The Education Hub - Conversation with the experts

CWTE: How to speak with families about NOT doing tests

"More is not always better when it comes to healthcare" is the mantra of the Choosing Wisely Australia campaign, which seeks to reduce unnecessary medical interventions. In this episode, Dr Joanna Lawrence, medical lead of the Choosing Wisely campaign at RCH, talks with A/Prof Ed Oakley about low value care. They discuss clinician reasons for performing low value tests and the potential harms. Ed discusses examples of low value care in the setting of bronchiolitis and pneumonia and how to approach discussing this issue with families. They reflect on the recommendation to treat on clinical grounds, trust your clinical judgement and reflect on the conscious decision to not perform tests.Resources:Top 5 'not to do practices' (low value care) as nominated by the RACP, Paediatric and Child Health division Royal Australasian College of Physicians PaCHdLawrence J, Andrew L, Bracken J, Voskoboynik A, Oakley E, South M, Middleton K, Scanlan B, Marshall T, Hiscock H. Bronchiolitis at a specialist paediatric centre: The electronic medical record helps to evaluate low value care. Journal of Paediatrics and Child Health/ Early View. Published online 25 August 2019 https://onlinelibrary.wiley.com/doi/epdf/10.1111/jpc.14602PODCAST DISCLAIMER:This podcast has been produced by The Education Hub, a collaboration between the Royal Children's Hospital and the University of Melbourne Department of Paediatrics.The producers have made considerable efforts to ensure the information contained in the podcast is accurate, evidence-based and up to date at the time of publication however t​he information and advice offered is intended as a guide only and does not replace the need for clinical expertise and the application of clinical judgment to each individual presentation.This podcast should not be reproduced without the written permission of The Education Hub (education.hub@rch.org.au​).

CWTE: Asthma in outpatients

Respiratory Physician Professor Colin Robertson discusses outpatient management of child and adolescents with asthma with Dr Amy Gray. Professor Robertson discusses what we are talking about when we refer to asthma, the need to ensure our diagnosis is correct, and reflects on when we may consider different types of preventative treatment.Resources:The RCH Asthma Clinical Practice GuidelinesThe RCH patient education videosPODCAST DISCLAIMER:This podcast has been produced by The Education Hub, a collaboration between the Royal Children's Hospital and the University of Melbourne Department of Paediatrics.The producers have made considerable efforts to ensure the information contained in the podcast is accurate, evidence-based and up to date at the time of publication however t​he information and advice offered is intended as a guide only and does not replace the need for clinical expertise and the application of clinical judgment to each individual presentation.This podcast should not be reproduced without the written permission of The Education Hub (education.hub@rch.org.au​).

CWTE: Preparing children and families for procedures

Patient comfort and safety are paramount when caring for children, especially in a daunting healthcare setting. Dr. Amanda Stock (Emergency Physician) talks to Sophie Karavaras from Child Life Therapy about different strategies and how to tailor your approach to different developmental stages and individual temperaments. Offer realistic choices, be direct with praise, give parents a role and use positive language.Resources:Child Life Therapy at The Royal Children's HospitalPODCAST DISCLAIMER:This podcast has been produced by The Education Hub, a collaboration between the Royal Children's Hospital and the University of Melbourne Department of Paediatrics.The producers have made considerable efforts to ensure the information contained in the podcast is accurate, evidence-based and up to date at the time of publication however t​he information and advice offered is intended as a guide only and does not replace the need for clinical expertise and the application of clinical judgment to each individual presentation.This podcast should not be reproduced without the written permission of The Education Hub (education.hub@rch.org.au​).

CWTE: Asthma

What is the difference between preschool wheeze and asthma? Professor Sarath Ranganathan joins us to explain why it is important to be cautious about the use of steroids and other asthma preventers in the preschool group. He offers insights into potential new therapies or opportunities for prevention of asthma with evidence coming from research in early childhood.Resources:The RCH Asthma Clinical Practice GuidelinesThe RCH patient education videosPODCAST DISCLAIMER:This podcast has been produced by The Education Hub, a collaboration between the Royal Children's Hospital and the University of Melbourne Department of Paediatrics.The producers have made considerable efforts to ensure the information contained in the podcast is accurate, evidence-based and up to date at the time of publication however t​he information and advice offered is intended as a guide only and does not replace the need for clinical expertise and the application of clinical judgment to each individual presentation.This podcast should not be reproduced without the written permission of The Education Hub (education.hub@rch.org.au​).

CWTE: Junior medical staff

In this episode A/Prof Lionel Lubitz reflects on his experiences of mentoring and learning from junior medical staff during his 30 year career at The Royal Children's Hospital.Lionel is an experienced paediatrician having worked at the RCH for the past 30 years as a consultant general paediatrician. He was formerly deputy director in the Dept. of General Medicine at the Royal Children's Hospital and is an Associate Professor in the Dept. of Paediatrics, University of Melbourne. He is a revered educator and mentor. PODCAST DISCLAIMER:This podcast has been produced by The Education Hub, a collaboration between the Royal Children's Hospital and the University of Melbourne Department of Paediatrics.The producers have made considerable efforts to ensure the information contained in the podcast is accurate, evidence-based and up to date at the time of publication however t​he information and advice offered is intended as a guide only and does not replace the need for clinical expertise and the application of clinical judgment to each individual presentation.This podcast should not be reproduced without the written permission of The Education Hub (education.hub@rch.org.au​).

CWTE: Chronic fatigue

Chronic Fatigue Syndrome can be hard to define and hard to diagnose. A/Prof Lionel Lubitz shares his tips for overcoming these challenges and provides useful management strategies.Lionel is an experienced paediatrician having worked at the RCH for the past 30 years as a consultant general paediatrician. He was formerly deputy director in the Dept. of General Medicine at the Royal Children's Hospital and is an Associate Professor in the Dept. of Paediatrics, University of Melbourne. He is a revered educator and mentor. PODCAST DISCLAIMER:This podcast has been produced by The Education Hub, a collaboration between the Royal Children's Hospital and the University of Melbourne Department of Paediatrics.The producers have made considerable efforts to ensure the information contained in the podcast is accurate, evidence-based and up to date at the time of publication however t​he information and advice offered is intended as a guide only and does not replace the need for clinical expertise and the application of clinical judgment to each individual presentation.This podcast should not be reproduced without the written permission of The Education Hub (education.hub@rch.org.au​).

CWTE: Autism, ADHD and transitions

This episode is the first of a three-part mini-series with expert guest and general paediatrician Associate Professor Lionel Lubitz, hosted by A/Prof Mike Starr. The series covers a range of paediatric conditions including autism, ADHD and chronic fatigue.Lionel is an experienced paediatrician having worked at the RCH for the past 30 years as a consultant general paediatrician. He was formerly deputy director in the Dept. of General Medicine at the Royal Children's Hospital and is an Associate Professor in the Dept. of Paediatrics, University of Melbourne. He is a revered educator and mentor. PODCAST DISCLAIMER:This podcast has been produced by The Education Hub, a collaboration between the Royal Children's Hospital and the University of Melbourne Department of Paediatrics.The producers have made considerable efforts to ensure the information contained in the podcast is accurate, evidence-based and up to date at the time of publication however t​he information and advice offered is intended as a guide only and does not replace the need for clinical expertise and the application of clinical judgment to each individual presentation.This podcast should not be reproduced without the written permission of The Education Hub (education.hub@rch.org.au​).

CWTE: Varicoceles

In this final episode of the series, Professor Hutson discusses this uncommon but interesting condition.Professor Hutson is recognised internationally for his research into testicular descent, disorders of sexual differentiation, and colonic dysmotility in children.Disclaimer: This podcast has been produced by The Education Hub, a collaboration between the Royal Children's Hospital and the University of Melbourne Department of Paediatrics. The producers have made considerable efforts to ensure the information contained in the podcast is accurate, evidence-based and up to date at the time of publication however the information and advice offered is intended as a guide only and does not replace the need for clinical expertise and the application of clinical judgment to each individual presentation. This podcast should not be reproduced without the written permission of The Education Hub (Education.Hub@rch.org.au)

CWTE: Hydroceles

A common condition but when should they be repaired? Professor Hutson discusses his approach to confirming the diagnosis and thoughts around surgical management.Professor Hutson is recognised internationally for his research into testicular descent, disorders of sexual differentiation, and colonic dysmotility in children.Disclaimer: This podcast has been produced by The Education Hub, a collaboration between the Royal Children's Hospital and the University of Melbourne Department of Paediatrics. The producers have made considerable efforts to ensure the information contained in the podcast is accurate, evidence-based and up to date at the time of publication however the information and advice offered is intended as a guide only and does not replace the need for clinical expertise and the application of clinical judgment to each individual presentation. This podcast should not be reproduced without the written permission of The Education Hub (Education.Hub@rch.org.au)

CWTE: Inguinal hernias

Professor Hutson shares his tips and tricks for examining for inguinal hernias in boys and girls and the rationale around timing of surgical approach.Professor Hutson is recognised internationally for his research into testicular descent, disorders of sexual differentiation, and colonic dysmotility in children.Disclaimer: This podcast has been produced by The Education Hub, a collaboration between the Royal Children's Hospital and the University of Melbourne Department of Paediatrics. The producers have made considerable efforts to ensure the information contained in the podcast is accurate, evidence-based and up to date at the time of publication however the information and advice offered is intended as a guide only and does not replace the need for clinical expertise and the application of clinical judgment to each individual presentation. This podcast should not be reproduced without the written permission of The Education Hub (Education.Hub@rch.org.au)

CWTE: Ectopic testes

How do ectopic testes present and how are they managed? Professor Hutson shares his wisdom on the embryology, assessment and management of ectopic testes.Professor Hutson is recognised internationally for his research into testicular descent, disorders of sexual differentiation, and colonic dysmotility in children.Disclaimer: This podcast has been produced by The Education Hub, a collaboration between the Royal Children's Hospital and the University of Melbourne Department of Paediatrics. The producers have made considerable efforts to ensure the information contained in the podcast is accurate, evidence-based and up to date at the time of publication however the information and advice offered is intended as a guide only and does not replace the need for clinical expertise and the application of clinical judgment to each individual presentation. This podcast should not be reproduced without the written permission of The Education Hub (Education.Hub@rch.org.au)

CWTE: Undescended testes (impalpable)

The vanishing testis: how do we find it and what investigations are needed? Prof Hutson shares his tips and tricks on examination technique and approach to this common presentation.Professor Hutson is recognised internationally for his research into testicular descent, disorders of sexual differentiation, and colonic dysmotility in children.Disclaimer: This podcast has been produced by The Education Hub, a collaboration between the Royal Children's Hospital and the University of Melbourne Department of Paediatrics. The producers have made considerable efforts to ensure the information contained in the podcast is accurate, evidence-based and up to date at the time of publication however the information and advice offered is intended as a guide only and does not replace the need for clinical expertise and the application of clinical judgment to each individual presentation. This podcast should not be reproduced without the written permission of The Education Hub (Education.Hub@rch.org.au)

CWTE: Undescended testes (retractile)

Professor Hutson is recognized internationally for his research into testicular descent. In this episode he shares his wealth of experience and wisdom regarding the topic of undescended testes from embryology to surgical management.Professor Hutson is recognised internationally for his research into testicular descent, disorders of sexual differentiation, and colonic dysmotility in children.Disclaimer: This podcast has been produced by The Education Hub, a collaboration between the Royal Children's Hospital and the University of Melbourne Department of Paediatrics. The producers have made considerable efforts to ensure the information contained in the podcast is accurate, evidence-based and up to date at the time of publication however the information and advice offered is intended as a guide only and does not replace the need for clinical expertise and the application of clinical judgment to each individual presentation. This podcast should not be reproduced without the written permission of The Education Hub (Education.Hub@rch.org.au)

CWTE: Segmental volvulus

This diagnosis can be hard to pick prior to surgery. Professor Hutson discusses the issues surrounding segmental volvulus.Professor Hutson is recognised internationally for his research into testicular descent, disorders of sexual differentiation, and colonic dysmotility in children.Disclaimer: This podcast has been produced by The Education Hub, a collaboration between the Royal Children's Hospital and the University of Melbourne Department of Paediatrics. The producers have made considerable efforts to ensure the information contained in the podcast is accurate, evidence-based and up to date at the time of publication however the information and advice offered is intended as a guide only and does not replace the need for clinical expertise and the application of clinical judgment to each individual presentation. This podcast should not be reproduced without the written permission of The Education Hub (Education.Hub@rch.org.au)

CWTE: Distal bowel pathology

In this episode Professor Hutson shares his approach to diagnosis and management of the neonatal distal bowel obstruction and discusses the different approaches in various centres.Professor Hutson is recognised internationally for his research into testicular descent, disorders of sexual differentiation, and colonic dysmotility in children.Disclaimer: This podcast has been produced by The Education Hub, a collaboration between the Royal Children's Hospital and the University of Melbourne Department of Paediatrics. The producers have made considerable efforts to ensure the information contained in the podcast is accurate, evidence-based and up to date at the time of publication however the information and advice offered is intended as a guide only and does not replace the need for clinical expertise and the application of clinical judgment to each individual presentation. This podcast should not be reproduced without the written permission of The Education Hub (Education.Hub@rch.org.au)

CWTE: Hirschsprung disease (adolescents)

How do we manage children with Hirschprungs disease as they grow up? Professor Hutson discusses the longer term management of this group of children including continence issues and complications from surgery.Professor Hutson is recognised internationally for his research into testicular descent, disorders of sexual differentiation, and colonic dysmotility in children.Disclaimer: This podcast has been produced by The Education Hub, a collaboration between the Royal Children's Hospital and the University of Melbourne Department of Paediatrics. The producers have made considerable efforts to ensure the information contained in the podcast is accurate, evidence-based and up to date at the time of publication however the information and advice offered is intended as a guide only and does not replace the need for clinical expertise and the application of clinical judgment to each individual presentation. This podcast should not be reproduced without the written permission of The Education Hub (Education.Hub@rch.org.au)

CWTE: Hirschsprung disease (ultra-short)

Is it real? Professor Hutson discusses the historical background and controversies surrounding this condition.Professor Hutson is recognised internationally for his research into testicular descent, disorders of sexual differentiation, and colonic dysmotility in children.Disclaimer: This podcast has been produced by The Education Hub, a collaboration between the Royal Children's Hospital and the University of Melbourne Department of Paediatrics. The producers have made considerable efforts to ensure the information contained in the podcast is accurate, evidence-based and up to date at the time of publication however the information and advice offered is intended as a guide only and does not replace the need for clinical expertise and the application of clinical judgment to each individual presentation. This podcast should not be reproduced without the written permission of The Education Hub (Education.Hub@rch.org.au)

CWTE: Hirschsprung disease (general)

Hirschprungs disease is a difficult condition to manage. In this episode Professor Hutson discusses some of the controversies in management and his approach.Professor Hutson is recognised internationally for his research into testicular descent, disorders of sexual differentiation, and colonic dysmotility in children.Disclaimer: This podcast has been produced by The Education Hub, a collaboration between the Royal Children's Hospital and the University of Melbourne Department of Paediatrics. The producers have made considerable efforts to ensure the information contained in the podcast is accurate, evidence-based and up to date at the time of publication however the information and advice offered is intended as a guide only and does not replace the need for clinical expertise and the application of clinical judgment to each individual presentation. This podcast should not be reproduced without the written permission of The Education Hub (Education.Hub@rch.org.au)

CWTE: Anorectal malformation in girls

Professor John Hutson shares his experience with managing anorectal malformations in girls including cloacal abnormalities.Professor Hutson is recognised internationally for his research into testicular descent, disorders of sexual differentiation, and colonic dysmotility in children.Disclaimer: This podcast has been produced by The Education Hub, a collaboration between the Royal Children's Hospital and the University of Melbourne Department of Paediatrics. The producers have made considerable efforts to ensure the information contained in the podcast is accurate, evidence-based and up to date at the time of publication however the information and advice offered is intended as a guide only and does not replace the need for clinical expertise and the application of clinical judgment to each individual presentation. This podcast should not be reproduced without the written permission of The Education Hub (Education.Hub@rch.org.au)

CWTE: Anorectal malformation in boys

This is the first episode of a 13-part series on paediatric surgical conditions with expert guest Professor John Hutson AO, interviewed by A/Prof Sebastian King. Professor Hutson is recognised internationally for his research into testicular descent, disorders of sexual differentiation, and colonic dysmotility in children.In this episode, Professor Hutson discusses his approach to the various anorectal malformations in male neonates.Resources: 1. "Jones Clinical Paediatric Surgery" 7th Edition 2015, Eds. Hutson JM, O'Brien M, Beasley SB, Teague WJ, King SK. Published by Wiley Blackwell, Oxford 2. "Paediatric Surgical Diagnosis: Atlas of Disorders of Surgical Significance" 2nd Edition 2018, Eds. Beasley SW, Hutson JM, Stringer M, King SK, Teague WJ. Published by CRC Press, Taylor and Francis Group, LondonDisclaimer: This podcast has been produced by The Education Hub, a collaboration between the Royal Children's Hospital and the University of Melbourne Department of Paediatrics. The producers have made considerable efforts to ensure the information contained in the podcast is accurate, evidence-based and up to date at the time of publication however the information and advice offered is intended as a guide only and does not replace the need for clinical expertise and the application of clinical judgment to each individual presentation. This podcast should not be reproduced without the written permission of The Education Hub (Education.Hub@rch.org.au)