The transition from medical student to junior doctor is a challenge; the UK General Medical Council has issued guidance emphasizing the importance of adequate preparation of medical students for clinical practice. This study aimed to determine whether a junior doctor-led simulation-based course is an effective way of preparing final year medical students for practice as a junior doctor.We piloted a new 'preparation for practice' course for final year medical students prior to beginning as Foundation Year 1 (first year of practice) doctors. The course ran over three days and consisted of four simulated stations: ward round, prescribing, handover, and lessons learnt. Quantitative and qualitative feedback was obtained.A total of 120 students attended (40 on each day) and feedback was collected from 95 of them. Using a scale of 1 (lowest) to 5 (highest), feedback was positive, with 99% and 96% rating 4 or 5 for the overall quality of the program and the relevance of the program content, respectively. A score of 5 was awarded by 67% of students for the ward round station; 58% for the handover station; 71% for the prescribing station, and 35% for the lessons learnt station. Following the prescribing station, students reported increased confidence in their prescribing.Preparation for practice courses and simulation are an effective and enjoyable way of easing the transition from Electronic supplementary material The online version of this article

This paper describes the process and outcomes of a project aimed at promoting community based multidisciplinary coordinated palliative care services in rural Australia. In preliminary health service needs assessment in rural Tasmania, key health workers appealed for additional information, support and education in palliative care. They expressed a preference for this education to be delivered locally to strengthen existing knowledge in communities and to take into account contextual factors. The project aimed to enhance skills available in rural communities by involving key stakeholders including formal and informal carers, volunteers, clergy, pharmacists, community nurses and general practitioners. The project objective was to strengthen existing expertise and commitment in rural communities, enabling service providers to respond to community needs in a sustainable way. This was achieved by facilitating options for sustainable linkages and ongoing support and through outreach programs from urban Palliative Care Units. An important element in this was the Tasmanian Telehealth network, which harnesses videoconferencing, digital diagnostic equipment and image transmission technologies to offer access to healthcare services to Tasmania's rural and isolated communities. The process centred on workshops facilitated by a multidisciplinary team, which provided information about the core components of palliative care. The paper reports on the responses of health professionals and community participants to the workshops.

The intervention significantly increased mean HW time, compliance with a 20-econd wash time and decreased bacterial QG of hands and these results were sustained over a 9-month period.

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