A customized simulation system with computer integrated auto-evaluation function for upper endoscopy training.

Competence in performing endoscopy requires a considerable amount of hands-on practice for a physician to master. In an effort to reduce the involvement of patients in the training process, simulation has become an important part of endoscopic training. This paper presents a low-cost training and evaluation system for upper endoscopy that serves as an additional or alternative tool, particularly for entry-level gastroenterology fellows. The protocol of making a customized mechanical training model that provides realistic visual appearances of the upper GI tract was created. The materials and methods used in the fabrication are outlined step-by-step in this report. A software application associated with the mechanical model was also developed to provide help for trainee during practice, evaluate the performance automatically upon completion of the training tasks, and record the performance and results in a database for review or further analysis by the trainee or instructor. Our software provides trainee with an interactive training experience. A survey obtained from sixteen gastroenterologists shows a promising feasibility of using the developed system. The developed low-cost upper endoscopy simulator can provide both training and evaluation functions with substantially low investment.

Assessment of the association between Blastocystis infection and irritable bowel syndrome.

OBJECTIVE: To assess the association between Blastocystis infection and irritable bowel syndrome (IBS) in Thai patients, Phramongkutklao Hospital. MATERIAL AND METHOD: A case-control study was conducted at Phramongkutklao Hospital, Bangkok, Thailand during 2007-2008. A total of 126 subjects were enrolled into the study. Sixty-six persons were enrolled in the IBS group and 60 persons were enrolled in the control group. Intestinal parasitic infections were determined using wet preparation and formalin-ethyl acetate concentration. Short-term in vitro culture was performed to detect Blastocystis sp. Additionally, stool specimens were cultured for pathogenic bacteria. Patients' history and physical examination were also recorded. RESULTS: Of 66 IBS patients, 61 (92.4%) had abdominal pain, 50 (78.1%) had diarrhea, and 14 (21.9%) had constipation. In vitro cultivation revealed that 10.0% and 16.7% were positive for Blastocystis sp. in the control and IBS group, respectively. There was no significant difference of the prevalence of Blastocystis infection between these 2 groups (p = 0.203). CONCLUSION: Blastocystis infection was a common parasitic infection which was predominant in both IBS and control group. The presence of Blastocystis sp. in stool did not imply gastrointestinal symptoms in the IBS patients. Further study of subtype characterization of Blastocystis sp. in a larger sample size of the case-control study might reveal a possible relationship between Blastocystis sp. and IBS patients.

Teaching medical ethics: Phramongkutklao College of Medicine's model.

BACKGROUND: Third-year (first preclinical year) Royal Thai Army (RTA) medical cadets were exposed to a rural community in a community medicine field activity. The poor, kind rural people gave good conditions for student's professional development and empathy. OBJECTIVES: To report a community medicine field work activity for professional development of the RTA medical school. MATERIAL AND METHOD: Descriptive analysis on two occasions to evaluate the third-year RTA medical cadets' impressions immediately after the community medicine field activity in a rural area in central Thailand and one year later using baseline scores of cadets' impressions against our institute's objectives. RESULTS: At the end of the field work, 90.9% of the cadets reported they achieved several institute objectives. The four most frequent mentioned were ethical development (70.6%), professionalism (84.3%), human relationship & communication skills (92.2%), and capability to work in the cmmunity (64.7%). Furthermore, RTA medical cadets rated the staff as good role models (51%). CONCLUSION: The community field work course provided a good environment for the third year medical cadets in building morality and professional development to be good doctors.