The float model: visualizing personal reflection in healthcare.

Challenge: Healthcare students and practitioners need to be able to critically assess themselves and their actions in order to learn from their experiences and improve their care of patients. Students' behaviours can be directly observed and faculty can provide direct feedback on it, when necessary. But 'reflection', a mechanism for assessing one's self, is less visible and often remains an abstract notion that is difficult to understand, use, and assess.

The effect of enhanced experiential learning on the personal reflection of undergraduate medical students.

Objective: This study's aim was to test the expectation that enhanced experiential learning is an effective educational method that encourages personal reflection in medical students.

Methods: Using a pre post-test follow-up design, the level of the personal reflection ability of an exposure group of first-year medical students participating in a new enhanced experiential learning program was compared to that of a control group of second- and third-year medical students participating in a standard problem-based learning program. Personal reflection was assessed using the Groningen Reflection Ability Scale (GRAS).

The development of a scale to measure personal reflection in medical practice and education.

Aim: Personal reflection is important for acquiring, maintaining and enhancing balanced medical professionalism. A new scale, the Groningen Reflection Ability Scale (GRAS), was developed to measure the personal reflection ability of medical students.

Method: Explorative literature study was conducted to gather an initial pool of items.

BEME systematic review: predictive values of measurements obtained in medical schools and future performance in medical practice.

Background: Effectiveness of medical education programs is most meaningfully measured as performance of its graduates.

Objectives: To assess the value of measurements obtained in medical schools in predicting future performance in medical practice.

Search Strategy: The English literature from 1955 to 2004 was searched using MEDLINE, Embase, Cochrane's EPOC (Effective Practice and Organization of Care Group), Controlled Trial databases, ERIC, British Education Index, Psych Info, Timelit, Web of Science and hand searching of medical education journals.

Core characteristics of the competent general practice trainer, a Delphi study.

Introduction: The specific skills, attitude, knowledge, and personality characteristics, which should define the competent GP-trainer have been subject of research for many years. What are the most important of these characteristics have yet to be delineated.

Aim: The aim of this study is to identify which characteristics are prerequisite for a competent GP-trainer.

What are the characteristics of the competent general practitioner trainer?

Background: Increasing attention is being given to the training of doctors to become teachers. This does not apply only to the schooling of teachers in undergraduate medical education: at the postgraduate level, general practitioner trainers (GP-trainers) receive special schooling to prepare them for their role. Yet the skills, knowledge and traits that should be expected in the competent GP-trainer have not been elucidated precisely.

Limited role of meta-iodobenzylguanidine scintigraphy in imaging phaeochromocytoma in patients with multiple endocrine neoplasia type II.

Objective: To compare diagnostic applicability of combined computed tomography (CT) and magnetic resonance imaging (MRI), with that of meta-iodobenzylguanidine (MIBG) scintigraphy in the preoperative localisation of MEN II related phaeochromocytoma.

Design: Retrospective study

Setting: University hospital, The Netherlands.

Materials: 17 patients with MEN II patients (33 adrenal glands) who were operated on for phaeochromocytoma.

Complications after bilateral adrenalectomy for phaeochromocytoma in multiple endocrine neoplasia type 2--a plea to conserve adrenal function.

Objective: To evaluate the complications of the adrenocortical supplementation that is needed after bilateral adrenalectomy for phaeochromocytoma in patients with multiple endocrine neoplasia (MEN) type 2 syndrome.

Design: Retrospective study.

Setting: University hospital, The Netherlands.

Oncological implications of RET gene mutations in Hirschsprung's disease.

Background: Germline mutations of the RET proto-oncogene identical to those found in the tumour predisposition syndrome multiple endocrine neoplasia type 2A (MEN2A), were detected in 2.5-5% of sporadic and familial cases of Hirschsprung's disease. Some patients with Hirschsprung's disease may therefore be exposed to a highly increased risk of tumours.

[Primary peritonitis due to Streptococcus pneumoniae in childhood].

Three patients, two boys of 5 months and 6 years and one girl aged 4 years, presented with acute abdominal pain, vomiting and fever, suggesting peritonitis. Imaging examinations (abdominal survey roentgenogram and (or) echography), exploratory laparotomy (in two patients) and blood cultures with growth of Streptococcus pneumoniae led to the diagnosis of primary peritonitis. Intravenous antibiotics led to recovery, in one patient complicated by paralytic ileus, which was treated surgically.

[Better postoperative pain management in children by introduction of guidelines; a prospective study].

Objective: To investigate the influence of recommendations on the quality of postoperative pain management in children.

Design: Prospective.

Setting: University Hospital Groningen, the Netherlands.

[Results of 25-year pheochromocytoma treatment in the Groningen Academic Hospital].

Objective: To evaluate 25 years' experience with the localisation techniques, operative management and results of treatment for phaeochromocytoma.

Design: Retrospective

Setting: Groningen University Hospital, the Netherlands.

Method: Localisation results, per- and postoperative morbidity, mortality and treatment results were evaluated in all 59 patients treated for phaeochromocytoma in the period 1970-1995; 41 patients underwent unilateral adrenalectomy, 18 underwent bilateral adrenalectomy.

[Surgical treatment of lymphadenitis caused by non-tuberculous mycobacteria in children].

A retrospective study was made of 43 consecutive cases of children with the diagnosis of non-tuberculous mycobacterial lymphadenitis treated in our surgical department between 1976 and 1992. In 16 of the 42 children the diagnosis was initially missed and these children elsewhere underwent incision and drainage resulting in a chronic sinus. In 37 children the disease was localized in the head-and-neck area, while in the other 6 inguinal or axillary lymph nodes were involved.

Bilateral split hand/foot malformation and inv(7)(p22q21.3).

A boy with typical tetramelic split hands and feet is described. In addition, there was a large arteriovenous malformation of the right arm. Chromosome studies showed a pericentric inversion of chromosome 7: 46,XY,inv(7)(p22q21.

Changing patterns in graduate surgical education in The Netherlands.

An overview is presented of the organization, outline, and contents of graduate surgical training programs in The Netherlands. Adaptations of these programs to changes in demands in surgical practice and health care delivery systems are discussed. Special emphasis is given to the relation of surgery and the surgical specialties, additional training, theoretic training, and manpower planning.

[Comparison of iodine scintigraphy and computerized tomography in the localization of pheochromocytoma].

A comparison is made of the results of CT scanning and MIBG scintigraphy in the localization of phaeochromocytoma. In 21 out of 24 patients with clinically diagnosed phaeochromocytoma in the University Medical Hospital, Groningen in 1983-1990, MIBG scintigraphy provided accurate localization, while in 16 out of 18 patients with phaeochromocytoma who underwent CT scanning a correct localization was obtained. False negative results were mainly present when lesions were smaller than 2 cm.

Teratogenic effects of transplacental transfusion of heterologous antisera simulated in an experimental model using in vitro whole rat embryo culture.

The effects of the transplacental transfusion of heterologous rabbit-anti-rat antiserum (RAR antiserum) and subsequent immunological interaction on the development of 9-10 days old rat embryos (stages 8-10 somites) were studied using an in vitro whole rat embryo culture. Transplacental transfusion was simulated by the embryonic intracardiac microinjection of approximately 0.5 microliter RAR antiserum, followed by an incubation period of 24 and 48 hours.

Enterocolonic fistula due to incarcerated inguinal hernia.

A 2 1/2-year-old boy presented severely underweight and with an extremely distended abdomen. He was born prematurely and at age 6 months had an incarcerated inguinal hernia, which had been treated conservatively. Laboratory investigations at the time of presentation showed evidence of bacterial overgrowth.

Successful surgical treatment of parathyroid carcinoma in two haemodialysis patients.

Parathyroid carcinoma is rare, occurring in less than 2-3% of the patients with clinical features of primary hyperparathyroidism. In haemodialysis patients parathyroid carcinoma has only once been described, although secondary hyperparathyroidism in these patients is common. We discuss two female haemodialysis patients with parathyroid carcinoma.