Background: Traditionally, paper cases are used as 'riggers' to stimulate learning in problem-based learning (PBL). However, video may be a better medium because it preserves the original language, encourages the active extraction of information, avoids depersonalization of patients and allows direct observation of clinical consultations. In short, it exposes the students to the complexity of actual clinical problems.
Aim: The study aims to find out whether students and facilitators who are accustomed to paper cases would prefer video triggers or paper cases and the reasons for their preference.
Method: After students and facilitators had completed a video PBL tutorial, their responses were measured by a structured questionnaire using a modified Likert scale.
Results: A total of 257 students (92%) and 26 facilitators (100%) responded. The majority of students and facilitators considered that using video triggers could enhance the students' observational powers and clinical reasoning, help them to integrate different information and better understand the cases and motivate them to learn. They found PBL using video triggers more interesting and preferred it to PBL using paper cases.
Conclusion: Video triggers are preferred by both students and facilitators over paper cases in PBL.
[Copyright of Medical Teacher is the property of Informa Healthcare . Full article may be available at the publisher's website:
http://dx.doi.org/10.3109/01421591003686260]

Background: Although recent quantitative research suggests that medical students are reluctant to engage in peer physical examination (PPE) of intimate body regions, we do not know why.
Aim: This article explores first-year medical students' anxieties about PPE of intimate body regions at six schools.
Methods: Using the Examining Fellow Students (EFS) questionnaire, we collected qualitative data from students in five countries (UK; Australia; New Zealand; Japan; Hong Kong) between 2005 and 2007.
Results: Our framework analysis of 617 (78.7%) students' qualitative comments yielded three themes: present and future benefits of PPE; possible barriers to PPE; and student stipulations for successful PPE. This article focuses on several sub-themes relating to students' anxieties about PPE of intimate body regions and their associated sexual, gender, cultural and religious concerns. By exploring students' euphemisms about intimate areas, our findings reveal further insights into the relationship between students' anxieties, gender and culture.
Conclusion: First-year students are anxious about examining intimate body regions, so a staged approach starting with manikins is recommended. Further qualitative research is needed employing interviews to explore in depth students' anxieties about examinations of intimate body regions and how their views are shaped by interactions with peers, patients and doctors.
[Copyright of Medical Teacher is the property of Informa Healthcare . Full article may be available at the publisher's website: http://dx.doi.org/10.3109/01421590802578244]

A four-hour integrated teaching session on clinical decision analysis has been developed and introduced as part of the Life Long Learning Skills course for medical students at The Chinese University of Hong Kong. The feasibility and effectiveness of teaching the principles and practice of clinical decision analysis to final-year undergraduate medical students was evaluated. One hundred and thirty-two students were randomly assigned to medical (intervention) and surgical rotations (control) and were assessed two weeks before and three weeks following a teaching session. The students' performance was assessed in response to 10 A-type multiple choice question items that incorporated various clinical scenarios requiring decision making and interpreting cost-effectiveness ratios and sensitivity analysis graphs. More students in the intervention group improved their overall performance scores compared with those in the control group (23.4% vs. 7.4%; 16.1% difference; 95% confidence interval [CI], 3.8-28.5%; p = 0.01). Improvements were in interpretation of decision making (22.2% difference; 95% CI, 10.1-34.4%; p < 0.001). No improvements were seen for calculating cost-effectiveness ratios or interpreting sensitivity analysis graphs. The overall educational intervention was well received by students and effective in improving students' clinical decision analysis skills under simulated conditions. Practice points Clinical decision-making skill is an important aspect of evidence-based medicine. A randomized controlled trial assessed the effect of teaching clinical decision analysis to undergraduate medical students. An integrated teaching session consisting of three 40-minute lectures on the principles and practice of clinical decision analysis, followed by two 1-hour workshops is effective in undergraduate final-year medical students.
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