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Objective: To evaluate the suitability and acceptability of virtual training post accreditation visits conducted online for medical specialist training in ophthalmology in Australia and New Zealand. Methods: A two-phase study (pilot and implementation) was conducted. In the pilot phase, an open-ended observation proforma was used by the authors to independently record their observations, which were later compared and discussed until consensus was achieved. All participants were asked to complete an online survey. A document analysis of accreditation documents was conducted. Observation data were broken down into themes and triangulated with online survey and document analysis results. In the implementation phase, the inspections were observed by one of the authors (SK) and the observation notes were discussed with other authors to obtain a contextual and consensual view. A document analysis of all accreditation-related documentation was undertaken. The documents included in the document analysis were planning and scheduling records, interview and inspection notes, training post inspection fact and document notices and accreditation reports. Finally, a post-inspection focus group of all inspectors was conducted. Results: The accreditation interviews adequately addressed all relevant issues with high levels of robustness and reliability. Participants found it more difficult to discuss complex issues virtually compared with onsite visits. The virtual accreditation reports were not any different to what would be expected if a face-to-face accreditation visit had been conducted; however, it was not possible using the virtual inspection to determine the appropriateness of facilities and clinic layout to support and facilitate trainee learning and supervision. Conclusions: Virtual accreditation of training posts in medical specialist training is viable in limited circumstances where there are no known complex training post-related issues and the site has not made substantial changes to clinic and theatre layout, equipment and facilities since the previous accreditation. What is known about the topic? All medical specialist colleges in Australia and New Zealand accredit the sites where training is delivered, usually by conducting periodic face‐to‐face visits. What does this paper add? This paper provides evidence that in limited circumstances, it is possible to accredit training posts virtually. What are the implications for practitioners? This paper provides an outline of issues to consider when planning virtual accreditation of training posts in medical specialist education. [ABSTRACT FROM AUTHOR]

Objective: The climate crisis necessitates urgent decarbonisation. The health sector must address its large carbon footprint. In the present study, we sought healthcare thought leaders' views about a future environmentally sustainable health system. Methods: The present study was a qualitative exploratory study consisting of semistructured, in-depth interviews with 15 healthcare thought leaders from Australia, the UK, the US and New Zealand. Audio recordings of the interviews were transcribed and analysed by matrix display and thematic analysis. Results: Overall, healthcare thought leaders believe that to reduce the carbon footprint of healthcare we need to look beyond traditional 'green' initiatives towards a more fundamental and longer-term redesign. Five main themes and one 'key enabler' (information communication technology) were identified. In this paper we draw on other relevant findings, but chiefly focus on the fifth theme about reshaping the role of healthcare within society and using the size and influence of the health sector to leverage wider health, environmental and societal benefits. Conclusions: These ideas represent potentially low-carbon models of care. The next step would be to pilot and measure the outcomes (health, environmental, financial) of these models. What is known about the topic?: The health sector needs to reduce its large carbon footprint. Traditional 'green' initiatives, such as recycling and improving energy efficiency, are insufficient to achieve the scale of decarbonisation required. What does this paper add?: Healthcare thought leaders surveyed in the present study suggested that we also consider other, non-traditional ways to achieve environmental sustainability. In this paper we discuss their ideas about adopting an anticipatory approach to healthcare using predictive analytics, and using the size and influence of the health sector to effect wider health and environmental benefits. What are the implications for practitioners?: Achieving an environmentally sustainable healthcare system is likely to require broad and fundamental (i.e. transformational) change to the current service model. Health practitioners throughout the sector must be closely engaged in this process. [ABSTRACT FROM AUTHOR]