Teaching Skill Improvement for Graduate Medical Trainees

The medical education literature concerned with the teaching role fulfilled by house officers was reviewed by the authors. Articles were presented in three categories: (1) studies of house officer effort, (2) perceptions of the house officer's teaching role, and (3) assessing and improving house officer teaching skills. House officers are involved in a large amount of teaching, greatly influence students, and fulfill a unique teaching role in medical education that is complementary to thefaculty teaching role. An agendafor research and development in the area of research teaching skills was proposed based on three broad research questions: (1) What types of teaching skills are most appropriate for residents? (2) How do faculty and student expectations of resident teaching influence resident teaching? (3) What type of intervention is most successful in improving resident teaching skills?Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/68183/2/10.1177_016327878801100101.pd

Sudden unexpected deaths and vaccinations during the first two years of life in Italy: a case series study.

The signal of an association between vaccination in the second year of life with a hexavalent vaccine and sudden unexpected deaths (SUD) in the two days following vaccination was reported in Germany in 2003. A study to establish whether the immunisation with hexavalent vaccines increased the short term risk of SUD in infants was conducted in Italy. METHODOLOGY/PRINCIPAL FINDINGS: The reference population comprises around 3 million infants vaccinated in Italy in the study period 1999-2004 (1.5 million received hexavalent vaccines). Events of SUD in infants aged 1-23 months were identified through the death certificates. Vaccination history was retrieved from immunisation registries. Association between immunisation and death was assessed adopting a case series design focusing on the risk periods 0-1, 0-7, and 0-14 days after immunisation. Among the 604 infants who died of SUD, 244 (40%) had received at least one vaccination. Four deaths occurred within two days from vaccination with the hexavalent vaccines (RR = 1.5; 95% CI 0.6 to 4.2). The RRs for the risk periods 0-7 and 0-14 were 2.0 (95% CI 1.2 to 3.5) and 1.5 (95% CI 0.9 to 2.4). The increased risk was limited to the first dose (RR = 2.2; 95% CI 1.1 to 4.4), whereas no increase was observed for the second and third doses combined. CONCLUSIONS: The RRs of SUD for any vaccines and any risk periods, even when greater than 1, were almost an order of magnitude lower than the estimates in Germany. The limited increase in RRs found in Italy appears confined to the first dose and may be partly explained by a residual uncontrolled confounding effect of age