Enabling diagnostic excellence in the real world: Managing complexity, uncertainty and clinical responsibility.

Diagnostic error is a significant category within preventable patient harm, and it takes many years of effort to develop proficiency in diagnostic reasoning. One of the key challenges medical schools must address is preparing students for the complexity, uncertainty and clinical responsibility in going from student to doctor. Recognising the importance of both cognitive and systems-related factors in diagnostic accuracy, we designed the QUID Prompt (Questions to Use for Improving Diagnosis) for students to refer to at the bedside. This set of questions prompts careful consideration, analysis, and signposting of decision-making processes, to assist students in transitioning from medical school to the real-world of work and achieving diagnostic excellence in clinical settings.

Generative Artificial Intelligence as a Tool for Teaching Communication in Nutrition and Dietetics Education-A Novel Education Innovation.

Although effective communication is fundamental to nutrition and dietetics practice, providing novice practitioners with efficacious training remains a challenge. Traditionally, human simulated patients have been utilised in health professions training, however their use and development can be cost and time prohibitive. Presented here is a platform the authors have created that allows students to interact with virtual simulated patients to practise and develop their communication skills. Leveraging the structured incorporation of large language models, it is designed by pedagogical content experts and comprises individual cases based on curricula and student needs. It is targeted towards the practice of rapport building, asking of difficult questions, paraphrasing and mistake making, all of which are essential to learning. Students appreciate the individualised and immediate feedback based on validated communication tools that encourage self-reflection and improvement. Early trials have shown students are enthusiastic about this platform, however further investigations are required to determine its impact as an experiential communication skills tool. This platform harnesses the power of artificial intelligence to bridge the gap between theory and practice in communication skills training, requiring significantly reduced costs and resources than traditional simulated patient encounters.

Utilisation of crown ethers in microemulsion electrokinetic chromatography for the separation of inorganic cations.

A new method to influence the separation selectivity of inorganic cations in capillary electrophoresis is presented. This method combines the use of certain crown ethers to form complexes with a specific cation (changing its ionic radius/charge ratio and thereby its electrophoretic mobility) with partitioning of the crown ether/analyte complex between an aqueous phase and a pseudo-stationary phase, such as the oil droplet of a microemulsion. Several microemulsions, including uncharged oil droplets and oil droplets with different degrees of surface charge were tested to evaluate their ability to improve the separation of the selected analytes.

Analysis of melamine resins by capillary zone electrophoresis with electrospray ionization-mass spectrometric detection.

A method for the determination of the major components of (methoxymethyl)melamine resins, with quantitative analysis of unreacted melamine by capillary zone electrophoresis (CZE) using electrospray ionization-mass spectrometry (ESI-MS) is presented. Using a low background electrolyte (BGE) pH, components are separated according to their charge/ionic radius ratio with a distinctly different separation selectivity compared to the HPLC methods commonly employed in melamine-resin analysis. The use of a time-of-flight mass spectrometer (TOF-MS) was concluded to be necessary, as the complex samples studied required maximum sensitivity and resolution, which is clearly superior for TOF-MS detectors over their quadrupole counterparts. A standard curve of free melamine was determined with an R(2) = 0.999 over a concentration range of an order of magnitude. This method offers the unique separation selectivity of CZE as well as a quicker analysis time, especially for dimers compared to the HPLC methods used to date.

Mechanistic studies on the separation of cations in zwitterionic ion chromatography.

Electrostatic ion chromatography, also known as zwitterionic ion chromatography, has been predominantly used for the analysis of anions. Consequently, separation mechanisms proposed for this technique have been based on anion retention data obtained using a sulfobetaine-type surfactant-coated column. A comprehensive cation retention data set has been obtained on a C18 column coated with the zwitterionic surfactant N-tetradecylphosphocholine (which has the negatively and positively charged functional groups reversed in comparison to the sulfobetaine surfactants), with mobile phases being varied systematically in the concentration and species of both the mobile-phase anion and cation. A retention mechanism based on both an ion exclusion effect and a direct (chaotropic) interaction with the inner negative charge on the zwitterion is proposed for the retention of cations. Despite the relatively low chaotropic nature of cations compared with anions, the retention data shows that cations are retained in this system predominantly due to a chaotropic interaction with the inner charge, analogous to anions in a system where the C18 column is coated with a sulfobetaine-type surfactant. The retention of an analyte cation, and the effect of the mobile-phase anion and cation, can be predicted by the relative positions of these species on the Hofmeister (chaotropic) series.