Alumni Newsletter - School of Medicine Trinity College Dublin December 2021

Alumni Newsletter School of Medicine

Winter 2021

Welcome

Dear alumni, colleagues and friends: I’m excited to introduce this special publication informing you of some of the education and research work that is ongoing at the School of Medicine. I’m sure that you all have shared the severe challenges posed by the Covid-19 pandemic, and may I take the opportunity to wish you all good health and safety during this time. Running a medical school during a pandemic has also posed challenges, not least ensuring that medicine and healthcare student qualify on time with the knowledge, skills and attitudes required for quality healthcare services and the best patient outcomes.

We are very proud of our students and the professionalism that they have demonstrated throughout the pandemic.

We are similarly proud of our researchers from senior investigators through young academic faculty, post doctoral researchers and postgraduate students, who have reacted quickly and intelligently to the pandemic and the research and clinical care questions that the virus has posed to us.

We plan to provide you with similar publications in the future, highlighting some of the ongoing work and the ambitions of the School. You are all former students of the School; many of you are our healthcare professional colleagues and research collaborators throughout the world.

We invite you to keep in touch with us and to engage where possible with our activities.

Professor Michael Gill Head of School of Medicine

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Trinity Alumni Newsletter Content

Volume 1, Issue 1

01

Trinity Alumnus Star Interview: Sarah Jane McDonnell – Lead Physiotherapist

02

Prof. Tom Rogers: From medical student to Professor and Chair of Clinical Microbiology

03

The best model of human disease is the human

04

Alzheimer’s disease – The road to a cure

05

A day in the life interview

06

Trinity IGNITE -Leading the way on patient and public involvement

07

The journey to online education

20 December 2021

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Trinity Alumnus Star Interview:

Sarah Jane McDonnell – Lead Physiotherapist

By Iracema Leroi

Sarah Jane McDonnell graduated from Trinity College Dublin with a BSc Hons in Physiotherapy in 1998. She subsequently practised physiotherapy in Ireland, New Zealand and Australia before completing her masters in sports physiotherapy from the University of Queensland, Australia in 2004. Sarah Jane was part of medical staff for Team Ireland at the 2008 Beijing Olympics, 2012 London Olympics and Rio 2016. She is the Head of Rehabilitation in Sport Ireland Institute. She has recently returned from the Tokyo Olympics where she was the lead Sports Physiotherapist for Team Ireland.

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interviewed Sarah-Jane at the beginning of October by zoom.

How did you get to this point in your profession?

I didn’t have the stereotypical route into sports physiotherapy. I meandered a bit – first in the public sector, then in neurorehabilitation, paediatric rehabilitation and the ICU. I then travelled and was already qualified for five years before I did my Master’s in Queensland. I then decided to come home to Ireland to see if could find work. I was soon asked to cover a training camp in St Moritz Switzerland with rowing, 2005.

This opened a new world for me.

The sports’ world in Ireland is small, so I quickly was able to become a part of it. I moved into working with competitive swimmers and have been doing this for the past 10 years.

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How has the field of sports’ physiotherapy changed over the past decade?

Since I took on the role of being part of Ireland’s elite sports’ teams, I have seen huge changes. The sector has become more structured and my career has followed suit. I have spent the past 10 years in the Sport Ireland Institute and closely followed the increasing professionalisation of sport. I feel I have played an important part in shaping the field and developing specialisation within my profession.

What are the key attributes of succeeding in your specialised field?

I think one has to be open to taking risks. One has to want to be part of a team and invest the time to developing it and building relationships. Being committed and passionate about supporting high

level athletes is essential. In the early years it was quite lonely as my role was still developing; however, as the team grew and the sport evolved, I have evolved with it and had the privilege of taking on a leading role.

What specific contribution have you made to elite sports in Ireland that you are particularly proud of?

Sports Ireland Institute has developed significantly over the past few years.

The building is about five times larger than when I started. I believe I have made a significant contribution to shaping the new design and making it fit for purpose. With other members of the team, I worked closely with the architects and builders to develop an optimal design that would embed sports’ physiotherapy service meaningfully into the overall structure of the building. This was a huge change from before.

How has this made a difference to the athletes?

lynchpin and requires much more 1:1 work than other members of the team.

I think athletes have benefited hugely from the innovations in the building.

By bringing the physiotherapy department into the centre of the Institute, we are fostering ongoing inclusion of injured athletes as well as blurring the lines between physiotherapy interventions for rehabilitation and performance. This is important as it helps to keep the athletes within the team regardless of which stage of conditioning they are at.

What does a typical day look like?

What advice would you give to early career professionals wanting to follow in your footsteps?

I am always keen to pass on wisdom to early career professionals. They key point is to convey that where you start is not necessarily where you end up. To contribute meaningfully to an interdisciplinary team such as we find in elite sport, those with a varied and richer and deeper background are preferred. So, my advice is not to sub-specialise immediately and gain experience in different places and in different sub-specialties of the profession.

How has your role changed over the past few years?

My week still involves quite a lot of clinical work for both injury and performance enhancement with athletes. I have to tailor this around their training and study schedules.

Once a week the team has a 30-minute review of the athlete group to go over key issues to address. I may then spend time with the team in my role as manager, firefighting or identifying key areas for further professional education. The role has peaks and troughs but is largely driven by the sporting calendar, which begins in September and ends in August. In winter there is generally a big block of hard training. Travel and competition happen in Spring and Summer.

What has been your greatest challenge?

Providing high contact support area during the global pandemic was a huge challenge. We were five months from the Olympics and the country shut down. We were left not knowing the status of the Olympics and the athletes had to maintain peak condition. We had five weeks of total uncertainty. As the lead agency for sports delivery, everyone looked to

us for how to respond and to find solutions. We had to keep the athletes safe. As therapists we had to be vigilant about passing on the COVID-19 virus to the athletes, potentially jeopardizing their Olympic hopes. We felt we had no touchpoint to steady the ship.

Is there anything you would have done differently?

I think sticking to core principles and responding quickly was important.

Overall I believe we did a good job.

It was difficult waiting for decisions from the organisation above us, the International Olympic Committee, but we realised we just had to be patient with the decision-making.

Finally, what has been your highest achievement Achieving a national leadership role.

Before I took on this role, it didn’t exist. However, now that I have achieved it, it’s a bit hard to recognise as a discrete achievement. Being at this Olympic games, enabled me to take the lead role within the OFI. I am very proud of what we have achieved to get to the games as team of practitioners. Our legacy is the map of how we worked and go there. I am very proud of that.

Overall, although my role is constantly evolving, it follows the four-year cycle of Olympic sports. Now that Tokyo has passed, we are starting a new cycle, which at this stage involves a lot of reflection, planning. It also involves transitioning out of a role from front line practitioner into coordinator, manager, and strategist. The role of the physiotherapist has changed a lot in that I have to examine all the factors impacting on the athletes ability to perform – holistic aspects, including academics, nutrition, life skills.

Physiotherapy is often seen as the

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Prof. Tom Rogers

From medical student to Professor and Chair of Clinical Microbiology

By Michelle Leech

Prof. Tom Rogers graduated in Medicine from RCSI in 1972 and, after some initial experience in pathology following his internship year, was advised by his mentor, Dr Bofin, then Dublin City Coroner, to consider a specialisation in Microbiology. As there was no training programme in Microbiology in Ireland at that time, he moved to London in 1975, which he describes as ‘quite a culture shock’ and a ‘very exciting time’. Prof. Rogers started a lecturing post in what was then the Westminster Medical School.

Bacteria “outnumber us, and they replicate and can mutate more rapidly in order to survive”

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uring his 18 years there as Lecturer/Senior Lecturer/ Consultant to Westminster Hospital there was continuous restructuring of the London Medical Schools that led to his relocation to Charing Cross Hospital.

Coincidentally, after he became Reader in Microbiology at the Royal Postgraduate Medical School, based at Hammersmith Hospital, in 1993, it together with both the Westminster and Charing Cross Medical Schools became incorporated into what is now Imperial College London, it was almost like ‘coming home’.

While at Hammersmith Hospital, Prof. Rogers discovered that he was working in a laboratory where William Hayes, graduate of TCD School of Medicine, had carried out seminal work in bacterial genetics in the 1950s.

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When Prof Rogers returned to Trinity as Chair of Clinical Microbiology in 2004, he noticed that one of the seminar rooms was called the ‘Hayes room’ in recognition of Hayes’ work on bacterial conjugation (a process by which bacteria share genetic material which can contribute to the evolution of antibiotic resistance). In 2020 Prof.

Rogers inaugurated a William Hayes prize for the 2nd year medical student with the highest mark in Microbiology.

Not long after his appointment Prof. Rogers’ chair was renamed the Joseph W Bigger Chair, in honour of Prof. Bigger who was Professor of Bacteriology and Preventive Medicine in TCD, and a School of Medicine graduate . Prof. Bigger carried out seminal research on the phenomenon of bacterial persistence which had influenced the work of Alexander

Prof. Tom Rogers

Fleming in his discovery of penicillin, something later acknowledged by Fleming in a lecture delivered in Belfast.

While Prof. Rogers held the first Chair in Clinical Microbiology at Trinity College, he acknowledges Prof. Conor Keane, Associate Professor in Clinical Microbiology, whom he states, ‘laid the foundations for modern training and

Prof. Rogers, Prof. Conor Keane and recipients of the Conor Keane Medal

practice of the Discipline of Clinical Microbiology’ in Ireland and was instrumental in the creation of the Chair position that Prof. Rogers was appointed to.

Ever-evolving- the field of Clinical Microbiology Prof. Rogers describes the field of Clinical Microbiology as ‘dynamic’ and ‘ever evolving’, much like the microorganisms that cause major infectious diseases. He reflects on the policy changes that occurred in many countries in the 1960s that diverted funding from infectious disease research into other medical specialties, as there was a prevailing view that the ‘war against infection’ was won following the discovery of penicillin and development of further antibiotic classes. However, he notes that he could ‘almost name on one hand’ the number of genuinely new antibiotic classes that have been brought to market in the last 10-15 years. Prof. Rogers added that he always emphasises to the medical students that bacteria are far more adaptable than humans as they “outnumber us, and they replicate and can mutate more rapidly in order to survive”.

While we have been rightly concerned with the Covid 19 pandemic over the past two years, it is easy to forget the other ‘plagues’ we have experienced in the past 15-25 years: MRSA and multidrug resistance in gram-negative bacteria have caused significant problems in both the hospital and community settings. In the past 50 years many new diseases and their causes have been discovered such as HIV, Ebola, Lyme Disease and Legionnaire’s Disease and there is increasing evidence that specific cancers are due to infectious agents, a prime example being Burkitt’s Lymphoma.

A triggering event Prof. Rogers was the Consultant Microbiologist at the Westminster Children’s Hospital in London during his time at Hospital in London during his time at the Westminster Medical School. A new bone marrow transplant unit was being built in the facility at the time, while continuing with bone marrow transplant procedures for children with leukaemia or rare metabolic conditions in the older adjacent building. During this time several children were infected and died from what later transpired to be the fungal infection Aspergillosis.

This experience led Prof. Rogers to specialise in the study of fungal diseases, particularly fungal diagnostics and treatment. Together with international collaborators, including Prof. Mat Fisher, coincidentally from Imperial College London, he and colleagues from other Irish institutions will soon publish on a major form of antifungal drug resistance in Aspergillus fumigatus that seems to be driven by the global use of fungicides in agriculture and floriculture that are similar to certain antifungals used in humans to treat

Changes in Teaching and Learning in Medicine Prof. Rogers describes how when he started teaching in the 1970s, small group teaching of 8-10 students per tutorial was the most common format and it was possible to get to know each student individually - some better than others it transpires, as this is how he met his wife when he couldn’t answer a microbiological question that she posed to him as a medical student; at least she was impressed! When he returned to Trinity College in 2004, similar small group tutorials were also commonly used to teach Microbiology, a resource-intensive strategy as, at the time, Prof. Rogers and Dr. Fred Falkiner

were the only academic microbiologists on staff, supported by clinical colleagues in the affiliated hospitals. With the increasing numbers of students in Medicine, teaching in small groups has become logistically quite difficult and not getting to know students individually is described

by Prof. Rogers as ‘a pity’. However, he counters this by describing the excellent student experience current team or hybrid teaching initiatives in the School brings and discusses how such strategies can inspire students to become interested in the field, citing a student who recently asked if they could work on a research project with him or his colleagues after such a teaching session.

Prof. Rogers does raise some concerns, as do all academics, about students ‘learning for exams’, rather than having a true understanding of the area which could facilitate their becoming infection specialists and future leaders in the field.

Prof. Rogers, together with Prof.

Stephen Smith developed a postgraduate diploma and Masters programmes in Clinical Microbiology 11 years ago, an initiative that clearly has been a rewarding experience for him as well as the students who have completed the programme. It started with a small intake of 3 students and now has an annual intake of 11-12.

Despite the pandemic, face-to-face teaching has been able to continue, which clearly has taken a significant level of organisation and dedication by a small Discipline in the School.

Masters in Clinical Microbiology Graduation Day

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Challenges for the future Prof. Rogers describes the difficulty with time management in the specialty and jokes that ‘whoever comes into this post will have to probably be a better time manager than I have been’. One challenge Prof.

Rogers cites is the ability to network with others in the field, given that it is a very specialist area, and encourages the new Chair to find cross linkages with colleagues in the Microbiology department in the Moyne Institute and well as interdisciplinary research strands within the School and College.

Combining interests-plans for retirement Prof. Rogers holds a grant funded by the Department of Agriculture in collaboration with four other university organisations in Ireland that is investigating whether farm animals play a role in transmission of Clostridioides difficile (the C. diff bug that causes infectious intestinal infection) to humans.

This project has been delayed by the pandemic so he and colleagues expect to continue to work on this into 2022.

Outside of that, he has an interest in astronomy and of course when the age-old question ‘is there life out there?’ is posited, that generally refers to bacterial or other microbial life - a perfect marriage of fields for Prof.

Rogers it seems!

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The best model of human disease is the human Professor Orla Hardiman. Professor of Neurology, Consultant Neurologist and Leader, ALS/MND Clinical and Research Group, Trinity College Dublin and Beaumont Hospital

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eurodegenerative diseases are debilitating incurable conditions that cause decline in movement, thinking and behaviour.

Amyotrophic Lateral Sclerosis (ALS) accounts for up to 10,000 deaths in Europe and costs >€600 million each year in care. It occurs in midlife and is primarily associated with degeneration in motor pathways, but also affects thinking and behaviour.

Researchers in the Academic Unit of Neurology have worked on ALS for the past 25 years in Ireland, and have has identified different subtypes of ALS including forms with varying degrees of cognitive and behavioural change. They have also shown a link between ALS and schizophrenia. They found that genetic factors account for about half of the risk of developing ALS and were involved in the discovery of many new genes for ALS. Two of the known genes that cause ALS have already been the target of a precision medicine-based approached toward therapy. These are SOD1 and C9orf72, and the group have participated in early phase gene therapy studies of C9orf72 that look promising.

“ALS is not untreatable; it is understudied and underfunded. Our work will change this .

Our goal is to find the right drug for the right patient in the right dose, at the right time”.

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However, for the forms of ALS in which there is no clearly established genomic basis, clinical trials of over 70 compounds have failed to demonstrate benefit despite positive outcomes in animal models. The reasons for this failure in translation from animal models to human trials are multifactorial, but can be grouped into four major categories, namely: (1) limited knowledge of different disease mechanisms in humans; (2) use of animal studies to incorrectly infer how the disease is likely to develop in humans; (3) an absence of reliable human markers of disease mechanisms; (4) inefficient or poorly designed clinical trials.

Within the Academic Unit of Neurology, researchers have initiated a radical change in perspective in how ALS is studied. As clinician scientists, they have shifted the main focus of research from laboratory-based work to applied clinical research in patients (https://rmn.ie/). They study individual aspects of a patient, including their genetic makeup, key biomarkers, prior treatment history, family history, environmental factors and behavioural preferences, as these all inform how human disease develops and progresses. This in turn influences design and testing of new treatments. Along with colleagues in the European Consortium TRICALS (www.tricals.org) the group have combined their extensive work in epidemiology, clinical assessment, family history studies, imaging, neuro-electric-signalling, genomic and biomarker datasets to make new discoveries into the causes and progression of ALS, and to develop new and more effective treatments.

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By disrupting the traditional focus on laboratory-based work and animal models and focussing instead on how best to maximise our understanding of human disease in humans, they bring the same scientific rigour that is applied to the laboratory model to human neurodegenerative disease.

The group’s international work, in collaboration with colleagues at the ADAPT Centre, will continue to process clinical data at scale, such that they will be able to provide a unique multimodal composite of the disease expression and progression for each individual that will help to drive new and more effective treatments for this tragic condition.

Alzheimer’s disease – The road to a cure

By Iracema Leroi

On the eve of World Alzheimer’s Day, Professor Iracema Leroi (Principal Investigator with Dementia Trials Ireland, a HRB research network to enhance dementia care and outcomes) discusses the importance of clinical trials for Alzheimer’s disease and other dementias.

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n a dark November morning in 2018, I sat on an early morning train to London. The destination was an advisory board meeting on the potential roll-out of what was anticipated to be the first disease-modifying treatment for Alzheimer’s disease to receive a licence globally. As I relaxed into my seat with my coffee for the twohour journey, I opened the Financial Times and read the devastating news that the definitive trial of this drug had “failed”. There would be no new disease-modifying treatment after all, devastating the hopes built over 20 years of painstaking research involving thousands of study participants and millions of euros.

This trial was to be the definitive one, addressing all lessons learned over the past several years, with a near perfect study design. But it was not be, and this setback for the entire dementia community led to some pharmaceutical companies dramatically scaling back their Alzheimer’s research programs. Much gnashing of teeth followed, with some suggesting that a cure for Alzheimer’s would never be found.

Professor Iracema Leroi is Principal Investigator with Dementia Trials Ireland, a HRB research network to enhance dementia care and outcomes.

A geriatric psychiatrist working with people who have developed dementia, Iracema leads the ‘Mind and Memory’ clinic at St. James’s Hospital in Dublin, which aims to support people with cognitive and behavioral complications in Parkinson’s-related conditions, including Lewy body dementia.

“Giving up is not an option.”

In the past 25 years, over 99% of clinical trials for new dementia drugs have failed.

In most fields, this would cause profound nihilism. But the overwhelming need for them, and the high prevalence of Alzheimer’s disease and other dementias, demands that we in the dementia community continue seeking a solution.

Giving up is not an option.

Fast forward to 2020, mid-pandemic.

The USA’s Federal Drug Agency (FDA) receives an application for clinical licensing from the pharmaceutical company, Biogen, for their new drug Aducanumab. Aducanumab is one of several drugs called monoclonal antibodies which attack the abnormal proteins in the brain associated with Alzheimer’s disease. The application was based on two large clinical trials, one of which had shown a positive outcome, and another which had “failed”. Regardless, the need for a new drug for Alzheimer’s was so great that in March 2021, a licence was granted. In America, a potential disease-modifying drug for Alzheimer’s is now available.

Unfortunately, much controversy surrounds the decision to licence it due to inconsistency in the data.

However, that discussion is for another day.

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“Research and clinical trials make a difference.”

This brings me to the point my blog – the critical importance of clinical trials for Alzheimer’s disease and other types of dementia. Our current treatments and interventions for this complex array of brain conditions is still very limited. While we talk a lot about ‘brain health’ and ‘dementia prevention’, our ability to arrest progression of dementia remains inadequate. Hence, clinical trials must continue. We need more trials, more interventions to trial, and more people volunteering to participate in trials. This is how cancer drugs have succeeded so well, and this is the only way we can more forward as a dementia community. National and regional infrastructures to support clinical trials for cancer have dramatically improved survival rates, showing that research works.

Research and clinical trials make a difference. We now need to translate this energy and experience into dementia.

In the UK, about a decade ago, fewer than 1% of people with dementia were enrolled in clinical trials. Following the Prime Minister’s Dementia 2012 Challenge there was a national push to increase capacity and capability for dementia trials, which resulted in a substantial increase nationwide.

What about Ireland? Today, only a few centres have conducted dementia trials, meaning that only a tiny handful of the over 60,000 people with dementia in Ireland have had the opportunity to participate in a study and access a potentially important treatment. This needs to change.

Ireland must take its place at the international table of those changing the landscape for dementia treatment.

That is the only way that people in Ireland will have early access to new treatments when they at last start emerging.

A national infrastructure for dementia trials In November this year, Dementia Trials Ireland (DTI), a HRB research network

to enhance dementia care and outcomes, will be launched. Funded by the Health Research Board for five years, DTI will create a national infrastructure to develop, attract and conduct dementia clinical trials across the state. Involving both lay and professional members of Ireland’s dementia community, DTI aims to significantly increase the capacity and capability to successfully undertake clinical trials across the range of stages of dementia (preclinical to advanced stage) and types of dementia (e.g. Alzheimer’s disease, dementia with Lewy bodies, frontotemporal dementia, and others).

DTI will support trials of all kinds, ranging from social and creative arts interventions such as dance therapy to complex drug interventions. It includes all members of the dementia community, working towards the common goal of improving the lives of Ireland’s residents at risk of or living with dementia.

While the licensing of Aducanumab has been controversial, and it’s certainly not the panacea for Alzheimer’s, it nonetheless marks a critical point on the pathway to better treatment. It has excited and galvanized the dementia community.

DTI is now part of this excitement, building the future for dementia trials’ research in Ireland into the future.

Further reading: HRB announces €6 million investment for Clinical Trial Networks on the eve of International Clinical Trials Day 2021

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A day in the life interview

By Iracema Leroi

Philomena McAteer and Siobhan Ward work as Chief Technical Officers in Trinity’s Dept of Anatomy.

An interview via Zoom on April 14, 2021, during Ireland’s third pandemic lockdown

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ou have both been in the job for over 40 years… why is that?

Siobhan: Our work is a bit unusual very niche, I’d say.

Anatomy was an unusual area to be working in and not readily transferrable, jobs weren’t that easy to come by in those early days, there was high unemployment so having an interesting job with full education provided by TCD meant I was happy to stay … little did I know I would stay so long.

Also seeing and being a part of developments in Anatomy can be rewarding. We enjoy the energy of the students and meeting with so many wonderful donors and their families.

Trinity is a lovely place to work, an oasis in the city centre.

What was the path that got you here?

Siobhan: I started back in 1977 in the ‘dark ages’ with two very ‘old’ gentlemen, Edward and Gerald, (they were only in their 40’s & 50’s)!

I saw a job advertised in the paper looking for a trainee technician in Anatomy and was interviewed

by Prof Erskine, Dr Blanche Weekes and Brian Thornburgh.

I sensed on entering the Anatomy Building an atmosphere that was unique, in that I was met at the door and ushered to the waiting area, which was surrounded by “No Entry” warning signs; it was indeed an interesting interview. I had no idea that I would be working with the dead… that was explained to me at the interview. I thought, well, that’s different, I think I will be ok with that.

I started as a trainee technician and progressed to Chief Technical Officer having qualified from TU Dublin. At that time TCD provided day-release for technical staff training, so day and night classes were the order of the week!

My mother didn’t like me being in the job; however, I ended up being the first female technician in Anatomy… today we are a team of 4 female technical staff!!!

Philomena: Like Siobhan, I saw a job vacancy advertised in the paper and applied! I was interviewed in 1981

by Professor Erskine, Dr Weekes and Pat Daly in the Old Anatomy Library. I was successful in the interview and so began my journey in Anatomy.

I studied science and laboratory techniques at Letterkenny IT and when I started in Trinity Siobhan and I completed our studies together, with day release and night classes. I was

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lucky to have Edward Kermode, Gerald O’Neill, and Siobhan Ward as mentors for me in those early difficult days.

Starting in Anatomy might not be as easy as starting in other areas, as the main requirement was to work with donor bodies…preserving remains and preparing classes for medical and therapy students.

develop the TCD Body Donor Program over the past years.

What aspects of body donation have you each researched?

Philomena: My MSc research focused on ‘What is the impact of whole-body

Day -2-Day: Siobhan and Philomena receive many enquiries (phone calls, letters, emails) each day from altruistic people who want to donate their bodies to medical science. Information packs and registration forms are sent out each week. Trinity’s human body donor program receive on average 15 - 20 donors each year. These bodies are preserved and used for teaching anatomy in daily practical classes to over 600 medical, dental and therapy students. Over the years, the program has been awarded various accolades for its contribution to medical science.

Siobhan and Philomena make every effort to listen to the needs of donors, bereaved donor families and students to ensure that each donor and their family is given the highest level of respect by everyone involved in the program. Together, they have expertly and sensitively managed Trinity’s Body Donor program helping donors and their families navigate the donation process during a most difficult time in their lives. They are also responsible for providing practical classes for scores of medical & therapy students along with Surgical Training events and conferences.

How have you furthered your education?

Siobhan: in 2010, the SOM supported us both to complete MSc’s in Bereavement Studies run by the Irish Hospice Foundation and RCSI. This has informed our work and helped to

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donation on the bereaved donor family?’ One of the findings from this research was that bereaved families would benefit from having a place to gather, while the donor was residing with us. During the planning for the new building we requested a ‘The Remembrance Room’ and this was accommodated. This has proved very beneficial to families, staff, and students. Along with this Remembrance Room we hold an Act of Remembrance and Thanksgiving in the College Chapel every 2 years which is also a support for families, staff, and students.

Siobhan: My research focused on the student experience. I asked the question “Are students adequately prepared to encounter donor bodies” and if not, how can we help to prepare them for working with the body in practical classes. This led to

the introduction of an orientation programme for 1st year students, to help prepare them better to encounter the body for the first time.

When introducing students to the donor body for the first time it is important to consider students’ past experiences, their religious and cultural backgrounds, age, and peer support. Some students may have a family member ill at home or in hospital or may have had a recent bereavement, which might make working in anatomy more challenging for them. Many international students are far from home when they have this first experience and we are very aware of their needs.

Another important development is that we now use the donor’s first name, rather than a number, when referring to the body. Students really value this, and it brings an important element of humanity into the process.

Tell me about Job-Sharing: Shivil: In 1996 with children starting school and trying to manage family and work life we applied to job share our position as senior technical officers on a trial basis. This created a temporary vacancy which was competently filled

by Mary Lynch.

In 1999, the then Chief Technical Officer, Gerald O’Neill, retired and the post was advertised, and again we decided to apply on a job-sharing basis. At this point in time there was no job sharing Chief Technical Officers, so this was a ‘first’ and the idea was not without criticism!!! To succeed, we

needed the endorsement of Prof Moira O’Brien, who was the first female Professor of Anatomy in Trinity.

Following the joint interview process we became the first job-sharing Chief Technical Officers in TCD. Another vacancy was thus created, and Claire Murphy successfully joined the team. It’s interesting to note that this team of 4 technical staff have remained together in Anatomy since 1999 following the long tradition of our predecessors (Edward Kermode, 57 years and Gerald O’Neill, 50 years, Siobhan, 44 years, Philomena, 40 years, Mary Lynch, 28 years and Claire Murphy, 22 years!!!). Perhaps the formaldehyde has helped to preserve the A-Team!!

Looking back now we can safely say that job sharing worked well for us and for college; we have seen our private and working lives roll out in parallel – marriage, children, further education, house moves, aging parents, illness, etc.

We have been described in College in many ways; one being “the pantomime horse” coined by Pat Daly and the other which combines

Siobhan and Phil “Shivil” coined by Paul Glacken, as a convenient way of addressing both of us simultaneously!!

What is one of the most Challenging aspects of the job?

What changes have you seen over the years?

Shivil: One major highlight and challenge in our career was when we were asked in 2012 by Loose Horse Productions to consider taking part in an RTE documentary which would examine the workings of the TCD Body Donor Programme, called A Parting Gift. This meant we were opening our doors to the public for the first time, to provide information and insight into the day to day operations of a modern donor programme.

Shivil: One of the biggest changes for us was the move from the Old Anatomy Building on campus to the new build, TBSI in 2011. This move celebrated 300 years of medical education at TCD and provided a fitting place for donor bodies to reside. Packing up and leaving the 1890 Anatomy Building was not an easy task! However, with the move we gained a dedicated Remembrance Room, a ‘state of the art’ Anatomy Dissection Theatre with modern AV facilities, a new Mortuary and Embalming facility in a very bright and clean new build. But… we forfeited the Old Anatomy Building and 1825 Museum.

The Old Anatomy Museum now lay vacant, housing our rich anatomical past. The question was how to manage this heritage site?

The atom was split in 2016 and Siobhan took herself off to the ‘Mother Ship’ Old Anatomy and Philomena remained in the ‘Star Ship Enterprise’, TBSI. Curating the contents of the old anatomy building was an enormous task. Initially the School of Medicine provided some students to assist Siobhan in the clearing out and sorting of the contents of the building.

This was the start of curating of the old anatomy collection, which is ongoing today, thankfully with the help and expertise of our new colleague and curator Evi Numen.

Interesting times ahead with the continuous development and plans for this area.

Traditionally Anatomy operated a ‘closed door policy,’ as a protection for the donor bodies. Now we had to consider allowing TV cameras to enter our domain. Why would we do this? With great consideration we thought about the benefits of providing information that was open and transparent, while still protecting the donors and their families. It was a huge challenge to get it right! So, with the backup and support of the Donor Families, Anatomy Staff, School of Medicine, College Secretary, College Communications, College Community and the Provost this documentary aired in November 2014 and was very well received. The main success of this documentary is that it gave a voice to donors and their families for the first time. Other highlights were being nominated for an IFTA award and receiving ‘The Provost’s Award for Enhancing the Trinity Experience’.

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To find out more about body donation, please see the documentary, ‘A Parting Gift’

Another significant challenge was a live broadcast on RTE, called ‘Growing Up Live’ which was hosted

by Old Anatomy and was run during Science Week and aired in 2018. This was a major operational challenge for College and along with allowing access to a live audience and a huge crew it had to be managed with great care and vigilance. Thankfully, Estates and Facilities staff performed brilliantly as always! But for me, Siobhan, giving a live presentation was both exciting and daunting!

The day to day challenges in Anatomy are dealing with bereaved donor families, looking after students in the Anatomy Dissection Theatre, caring for the donor remains and attending donor funerals.

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During this covid-19 pandemic we had to suspend the donor program and explain this to families. Declining donors at any time is difficult and always a challenge. Thankfully when the vaccines are fully rolled out, we will be able to receive donors again.

Another ongoing challenge in Old Anatomy is addressing ethical considerations regarding the use and display of sensitive historical human remains.

Thankfully we can contact the Inspector of Anatomy, Professor Ceri Davies, for guidance and advice on any challenges relating to the donor programme.

Please share a meaningful experience you have had recently.

Shivil: We recently had a plastic surgeon practicing skin grafts techniques using one of our donor bodies. The donor’s name was Mary Ellen. Following this the surgeon performed surgery on the living patient. The surgeon wrote a note to the family thanking them for this invaluable experience.

Trinity IGNITE -Leading the way on patient and public involvement

A

bhisweta Bhattacharjee doesn’t want to change the world: she wants people with dementia to do it: “My work is about trying to create meaningful and active partnerships between researchers, clinicians, artists and people directly affected by dementia. We call it PPV – person and public voice, but it’s also known as PPI, or public and patient involvement. And it’s transformational”.

Bhattacharjee is the Research Project Coordinator in the Global Brain Health Institute (GBHI), colocated between Trinity and UCSF in San Francisco.

Abhisweta Bhattacharjee

‘‘My work is about trying to create meaningful and active partnerships between researchers, clinicians, artists and people directly affected by dementia’’.

“Our role”, she says, “is to integrate the culture of involving people living with dementia and their carers into the operational, training and research activities of GBHI, both here and in the States. We’ve done this through creating our own PPV panel to advise us on everything we do. We’ve also developed training for our Atlantic Fellows programme so that, regardless of where people are from, they get some exposure to working in partnership with people with dementia, their carers and supporters. And, right now, we’re working on a global toolkit, so that people can develop PPV projects that are appropriate to their own cultures. It’s an exciting time.” The GBHI PPI program was instigated and is now led by Professor Iracema Leroi, Department of Psychiatry. “Our role”, she says, “is to integrate the culture of involving people living with dementia and their carers into the GBHI PPI program was instigated and is now

By Michael Foley

Michael Foley led by Professor Iracema Leroi, Department of Psychiatry.

The successful training element to the programme has been rolled out

by Dr Sarah Fox, a Project Manager with the Manchester Health and Social Care Partnership and previous Atlantic Fellow, and Michael Foley, Programme Manager for Trinity’s PPI Ignite Office, a HRB-IRC funded initiative to promote and celebrate public and patient involvement across Trinity.

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“PPV is a type of ‘knowledge equity”

Fox sees the benefits of researchers getting involved in PPV: “It can have a real impact on researchers, the research itself and the patients and public contributors involved in the process. In fact, in the field of dementia, I’d argue that the benefit for patients may be even greater.

Dementia is still widely stigmatised; there is still this prevailing and damaging view that people with cognitive impairments won’t be capable of contributing to academic activity”. Foley agrees: “The people with dementia I’ve spoken to have told me about experiences of feeling written off, feeling that they are spoken about but not spoken to.

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This work, I think, helps people to regain some sense of agency over the condition, that they are making a difference for the next generation.

Many are driven by the hope that future generations won’t have to go through what they’re going through.

And, as people living with dementia, their insights can really change how researchers see a problem”. “PPV is a type of ‘knowledge equity”, says Fox, “It recognises the unique experiences and perspectives patients and members of the public bring to this process.”

GBHI are also working on a PPV Global Toolkit, in order to spread the idea of people with dementia being involved in research around the world. “This is being led out by Prof Leroi,” says Bhattacharjee. “There is such diverse regional intelligence with the Fellows around the world, that it will be very exciting to see how PPV can work in cultures where hierarchical structures and attitudes in healthcare exist.

Giving people with dementia a voice might just change everything.”

The Journey to Online Education

By Dr Jennifer Conlan

I

first walked through Front Gate as a Natural Science’s student in October 1998. It is difficult to believe that it was so long ago until I look around at the advances we have made since then. One of the things that strikes me most is the many technological advances that have taken place over the years (almost a quarter of a century but who’s counting?!) I got my first primitive mobile phone as a Fresher but it could do little more than send a text message and make a phone call. I was given my Trinity login details so that I could access the internet in college and use email for the first time. Students queued up to use a computer in one of the PC or MAC rooms dotted throughout college. We saved our assignments and projects on floppy discs or zip discs. Researching a project certainly involved a trip to the library to find the books and papers needed as it was not possible to access these resources online. Students relied on their trusty Kopikat photocopying card to make physical copies of these resources, always hoping there were enough ‘units’ on the card to get the job done. Photocopiers were in high demand in the run up to examination time when students were scrambling to make copies of the coveted past examination papers in the library.

In the lecture halls, PowerPoint didn’t exist. The lecturer would either use a slide projector or an overhead projector. Some lecturers would

Dr Jennifer Conlan (School of Medicine) have pre-prepared printed acetates or others just simply wrote up some notes on a blackboard. If we were very lucky the lecturer would supply us with some photocopied handouts.

Following my undergraduate and postgraduate degrees in Trinity I went back to study Medicine in 2005. Things were really starting to change at that point. PowerPoint was becoming the norm in lecture theatres with slideshow and overhead projectors beginning to gather dust. Some students even had their own personal laptops and lecture notes were emailed to the class (if the file sizes weren’t too large!).

I have been a staff member in the School of Medicine for almost 10 years now and the pace of technological advances seems to have increased exponentially over that time. The Covid pandemic saw the use of online teaching and examination tools to facilitate remote teaching and

examinations. We also communicate in different ways, for example via Zoom. We use a range of devices such as smartphones and tablets. I could never have imagined such advances back in 1998 but students today turn first to online resources and are used to having vast quantities of knowledge at their fingertips.

The School of Medicine established an Online Education Committee (OLEC) in May 2020 to promote and advance high quality online education throughout the school. There are currently over 45 purpose built online education projects within the school. These projects focus on many different aspects of online education, whether stand-alone courses or in support of more traditional teaching.

They represent all 5 undergraduate disciplines, postgraduate teaching and the public domain (through MOOCs).

I am certainly excited to see what the next 25 years of online education will bring!

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Meet the Team

Iracema Leroi

Michelle Leech

Steve Thomas

Mary O’Neill

mednews@tcd.ie

Lucie Mingmei Hao

Michelle Hendrick