Undergraduate education in anaesthesia, intensive care, pain, and perioperative medicine: The development of a national curriculum framework.

INTRODUCTION: The study describes the development of the first UK national framework to guide undergraduate education in anesthesia, perioperative medicine, critical care, and pain medicine. METHODS: We followed an inclusive process of curriculum design aiming to promote high-level learning amongst students. We conducted telephone interviews with senior anesthetic educators at 33 UK medical schools to establish current provision and practice. We then held a consultative national workshop for educators, using focus group interviews to set broad aims for the final framework and gather information. RESULT: Anesthesia undergraduate educators demonstrated a conceptual focus that moves beyond simple acquisition of knowledge to one geared to encouraging clinical behavioral change in learners to equip them for practice as new doctors. Respondents also highlighted the opportunities for promoting spiral, integrated, and longitudinal learning within the undergraduate curriculum. We also formulated eight key domains of practice in anesthesia and critical care and mapped 63 of the 106 General Medical Council's Outcomes for Graduates against these domains, and created a brief suggested syllabus. CONCLUSIONS: The framework aims to provide support and guidance for medical schools in the development of competent, well-rounded doctors who are able to provide safe, patient-centered care in all areas of medical practice.

What factors are associated with repeated domestic assault in patients attending an emergency department? A cohort study.

OBJECTIVE: To identify what clinical variables are associated with repeat attendances at the emergency department (ED) in patients who have experienced domestic assault. METHODS: A medical records-based cohort study was conducted in a single ED in Cambridge, UK. PARTICIPANTS: 294 adult patients with disclosed domestic assault presenting between 2001 and 2004 were followed up by examining their medical records until 2004. MAIN OUTCOME MEASURES: Re-presentation at the ED with disclosed domestic assault. RESULTS: 45 patients re-presented at the ED with further domestic assault. Repeated assault was more likely in patients in whom no clear diagnosis was made (odds ratio (OR) 4.6 95%, CI 1.4 to 14.5; p<0.001), who had head injuries (OR 4.08, 95% CI 1.94 to 8.59; p<0.001), injuries to the upper limb (OR 1.94, 95% CI 1.01 to 3.73; p=0.05), or who had a psychiatric diagnosis (OR 3.43, 95% CI 1.34 to 8.76; p=0.1). CONCLUSIONS: There are readily measurable clinical features that are associated with repeat ED attendance as a result of domestic assault.