[Correction of body contour in an obese man after large weight loss following a bariatric procedure]. / Correctie van de lichaamscontour bij een obese man die sterk was afgevallen door een bariatrische ingreep.

A 42-year-old man was referred to the plastic surgery outpatient clinic with the request for body contouring surgery after previous bariatric surgery elsewhere. With help of the bariatric interventions he had lost 109 kg and now weighed 227 kg. At this stable weight he had a large surplus of abdominal wall skin with functional hindrance and inflammation due to chafing. After treating his comorbidity we eventually performed an extended abdominal dermolipectomy and excised 32.8 kg of skin surplus. There was some temporary wound dehiscence which was treated conservatively. The patient was very satisfied with the improvement in his body contour.

Evaluation of a pharmacotherapy context-learning programme for preclinical medical students.

AIM: To evaluate a context-learning pharmacotherapy programme for approximately 750 2nd, 3rd and 4th year preclinical medical students with respect to mastering cognitive pharmacotherapeutic skills, i.e. choosing a (drug) treatment and determining patient information. METHODS: The context-learning pharmacotherapy programme consists of weekly organized role play sessions in the form of consulting hours. Fourth year students sit for a therapeutic Objective Structured Clinical Examination (OSCE) in the form of consulting hours at the outpatient clinic. Sixty-one 2nd, 74 3rd and 49 4th year medical students who attended the role play sessions and the OSCE were randomly selected. Their performances were assessed by clinical examiners and clinical experts and compared with a reference group of 6th year graduated students. Additionally, the scores of a questionnaire on study load and appreciation were collected. RESULTS: The level of the pharmacotherapeutic skills of the 4th year students who followed the pharmacotherapy context-learning programme was not far below that of 6th year graduates who had finished their clinical clerkships, but had not followed the pharmacotherapy programme. The time spent on the programme was about 1% of the total study load per year. The students appreciated the role play sessions and OSCE by around 80% and 99% of the maximum possible scores. CONCLUSIONS: Preclinical pharmacotherapy context learning has a modest but positive effect on learning cognitive pharmacotherapeutic skills, i.e. choosing a drug treatment and determining patient information. This effect has been obtained with role play sessions, a suboptimal form of context learning, with a minimal study load and a high appreciation by students.