Perception of educational value in clinical rotations by medical students.

AIM: Clinical teaching in Australian medical schools has changed to meet the needs of substantially increased medical student cohorts. As such, formal feedback from these student cohorts is needed about the value they place on the educational input from each clinical rotation. This study aims to determine which aspects of clinical placements are most educationally useful to medical students. METHODS: In this study, final year medical students from the University of Western Australia (UWA) were surveyed via an anonymous online questionnaire, identifying which clinical placements were found to be the most and the least useful to their learning and the positive aspects of these placements. Two focus groups were conducted prior to the design of the questionnaire to determine the key areas of focus important to medical students. Ethics approval for this study was obtained from the UWA Human Research Ethics Committee. RESULTS: Our focus groups were consistent in finding that students enjoyed placements where they were included as a part of the medical team and played a role in patient care. This was consistent with the concept that inclusiveness and participation in the clinical setting are important in developing competence in tasks and skills. The ratio of students to doctors was crucial, with a low ratio given a higher rating as seen in the rural clinical school. CONCLUSION: The results of this project could benefit both the local and national medical curricula in identifying the most effective clinical attachments for learning and preparation for prevocational training. This is relevant especially due to the limited number of clinical placements and growing cohort of medical students. The results of this study can also be extrapolated to international medical education.

Atypical scleromyxedema presenting with cutaneous and cardiovascular manifestations.

Scleromyxedema is part of a group of cutaneous mucinoses, characterized by a generalized papular eruption, dermal mucin deposition, and an increase in dermal collagen. This condition can be localized as discrete papular lichen myxedematous skin or as a systemic condition usually associated with paraproteinaemia. To date, there is no unifying treatment and is limited by rarity, small number of case reports, and the lack of randomized controlled trials. We describe the case of a 56-year-old gentleman with features of scleromyxedema who had cutaneous and cardiac involvement, and significant mediastinal lymphadenopathy without monoclonal gammopathy.

Development of granulomatosis with polyangiitis (Wegener): listen to the patient.

Patients with rare or complex conditions may sometimes come up with the right diagnosis because of their previous exposure to the condition. This may be due to their knowledge of their family history or even concerns based on their exposure to information from electronic or paper repositories. In this case report, a 40-year-old woman who already had 1 rare condition of lymphangioleiomyomatosis developed breast "abscesses" that did not respond to traditional surgical debridement and antibiotics. She wondered if the lesions could be related to granulomatosis with polyangiitis (Wegener) as she had a strong family history of this condition. Subsequent investigations confirmed the diagnosis. Her response to treatment was complete. Breast lesions in granulomatosis with polyangiitis (Wegener) have been infrequently reported in the literature but should be considered in poorly healing lesions, despite the absence of other more typical symptoms at the time of presentation.