Does the inclusion of 'professional development' teaching improve medical students' communication skills?

Background: This study investigated whether the introduction of professional development teaching in the first two years of a medical course improved students' observed communication skills with simulated patients. Students' observed communication skills were related to patient-centred attitudes, confidence in communicating with patients and performance in later clinical examinations.Methods: Eighty-two medical students from two consecutive cohorts at a UK medical school completed two videoed consultations with a simulated patient: one at the beginning of year 1 and one at the end of year 2. Group 1 (n = 35) received a traditional pre-clinical curriculum. Group 2 (n = 47) received a curriculum that included communication skills training integrated into a 'professional development' vertical module. Videoed consultations were rated using the Evans Interview Rating Scale by communication skills tutors. A subset of 27% were double-coded. Inter-rater reliability is reported.Results: Students who had received the professional development teaching achieved higher ratings for use of silence, not interrupting the patient, and keeping the discussion relevant compared to students receiving the traditional curriculum. Patient-centred attitudes were not related to observed communication. Students who were less nervous and felt they knew how to listen were rated as better communicators. Students receiving the traditional curriculum and who had been rated as better communicators when they entered medical school performed less well in the final year clinical examination.Conclusions: Students receiving the professional development training showed significant improvements in certain communication skills, but students in both cohorts improved over time. The lack of a relationship between observed communication skills and patient-centred attitudes may be a reflection of students' inexperience in working with patients, resulting in 'patient-centredness' being an abstract concept. Students in the early years of their medical course may benefit from further opportunities to practise basic communication skills on a one-to-one basis with patients

Quality Evaluation of Manipulated and Industrialized Simvastatin Formulations

Medicamentos de uso crônico, como a sinvastatina, podem representar ao usuário um custo elevado, propiciando a utilização de medicamentos manipulados como uma alternativa, no entanto a sua qualidade deve ser assegurada. Assim, o trabalho tem como objetivo verificar a qualidade de comprimidos referência (R), genéricos (G1-2) e similares (S1-2) e cápsulas manipuladas (M1-4) de sinvastatina avaliando- se peso médio, perfil de dissolução, doseamento e uniformidade de conteúdo. Os resultados da avaliação da qualidade dos comprimidos industrializados e das cápsulas manipuladas 1-3 estão de acordo com os parâmetros especificados nas Farmacopéias. No entanto, os resultados da uniformidade de conteúdo para a formulação M4 indicaram que 3 amostras apresentaram teor inferior a 75% com DPR de 10,30%. Ainda, a quantidade de sinvastatina liberada foi de 63,74% em 30 minutos não atendendo o recomendado pela Farmacopéia Americana. O trabalho mostrou a importância em assegurar a qualidade dos medicamentos comercializados com o interesse em evitar ineficácia terapêutica.Chronic drug treatments with simvastatin may be expensive to patients, favoring the use of manipulated pharmaceutical forms as an alternative, thus, quality must be ensured. Thus, the study addressed the quality of the reference (R), generics (G1 and G2) and similars (S1 and S2) industrialized tablets, and four pharmacy manipulated capsules (M1-4) of simvastatin by evaluating the average weight, dissolution profile, content of active substance and uniformity of dosage unity. All parameters tested were in accordance with the Pharmacopeias for all dosage forms, except for the uniformity of dosage unity of M4, which presented less than 75% of the expected simvastatin content with relative standard deviation of 10.30 % for three samples. Furthermore, the amount of released sinvastatin was 63.74% within 30 minutes, which is below the recommendation of the American Pharmacopeia. Thus, it was shown the importance to ensure the quality of commercially available medicines avoiding therapeutic inefficacy.Universidad Nacional de La Plat