Writing clinical scenarios for clinical science questions.

Written knowledge assessments for physicians in training typically involve multiple-choice questions that use a clinical scenario in a single-best-answer format. The Royal College of Physicians Part 1 MRCP(UK) examination includes basic sciences themes that are challenging to assess through a clinical scenario. A realistic clinical setting based on everyday clinical practice and integral to the question is the clearest demonstration that the knowledge being assessed is clinically relevant.

e-Learning initiatives to support prescribing.

Preparing medical students to prescribe is a major challenge of undergraduate education. They must develop an understanding of clinical pharmacology and acquire knowledge about drugs and therapeutics, as well as the skills to prescribe for individual patients in the face of multiple variables. The task of delivering the learning required to achieve these attributes relies upon limited numbers of teachers, who have increasingly busy clinical commitments.

Assessing prescribing competence.

Prescribing of medicines is the key clinical activity in the working life of most doctors. In recent years, a broad consensus regarding the necessary competencies has been achieved. Each of these is a complex mix of knowledge, judgement and skills.

Development and implementation of the specialty certificate examinations.

Following successful pilots in 2006, knowledge-based assessments for those engaged in specialty training have been developed and implemented in 11 medical specialties, by the Federation of Royal Colleges of Physicians in partnership with the specialist societies. Over 400 physicians have been involved in a project that has required recruitment and training of up to 25 question writers in each discipline, and the constitution of examining boards and standard setting advisory groups in each specialty. The assessments (now known as the specialty certificate examinations) are delivered by computer-based testing in centres throughout the UK and overseas.

How to write high-quality questions for a high-stakes examination.

Both the MRCP(UK) written examinations and the specialty certificate examinations (SCEs) use single-best-answer questions to assess the knowledge and problem-solving skills of physicians in training. Since 1999, specialists and senior trainees have created large banks of questions for these examinations that cover the relevant curricula. Question-writing workshops provide detailed guidance on the design of questions that discriminate between candidates of differing ability, in a format and a style that aid speed reading and comprehension.

The standard error of measurement is a more appropriate measure of quality for postgraduate medical assessments than is reliability: an analysis of MRCP(UK) examinations.

Background: Cronbach's alpha is widely used as the preferred index of reliability for medical postgraduate examinations. A value of 0.8-0.

Bedside clinical guidelines: the missing link.

Clinical guidelines for acute general (adult) medicine, general (adult) surgery, nursing and acute paediatrics, for use at the bedside, were developed over 10 years in North Staffordshire. The guidelines have been adopted by 15 other hospitals, all members of the Bedside Clinical Guidelines Partnership. The guidelines include advice on clinical management, prescribing aids, and practical procedures.

What knowledge and skills are essential for specialists in Clinical Pharmacology and Therapeutics? Results of a Delphi study.

Aims: To identify the knowledge and skills that should be considered essential for specialists in Clinical Pharmacology and Therapeutics (CPT) with a commitment to the National Health Service (NHS).

Methods: A Delphi study using a sample of current specialists.

Results: Members of the expert panel (20 in all, representative of the Clinical Section membership) identified 78 statements for consideration, in four domains (core of knowledge, therapeutic skills, educative skills, and investigative skills), of which 58 (74.

Continuing Medical Education in Clinical Pharmacology and Therapeutics: report of a questionnaire survey.

Aims: To seek the views of medically qualified members of the Clinical Section of the British Pharmacological Society (BPS) on their perceived needs for Continuing Medical Education (CME); on how and by whom these needs should be addressed; and on how the outcome of any educational intervention might best be assessed.

Methods: A structured questionnaire.

Results: Of 233 recipients, 140 (60%) responded, but only 123 of these fulfilled the criteria for analysis.

How can we afford costly medicines?

Affording the ever-increasing cost of medicines is a struggle throughout the NHS. A College Working Party has addressed the issues in an extensive recent report that analyses the cost of medicines, their licensing and evaluation, priority setting and its ethical and legal implications. It considers options for increasing the available resource, but explains why everyone concerned with the evaluation, funding and use of medicines must recognise the need to set priorities.

Consulting the oracle: a Delphi study to determine the content of a postgraduate distance learning course in therapeutics.

Aims: To determine the content of a distance learning course in therapeutics for general practitioners (GPs).

Methods: This paper reports the results of a three-round Delphi study. The respondent group comprised 21 GPs who were expert in their field.

Studies of the oral bioavailability of alendronate.

Clinical studies were performed to examine the oral bioavailability of alendronate (4-amino-1-hydroxy-butylidene-1,1-bisphosphonate monosodium). All studies, with the exception of one performed in men, involved postmenopausal women. Short-term (24 to 36 hours) urinary recovery of alendronate after an intravenous dose of 125 to 250 micrograms averaged about 40% in both men and women.

Transepithelial water movement in response to carbamazepine, chlorpropamide and demeclocycline in toad urinary bladder.

1. Osmotic water movement across toad isolated hemibladders was measured by a gravimetric method. 2.

A single oral dose method for predicting steady state theophylline concentrations in clinical practice.

A single dose, single point method of predicting patients' oral maintenance theophylline dosage has been compared with a noninvasive method. Twenty patients with obstructive lung disease received an oral dose (6 mg kg-1) of micro-crystalline theophylline. The plasma theophylline concentration after 8-10 h was then used to calculate the optimum maintenance dose of sustained release aminophylline required to achieve steady state concentrations between 55 and 110 mumols l-1.

Perceptions of pain relief after surgery.

Objective: To assess patients' satisfaction with postoperative pain relief.

Design: A descriptive and questionnaire study of patients' experience.

Setting: Two surgical and two gynaecological wards.