Swiss medical weekly
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Swiss medical weekly · Jul 2009
Comparative StudyEmergency medicine training: a prospective, comparative study of an undergraduate clinical clerkship and an army programme.
To evaluate and compare the educational impact of the University of Geneva Faculty of Medicine (UGFM) emergency medicine clerkship training with that provided by the Swiss Army medical officer cadets school (ARMY). The assessment was designed to assess students' clinical knowledge and competency in major emergency situations, ACLS (Advanced Cardiac Life Support) and ATLS (Advanced Traumatic Life Support). ⋯ In general, the multimethod assessment seemed to provide a complementary approach to evaluation of the trainees' competency in emergency training. Except for the ARMY MCQ performance, both training programmes seemed to be effective in improving trainees' overall knowledge and clinical performance. The trainees' performances are reviewed and discussed in terms of the specific skills assessed on the SOE, the context of the trainees' expected level of performance, the teaching and evaluation approaches, and implications in establishing the equivalence of the two programmes.
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Respiratory care is universally recognised as useful, but its indications and practice vary markedly. In order to improve the appropriateness of respiratory care in our hospital, we developed evidence-based local guidelines in a collaborative effort involving physiotherapists, physicians and health service researchers. ⋯ Despite a marked heterogeneity of scientific evidence, the method used allowed us to develop commonly agreed local guidelines for respiratory care. In addition, this work fostered a closer relationship between physiotherapists and physicians in our institution.
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The functional capacity of the human lung as gas exchanger is to a large extent determined by structural design. Quantitative structure-function correlations can be established by morphometry. ⋯ However, these design features also pose problems, such as how to ventilate and perfuse this large surface evenly and efficiently, or how to ensure mechanical stability against surface forces with a minimum of supporting tissue. The discussion focuses on the extent to which novel design principles are used to overcome such problems by designing the airways as a fractal tree and the fibre support system as a tensegrity structure.