Zoonotic transmission of Chlamydia felis from domestic cats; A case series of chronic follicular conjunctivitis in humans.

We present three cases of chronic follicular conjunctivitis resulting from the zoonotic transmission of Chlamydia felis from domestic cats. Our objective is to raise awareness regarding the potential zoonotic transmission of Chlamydia felis from domestic cats and describe the methodology for definitive pathogen identification using Polymerase Chain Reaction (PCR) and subsequent sequence analysis, a useful tool in the identification of these rare pathogens. We discuss the factors that could be contributing to the potential under-diagnosis of zoonotic C. felis infections and propose a treatment regime for cases of C. felis-related conjunctivitis.

Feedback by simulated patients in undergraduate medical education: a systematic review of the literature.

OBJECTIVES: Although the importance of feedback by simulated patients (SPs) is generally recognised, knowledge is scarce about the most effective ways in which SPs can provide feedback. In addition, little is known about how SPs are trained to provide feedback. This study aimed to provide a systematic overview of the ways in which SPs provide feedback to undergraduate medical students, the domains in which SPs provide feedback and the ways in which SPs are trained to provide feedback. METHODS: We performed a systematic search of the literature using PubMed, PsychINFO and ERIC and searched for additional papers cited in reference lists. Papers were selected on the basis of pre-established inclusion and exclusion criteria and were classified, using a pre-established form, according to three aspects of SP feedback: training in giving feedback; the process of delivering feedback, and the domain(s) in which feedback is given. RESULTS: A total of 49 studies were included and described in detail on the basis of the three aspects of SP feedback described above. The ways in which SPs were trained to give feedback were largely heterogeneous, as were the processes by which feedback was provided by SPs. Only a few studies described feedback processes that were in accordance with general recommendations for the delivery of effective feedback. Although feedback from the patient's perspective is generally recommended, most SPs provided feedback on clinical skills and communication skills. DISCUSSION: There appear to be no clear standards with regard to effective feedback training for SPs. Furthermore, the processes by which feedback is provided by SPs and the selection of domain(s) in which SPs give feedback often seem to lack a solid scientific basis. Suggestions for further research are provided.

The longitudinal simulated patient program: evaluations by teachers and students and feasibility.

OBJECTIVE: Simulated patients (SPs) are mostly used in single-case encounters. However, for chronic care training longitudinal patient encounters are more suitable. Evaluations of students and teachers regarding a new, longitudinal SP program were explored and compared to the single-case SP program. Furthermore, the feasibility of the program was explored. METHODS: Year 3 students participating in the longitudinal SP program (N=272) had four encounters with the same SP portraying a chronic health problem in eight months. Student evaluations regarding the longitudinal SP program were assessed with a validated questionnaire (the MaSP) and both teachers and students completed another questionnaire on their views. RESULTS: In general, students and teachers were positive about the longitudinal SP program. We found no differences between student evaluations regarding the longitudinal SP program and those regarding the single-case SP program. The longitudinal SP program appeared not to be feasible because of uncooperative faculty staff and the workload. CONCLUSIONS: Students consider the longitudinal SP program as good as the single-case SP program. In its current form the longitudinal SP program appeared not to be feasible. Further research is needed in our search for an instructive, enjoyable and feasible SP program to teach students about continuity of care.

Simulating the longitudinal doctor-patient relationship: experiences of simulated patients in successive consultations.

CONTEXT: The use of simulated patients (SPs) in teaching communication and practical skills at medical schools is mostly limited to single-case use: a student has 1 consultation with an SP and receives feedback afterwards. Very little literature is available that describes consecutive consultations between the same student and SP. In this study, we explored the experiences of SPs in a new, longitudinal SP programme in which SPs met the same Year 3 students ('GP') in 4 consecutive consultations during the year. The SPs suffered from a chronic disease in their patient roles. METHODS: Four focus group discussions were conducted with 23 SPs (8 men, 15 women; average age 60.9 years) who had performed in the new programme. Discussions were semi-structured and followed a pre-established interview guide. Data were categorised by 3 independent raters. RESULTS: The SPs described the development of a more familiar relationship with students under the new programme, compared with single-case consultations. They developed specific expectations of students' performances. The SPs enjoyed participating in the programme and felt it was more realistic than single-case consultations. Feedback changed and became more detailed as SPs were able to compare consultations; students' response to feedback could be experienced during the next consultation. DISCUSSION: Practising the development of a realistic, longitudinal doctor-patient relationship may help prepare students for real practice. Longitudinal feedback is now possible; it may be of higher quality and of benefit to SPs as well. These findings suggest new possibilities for SP-based education and research. Future studies should focus on quantitative analysis and students' perspectives.