scholarly journals How to apply clinical cases and medical literature in the framework of a modified “failure mode and effects analysis” as a clinical reasoning tool – an illustration using the human biliary system

2016 ◽  
Vol 10 (1) ◽  
Author(s):  
Kam Cheong Wong
Author(s):  
Matteo Coen ◽  
Julia Sader ◽  
Noëlle Junod-Perron ◽  
Marie-Claude Audétat ◽  
Mathieu Nendaz

2013 ◽  
Vol 88 (4) ◽  
pp. 541-544 ◽  
Author(s):  
Jose Alexandre de Souza Sittart ◽  
Monica Senise

BACKGROUND: cutaneous metastases are not so frequent and in the medical literature there are several communications of isolated cases, thereby we decided to continue our study initiated in 1981 (45 years).OBJECTIVE: our objective is to present the research and review of cutaneous metastases of 45 years through our archives at Hospital do Servidor Publico Estadual de Sao Paulo. METHODS: the data were collected from clinical cases registered in our archives at anatomopathology department.RESULTS: since 1963 we have registered 209 patients with cutaneous metastases being the anterior thorax region the most affected area and in second place the abdominal region. Breast cancer was responsible for most of the cases in women and the lung in men.CONCLUSION: this study represents a signioficant number of cases in medical practice because skin metastases of internal carcinomas rarely are observed and the great predominance, mainly due of his origin were represented by adenocarcinomas.


2020 ◽  
Vol 22 (Supplement_L) ◽  
pp. L121-L123
Author(s):  
Claudio Rapezzi ◽  
Massimiliano Lorenzini

Abstract Clinical guidelines irreparably characterize contemporary medicine. Referring to guidelines has become routine in both medical literature and daily clinical activity, with the risk of becoming the only—or at least the main—inspiring element of the physician's behaviour. This would lead to the mortification of clinical reasoning, a term that is synonymous with an individualized approach, focused on the single patient, and not on a population.


2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
A Fassa ◽  
E J Fantinel ◽  
D C Soares ◽  
M L V Carret ◽  
R Linhares ◽  
...  

Abstract Background Health service evaluation studies point to the low quality of care, however the permanent education of health professionals is a major challenge. Within the scope of the Open University for the Unified Health System (SUS), the Department of Social Medicine of the Federal University of Pelotas produced open access self-learning courses, for primary health care, based on interactive clinical cases, through distance learning. Methods The courses, with 45 hours, provides interactive clinical cases, medical calculators and textual materials for use by the professional or with the community. The cases are presented and followed by multiple choice questions, focusing diagnosis and treatment. The feedback is automatic. An expanded theoretical content ('learn more') that privileges the use of illustrations, images, infographics and flowcharts useful for professional practice can be accessed. Bibliographical references on the subject are also available. The courses are available in a responsive web client app, for various types of devices, providing control of progress and automatic certification. The app allows the work offline, enabling the permanent education of professionals working in remote areas. Results Six courses were produced for doctors, nurses and dentists, more than 30,000 users were certified. Conclusions This problem-based learning initiative allows the student to have a menu of cases, providing a choice of the subject, decision on the time allocated to the activity, repetition according to its need, access to a large bibliography and reading in the quantity and depth chosen by the student. In addition, the format is challenging and develops clinical reasoning. The proposition of questions promotes the reflection of the student in relation to his knowledge on the subject. Automatic feedback, 'learn more' and selected bibliographies provide formative assessment and subsidize students to define their study needs in each subject. Key messages Distance learning expands the possibility of qualifying the clinical practice of health professionals, especially those in remote areas. Interactive clinical cases provide the development of clinical reasoning, content review and promote formative assessment.


Author(s):  
Людмила Круглякова ◽  
Lyudmila Kruglyakova ◽  
Сергей Кругляков ◽  
Sergey Kruglyakov

Last years are marked by the increased number of cases of extra pulmonary localizations of tubercular process that are proved by the numerous publications. The diagnostics of these forms of tuberculosis is not easy because it requires a detailed examination of the patient. Cases of abdominal tuberculosis are among them. The article contains the data of modern medical literature on extra pulmonary forms of tuberculosis and information of clinical cases of posthumous diagnostics of tuberculosis of serous membranes of abdominal cavity and lungs.


2018 ◽  
Vol 16 (3) ◽  
pp. 366 ◽  
Author(s):  
Luciana Silva de Melo ◽  
Lyvia Da Silva Figueiredo ◽  
Juliana De Melo Vellozo Pereira ◽  
Paula Vanessa Peclat Flores ◽  
Marina Einstoss Barbosa Siqueira ◽  
...  

Aim: to identify educational strategies used in the training of nurses regarding the process of nursing involving standardized language systems. Method:  this is  an  integrative  review  of  the  relevant  literature,  performed  using the  following databases:  MEDLINE,  via  PUBMED;  CINAHL; SCOPUS;  and  LILACS.  Results: six  papers were  selected.  The  main  features  of  such  papers  were:  the  use  of  a  practical  guide, workshops,  study  groups,  recording  using  standardized  instruments,  discussion  of studies  based  on  fictitious  and  real  cases,  theoretical-practical  classes  using  clinical cases, and guided clinical reasoning. Discussion: the knowledge produced regarding the strategies used to train nurses about the nursing process – with or without standardized language  systems –  reinforced  the  importance  of  such  strategies  to  produce  clearer recorded  information,  as  seen  in  four  clinical  studies  and  two  descriptive  ones. Conclusion:  educational  strategies  involving  standardized  language  systems  in  the training of nurses promote development in the implementation of nursing processes.


2020 ◽  
Author(s):  
Sungjun Choi ◽  
Sohee Oh ◽  
Dong-Hun Lee ◽  
Hyun-Sun Yoon

Abstract BACKGROUND: There are few studies that directly compared different interventions to improve medical students’ clinical reasoning for dermatologic conditions. OBJECTIVE: To investigate the effectiveness of adding practice with reflection and immediate feedback on traditional dermatology electives in improving medical students' ability in evaluating skin lesions.METHODS: The participants were fourth-year medical students of Seoul National University College of Medicine, Korea, who were enrolled to take a 2-week dermatology elective course (n=87). Students were assigned to one of the three educational interventions: 2-hour training involving 10 written clinical cases (experimental); 1-hour lecture and 1-hour outpatient clinic (lecture); and 2-hour outpatient clinic (no intervention). Before and at the end of rotation, diagnostic accuracy was estimated using 20 written clinical cases with photographs (10 novel cases presented in diagnostic training [training set], 10 cases with diagnoses not included in training [control set]).RESULTS: There was a significant interaction effect of intervention×set×time. A post hoc analysis indicated that the students in the experimental group outperformed students in the other two groups only in the training set of the final tests; after completing the 2-week rotation, for the training set, the mean score was higher in the experimental group (7.5±1.3) than in the lecture (5.7±1.6) and no intervention (5.6±1.3) groups, producing an effect size of 1.2 standard deviation (SD) and 1.5 SD, respectively. CONCLUSION: Practicing written clinical cases with reflection and feedback is superior to a lecture-based approach and yields additional benefits to a dermatology elective, thereby enhancing medical students’ ability to accurately diagnose skin lesions.


2020 ◽  
Author(s):  
Sungjun Choi ◽  
Sohee Oh ◽  
Dong-Hun Lee ◽  
Hyun-Sun Yoon

Abstract BACKGROUND: There are few studies that directly compared different interventions to improve medical students’ clinical reasoning for dermatologic conditions. OBJECTIVE: To investigate the effectiveness of adding practice with reflection and immediate feedback on traditional dermatology electives in improving medical students' ability in evaluating skin lesions. METHODS: The participants were fourth-year medical students of Seoul National University College of Medicine, Korea, who were enrolled to take a 2-week dermatology elective course (n=87). Students were assigned to one of the three educational interventions: 2-hour training involving 10 written clinical cases (experimental); 1-hour lecture and 1-hour outpatient clinic (lecture); and 2-hour outpatient clinic (no intervention). Before and at the end of rotation, diagnostic accuracy was estimated using 20 written clinical cases with photographs (10 novel cases presented in diagnostic training [training set], 10 cases with diagnoses not included in training [control set]). RESULTS: There was a significant interaction effect of intervention×set×time. A post hoc analysis indicated that the students in the experimental group outperformed students in the other two groups only in the training set of the final tests; after completing the 2-week rotation, for the training set, the mean score was higher in the experimental group (7.5±1.3) than in the lecture (5.7±1.6) and no intervention (5.6±1.3) groups, producing an effect size of 1.2 standard deviation (SD) and 1.5 SD, respectively. CONCLUSION: Practicing written clinical cases with reflection and feedback is superior to a lecture-based approach and yields additional benefits to a dermatology elective, thereby enhancing medical students’ ability to accurately diagnose skin lesions. Trial registration: ClinicalTrials.gov, NCT03472001. Registered 21 March 2018, https://clinicaltrials.gov/ct2/show/NCT03472001


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