learning impact, and social media and the internet have dark sides. Vic offers us some thoughts on navigating the good, bad and ugly and suggests some personal strategies for making the most of technology for learning. And there is no Powerpoint.

It's hard to die without passing through MET-calling criteria; if you try to do so on a hospital ward, chances are you'll have an Intensivist next to you. By designing systems to detect patient deterioration, we've inadvertently invented acute palliative care. How did we move from resuscitators to out-of-hours death doulas so rapidly? Is death the future of Intensive Care Medicine?

A neonates journey, just what feedback would your neonatal patient give you after 3 months of intensive care? Listen to the innocent observation and experience of daily life in NICU and perhaps approach a future patient with little voice slightly differently.

How can you live a full creative life in the midst of a busy medical career? Fiona gives a very inspiring talk at the Get Creative Workshop, discussing the fascinating pathway her life has taken, allowing her to fulfill her creative potential whilst still developing her medical career as a paediatric emergency physician.

Delivery of safe healthcare currently faces unprecedented challenges in the UK and globally. This arises, at least partly, from a rising involvement of the criminal law in the investigation of medical errors apparently conflicting with the need to respect a "duty of candour". As a result, doctors face enormous pressures in fear of being blamed for medical errors. David Sellu is a consultant surgeon who was convicted for gross negligence manslaughter in late 2013 after the death of a patient in a private hospital. I (@DrJennyVaughan) was the medical lead for a group of David Sellu's friends as we launched a campaign to overturn his conviction. There has never been a successful 'out of time' appeal in this area of the law so we were dealing with almost impossible odds from the start. The positive result was extraordinary, both for David and our whole profession (www.medicalmanslaughter.co.uk). Since these events, I have supported other doctors facing criminal conviction, such as the paediatrician Dr Hadiza Bawa-Garba, through my work with the Doctors Association UK (DAUK, @TheDA_UK). Thousands of doctors crowd-funded a campaign and successfully overturned a court decision to erase her from the UK medical register. Her case proved to be a lightning rod in the UK for a profession at breaking point. Many healthcare staff are working on critically under-staffed wards and in under-resourced departments, with an increasingly unmanageable workload. DAUK have since launched a "Learn Not Blame" campaign to improve safety for patients and healthcare professionals. We believe that the involvement of the criminal justice system in these cases often does not allow an appreciation of the interplay of individuals within complex health systems. We also remain particularly concerned that a recent analysis of conviction trends shows an excessive conviction rate of black and minority ethnic (BME) healthcare staff.

OHCA, Out of Hospital Cardiac Arrest is surrounded in controversies from bystander CPR and the use of Adrenaline, to airway management and mechanical CPR. Who better to hear the latest updates from other than Gavin Perkins, author of Paramedic 2 and lead on ILCOR guidelines

Learn how to reinvigorate yourself after nights, a period of downtime, or when you are recovering from compassion fatigue or post critical care exhaustion - Reflection is Key

What can Prehospital and Retrieval Medicine teach us about life? Natalie May reflects on lessons learned at Sydney HEMS - from the practical to the philosophical.

Many critical care practitioners, like workers in other industries, sleep less than recommended amounts, in what is truly an epidemic of poor sleep in our modern industrialised society. The effects of sleep deprivation are serious and visible across all levels of our community. The actual proportion of people who can live on insufficient sleep is extremely low and the first step towards improvement is to recognise when our sleep tank is running on empty. Simple changes in daily habits based on optimizing sleep hygiene can lead to improved wellbeing and are highly likely to lead to profound improvements in physical, mental and emotional health and performance. Sleep quality may well be more important than sleep quantity. Shift work and the scheduling of multiple consecutive daily shifts are a serious impediment and must be considered carefully by our institutional managers. Taking naps is another seemingly simple but logistically challenging method to improve overall sleep. The bravado that sleep is not important needs to be carefully redirected in our hospitals as the health and performance improvements of practitioners seem likely to lead to greater work satisfaction, less burnout, improved teamwork and ultimately improved patient outcomes. Of course if most of us need more sleep, and will benefit from doing so, just imagine what might happen if our patients could get more sleep.