Foucault on the Wards: Rediscovering Reflection as a Social Pediatrician in Training.

The author states that as a second-year medical student with a liberal arts degree, it was often difficult for him to reconcile his former liberal arts education with the current demands of his training. Although the medical curriculum increasingly acknowledges the importance of a biopsychosocial model, the prioritization of knowledge remains the same: know your biological, pharmacological, and anatomical facts. However, the author's experience with a social pediatrics research summer studentship moved him beyond this basic sciences mindset and provided a practical framework for the application of his liberal arts training. The experience was twofold: he worked on a research project while simultaneously shadowing a pediatrician twice a week. His project applied a Foucauldian critical discourse analysis (CDA) to an archive of texts that sought to better characterize the term social pediatrics. The author concludes that the thought-changing reflection, mentorship, and concrete clinical experiences made possible by the summer studentship expanded his worldview.The author discusses the complementary relationship between CDA, clinical experience, and self-reflection in the developing clinician. The purpose of his essay is threefold. First, by drawing on concepts from Descartes' Meditations and Plato's allegory of the cave, he establishes educational continuity between his liberal arts and medical training. Second, using clinical examples, he explores the practicality of discourse analysis and how skills regarding empathy and bias awareness are transferrable to the wards. Last, he highlights the importance of cognitive dissonance and transformative learning in the maturing physician.

Single Sensor Gait Analysis to Detect Diabetic Peripheral Neuropathy: A Proof of Principle Study.

This study explored the potential utility of gait analysis using a single sensor unit (inertial measurement unit [IMU]) as a simple tool to detect peripheral neuropathy in people with diabetes. Seventeen people (14 men) aged 63±9 years (mean±SD) with diabetic peripheral neuropathy performed a 10-m walk test instrumented with an IMU on the lower back. Compared to a reference healthy control data set (matched by gender, age, and body mass index) both spatiotemporal and gait control variables were different between groups, with walking speed, step time, and SDa (gait control parameter) demonstrating good discriminatory power (receiver operating characteristic area under the curve >0.8). These results provide a proof of principle of this relatively simple approach which, when applied in clinical practice, can detect a signal from those with known diabetes peripheral neuropathy. The technology has the potential to be used both routinely in the clinic and for tele-health applications. Further research should focus on investigating its efficacy as an early indicator of or effectiveness of the management of peripheral neuropathy. This could support the development of interventions to prevent complications such as foot ulceration or Charcot's foot.