Pediatric Conjunctivitis: A Review of Clinical Manifestations, Diagnosis, and Management.

Conjunctivitis is a common pediatric problem and is broadly divided into infectious and non-infectious etiologies. Bacterial conjunctivitis makes up the majority of cases in children and often presents with purulent discharge and mattering of the eyelids. Treatment is supportive with an individual approach to antibiotic use in uncomplicated cases since it may shorten symptom duration, but is not without risks. Viral conjunctivitis is the other infectious cause and is primarily caused by adenovirus, with a burning, gritty feeling and watery discharge. Treatment is supportive. Allergic conjunctivitis is largely seasonal and presents with bilateral itching and watery discharge. Treatment can include topical lubricants, topical antihistamine agents, or systemic antihistamines. Other causes of conjunctivitis include foreign bodies and non-allergic environmental causes. Contact lens wearers should always be treated for bacterial conjunctivitis and referred to evaluate for corneal ulcers. Neonatal conjunctivitis requires special care with unique pathogens and considerations. This review covers essential information for the primary care pediatric provider as they assess cases of conjunctivitis.

Longitudinal Experience With a Transparent Weighted Lottery System to Incentivize Resident Scholarship.

BACKGROUND: Promoting resident scholarship is important to programs. Positive Peer-Pressured Productivity (P-QUAD) is a dual incentive model that combines increased transparency through awareness of peers' engagement in scholarship, with a weighted cash lottery where tickets are earned for various dimensions of academic success (ie, 1 point/ticket for an abstract submission up to 6 for manuscript acceptance). OBJECTIVE: We explored whether a weighted lottery system contributes to sustained increases in academic productivity in a residency program. METHODS: We implemented P-QUAD in 1 pediatrics residency program in July 2015. Residents reported their scholarship submissions/acceptances for the prior year, establishing a program baseline. During the 2-year intervention, residents logged their academic submissions/acceptances on a web interface where they could view real-time scores and the work of their peers. At the end of each academic year, we compared P-QUAD points for each category to baseline. RESULTS: During the intervention, 31% of residents (68 of 218) reported engaging in scholarship. Using P-QUAD was acceptable to most residents. Engagement in scholarship across the program, as measured by total P-QUAD score, increased 53% from baseline (329 versus 504 points per year). Mean submission and acceptance rates for individual residents reporting research through P-QUAD increased across all categories, ranging from 19% for abstract submissions (1.62 to 1.93 per year) to 275% (0.24 to 0.90 per year) for accepted manuscripts. CONCLUSIONS: The residency program sustained gains in academic productivity at the program-wide and participating resident level in the 2 years since implementing P-QUAD.

Gaming the System: Creation of a Random Case-Generating Game for Use in Morning Report.

Discussing real-world cases with known outcomes is a common feature of resident morning report. We present a novel case-generating game that allows for creative, dynamic problem-solving discussions and appears to encourage more peer-directed learning than traditional morning report.

Not all unprofessional behaviors are equal: The creation of a checklist of bad behaviors.

INTRODUCTION: Professionalism is a key component of medical education and training. However, there are few tools to aid educators in diagnosing unprofessional behavior at an early stage. The purpose of this study was to employ policy capturing methodology to develop two empirically validated checklists for identifying professionalism issues in early-career physicians. METHOD: In a series of workshops, a professionalism competency model containing 74 positive and 70 negative professionalism behaviors was developed and validated. Subsequently, 23 subject matter experts indicated their level of concern if each negative behavior occurred 1, 2, 3, 4, or 5 or more times during a six-month period. These ratings were used to create a "brief" and "extended" professionalism checklist for monitoring physician misconduct. RESULTS: This study confirmed the subjective impression that some unprofessional behaviors are more egregious than others. Fourteen negative behaviors (e.g. displaying obvious signs of substance abuse) were judged to be concerning if they occurred only once, whereas many others (e.g. arriving late for conferences) were judged to be concerning only when they occurred repeatedly. DISCUSSION: Medical educators can use the professionalism checklists developed in this study to aid in the early identification and subsequent remediation of unprofessional behavior in medical students and residents.

Twelve tips for maximizing the effectiveness of game-based learning.

Game-based learning (GBL) in medical education is emerging as a valid alternative to traditional teaching methods. Well-designed GBL sessions use non-threatening competition to capitalize on heightened learner arousal, allowing for high-level engagement and dynamic group discussion. While many templates for specific educational games have been published, little has been written on strategies for educators to create their own or how to use them with maximal effectiveness. These 12 tips provide specific recommendations for the successful design and implementation of GBL sessions in medical education based on a review of the literature and insight from experienced designers.