ERCP training.
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Biomedical subjects
Publications and source records attributed to D Bullimore.
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Clinical bedside teaching forms a major part of undergraduate medical education but clinicians rarely have training in teaching or access to educational experts. Outlined is a programme used by a clinician to run a workshop for colleagues and students using collaborative learning. The workshop begins with a reflection on current teaching practice. Having determined priorities in bedside teaching a session is replanned to take account of these. A tutor-led session on dialogue skills is followed by further sessions on planning the teaching of a whole firm. Problems related to assessment are briefly considered to conclude the workshop. Despite limitations such workshops can successfully circumvent the scarcity of educationalists in the clinical setting. The workshop material is offered to other clinicians wishing to run similar workshops for colleagues.
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Variation in time of patient admission to studies of prognosis after variceal haemorrhage has been proposed as a major factor in the wide range of reported results. A study of 144 unselected subjects with a low initial mortality (3% at two days) suggests that the effect has been overemphasised and studies in which time of entry is later than the date of bleeding may be usefully compared. Reanalysis of previous work suggests that even in populations with a high initial mortality limited comparisons between studies can still be usefully made. It is stressed that survival analysis must be started from the date of study entry and not from the date of the index bleed which involves incorporating a retrospective period of survivorship.
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