Acute Disease ; Arthritis ; diagnosis ; Edema ; diagnosis ; Female ; Humans ; Middle Aged ; Skin Diseases ; diagnosis ; Syndrome ; Synovitis ; diagnosis

Humans ; Infant ; Male ; Severity of Illness Index ; Vitamin B 12 Deficiency ; complications ; diagnosis

In response to the demands of an ageing nation, the postgraduate medical education in Singapore is currently in the early stage of transition into the American-styled residency programme. This study assessed the expectations of both radiology trainees and faculty on their ideal clinical learning environment (CLE) which facilitates the programme development. A modified 23-item questionnaire was administered to both trainees and faculty at a local training hospital. All items were scored according to their envisioned level of importance and categorised into 5 main CLE domains-supervision, formal training programme, work-based learning, social atmosphere and workload. 'Supervision' was identified as the most important domain of the CLE by both trainees and faculty, followed by 'formal training programmes', 'work-based learning' and 'social atmosphere'. 'Workload' was rated as the least important domain. For all domains, the reported expectation between both trainees and faculty respondents did not differ significantly. Intragroup comparison also showed no significant difference within each group of respondents. This study has provided valuable insights on both respondents' expectations on their ideal CLE that can best train competency in future radiologists. Various approaches to address these concerns were also discussed. The similarities in findings between ours and previous studies suggest that the 'supervision', 'formal training programmes' and 'work-based learning' domains are crucial for the success of a postgraduate medical training and should be emphasised in future curriculum. 'Workload' remains a challenge in postgraduate medical training, but attempts to address this will have an impact in future radiology training.
Attitude of Health Personnel ; Competency-Based Education ; Curriculum ; Education, Medical, Graduate ; methods ; organization & administration ; Faculty, Medical ; Female ; Humans ; Internship and Residency ; methods ; organization & administration ; Male ; Radiology ; education ; Singapore ; Students, Medical ; psychology ; Surveys and Questionnaires ; Workload

INTRODUCTIONThe aim of the study was to determine if age at the creation of an ileal pouchanal anastomosis (IPAA) has an impact on the outcomes in patients with ulcerative colitis (UC).

MATERIALS AND METHODSA retrospective review of all patients who underwent IPAA for UC from 1999 to 2011 was performed. Long-term functional outcome was assessed using both the Cleveland Clinic and St Mark's incontinence scores.

RESULTSEighty-nine patients, with a median age of 46 (range, 16 to 71) years, formed the study group. The median duration of disease prior to their pouch surgery was 7 (0.5 to 39) years. There were 57 (64%) patients who were aged ≤50 years old and 32 (36%) who were >50 years old. Fifty-seven (64%) patients developed perioperative complications of which 51 (89.5%) were minor. High ileostomy output (n = 21, 23.6%) and urinary symptoms (n = 13, 14.6%) were the most commonly encountered complications. The older patients were more likely to have an ASA score ≥3 and a longer length of stay. Although there was a higher incidence of complications in the older group of patients, the difference was not statistically significant. There were no significant differences in the incidence of severe complications. Forty-nine (55%) patients completed our questionnaire on the evaluation of their functional outcomes. There were no significant differences in the Cleveland Clinic and St Mark's incontinence scores between the older (n = 19, 38.8%) and younger (n = 30, 61.2%) patients. There were also no significant differences in the frequency of bowel movements during the day or overnight after sleep between the 2 groups.

CONCLUSIONIPAA procedure for patients with UC can be safely performed. Long-term functional outcome is not significantly influenced by the age at which the IPAA was created.

Adolescent ; Adult ; Age Factors ; Aged ; Colitis, Ulcerative ; surgery ; Colonic Pouches ; Fecal Incontinence ; diagnosis ; epidemiology ; etiology ; Female ; Follow-Up Studies ; Humans ; Incidence ; Male ; Middle Aged ; Postoperative Complications ; diagnosis ; epidemiology ; Proctocolectomy, Restorative ; Retrospective Studies ; Treatment Outcome ; Young Adult

INTRODUCTIONIncidental reports collected in clinical trials suggest that amongst participants, omega-3 fatty acids derived from fish oil ('omega-3') may be difficult to blind.

MATERIALS AND METHODSWe conducted a systematic evaluation of blinding success in a 24-week trial of omega-3 versus an oil-based placebo. Within 1 week of supplement commencement (Week 1), a blinding questionnaire was completed by 131 children enrolled in a trial of omega-3 for the treatment of disruptive behaviour disorders. A version of the questionnaire was also completed by their parents at Week 1, and by the children at the end of supplement administration (Week 24).

RESULTSParticipants were unable to differentiate omega-3 from placebo, and accuracy did not improve as a function of: the confidence of guesses, reason for guesses, notice of any change, beliefs about what should change, or time. Child and parent guesses also showed high concordance.

CONCLUSIONTaken together, these data provide strong evidence that the identity of omega-3 can be blinded to participants.

Adolescent ; Attention Deficit and Disruptive Behavior Disorders ; diet therapy ; Child ; Dietary Supplements ; Fatty Acids, Omega-3 ; therapeutic use ; Female ; Humans ; Male ; Parents ; Single-Blind Method ; Surveys and Questionnaires

INTRODUCTIONThis study aimed to examine the impact of housemanship and cohort effect on the perceptions of what constitutes a "role model physician" between 2 cohorts of medical students.

MATERIALS & METHODSFinal year medical students of the Yong Loo Lin School of Medicine, National University of Singapore, from the classes of 2005 (pre- and post-housemanship) and class of 2009 (pre-housemanship) responded to an anonymous 25-statement questionnaire reflecting Fones et al's 25-item characterisation of a "role model" doctor. Qualitative data was also collected on student's perceived qualities of a role model doctor.

RESULTSFor the 2005 cohort pre- and post-housemanship, only 3 of the 25 items had increased in importance post-housemanship. However, when comparing the 2005 and 2009 cohorts pre-housemanship, the latter cohort placed significantly greater importance on 12 of the 25 items. Willingness to teach was identified via qualitative analysis as a new important quality of a role model doctor for medical students.

CONCLUSIONThe importance placed on characteristics of "role model" physicians were relatively unchanged by housemanship within the same cohort but increased with time between 2 cohorts 5 years apart. This suggests that professional standards of an "ideal" doctor expected and aspired to by medical students may not be eroding as feared by the medical profession and society.

Attitude of Health Personnel ; Humans ; Mentors ; Physician's Role ; Physicians ; standards ; Singapore ; Students, Medical ; psychology ; Surveys and Questionnaires

Competency-Based Education ; Curriculum ; Education, Medical, Graduate ; methods ; Emergency Medicine ; education ; Humans ; Internship and Residency ; methods ; Singapore

Adolescent ; Diagnosis, Differential ; Humans ; Hyperoxaluria, Primary ; diagnosis ; Knee ; diagnostic imaging ; Lumbar Vertebrae ; diagnostic imaging ; Male ; Patella ; diagnostic imaging ; injuries ; Radiography

Biopsy, Fine-Needle ; methods ; Female ; Humans ; Image-Guided Biopsy ; Male ; Specialties, Surgical ; Thyroid Nodule ; pathology

Humans ; Male ; Middle Aged ; Prurigo ; complications ; diagnosis ; Pruritus ; Sciatica