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111

E-learning module in psychiatry on Attention Deficit Hyperactivity Disorder (ADHD)

As part of my 5th year Senior Clinical Project I developed a psychiatry e-learning module in the form of a virtual patient on Attention Deficit Hyperactivity Disorder (ADHD), constructed using a PowerPoint template from the e-learning department at Cardiff University. This consisted of a simulated ADHD case, with the student taking the role of a General Practitioner and Specialist Paediatrician involved in the patient’s care. During the course of the module the user is required to make clinical and therapeutic decisions regarding the patient, with educational material revealed to them as they complete a selection of multiple-choice questions on the disorder. The module has since been made available as a resource for future students via blackboard, which can be found at: https://learningcentral.cf.ac.uk/bbcswebdav/institution/Medic/Undergraduate/Virtual%20Patient/src/adhd/adhd.htm Before developing the module, I conducted a thorough literature search on ‘e-learning and medical education’, in order to access current literature and gain an insight into some of the educational theory surrounding the subject. A combination of textbook research, published literature, and national guidelines were then used to establish an extensive knowledge of ADHD from which the module content could be derived. I strongly believe my learning resource will help improve future students' understanding of the disorder, which only forms a small part of the current fourth year psychological medicine curriculum.  
Oliver Mumby
almost 7 years ago
Www.bmj
1
40

A man with a mass in the thigh

A 54 year old man presented to his general practitioner because of a fullness in his left lateral thigh that he first noticed while playing golf, although it was not related to an identifiable injury. He had a history of hypertension and fibromyalgia and was taking atenolol, ramipril, pregabalin, and tramadol but was otherwise well. The GP thought that the swelling was caused by a muscular injury, but the patient re-presented four months later because the mass had grown from a small bump to a swelling of 8 cm in diameter. It was also beginning to cause some knee stiffness but no pain. On examination he had a large firm swelling in his lateral thigh. On this occasion his GP referred him on a two week wait to the regional plastic surgery department. An ultrasound scan showed a 6 × 8 cm intramuscular mass with cystic changes and patchy neovascularity, but no inguinal or pelvic lymphadenopathy. Ultrasonography was followed by magnetic resonance imaging, with and without gadolinium contrast (fig 1⇓).  
bmj.com
about 5 years ago
Preview
1
14

Setting performance targets in pay for performance programmes: what can we learn from QOF?

The UK’s Quality and Outcomes Framework, which was introduced in 2004 to reward general practitioners for meeting performance targets, has been controversial. Tim Doran and colleagues reflect on the difficulties of setting and adjusting targets and the missed opportunities for improving the evidence base  
bmj.com
about 5 years ago
Www.bmj
1
46

A man with a mass in the thigh

A 54 year old man presented to his general practitioner because of a fullness in his left lateral thigh that he first noticed while playing golf, although it was not related to an identifiable injury. He had a history of hypertension and fibromyalgia and was taking atenolol, ramipril, pregabalin, and tramadol but was otherwise well. The GP thought that the swelling was caused by a muscular injury, but the patient re-presented four months later because the mass had grown from a small bump to a swelling of 8 cm in diameter. It was also beginning to cause some knee stiffness but no pain. On examination he had a large firm swelling in his lateral thigh. On this occasion his GP referred him on a two week wait to the regional plastic surgery department. An ultrasound scan showed a 6 × 8 cm intramuscular mass with cystic changes and patchy neovascularity, but no inguinal or pelvic lymphadenopathy. Ultrasonography was followed by magnetic resonance imaging, with and without gadolinium contrast (fig 1⇓).  
bmj.com
about 5 years ago
Www.bmj
1
38

A man with a mass in the thigh

A 54 year old man presented to his general practitioner because of a fullness in his left lateral thigh that he first noticed while playing golf, although it was not related to an identifiable injury. He had a history of hypertension and fibromyalgia and was taking atenolol, ramipril, pregabalin, and tramadol but was otherwise well. The GP thought that the swelling was caused by a muscular injury, but the patient re-presented four months later because the mass had grown from a small bump to a swelling of 8 cm in diameter. It was also beginning to cause some knee stiffness but no pain. On examination he had a large firm swelling in his lateral thigh. On this occasion his GP referred him on a two week wait to the regional plastic surgery department. An ultrasound scan showed a 6 × 8 cm intramuscular mass with cystic changes and patchy neovascularity, but no inguinal or pelvic lymphadenopathy. Ultrasonography was followed by magnetic resonance imaging, with and without gadolinium contrast (fig 1⇓).  
bmj.com
about 5 years ago
Www.bmj
1
39

Drugs for neuropathic pain

The patient is a 63 year old freelance editor with type 2 diabetes diagnosed about five years ago that is relatively well controlled with insulin. He has early signs of retinopathy, with normal kidney function and electrocardiogram. Lipid values are normal with diet and atorvastatin 20 mg/day. He developed autonomic and peripheral neuropathy a few months ago, and now experiences postural hypotension and burning pain and clumsiness in his feet. His pain makes concentration and falling asleep difficult. He asks his general practitioner for painkillers to help him continue working.  
bmj.com
about 5 years ago
Www.bmj
1
35

A man with tingling fingers

A 73 year old man with a three month history of bilateral persistent tingling in the index and middle fingers presented to his general practitioner. He was referred for an injection for suspected carpal tunnel syndrome. When he attended, as well as the tingling sensation, he described loss of fine motor function in his hands, with altered sensation in both legs and his inner thighs. Examination at this time showed no objective sensory loss in either hand. Phalen’s test and Tinel’s test were both negative. His upper limb tendon reflexes were normal.  
bmj.com
about 5 years ago
Www.bmj
1
43

A man with a mass in the thigh

A 54 year old man presented to his general practitioner because of a fullness in his left lateral thigh that he first noticed while playing golf, although it was not related to an identifiable injury. He had a history of hypertension and fibromyalgia and was taking atenolol, ramipril, pregabalin, and tramadol but was otherwise well. The GP thought that the swelling was caused by a muscular injury, but the patient re-presented four months later because the mass had grown from a small bump to a swelling of 8 cm in diameter. It was also beginning to cause some knee stiffness but no pain. On examination he had a large firm swelling in his lateral thigh. On this occasion his GP referred him on a two week wait to the regional plastic surgery department. An ultrasound scan showed a 6 × 8 cm intramuscular mass with cystic changes and patchy neovascularity, but no inguinal or pelvic lymphadenopathy. Ultrasonography was followed by magnetic resonance imaging, with and without gadolinium contrast (fig 1⇓).  
bmj.com
about 5 years ago
Www.bmj
2
54

A man with a mass in the thigh

A 54 year old man presented to his general practitioner because of a fullness in his left lateral thigh that he first noticed while playing golf, although it was not related to an identifiable injury. He had a history of hypertension and fibromyalgia and was taking atenolol, ramipril, pregabalin, and tramadol but was otherwise well. The GP thought that the swelling was caused by a muscular injury, but the patient re-presented four months later because the mass had grown from a small bump to a swelling of 8 cm in diameter. It was also beginning to cause some knee stiffness but no pain. On examination he had a large firm swelling in his lateral thigh. On this occasion his GP referred him on a two week wait to the regional plastic surgery department. An ultrasound scan showed a 6 × 8 cm intramuscular mass with cystic changes and patchy neovascularity, but no inguinal or pelvic lymphadenopathy. Ultrasonography was followed by magnetic resonance imaging, with and without gadolinium contrast (fig 1⇓).  
bmj.com
about 5 years ago
Www.bmj
1
33

A man with a mass in the thigh

A 54 year old man presented to his general practitioner because of a fullness in his left lateral thigh that he first noticed while playing golf, although it was not related to an identifiable injury. He had a history of hypertension and fibromyalgia and was taking atenolol, ramipril, pregabalin, and tramadol but was otherwise well. The GP thought that the swelling was caused by a muscular injury, but the patient re-presented four months later because the mass had grown from a small bump to a swelling of 8 cm in diameter. It was also beginning to cause some knee stiffness but no pain. On examination he had a large firm swelling in his lateral thigh. On this occasion his GP referred him on a two week wait to the regional plastic surgery department. An ultrasound scan showed a 6 × 8 cm intramuscular mass with cystic changes and patchy neovascularity, but no inguinal or pelvic lymphadenopathy. Ultrasonography was followed by magnetic resonance imaging, with and without gadolinium contrast (fig 1⇓).  
bmj.com
about 5 years ago
Www.bmj
1
39

A man with a mass in the thigh

A 54 year old man presented to his general practitioner because of a fullness in his left lateral thigh that he first noticed while playing golf, although it was not related to an identifiable injury. He had a history of hypertension and fibromyalgia and was taking atenolol, ramipril, pregabalin, and tramadol but was otherwise well. The GP thought that the swelling was caused by a muscular injury, but the patient re-presented four months later because the mass had grown from a small bump to a swelling of 8 cm in diameter. It was also beginning to cause some knee stiffness but no pain. On examination he had a large firm swelling in his lateral thigh. On this occasion his GP referred him on a two week wait to the regional plastic surgery department. An ultrasound scan showed a 6 × 8 cm intramuscular mass with cystic changes and patchy neovascularity, but no inguinal or pelvic lymphadenopathy. Ultrasonography was followed by magnetic resonance imaging, with and without gadolinium contrast (fig 1⇓).  
bmj.com
about 5 years ago
Www.bmj
1
18

Trainee GP is struck off after concocting “frankly ridiculous” story to explain missing data

A trainee general practitioner has been struck off the UK medical register after a fitness to practise panel labelled as “incredible” her denial of falsifying questionnaires on patient satisfaction.  
bmj.com
about 5 years ago
Preview
1
16

Balance between GP and hospital doctor numbers may need to shift, says new NHS chief

Workforce numbers among general practitioners have not risen as quickly as those of hospital consultants despite a shift in the NHS to provide more care outside hospitals, the new head of the NHS in England has said.  
www.bmj.com
about 5 years ago
Preview
1
9

Funding for GP out of hours in England has fallen by £65m since 2012

Funding for out of hours general practitioner services in England has decreased by some 13% in the past two years, new figures have shown.  
bmj.com
about 5 years ago
Www.bmj
1
20

New guidance urges NHS commissioners to buy ethically

The BMA and Royal College of General Practitioners have published joint guidance for GPs and commissioning organisations in the United Kingdom to help protect the rights of workers in medical supply chains.1  
bmj.com
about 5 years ago
Www.bmj
2
14

NHS will collapse without “building blocks” of general practice, warns GP leader

General practice is the “building blocks” of the NHS, and without it the system would collapse, the chairman of the BMA’s General Practitioners Committee told representatives attending the BMA’s local medical committees conference in York this week.  
bmj.com
almost 5 years ago
Www.bmj
1
15

A woman with a sore spot on her leg

A 41 year old civil servant, with a background of poorly controlled Crohn’s disease, presented to her general practitioner with a skin lesion on her left shin that had been there for eight weeks (fig 1⇓).  
bmj.com
almost 5 years ago
Www.bmj
1
46

A woman with a sore spot on her leg

A 41 year old civil servant, with a background of poorly controlled Crohn’s disease, presented to her general practitioner with a skin lesion on her left shin that had been there for eight weeks (fig 1⇓).  
bmj.com
almost 5 years ago
Www.bmj
1
15

A woman with a sore spot on her leg

A 41 year old civil servant, with a background of poorly controlled Crohn’s disease, presented to her general practitioner with a skin lesion on her left shin that had been there for eight weeks (fig 1⇓).  
bmj.com
almost 5 years ago
Www.bmj
2
14

A woman with a sore spot on her leg

A 41 year old civil servant, with a background of poorly controlled Crohn’s disease, presented to her general practitioner with a skin lesion on her left shin that had been there for eight weeks (fig 1⇓).  
bmj.com
almost 5 years ago