There is a 4-12% increase in mortality in the month following the start of Foundation Year 1 doctors (FY1s) in the UK. In 2012 the National Health Service announced a compulsory shadowing period for FY1s, aiming to increase familiarity with the environment in which the FY1 would be commencing work. There is no national curriculum of the content for this shadowing period and evidence suggests variable content of induction programmes across the UK.Our project aimed to provide a near-peer induction, based on needs previously identified by a national survey and outgoing FY1s' experiences. The day consisted of expert-led lectures, interactive practical sessions delivered by outgoing FY1s, and simulated tasks within the clinical environment where they were about to commence work. The day was evaluated by questionnaires distributed to participants before and after the induction to measure whether there was a change in the perceived confidence of the FY1s in different aspects of their role.There was a 61% improvement in familiarity of equipment and knowing how to request investigations. Confidence levels increased by 45% and 28% in prescribing insulin and intravenous fluids, respectively. There was a 9% improvement in feeling adequately prepared to recognise the critically ill patient. Confidence was high in prescribing intravenous fluids (72% pre-induction and 100% post-induction) and simple analgesics (94% pre-induction and 96% post-induction).The induction day improved self-perceived confidence in all measured areas. The largest increase was in the area given most focus during the day - knowledge of the environment. Combining factual content with orientation of the environment increases confidence for new FY1s. Teaching by outgoing FY1s provides insight into what the job entails. We recommend this style of induction to maximise preparedness within a limited time frame.

is an academic clinical fellow and specialty registrar in renal and general medicine in the South West Peninsula. She has research interests in monogenic renal disease and big data analysis.

No abstract

Fine-group whole-core reactor analysis remains one of the long sought goals of the reactor physics community. Such a detailed analysis is typically too computationally expensive to be realized on anything except the largest of supercomputers. Recondensation using the Discrete Generalized Multigroup (DGM) method, though, offers a relatively cheap alternative to solving the fine group transport problem. DGM, however, suffered from inconsistencies when applied to high-order spatial methods. While an exact spatial recondensation method was developed and provided full spatial consistency with the fine group problem, this approach substantially increased memory requirements for realistic problems. The method described in this paper, called the Source Equivalence Acceleration Method (SEAM), forms a coarse-group problem which preserves the fine-group problem even when using higher order spatial methods. SEAM allows recondensation to converge to the fine-group solution with minimal memory requirements and little additional overhead. This method also provides for consistency when using different spatial methods and angular quadratures between the coarse group and fine group problems. SEAM was implemented in OpenMOC, a 2D MOC code developed at MIT, and its performance tested against Coarse Mesh Finite Difference (CMFD) acceleration on the C5G7 benchmark problem and on a 361 group version of the problem. For extremely expensive transport calculations, SEAM was able to outperform CMFD, resulting in speed-ups of 20-45 relative to the normal power iteration calculation.

No abstract