Establishing the Predictive Validity of the Assessment of Motor and Process Skills for Driving Performance Outcomes.

Importance: Although the Assessment of Motor and Process Skills (AMPS) is an excellent tool for evaluating the functional performance of instrumental activities of daily living (IADLs), a limited number of studies have used the AMPS for decisions regarding the IADL of fitness to drive and community mobility.

Objective: To determine the specificity and sensitivity of the AMPS as a tool for determining a person's fitness to drive.

Design: Cross-sectional observational design.

Improving Functional Outcomes for Vascular Amputees Through Use of Mirror Therapy and Elimination of the Effects of Electromagnetic Fields.

The objective of this pilot study was to investigate the effectiveness of combining an amputee limb cover to eliminate the effects of electromagnetic fields (i.e., pain) and a Mirror Therapy exercise program to improve functional outcomes for vascular amputees.

Participants' preference for type of leaflet used to feed back the results of a randomised trial: a survey.

Background: Hundreds of thousands of volunteers take part in medical research, but many will never hear from researchers about what the study revealed. There is a growing demand for the results of randomised trials to be fed back to research participants both for ethical research practice and for ensuring their co-operation in a trial. This study aims to determine participants' preferences for type of leaflet (short versus long) used to summarise the findings of a randomised trial; and to test whether certain characteristics explained participants' preferences.

Some effects of teaching undergraduate medical students on general practitioner thinking and learning.

Background: This study examined the processes of thinking and learning undertaken by general practitioners (GPs, family physicians) brought about by the presence of undergraduate medical students.

Method: A qualitative study was undertaken using critical incident templates (a novel approach in this context) and focus groups. Data were analysed thematically, with iterative discussion between members of the study team after independent analysis.

A question of balance: a qualitative study of mothers' interpretations of dietary recommendations.

Purpose: Poor nutrition is an increasing problem for economically deprived families, and mothers play a key role in establishing children's diets. We explored mothers' understanding of health-promotion recommendations for healthy eating.

Methods: We conducted qualitative semistructured interviews of 46 mothers within a relatively socioeconomically deprived community.

An evaluation of the sources and availability of careers advice in UK medical schools.

This article reports a study evaluating the sources and availability of career advice available to students in UK medical schools in order to ascertain the need for an enhanced role for careers information in undergraduate curricula.

Evaluation of different delivery modes of an interactive e-learning programme for teaching cultural diversity.

Objective: UK medical schools find it challenging to provide standardised teaching to expanding year intakes. In addition, developing and implementing diversity training can cause difficulties. This paper describes the evaluation of an interactive e-learning programme to raise awareness and understanding of communication difficulties in diversity consultations.

Using postal randomization to replace telephone randomization had no significant effect on recruitment of patients.

Objective: To test the effect of postal randomization on recruitment of patients into a randomized trial in primary care.

Study Design And Setting: General practices used a telephone service to randomize patients in our trial. Delays in the start of recruitment at some sites led us to modify the randomization procedure.

Exploring students' perceptions on the use of significant event analysis, as part of a portfolio assessment process in general practice, as a tool for learning how to use reflection in learning.

Background: Portfolio learning enables students to collect evidence of their learning. Component tasks making up a portfolio can be devised that relate directly to intended learning outcomes. Reflective tasks can stimulate students to recognise their own learning needs.

Improving response rates using a monetary incentive for patient completion of questionnaires: an observational study.

Background: Poor response rates to postal questionnaires can introduce bias and reduce the statistical power of a study. To improve response rates in our trial in primary care we tested the effect of introducing an unconditional direct payment of 5 pounds for the completion of postal questionnaires.

Methods: We recruited patients in general practice with knee problems from sites across the United Kingdom.

The DAMASK trial protocol: a pragmatic randomised trial to evaluate whether GPs should have direct access to MRI for patients with suspected internal derangement of the knee.

Background: Though new technologies like Magnetic Resonance Imaging (MRI) may be accurate, they often diffuse into practice before thorough assessment of their value in diagnosis and management, and of their effects on patient outcome and costs. MRI of the knee is a common investigation despite concern that it is not always appropriate. There is wide variation in general practitioners (GPs) access to, and use of MRI, and in the associated costs.

Learning to mark: a qualitative study of the experiences and concerns of medical markers.

Background: Although there is published research on the methods markers use in marking various types of assessment, there is relatively little information on the processes markers use in approaching a marking exercise. This qualitative paper describes the preparation and experiences of general practice (GP) teachers who undertake marking a written assessment in an undergraduate medical course.

Methods: Semi-structured interviews were conducted with seven of the 16 GP tutors on an undergraduate course.

Students' views of reflective learning techniques: an efficacy study at a UK medical school.

Objective: To describe the effects of a voluntary intervention using reflective learning techniques on students' learning.

Design: An interventional study with reflective learning techniques offered to medical students.

Setting: Year 3 of undergraduate medicine at Cardiff University where the curriculum is integrated with early clinical contact.

Previously unidentified morbidity in patients with intellectual disability.

Background: Adults with a learning disability frequently have unmet health needs. The cause for this is complex and may be related to difficulties in accessing usual primary care services. Health checks have been widely recommended as a solution to this need.

Assessment of professional attitude and conduct in medical undergraduates.

One year after implementation of a new schedule of summative assessment of professional attitude and conduct (AC) for medical undergraduates at the University of Wales College of Medicine (UWCM), we evaluated its effectiveness and obtained feedback of the perceptions of participating teachers and students. An anonymous questionnaire was administered to all 4th year students and their clinical teachers. Four out of 180 students actually failed to complete the 4th year as a result of unsatisfactory AC.

Communication, stress and distress: evolution of an individual support programme for medical students and doctors.

Background: The stress and distress that can be associated with poor communication is well recognised. The problem of how to manage this effectively has yet to be solved.

Methods: In December 2001, the Communication Skills Unit sited in the Department of General Practice in the University of Wales, College of Medicine set up a pilot project for medical students and qualified doctors who were perceived to have communication difficulties.

Putting double marking to the test: a framework to assess if it is worth the trouble.

Background: It is a challenge to assign a mark that accurately measures the quality of students' work in essay-type assessments that require an element of judgement and fairness by the markers. Double marking such assessments has been seen as a way of improving the reliability of the mark. The analysis approach often taken is to look for absolute agreement between markers instead of looking at all aspects of reliability.

Shared decision making and risk communication in practice: a qualitative study of GPs' experiences.

Background: Important barriers to the wider implementation of shared decision making remain. The experiences of professionals who are skilled in this approach may identify how to overcome these barriers.

Aims: To identify the experiences and views of professionals skilled in shared decision making and risk communication, exploring the opportunities and challenges for implementation.

Predicting the clinical course of suspected acute viral upper respiratory tract infection in children.

Background: Suspected acute viral upper respiratory tract infection (SAVURTI) is the commonest acute reason why children consult in general practice. The clinical course varies widely and about one in five children re-consult for the same SAVURTI episode. If clinicians had feasible tools for predicting which children are likely to suffer a prolonged course, then additional explanations and possibly treatments could be provided at the initial consultation that might enable carers to manage the condition without re-consulting.

Communicating about expected course and re-consultation for respiratory tract infections in children: an exploratory study.

Acute respiratory tract infection is the commonest reason for children consulting, and about one-fifth re-consult for the same illness episode. Fifty-nine audiotape recordings from nine general practitioners (GPs) consulting with children with acute respiratory tract infections were examined. Prognosis was mentioned in only 22 consultations, with GPs predicting a brief course in 11, a possibly longer than expected course in six, and with predicted duration not made explicit in five.

The development of COMRADE--a patient-based outcome measure to evaluate the effectiveness of risk communication and treatment decision making in consultations.

Some instruments have been developed to evaluate 'decision effectiveness' such as the 'satisfaction with decision (SWD)' and 'decision conflict (DCS)' scales and are validated for the US context. Patients identify further outcome domains that are not fully covered in these scales. We developed a patient-based outcome measure to evaluate risk communication and decision making effectiveness, addressing these further domains and validated for use in the UK.

General practitioners' use of magnetic resonance imaging: an open randomized trial comparing telephone and written requests and an open randomized controlled trial of different methods of local guideline dissemination.

Aim: To determine the impact and cost-effectiveness of telephone versus written access to magnetic resonance imaging (MRI), and of different strategies for disseminating locally produced guidelines, upon requests by general practitioners (GPs) for knee and lumbar spine investigation.

Material And Methods: Two sequential pragmatic open cluster-randomized trials were conducted within 39 general practices. The outcome measure in each trial was concordance of request with local guidelines.