Search

Introduction: A trauma resuscitation is dynamic and complex process in which failures could lead to serious adverse events. In several trauma centers, evaluation of trauma resuscitation is part of a hospital's quality assessment program. While video analysis is commonly used, some hospitals use live observations, mainly due to ethical and medicolegal concerns. The aim of this study was to compare the validity and reliability of video analysis and live observations to evaluate trauma resuscitations. Methods: In this prospective observational study, validity was assessed by comparing the observed adherence to 28 advanced trauma life support (ATLS) guideline related tasks by video analysis to life observations. Interobserver reliability was assessed by calculating the intra class coefficient of observed ATLS related tasks by live observations and video analysis. Results: Eleven simulated and thirteen real-life resuscitations were assessed. Overall, the percentage of observed ATLS related tasks performed during simulated resuscitations was 10.4% (P < 0.001) higher when the same resuscitations were analysed using video compared to live observations. During real-life resuscitations, 8.7% (p < 0.001) more ATLS related tasks were observed using video review compared to live observations. In absolute terms, a mean of 2.9 (during simulated resuscitations) respectively 2.5 (during actual resuscitations) ATLS-related tasks per resuscitation were not identified using live observers, that were observed through video analysis. The interobserver variability for observed ATLS related tasks was significantly higher using video analysis compared to live observations for both simulated (video analysis: ICC 0.97; 95% CI 0.97-0.98 vs. live observation: ICC 0.69; 95% CI 0.57-0.78) and real-life witnessed resuscitations (video analyse 0.99; 95% CI 0.99-1.00 vs live observers 0.86; 95% CI 0.83-0.89). Conclusion: Video analysis of trauma resuscitations may be more valid and reliable compared to evaluation by live observers. These outcomes may guide the debate to justify video review instead of live observations.

Introduction: A trauma resuscitation is dynamic and complex process in which failures could lead to serious adverse events. In several trauma centers, evaluation of trauma resuscitation is part of a hospital's quality assessment program. While video analysis is commonly used, some hospitals use live observations, mainly due to ethical and medicolegal concerns. The aim of this study was to compare the validity and reliability of video analysis and live observations to evaluate trauma resuscitations. Methods: In this prospective observational study, validity was assessed by comparing the observed adherence to 28 advanced trauma life support (ATLS) guideline related tasks by video analysis to life observations. Interobserver reliability was assessed by calculating the intra class coefficient of observed ATLS related tasks by live observations and video analysis. Results: Eleven simulated and thirteen real-life resuscitations were assessed. Overall, the percentage of observed ATLS related tasks performed during simulated resuscitations was 10.4% (P < 0.001) higher when the same resuscitations were analysed using video compared to live observations. During real-life resuscitations, 8.7% (p < 0.001) more ATLS related tasks were observed using video review compared to live observations. In absolute terms, a mean of 2.9 (during simulated resuscitations) respectively 2.5 (during actual resuscitations) ATLS-related tasks per resuscitation were not identified using live observers, that were observed through video analysis. The interobserver variability for observed ATLS related tasks was significantly higher using video analysis compared to live observations for both simulated (video analysis: ICC 0.97; 95% CI 0.97-0.98 vs. live observation: ICC 0.69; 95% CI 0.57-0.78) and real-life witnessed resuscitations (video analyse 0.99; 95% CI 0.99-1.00 vs live observers 0.86; 95% CI 0.83-0.89). Conclusion: Video analysis of trauma resuscitations may be more valid and reliable compared to evaluation by live observers. These outcomes may guide the debate to justify video review instead of live observations.

Communication of goals and realistic expectations between the surgeon and patient is a crucial step of aesthetic rhinoplasty. Three-dimensional (3D) imaging technology allows for sharing of simulated outcomes in the office setting, thereby facilitating this process. This article highlights the use of 3D rhinoplasty simulation in preoperative assessment and the senior author’s preferred surgical technique in open rhinoplasty.

Introduction In light of the opioid overdose epidemic in the US and the necessity of developing training to conduct difficult conversations around opioid dependence, three case-based videos were created to demonstrate providers using motivational interviewing (MI) with patients who have opioid use disorder (OUD). These vignettes displayed a primary care provider interacting with a patient seeking opioids. Methods Learners—including third-year medical and physician assistant (PA) students, and family medicine residents—viewed three videos set in a family medicine clinic and assessed clinician use of MI when interacting with patients with OUD. The patients were at different levels of acknowledging their need to change their opioid use behaviors and/or pursue treatment. Learners rated each video with an MI rating scale, and a facilitator debriefed strengths, weaknesses, and omissions regarding MI. Results Medical and PA students, and resident family physicians provided 572 ratings. Analysis of variance of mean percent incorrect was lower in residents than in all groups combined, but failed to reach statistical significance (47% + 12.0 vs 53% + 15.0, p = .43). Discussion These case-based videos with MI ratings afforded students and residents the opportunity to assess clinician use of MI techniques with patients with OUD. The MI rating scale had clinical significance (residents scored +5 points and had more training) despite lacking statistical significance. These scenarios allowed learners to recognize how to use MI when having a difficult conversation with patients who misuse opioids. We envision individual use or use for group discussion.

A concave profile with class III malocclusion is most often due to a combination of maxillary hypoplasia and mandibular hyperplasia. Surgical correction entails normalization of jaw positions and is more challenging in the setting of concurrent asymmetry and open bite. Treatment should optimize both facial harmony and occlusion. Orthognathic surgery for class III deformities occurs at skeletal maturity and should address all aspects of the condition while preventing unnecessary emotional stress from delayed treatment. In this article, the authors describe the 3-jaw orthognathic surgery technique to address maxillary hypoplasia, mandibular prognathism, open bite, and mandibular asymmetry in a single procedure. The process of preoperative 3-dimensional (3D) virtual surgical planning, detailed surgical technique, fat grafting, and a comparison of preoperative and postoperative 3D aesthetic outcomes is presented. Additionally, a retrospective review of postoperative outcomes of 54 patients who received 3-jaw orthognathic surgery is presented as well.

Postoperative cicatricial lower lid retraction is a challenging surgical problem that often disfigures the shape of the eye and has functional consequences. Depending on the severity, more than one surgical procedure may be needed to achieve the desired lower lid shape and position given the recurrent nature of scarring. Concepts of scar release, establishing lower lid vertical height, soft tissue replacement, and midcheek support are discussed in this video.

Introduction Our institution uses video review as a quality improvement tool. Starting in March 2018, we specifically focused on meeting certain time goals during trauma resuscitation aimed at decreasing time to final disposition. The purpose of this study was to evaluate the effect of establishing strict time goals on total time spent in the trauma bay by pediatric trauma patients. Materials and methods A retrospective review of all level I trauma activations at a level I pediatric trauma center between November 2017 and December 2018 was performed via manual review of the recorded trauma activations. Data on key time points such as time from arrival to transfer to gurney, to completion of primary survey, to chest x-ray, to Emergency Medical Services (EMS) report, to CT scan, and to disposition (CT or admission/operating room [OR] if no CT scan was performed) were analyzed and compared between the cohort of patients prior to implementation of the time goals with that after. The cohort of patients who presented between March 2018 and May 2018 were excluded to allow for time for the intervention to take effect. Results There were 13 level I trauma activations before implementation of the time goals and 41 after. There was a significant decrease in time to transfer to gurney (1.8 minutes vs. 1.0 minutes; p=0.02), to CT scan (18.8 minutes vs. 14.2 minutes; p=0.01), and to disposition (18.3 minutes vs. 14.9 minutes; p=0.047). There was no decrease in time to completion of primary survey, EMS report, or chest x-ray. Conclusions Utilizing video review in pediatric trauma as a quality improvement initiative with a focus on meeting specific time goals for key elements of the activation led to decreased total time in our trauma bay with critically ill patients.

Submitted by Lucienne Costa (lucienneferreira@ufcg.edu.br) on 2019-08-19T19:58:36Z No. of bitstreams: 1 FLÁVIA THAÍS ALVES BRITTO – DISSERTAÇÃO (PPGLE) 2019.pdf: 3881596 bytes, checksum: d0ef35f334f517f495662b205e55ccdf (MD5) Made available in DSpace on 2019-08-19T19:58:36Z (GMT). No. of bitstreams: 1 FLÁVIA THAÍS ALVES BRITTO – DISSERTAÇÃO (PPGLE) 2019.pdf: 3881596 bytes, checksum: d0ef35f334f517f495662b205e55ccdf (MD5) Previous issue date: 2019-06-28 As diversificadas formas de interatividade, conferidas às redes sociais, têm proporcionado a proliferação de uma variedade de textos cada vez mais híbridos em suas semioses. Muitos deles são fruto da (re)criação dos propósitos e das construções composicionais de gêneros de notória circulação social, para suprir as exigências das situações comunicativas diversas e dinâmicas. Nesse cenário, a rede social YouTube, devido a sua diversidade de recursos, tem adquirido grande destaque como um suporte para o surgimento de modelos textuais inéditos, como a videorresenha. Na medida em que esse gênero se oriunda da resenha, comumente inclusa no currículo escolar, evidencia sua potencialidade como recurso complementar a ações docentes, que possibilitem ao professor unir o ensino de leitura a práticas cotidianas dos alunos. Diante disso, o presente estudo pretende responder ao seguinte questionamento: Qual o potencial didático da videorresenha, divulgada em ambiente digital, como recurso complementar ao ensino de leitura?. Para tanto, realizamos uma análise de nove videorresenhas, publicadas em canais do YouTube, por meio de uma pesquisa qualitativa e de inspiração netnográfica, tendo como objetivo geral: refletir sobre a emergência do gênero em questão, enquanto um instrumento auxiliar a práticas de ensino de leitura no Ensino Médio. Os nossos objetivos específicos são: (1) identificar a estrutura da videorresenha, sistematizando suas peculiaridades, em detrimento a outros gêneros que se coadunam com sua produção; e (2) relacionar a produtividade desse gênero em contexto digital às práticas docentes de leitura necessárias ao referido nível de ensino. Tais decisões se embasam em fundamentos teóricos, que definimos em dois eixos centrais: o primeiro envolve os estudos sobre gêneros, multimodalidade do ambiente digital e constituição da videorresenha como emergente nesse ambiente, com base em: Araújo (1996); Bakhtin ([ca. 1953] 1997); Barton e Lee (2015); Bazerman (2006); Jeffman (2017); Silva (2011); Swales (1990); Motta-Roth (1995); entre outros. O segundo compreende concepções relacionadas à leitura, ao ensino e às práticas docentes que utilizam recursos digitais, em diálogo com; Jouve (2002, 2012); Koch e Elias (2014); Leffa (1999) e Rojo (2004). Os resultados nos permitiram o reconhecimento da videorresenha como autônoma à resenha, visto que, apesar de ambos os gêneros apresentarem propósitos comunicativos semelhantes, a análise daquele revela a execução de movimentos retóricos particulares, com uma estrutura prototípica própria, delineada pela multimodalidade do ambiente digital. Além disso, a videorresenha foi identificada como um recurso complementar em potencial para as práticas docentes de desenvolvimento de competências relacionadas à leitura, por proporcionar uma apreciação de gêneros textuais e auxiliar o ensino da leitura literária voltada aos exames vestibulares. The diverse forms of interactivity conferred on social networks have led to the proliferation of a variety of increasingly hybrid texts in their semioses. Many of them are the result of the (re)creation of the purposes and compositional constructions of genres of notorious social circulation, to meet the demands of diverse and dynamic communicative situations. In this scenario, the social network YouTube, due to its diversity of resources, has acquired great prominence as a support for the emergence of unpublished textual models, such as video review. As this genre derives from the review, commonly included in the school curriculum, it shows its potentiality as a complementary resource to teaching actions, which enable the teacher to gather reading teaching with students' daily practices. Given this, the present study intends to answer the following question: What is the didactic potential of video review, spread in digital environment, as a complementary resource to the teaching of reading? To this end, we conducted an analysis of nine video reviews, published on YouTube channels, through a qualitative and netnographic-inspired research, with the general objective: reflect on the emergence of the genre in question, as an auxiliary tool to teaching practices of reading in high school. Our specific objectives are: (1) to identify the structure of the video review, systematizing its peculiarities, to the detriment of other genres that are in line with its production; and (2) to relate the productivity of this genre in a digital context to the reading teaching practices necessary for that level of education. Such decisions are based on theoretical foundations, which we define in two central axes: the first involves the studies on genres, multimodality of the digital environment and the constitution of the video review as emerging in this environment, based on: Araújo (1996); Bakhtin ([ca. 1953] 1997); Barton and Lee (2015); Bazerman (2006); Jeffman (2017); Silva (2011); Swales (1990); Motta-Roth (1995); among others. The second comprises conceptions related to reading, teaching and teaching practices that use digital resources, in dialogue with Jouve (2002, 2012); Koch and Elias (2014); Leffa (1999) and Rojo (2004). The results allowed us to recognize the video review as autonomous to the review, since, although both genres have similar communicative purposes, its analysis reveals the execution of particular rhetorical movements, with its own prototypical structure, outlined by the multimodality of the digital environment. In addition, the video review has been identified as a potential complementary resource for teaching practices related to reading-related skills development, as it provides an appreciation of textual genres and assists the teaching of literary reading focused on universities’ entrance exams.

The article analyzes book (literary) videoblogs which are extremely popular in different countries of the world. In Ukrainian Internet space, this phenomenon is rapidly developing, the number of book blogs is steadily increasing. Literary observers have a significant influence on the development of modern information space in general and on the book business in particular, since they promote the popularization of reading (especially among youth) and the promotion of books through online stores and publishing houses web-sites. In addition, book video blogs perform a number of other functions: provide information on the contents of the book read, demonstrate the artistic and technical design of the publication (format, cover, fonts, paper, the presence of illustrations, etc.), allow blogger to express his impressions about the book and, in some cases, to get profit for video review. Also, the article represents main content components of book blogs: the book plot, its abstract; the emphasis on the best book moments, or vice versa— criticism of the failure moments, according to the observer; contextual analysis of the work; various collections (thematic, one author compilations, one publishing house novelties, one country authors, school program works for a certain class, etc.); interesting facts about the author; history of book writing; illustrations; original design of the publication; book adaptation; story about books read by others, etc. Moreover, the article examines the issues of literary video blogs genres that arose as a result of bloggers various activities existence, as well as various goals that have become the cause of book blogs appearance: book review or thematic collection; video summary of read literature for a certain period (week, month, year); reader plan for some time (week, month, year); displaying books that the blogger has recently purchased or is planning to purchase; a blogger’s offer to give away, sell, exchange or present the book that he did not like for any reason; unpacking parcels, gifts and surprises with books; home library reviews; reviews of favorite reading places; an interactive video in which the blogger answers the questions of his audience; video calls and tasks from booktubers (the so-called «Challenges»). It is important to create Ukrainian language book blogs that promote Ukrainian literature and activity of Ukrainian publishing houses. Book blogs have taken their niche in our information space, and their rapid development and continuous improvement makes it possible to give positive forecasts for their development.

The article analyzes book (literary) videoblogs which are extremely popular in different countries of the world. In Ukrainian Internet space, this phenomenon is rapidly developing, the number of book blogs is steadily increasing. Literary observers have a significant influence on the development of modern information space in general and on the book business in particular, since they promote the popularization of reading (especially among youth) and the promotion of books through online stores and publishing houses web-sites. In addition, book video blogs perform a number of other functions: provide information on the contents of the book read, demonstrate the artistic and technical design of the publication (format, cover, fonts, paper, the presence of illustrations, etc.), allow blogger to express his impressions about the book and, in some cases, to get profit for video review.Also, the article represents main content components of book blogs: the book plot, its abstract; the emphasis on the best book moments, or vice versa — criticism of the failure moments, according to the observer; contextual analysis of the work; various collections (thematic, one author compilations, one publishing house novelties, one country authors, school program works for a certain class, etc.); interesting facts about the author; history of book writing; illustrations; original design of the publication; book adaptation; story about books read by others, etc.Moreover, the article examines the issues of literary video blogs genres that arose as a result of bloggers various activities existence, as well as various goals that have become the cause of book blogs appearance: book review or thematic collection; video summary of read literature for a certain period (week, month, year); reader plan for some time (week, month, year); displaying books that the blogger has recently purchased or is planning to purchase; a blogger’s offer to give away, sell, exchange or present the book that he did not like for any reason; unpacking parcels, gifts and surprises with books; home library reviews; reviews of favorite reading places; an interactive video in which the blogger answers the questions of his audience; video calls and tasks from booktubers (the so-called «Challenges»).It is important to create Ukrainian language book blogs that promote Ukrainian literature and activity of Ukrainian publishing houses.Book blogs have taken their niche in our information space, and their rapid development and continuous improvement makes it possible to give positive forecasts for their development., У статті проаналізовано книжкові (літературні) відеоблоги, які є надзвичайно популярними в різних країнах світу. В українському інтернет-просторі це явище стрімко розвивається, кількість книжкових блогів постійно збільшується. Літературні оглядачі суттєво впливають на розвиток сучасного інформаційного простору загалом і на книжкову справу зокрема, адже сприяють популяризації читання (особливо серед молоді) і просуванню книг через інтернет-магазини та власні web-сайти видавництв. Крім цього, книжкові відеоблоги виконують низку інших функцій: подають інформацію про зміст прочитаної книги, демонструють художньо-технічне оформлення видання (формат, обкладинку, шрифти, папір, наявність ілюстрацій тощо), дозволяють блогеру висловити свої враження про прочитану книгу і в окремих випадках отримати прибуток за відеорецензію.Також стаття репрезентує основні складові змісту книжкових блогів: сюжет книги, її анотація; акцент на тому, що найбільше сподобалось у книзі, або навпаки — критика невдалих, на думку оглядача, моментів; контекстуальний аналіз твору; різноманітні добірки (тематичні, добірки одного автора, новинок одного видавництва, авторів однієї країни, творів шкільної програми певного класу тощо); цікаві факти про автора; історія написання книги; ілюстрації; оригінальне оформлення видання; екранізація книги, якщо така існує; розповідь про книги, які читають інші, тощо.Крім того, у статті досліджено питання жанрів літературних відеоблогів, які виникли внаслідок існування різних видів діяльності блогерів, а також різних цілей, що стали причиною появи книжкових блогів: огляд-рецензія прочитаної книги або тематична добірка; відеопідсумок прочитаної літератури за певний період (тиждень, місяць, рік); читацький план на якийсь час (тиждень, місяць, рік); демонстрування книг, які блогер нещодавно придбав або планує придбати; пропозиція блогера віддати, продати, обміняти або розіграти книгу, яка йому не сподобалася з якихось причин; розпаковування посилок, подарунків і сюрпризів з книжками; огляди домашньої бібліотеки; огляди улюблених місць для читання; інтерактивне відео, в якому блогер відповідає на питання своєї аудиторії; відеовиклики і завдання від буктьюберів (т. зв. «челенджі»).Важливим є створення українськомовних книжкових блогів, які пропагують українську літературу і діяльність українських видавництв.Книжкові блоги зайняли свою нішу в нашому інформаційному просторі, а їх стрімкий розвиток і постійне вдосконалення дає можливість давати позитивні прогнози щодо їх розвитку.

Background Rugby league is a full-contact collision sport with an inherent risk of concussion. Wearable instrumented technology was used to observe and characterize the level of exposure to head impacts during game play. Purpose To verify the impacts recorded by the x-patch™ with video analysis. Study design Observational case series. Methods The x-patch™ was used on eight men’s semi-professional rugby league players during the 2016 Newcastle Rugby League competition (five forwards and three backs). Game day footage was recorded by a trained videographer using a single camera located at the highest midfield location to verify the impact recorded by the x-patch™. Videographic and accelerometer data were time synchronized. Results The x-patch™ sensors recorded a total of 779 impacts ≥ 20 g during the games, of which 732 (94.0%) were verified on video. In addition, 817 impacts were identified on video that did not record an impact on the sensors. The number of video-verified impacts ≥ 20 g, per playing hour, was 7.8 for forwards and 4.8 for backs (range = 3.9–19.0). Impacts resulting in a diagnosed concussion had much greater peak linear acceleration (M = 76.1 g, SD = 17.0) than impacts that did not result in a concussion (M = 34.2g, SD = 18.0; Cohen’s d = 2.4). Conclusions The vast majority (94%) of impacts ≥ 20 g captured by the x-patch™ sensor were video verified in semi-professional rugby league games. The use of a secondary source of information to verify impact events recorded by wearable sensors is beneficial in clarifying game events and exposure levels.

The emergence of the Internet and digital media has irreversibly erased the differences between media producers and their consumers. Nowhere it is more palpable than on the YouTube video service, which has since 2005 relied on contributions from both professional media organisations and amateur creators alike. Master's thesis titled Film Video Review as a Format of Online Journalism deals with the phenomenon of video reviews - i.e. videos in which one or more film critics introduce and review a film that is currently premiering in the cinemas - whose popularity is directly related to the worldwide reach and communal function of said social media. The aim of this thesis is to define the film video review as a separate format of online journalism based on the comparison of selected video reviewers that represent both Czech and foreign media, as well as platforms of participative journalism. The first chapter provides a general overview of what requirements film reviews and film criticism should meet, the second then summarises expert views on the crisis of film criticism and the alleged death of the film critic. The last chapter of the theoretical part then presents basic findings on video reviews and the related format of video essay. Subsequently, the fourth chapter introduces the reader to a...

International audience; Background: Falls of individuals with dementia are frequent, dangerous, and costly. Early detection and access to the history of a fall is crucial for efficient care and secondary prevention in cognitively impaired individuals. However, most falls remain unwitnessed events. Furthermore, understanding why and how a fall occurred is a challenge. Video capture and secure transmission of real-world falls thus stands as a promising assistive tool.Objective: The objective of this study was to analyze how continuous video monitoring and review of falls of individuals with dementia can support better quality of care.Methods: A pilot observational study (July-September 2016) was carried out in a Californian memory care facility. Falls were video-captured (24×7), thanks to 43 wall-mounted cameras (deployed in all common areas and in 10 out of 40 private bedrooms of consenting residents and families). Video review was provided to facility staff, thanks to a customized mobile device app. The outcome measures were the count of residents’ falls happening in the video-covered areas, the acceptability of video recording, the analysis of video review, and video replay possibilities for care practice.Results: Over 3 months, 16 falls were video-captured. A drop in fall rate was observed in the last month of the study. Acceptability was good. Video review enabled screening for the severity of falls and fall-related injuries. Video replay enabled identifying cognitive-behavioral deficiencies and environmental circumstances contributing to the fall. This allowed for secondary prevention in high-risk multi-faller individuals and for updated facility care policies regarding a safer living environment for all residents.Conclusions: Video monitoring offers high potential to support conventional care in memory care facilities.

Introduction : Medical students at the Faculty of Medicine, University of Geneva, Switzerland, have the opportunity to practice clinical skills with simulated patients during formative sessions in preparation for clerkships. These sessions are given in two formats: 1) direct observation of an encounter followed by verbal feedback (direct feedback) and 2) subsequent review of the videotaped encounter by both student and supervisor (video-based feedback). The aim of the study was to evaluate whether content and process of feedback differed between both formats. Methods : In 2013, all second- and third-year medical students and clinical supervisors involved in formative sessions were asked to take part in the study. A sample of audiotaped feedback sessions involving supervisors who gave feedback in both formats were analyzed (content and process of the feedback) using a 21-item feedback scale. Results : Forty-eight audiotaped feedback sessions involving 12 supervisors were analyzed (2 direct and 2 video-based sessions per supervisor). When adjusted for the length of feedback, there were significant differences in terms of content and process between both formats; the number of communication skills and clinical reasoning items addressed were higher in the video-based format (11.29 vs. 7.71, p= 0.002 and 3.71 vs. 2.04, p= 0.010, respectively). Supervisors engaged students more actively during the video-based sessions than during direct feedback sessions (self-assessment: 4.00 vs. 3.17, p= 0.007; active problem-solving: 3.92 vs. 3.42, p= 0.009). Students made similar observations and tended to consider that the video feedback was more useful for improving some clinical skills. Conclusion : Video-based feedback facilitates discussion of clinical reasoning, communication, and professionalism issues while at the same time actively engaging students. Different time and conceptual frameworks may explain observed differences. The choice of feedback format should depend on the educational goal. Keywords: formative; OSCEs; feedback; quality; video review; direct observation (Published: 8 November 2016) Citation: Med Educ Online 2016, 21: 32160 - http://dx.doi.org/10.3402/meo.v21.32160

This standardized patient case and its accompanying sequence of activities are intended to build skill among first-year medical students in recognizing patient clues and eliciting contextual information. Additional activities include a large-group introduction prior to the standardized patient encounter, a stimulated review of the standardized patient encounter, and a small-group reflection and discussion. The standardized patient case embeds three contextual themes (beliefs about treatment, stressful environment, and fear of what symptoms mean) that are each assigned a specific behavioral cue or clue. Standardized patients are trained to drop these clues and then to give further information only if the student interviewer follows up on the clue. Each theme is constructed to yield potentially meaningful differences in physician decision-making if the clue is or is not followed up on. Students and standardized patients then review the video independently and mark moments in the video that they feel represented clues and whether or not the clue was followed up on. Once the moments have been marked, the students view the video a second time to compare their own markings with those of the standardized patient. Lastly, the students meet in small groups with a faculty facilitator to share one exemplar moment and discuss with the group. Students indicated that the stimulated recall video review of their standardized patient encounter was the most effective activity for triggering reflection, followed by the small-group discussion and the review of the merged standardized patient bookmarks. Students felt that the activities were effective overall in promoting reflection on the relevance of context in the medical encounter.

Overdoses of tricyclic antidepressants are among the commonest causes of drug poisoning seen in accident and emergency departments. This review discusses the pharmacokinetics, clinical presentation and treatment of tricyclic overdose.

Up from the ashes: the fight for a new Tobacco Act is an entirely different sort of film, but one of great merit as well. Although lacking the atmospherics and breadth of Smoke and mirrors , this Canadian case study provides practical tools and direction for tobacco control advocates in all countries. Director Jack Micay, a former president of the Non-Smokers' Rights Association, has gone behind the scenes …