Total subapical mandibular osteotomy to correct class 2 division 1 dento-facial deformity

A severe Class 2 division 1 dento-facial deformity in an adult is normally treated by a combination of orthodontics and orthognathic surgery. The surgical procedure may involve either a single or double jaw osteotomy. The sagittal split osteotomy with forward mandibular slide has been the procedure of choice for many years for correcting the antero-posterior discrepancy between the dental arches. Although the total subapical mandibular osteotomy was described over 20 years ago, reports of its use in the literature are sparse. We report two cases to demonstrate that it can be the operation of choice for surgical correction of Class 2 dento-facial deformity in carefully selected cases. When performed correctly it can have very good aesthetic and functional results.     

‘More effort and more time.’ Considerations in the establishment of interprofessional education programs in the workplace

The argument for integrating interprofessional education (IPE) activities into the workplace has been made concurrently with the call for collaborative clinical practice. An exploratory case study investigation of existing activities in a large metropolitan health care network was undertaken to inform the development of future IPE initiatives. Purposive sampling invited clinicians involved in the design or delivery of workplace IPE activities to participate in a semi-structured interview to discuss their existing programs and the opportunities and challenges facing future work. Interviews were audiotaped, transcribed and thematically analysed. In total, 15 clinicians were interviewed representing medicine, nursing, occupational therapy, pharmacy, physiotherapy, psychology, social work and speech pathology. The IPE programs identified included one medical and midwifery student workshop, several dedicated new graduate or intern programs combining the professions and multiple continuing professional development programs. Three dominant themes were identified to inform the development of future work: clinician factors, organisational factors and IPE considerations. In addition to the cultural, physical and logistical challenges associated with education that integrates professions in the workplace, the time required for the design and delivery of integrated team training should be accounted for when establishing such programs. Considerations for sustainability include ongoing investment in education skills for clinicians, establishment of dedicated education roles and expansion of existing education activities.     

Neonatal education in the North East: A collaborative venture

This article describes a change in the teaching and learning strategy for newly qualified neonatal nurses who wish to become qualified in the speciality (QIS) of neonatal nursing. Two modules have undergone revision in the light of feedback from the Regional Neonatal Network and evaluations from stakeholders. This paper provides the rationale for change and discusses developments in teaching and learning strategies, and the planning and implementing process involved in the change. Factors to take into consideration when evaluating the change and implications for future developments are also briefly discussed.