A team approach to practice teaching

The ideas presented in this paper were originally generated in a workshop at an NSPCC conference on Practice Teaching in March 1996. In this article we wish to develop some of these ideas further and explore the idea of a team approach to practice teaching. This is not some radical new notion, but an acknowledgement of the reality of many placements. Although a student will be allocated a practice teacher (and possibly an off-site practice teacher) he or she will not function by themselves but will be part of an organisation. It is this wider structure and its effects on the student that we feel needs closer scrutiny. Firstly, we believe that not enough attention has been given to the power that organisations can have over an individual (particularly one whose stay is only short-term and possibly part-time). Secondly, we believe students can obtain benefits from the wealth of knowledge existing in any team, drawing on the skills and expertise of all team members. When team learning works well we feel that it provides benefits for all parties - the student, the practice teacher, the team and service users.     

Distal upper extremity musculoskeletal risk factors associated with colonoscopy

Gastroenterologists are at increased risk for developing recurrent thumb, hand, and elbow pain due to colonoscopy procedures. We evaluated forearm muscle loads and wrist postures during routine colonoscopy (N=12 gastroenterologists) to understand distal upper extremity musculoskeletal risk factors associated with the 4 different subtasks of colonoscopy. Bilateral forearm extensor carpiradialis (ECR) and flexor digitorum superficialis (FDS) surface electromyography and bilateral wrist postures were recorded continuously. The mean duration of colonoscopy was 24.2 (± 12.1) minutes and was dominated by the withdrawal subtask [13.7 (± 8.8) min] followed by right colon insertion [5.8 (± 4.8) min], left colon insertion [3.5 (± 3.1) min], and retroflexion [1.2 (± 2.1) min]. Median (APDF50) and peak (APDF90) left forearm muscle activity was significantly greater than right forearm muscle activity across all subtasks. Median and peak ECR muscle activity was significantly greater during the left and right colon insertion subtasks compared to retroflexion. Both wrists were predominantly in wrist extension during all phases of colonoscopy. The left forearm muscle activity was higher than right forearm activity due to differences in wrist posture and grip force. The risk factors for the left hand may be reduced with alternative designs and support mechanisms for the colonoscope head.