The Medical journal of Australia
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To assess the accuracy of data linkage across the spectrum of emergency care in the absence of a unique patient identifier, and to use the linked data to examine service delivery outcomes in an emergency department (ED) setting. ⋯ Our results indicate that automated linking provides a sound basis for health service analysis, even in the absence of a unique patient identifier. The use of an automated linking tool yields accurate data suitable for planning and service delivery purposes and enables the data to be linked regularly to examine service delivery outcomes.
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Emergency departments around Australia use a range of software to capture data on patients' reason for encounter, presenting problem and diagnosis. The data collected are mainly based on descriptions and codes of the International Classification of Diseases, 10th revision, Australian modification (ICD-10-AM), with each emergency department having a tailored list of terms. The National E-Health Transition Authority is introducing a standard clinical terminology, the Systematized Nomenclature of Medicine--Clinical Terms (SNOMED CT), as one of the building blocks of an e-health infrastructure in Australia. ⋯ Existing software systems need to be able to implement these reference sets to support standardised recording of data at the point of care. As the terms collected will be part of a larger terminology, they will be useful for patients' admission and discharge summaries and for computerised clinical decision making. Mapping existing sets of clinical terms to a national emergency department SNOMED CT reference set will facilitate consistency between emergency department data collections and improve the usefulness of the data for clinical and analytical purposes.
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To evaluate an intern educational project, the More Learning for Interns in Emergency (MoLIE) project, designed to increase intern placements in the emergency department (ED). ⋯ The project successfully combined increased intern numbers with educational outcomes that were well perceived by interns and senior staff, without adversely affecting service delivery or supervision workload in the ED.
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There is increasing evidence that educating trainee surgeons by simulation is preferable to traditional operating-room training methods with actual patients. Apart from reducing costs and risks to patients, training by simulation can provide some unique benefits, such as greater control over the training procedure and more easily defined metrics for assessing proficiency. Virtual reality (VR) simulators are now playing an increasing role in surgical training. ⋯ Recent technological developments in other industries using simulation, such as the games and entertainment and aviation industries, suggest that the next generation of VR simulators should be suitable for training, maintenance and certification of advanced surgical skills. To be effective as an advanced surgical training and assessment tool, VR simulation needs to provide adequate and relevant levels of physical realism, case complexity and performance assessment. Proper validation of VR simulators and an increased appreciation of their value by the medical profession are crucial for them to be accepted into surgical training curricula.
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A decline in cognition greater than expected with ageing and accompanied by subjective cognitive concerns or functional changes may be indicative of a dementing disorder. The capacity to correctly identify cognitive decline relies on comparisons with normative data from a suitably matched healthy reference group with relatively homogeneous demographic features. ⋯ Data from 727 healthy older Australians participating in the Australian Imaging, Biomarkers and Lifestyle (AIBL) Flagship Study of Ageing have been used to create a normative dataset. A web-based calculator was developed to simplify the time-consuming process of comparing cognitive performance scores with these representative data.