Clin Med
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Comparative Study
Assessment centres for core medical training: how do the assessors feel this compares with the traditional interview?
In 2007, an assessment centre approach (a structured interview, a case-based discussion and a communication exercise) was implemented to replace the traditional interview for entry to core medical training. Feedback was obtained from 53 of 69 assessors, all consultants and most with extensive experience of the traditional system. Each station was rated by around 20 interviewers. ⋯ Comparison with the previous system was only provided by between 12 and 21 people per station. The structured interview was rated better (n=12), undecided (8), or worse (1); the case-based discussion better (16), or undecided (3); the communication station better (8), undecided (3), or worse (1). There is still work to do on the best components to include but the principle of multiple assessments to examine differing parts of the person specification seems, subjectively, to be supported.
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Little research has been performed to determine how a stroke unit should be staffed and what the links are between patient dependency and staffing. For this study, 140 stroke units were randomly selected--35 from each of the four quartiles of performance in the National Sentinel Audit of Stroke. A questionnaire was sent to each of the units to collect data on patient numbers and dependency, staffing numbers and therapy, and nursing contact times on a single weekday. ⋯ Of the patients, 74% received physiotherapy, 46% occupational therapy and 25% speech and language therapy during the day with median contact times being 170 minutes for nursing, 40 minutes for physiotherapy, 45 minutes for occupational therapy and 30 minutes for speech therapy. There was a weak correlation between patient dependency and contact time with nurses and therapists. Stroke patients in England receive relatively little rehabilitation from therapists and there is a wide variation in the amount of nursing time each patient receives.
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Significant hypercalcaemia can cause electrocardiogram (ECG) changes mimicking an acute myocardial infarction. It is important to recognise that some ECG changes are due to conditions other than cardiac disease so that appropriate treatment is given, and importantly, inappropriate treatments are avoided.
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Climate change was originally expected to have its main impact on countries in temperate latitudes which, because of their relative wealth, would be best able to cope. It is now far more likely that much poorer states in the tropics and sub-tropics will experience severe impacts. ⋯ The dangerous response to the prospects of mass migration and radical social movements is to attempt to maintain control without addressing underlying problems. Instead, there is an urgent need to embrace new concepts of sustainable security.