Ascites Module for Third-Year Medical Students: Group-Based Learning Workshop on the Diagnosis, Workup, and Management of Ascites.

INTRODUCTION: As medical students transition from didactic courses to clinical rotations, they will frequently encounter patients with cirrhosis and ascites. It is paramount that they have a firm foundation of how to diagnose ascites and perform a proper diagnostic workup in order to understand the etiology and therefore the proper management. This module is designed as a group-based, interactive learning workshop for those transitioning students. METHODS: The session begins with the students obtaining a pertinent history of a standardized patient case. The students are then divided into four groups and rotate through four stations: physical examination, diagnostic studies, paracentesis, and ascitic fluid analysis. Each station is designed for up to 10-12 students and typically lasts 20 minutes. After all of the students have rotated through each station, they reconvene to review ascites management, case conclusions, and summary. The total time allocated for this module is 125 minutes for 40-48 students. RESULTS: Postmodule evaluations by the students showed a high level of satisfaction and improvement in the students' fund of knowledge and clinical skills. Evaluations completed by the students after each workshop revealed more than 95% either agreeing or strongly agreeing with the learning objectives being clear, the learning materials being effective, overall satisfaction with the learning material and teaching, and having a better understanding of the evaluation, diagnosis, and management of ascites. DISCUSSION: Through this team-based interactive module, students obtain clinical and hands-on experience that better prepares them for their clinical rotations.

Orthodontics using an occlusal splint: a clinical report.

Careful management of the occlusion is necessary for successful prosthodontic treatment. A reorganized occlusal approach requires a more accurate registration of the desired jaw position, and where it is difficult to achieve this, an occlusal splint is indicated. This clinical report documents a 60-year-old man with a Prosthodontic Diagnostic Index Class IV dentition, who prior to a full-mouth reconstruction, underwent occlusal splint therapy with a Michigan-type splint that incorporated z-springs to allow concurrent orthodontic tooth movement of two anterior teeth to positions that would allow favorable restorations by correcting occlusal and esthetic form.

Stress in dental specialists: a comparison of six clinical dental specialties.

OBJECTIVE: To describe and compare the levels of stress reported by dental practitioners working within clinical dental specialties. METHOD: Questionnaire survey of 220 dental practitioners identified from the General Dental Council lists of specialist practitioners in the following clinical specialties: orthodontics, paediatric dentistry, restorative dentistry, endodontics, periodontology, prosthetic dentistry. FINDINGS: The clinical specialties did not differ in their reported levels of stress. Practitioners working in the field of paediatric dentistry reported the highest median levels of reported stress for three of the four scales, though this trend was not significant. CONCLUSIONS: The practitioners surveyed from six clinical specialties did not experience significantly different sources of stress.