Clin Med
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This paper outlines the development and evaluation of the utility of workplace-based assessments in higher medical training: case-based discussion (CbD); the acute care assessment tool (ACAT); audit assessment; teaching observation and patient survey (PS). The study population included trainees in higher medical training (ST3+) from physician specialties in the U. K. ⋯ For adequate reliability (co-efficient 0.7) a total of 12 CbDs; three ACATs and 16 PS raters are required. There was evidence for the validity and positive educational impact of all the tools. There were difficulties with the feasibility of the PS.
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Access to adequate clinical information is essential for out-of-hours palliative care teams and general practitioners, specific examples to illustrate and justify this need are surprisingly rare in the medical literature. Without access to the full clinical background the patient in this lesson may have been inappropriately admitted to a palliative care unit and delayed investigations would have misguided the admitting doctor's assessment, planned investigations and management.
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Application for Research Ethics Committee (REC) approval and the conduct of medical research is paper intensive. This retrospective study examined all applications to a single REC in the south of England over one year. It estimated the mass of paper used, comparing the proportional paper consumption of different trial types and during different stages of the research process, quantifying the consumption in terms of carbon dioxide emissions. ⋯ K.; the REC process accounted for 26.4%. REC applications and the conduct of approved trials generate considerable environmental impact through paper consumption contributing to the NHS's carbon footprint. Paper use might be reduced through the implementation of digital technologies and revised research methods, namely changing attitudes in both researchers and ethics committees.