Emergency medicine Australasia : EMA
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Emerg Med Australas · Aug 2016
The inverted U curve and emergency medicine: Overdiagnosis and the law of unintended consequences.
We all think and assume that more is better, but unintended consequences can arise in a complex system. However, in our complex world, everything of consequence follows an inverted U curve. The inverted U curve helps us challenge our natural assumption that more is better. ⋯ What patients actually value is thinking doctors who talk to them. Promoting clinical judgement reinforces the mantra that less is more, resulting in positively intended consequences. This essay aims to be a thought-provoking commentary of our practice.
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Emerg Med Australas · Aug 2016
Older adolescent presentations to a children's hospital emergency department.
To describe the characteristics, diagnoses and outcomes of older adolescents, aged 16-19 years, presenting to a paediatric ED. ⋯ A high prevalence of chronic illness was found in older adolescents attending the paediatric ED. There was no evidence that behavioural and mental health issues dominated. These findings reflect admission policy.
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Emerg Med Australas · Aug 2016
Assessing a doctor you've rarely worked with: The use of workplace-based assessments in a busy inner city emergency department.
Historically, end-of-term assessments for Junior Medical Officers in our ED have been completed by nominated Consultants based on varying amounts of observation in addition to feedback from other health professionals. Our hypothesis is that this system of assessment is both inconsistent and unreliable. Our objective was to increase the validity of our assessment process using workplace-based assessments linked specifically to the domains set out in the Australian Medical Council intern assessment form. ⋯ Workplace-based assessments improve the validity of end-of-term assessments for junior doctors in an ED as perceived by those performing the assessment.