Narrow Results

Background: Knowledge of hand anatomy and pathology is important for final year medical students as it frequently appears in examinations as a short case or in a written paper. Studies have shown that doctors in the Emergency Department have a deficient grasp of musculoskeletal anatomy secondary to a lack of dedicated teaching in medical school.

Methods: A questionnaire was handed out to 111 final year medical students. Students were asked to fill it out before and after dedicated upper limb teaching sessions during their rotation. The questionnaire consisted of an anatomical and pathological component. Students were tested on basic anatomy and pathology of several common upper limb conditions.

Results: There was a significant improvement in the medical students knowledge after the dedicated hand teaching. The identification of the carpal bones showed the most improvement overall.

Conclusions: Basic musculoskeletal knowledge is essential to the practice of medicine. The majority of medical students gravitate towards a career in general practice or emergency medicine and good knowledge of upper limb anatomy is important. We have piloted a new interactive dedicated upper limb teaching module and have shown that there has been a significant improvement in students knowledge.

Artificial intelligence (AI) has witnessed significant advancements, reshaping various industries, including healthcare. The introduction of ChatGPT by OpenAI in November 2022 marked a pivotal moment, showcasing the potential of generative AI in revolutionising patient care, diagnosis and treatment. Generative AI, unlike traditional AI systems, possesses the ability to generate new content by understanding patterns within datasets. This article explores the evolution of AI in healthcare, tracing its roots to the term coined by John McCarthy in 1955 and the contributions of pioneers like John Von Neumann and Alan Turing. Currently, generative AI, particularly Large Language Models, holds promise across three broad categories in healthcare: patient care, education and research. In patient care, it offers solutions in clinical document management, diagnostic support and operative planning. Notable advancements include Microsoft’s collaboration with Epic for integrating AI into electronic medical records (EMRs), enhancing clinical data management and patient care. Furthermore, generative AI aids in surgical decision-making, as demonstrated in plastic, orthopaedic and hepatobiliary surgeries. However, challenges such as bias, hallucination and integration with EMR systems necessitate caution and ongoing evaluation. The article also presents insights from the implementation of NUHS Russell-GPT, a generative AI chatbot, in a hand surgery department, showcasing its utility in administrative tasks but highlighting challenges in surgical planning and EMR integration. The survey showed unanimous support for incorporating AI into clinical settings, with all respondents being open to its use. In conclusion, generative AI is poised to enhance patient care and ease physician workloads, starting with automating administrative tasks and evolving to inform diagnoses, tailored treatment plans, as well as aid in surgical planning. As healthcare systems navigate the complexities of integrating AI, the potential benefits for both physicians and patients remain significant, offering a glimpse into a future where AI transforms healthcare delivery.

Level of Evidence: Level V (Diagnostic)

Background: Simulation models enable learners to have repeated practise at their own time, to master the psycho-motor and sensory acuity aspects of surgery and build their confidence in the procedure. The study aims to develop and evaluate the feasibility of a low-cost drilling model to train surgeons in the drilling task. The model targets three aspects of drilling – (1) Reduce plunge depth, (2) Ability to differentiate between bone and medullary canal and (3) Increase accuracy drilling in various angles.

Methods: This cross-sectional study was conducted after obtaining ethics approval. We invited Consultants in the field of Orthopaedic or Hand Surgery to form the ‘expert’ group, and the ‘novice’ group consisted of participants who had no prior experience in bone drilling. We developed a drilling simulator model made from a polyvinyl chloride (PVC) pipe filled with liquid silicone. This model cost less than US$5. An electric Bosch drill (model GBM 10 RE) with a 1.4 mm K-wire 10 cm in length (6.5 cm outside the drill) was used for drilling. The main outcomes of the study were time taken for drilling, plunge depth, ability to penetrate the far cortex and accuracy.

Results: Thirty-one participants were recruited into the study, of which 15 were experts and 16 were novices. The experts performed significantly better for plunge depth (t = −3.65, p = 0.0003) and accuracy (t = −2.07, p = 0.04). The experts required 20% less time to complete the drilling tasks, but it was not statistically significant (t = −0.79, p = 0.43).

Conclusions: The low-cost drilling model could be useful in training Residents in the drilling task. It will allow Residents to practise independently at their own time and assess their own performance.

Diabetic foot care education and diabetic foot screening are essential for all diabetic patients. One of the major complications in diabetes is foot ulceration due to poor vascular status, nerve damage and lack of self-foot care. Patients should follow-up on a six-month or yearly checkup with diabetic foot care nurses. The physical examination and testing results are useful for the physician when considering the state of the patient's feet condition. Diabetic foot care education plays an important role in the care of the patient's feet. Diabetic foot care nurses are trained and qualified to conduct foot screening and provide education sessions to patients. Educational resources are used in assisting patient's understanding in self-foot care. Places such as hospitals, polyclinics and national foot care centres provide diabetic foot screening and foot care services to all diabetic patients. The aim is to achieve an effective and structured foot care education in order to improve treatment outcome and prevent recurrence of the foot problem. According to the National Institute for Health and Clinical Excellence (NICE) guideline, “education is an essential element in the empowerment of people with diabetes”.