Performance-based assessment of radiology faculty.
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Clinical Competence↗
Biomedical subjects
Richard FitzGerald
Publications and source records attributed to Richard FitzGerald.
Radiological error: analysis, standard setting, targeted instruction and teamworking.
Diagnostic radiology does not have objective benchmarks for acceptable levels of missed diagnoses. Until now, data collection of radiological discrepancies has been very time consuming. The culture within the specialty did not encourage it. However, public concern about patient safety is increasing. There have been recent innovations in compiling radiological interpretive discrepancy rates which may facilitate radiological standard setting. However standard setting alone will not optimise radiologists' performance or patient safety. We must use these new techniques in radiological discrepancy detection to stimulate greater knowledge sharing, targeted instruction and teamworking among radiologists. Not all radiological discrepancies are errors. Radiological discrepancy programmes must not be abused as an instrument for discrediting individual radiologists. Discrepancy rates must not be distorted as a weapon in turf battles. Radiological errors may be due to many causes and are often multifactorial. A systems approach to radiological error is required. Meaningful analysis of radiological discrepancies and errors is challenging. Valid standard setting will take time. Meanwhile, we need to develop top-up training, mentoring and rehabilitation programmes.
Communication↗
Environment affects stress in exercised turbot.
We investigated the interaction of water temperature (10, 18 and 22 degrees C) and salinity (33.5 and 15 per thousand ) on the stress response of juvenile turbot. At each temperature/salinity combination, fish were subjected to 10 min enforced exercise. This induced a moderate stress response, which differed at the various temperature and salinity combinations. High temperatures caused more rapid increases in plasma cortisol and glucose, larger and more rapid increases in plasma lactate levels, which were also influenced by body weight, and a faster recovery in plasma Na(+) and Cl(-). Low salinity ameliorated cortisol responses at low but not at high temperatures. The magnitude of ionic disturbance was reduced at 15 per thousand. Plasma K(+) did not change at any temperature or salinity. The stress response involved activation of the brain-pituitary-interrenal axis, as indicated by the cortisol elevations. The low magnitude of glucose responses, the mild Na(+) and Cl(-) disturbances, and the lacking K(+)-responses indicated mild activation of the brain-sympathetic-chromaffin cell axis, and hence a low release of catecholamines, which seemed though to occur to a higher extent at higher temperatures. The relatively low catecholaminergic response of turbot may be linked to their inactive sedentary lifestyle. The higher responsiveness at higher water temperatures may reflect a higher overall adaptive capacity.
Animals↗