Learning-by-Concordance (LbC): introducing undergraduate students to the complexity and uncertainty of clinical practice.

Background: A current challenge in medical education is the steep exposure to the complexity and uncertainty of clinical practice in early clerkship. The gap between pre-clinical courses and the reality of clinical decision-making can be overwhelming for undergraduate students. The Learning-by-Concordance (LbC) approach aims to bridge this gap by embedding complexity and uncertainty by relying on real-life situations and exposure to expert reasoning processes to support learning.

Learning medical professionalism with the online concordance-of-judgment learning tool (CJLT): A pilot study.

Context: Professionalism development entails learning to make judgments in ambiguous situations. A Concordance of Judgment Learning Tool (CJLT), comprised of 20 vignettes involving professionalism issues, was developed. Students obtained a measure of how concordant their judgments were with a panel of experts and learned from given explanations.

Coeliac disease in an adult presenting as intussusception without a lead point.

A case of adult intussusception is presented in which previously undiagnosed coeliac disease was the cause. The diagnosis was made following microscopic examination of a resected segment of small intestine containing multiple intussusception sites. Adult intussusception is rare and in most cases associated with a 'lead point' lesion, often a tumour.

Risk factors for mortality following emergency colectomy for fulminant Clostridium difficile infection.

Purpose: This study evaluated risk factors for mortality after emergency colectomy for fulminant Clostridium difficile infection.

Methods: Retrospective study of 130 cases of Clostridium difficile infection that required a colectomy between 1994 and 2007 in four hospitals of Quebec, Canada. Primary outcome was 30-day mortality.

Peripherally inserted central venous catheters are not superior to central venous catheters in the acute care of surgical patients on the ward.

Background: Peripherally inserted central venous catheters (PICC) have supplanted central venous catheters (CVC) for the administration of intravenous antibiotics and total parenteral nutrition to patients in our hospital. From the literature, it appears that this change has occurred in a number of other surgical units. Accounting for the change are the expected advantages of low complication rates at insertion, prolonged use without complications and interruption, and cost- and time-savings.

Phase I study on sentinel lymph node mapping in colon cancer: a preliminary report.

Background And Objectives: Lymph node (LN) metastasis is one of the most significant prognostic factor in colorectal cancer. In fact, therapeutic decisions are based on LN status. However, multiple studies have reported on the limitations of the conventional pathological LN examination techniques, and therefore, the actual number of patients with LN positive colorectal cancer is probably underestimated.