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Objective: The study was conducted to evaluate impact of multisource feedback in pediatric residency training., Methods: A crossover study of pediatric residents at Wadia Children's Hospital was conducted with assessment of core competencies like knowledge, practice-based learning, system-based practice, professionalism, communication skills and interpersonal interaction. After randomization both groups (A and B) were given MSF and traditional feedback, respectively and later the groups were crossed over to other method of feedback. Control faculty assessed both groups at three points - Pre-intervention, after first and after second intervention., Results: There were 16 residents in each group (13,7,7 in first, second and third year of residency, respectively). Both groups had comparable scores in all six competencies at entry point. Group A after MSF showed significant improvement in all six competencies (all P<0.01). No significant improvement was observed in group B after traditional feedback. After cross-over to MSF, group B showed statistically significant improvement in all core competencies. Traditional feedback to group A after crossover showed statistically significant improvement only in knowledge, professionalism and system based practice., Outcome: MSF was beneficial in improving competency based performance scores in pediatric residents.

Background: Cerebrotendinous xanthomatosis is an inherited lipid storage disease manifesting with infantile onset diarrhea, cataracts, xanthomas and adult-onset neurological dysfunction with cerebellar signs and neuropathy., Case Characteristics: 10-year-old boy presented with progressive ataxia, neuropathy and cataracts. Over 6 years, he developed dementia, kyphoscoliosis with worsening ataxia, and neuropathy., Outcome: Sterol analysis and CYP27A1 sequencing confirmed the diagnosis., Message: The condition should be considered in childhood onset cerebellar ataxia with cataracts, even in the absence of skin signs.