Professionalism and inter-communication skills (ICS): a multi-site validity study assessing proficiency in core competencies and milestones in medical learners.

BACKGROUND: Interpersonal and Communication Skills (ICS) and Professionalism milestones are challenging to evaluate during medical training. Paucity in proficiency, direction and validity evidence of assessment tools of these milestones warrants further research. We validated the reliability of the previously-piloted Instrument for Communication skills and Professionalism Assessment (InCoPrA) in medical learners. METHODS: This validity approach was guided by the rigorous Kane's Framework. Faculty-raters and standardized patients (SPs) used their respective InCoPrA sub-component to assess distinctive domains pertinent to ICS and Professionalism through multiple expert-built simulated-scenarios comparable to usual care. Evaluations included; inter-rater reliability of the faculty total score; the correlation between the total score by the SPs; and the average of the total score by two-faculty members. Participants were surveyed regarding acceptability, realism, and applicability of this experience. RESULTS: Eighty trainees and 25 faculty-raters from five medical residency training sites participated. ICC of the total score between faculty-raters was generally moderate (ICC range 0.44-0.58). There was on average a moderate linear relationship between the SPs and faculty total scores (Pearson correlations range 0.23-0.44). Majority of participants ascertained receiving a meaningful, immediate, and comprehensive patient-faculty feedback. CONCLUSIONS: This work substantiated that InCoPrA was a reliable, standardized, evidence-based, and user-friendly assessment tool for ICS and Professionalism milestones. Validating InCoPrA showed generally-moderate agreeability and high acceptability. Using InCoPrA also promoted engaging all stakeholders in medical education and training-faculty, learners, and SPs-using simulation-media as pathway for comprehensive feedback of milestones growth.

Isolated Intravascular Prostate Carcinoma Recurrence Confirmed With 18F-Fluciclovine PET/CT and MRI.

Late recurrence of prostate cancer after remission with prior radical prostatectomy is uncommon. This is a unique case of biochemical recurrence after being in remission for 12 years. The patient presented with swelling of the right lower extremity with pelvic MRI demonstrating an arterially enhancing filling defect in the right common iliac. An F-fluciclovine PET/CT showed corresponding increased intravascular radiotracer activity. Targeted biopsy of the intravascular lesion showed poorly differentiated carcinoma, suggestive of prostate origin. Although MRI evaluation is the mainstay for pelvic evaluation, characterization with F-fluciclovine PET/CT imaging adds high whole-body specificity and diagnostic accuracy.

Self-management of headache: a cross-sectional survey in the General Public of Islamabad.

OBJECTIVES: To quantify the frequency of self-management for headache by adult population aged >18 years in urban and rural Islamabad. METHODS: The cross-sectional study using systematic sampling of households was conducted in I-8 sector of Islamabad and its outskirts (in Nurpur Shahan) from March to September 2011. It comprised 248 individuals above 18 years of age who were interviewed using a structured questionnaire. SPSS 16 was used for data analysis. RESULTS: Of the total, 136 (54.8%) were males and 112 (45.2%) were females. The overall mean age was 32 +/- 12.5 years, and 218 (87.9%) suffered from headache. Out of those suffering from headaches, 178 (81.7%) employed self-management. Pharmaceutical drugs (n = 155; 87.1%) were the commonest modality employed, while vitamins (n = 6; 3.4%), massage (n = 8; 4.5%), herbal remedies (n = 4; 2.2%) and homeopathic medicines (n = 5; 2.8%) were infrequently utilised. Acetaminophen (panadol) was the commonest pharmaceutical drug used (n = 91; 58.7%), followed by salicylic acid (aspirin) (n = 46; 29.7%). Self-management was slightly more frequent among males (n = 95; 53.37%) and in the above-matriculation group (n = 103; 57.8%). A total of 151 (84.7%) people claimed to be satisfied with their self-management. CONCLUSION: Self-management of headaches is highly prevalent among the general public. The majority opts for pharmaceutical drugs, mostly preferring acetaminophen. Most are satisfied with their self-management.