ABSTRACT
INTRODUCTION@#With Singapore's ageing population, there are increasing numbers of elderly cyclists and motorcyclists. Compared to younger riders, this cohort sustains more injuries and has poorer outcomes. This study aimed to describe and compare patient demographics, injury patterns and outcomes among elderly cyclists and motorcyclists at a Level 1 trauma centre.@*METHODS@#Data of all cyclists, motorcyclists and pillion riders aged 65 years and above who presented to the emergency department after accidents from 1 January 2013 to 31 December 2017 was extracted from the hospital's trauma registry and reviewed.@*RESULTS@#Cyclists and motorcyclists formed 42.0% and 58.0%, respectively, of 157 recruited patients. At the time of the accident, 40.8% of the patients were employed. The mean age of the patients was 71.6 ± 5.8 years. Extremities and pelvic girdle injuries (61.1%) were the most frequent, followed by chest injuries (48.4%), and head and neck injuries (40.1%). Among severe injuries (defined as Abbreviated Injury Scale score ≥ 3), chest injuries (39.5%) were the most common, followed by head and neck injuries (36.3%). The overall mortality rate was 9.6%, with cyclists at nearly three times the risk compared to motorcyclists. More cyclists than motorcyclists (18.2% vs. 11.0%) required intensive care. There were no significant differences in the length of hospital stay between cyclists and motorcyclists.@*CONCLUSION@#Elderly riders have unique injury patterns and consume significant healthcare resources. Trauma systems need to acknowledge this changing injury epidemiology and equip trauma centres with the necessary resources targeted at elderly patients. Future work should focus on strategies to minimise extremity and chest injuries.
ABSTRACT
The Observer-Reporter-Interpreter-Manager-Educator (ORIME) is adapted from RIME, an intuitive, self-explanatory and "synthetic" framework that assesses formatively, a student's ability to synthesise knowledge, skills and attitude during a clinical encounter with a patient. The "O" refers to a student's ability to pay attention and perceive with open-mindedness, people and events around him or her. The framework is suitable for definition of interim outcomes in a 5-year undergraduate programme. To align students' and clinical teachers' expectations further, selection of case complexity that is commensurate with student's seniority and competence should be guided and an adapted version of the Minnesota Complexity Assessment Tool is proposed.
Subject(s)
Humans , Clinical Clerkship , Clinical Competence , Education, Medical, Undergraduate , Educational Measurement , Students, MedicalABSTRACT
<p><b>AIM</b>To determine the views of new house officers (HO) on professionalism and unprofessional behaviour following dismissal in January 2007 of a HO who was caught video-taping nurses in the shower.</p><p><b>METHODS</b>An anonymous self-administered questionnaire was administered during new house officers' orientation. Using a Likert scale (1 = strongly disagree to 5 = strongly agree), HO were asked to rank statements regarding teaching and their understanding of professionalism and professional behaviour, role model-clinicians, their response to 3 real-life examples of unprofessional behaviour, and dismissal and Singapore Medical Council (SMC) registration of the sacked HO. Participation was voluntary.</p><p><b>RESULTS</b>Twenty-eight out of twenty-nine (96.6%) international medical graduates (IMG) and 84/95 (88%) house officers who graduated from National University of Singapore (NUS) responded. Their median age was 24 years and 63 of them were male. All IMG compared to 63.1% NUS HO agreed that professionalism was well taught in their medical school (P <0.0001). Majority (82.1%) of IMG compared to 67.9% NUS HO agreed they had adequate role model-clinicians exemplifying professionalism (P <0.0001). Majority (90.8%) of the respondents agreed that the sacked HO's behaviour was not pardonable, a smaller proportion (83.9%) agreed with dismissal but only half (52.7%) agreed that SMC should not register the sacked HO.</p><p><b>CONCLUSION</b>In this study, only two-thirds of NUS HO felt that professionalism was well taught and they had adequate role models. NUS should review this aspect of medical education. Majority of HO agreed with the dismissal but only half felt the misdemeanor was serious enough for SMC not to register the sacked HO.</p>