James Tomlinson, a simulation fellow in surgery, argues that we need to look outside the medical world to enhance our understanding and utilisation of simulation training

Ms C, a 42-year-old risk manager, fell from her horse whilst out riding. At the time of the fall she felt her left knee twist, as her left foot had been caught in the stirrup.

Dr Paula–Jane Marrett, Dr Fiona Boyd and Beverley Chapman recently won the poster competition at the annual Patient Safety Congress. They share their research and findings

Dr Beatrice Baiden shares her experiences of working in palliative care

Six-year-old FM underwent a left Salter’s osteotomy to treat the developmental dysplasia of his hip. Mr R, consultant orthopaedic surgeon, performed the procedure. Prior to it, he discussed the risks and benefits of this operation with FM’s parents and recorded it all in the clinical notes.

Mrs A, 50, had initially consulted her GP with heartburn and some minor weight loss. A gastroscopy was performed and demonstrated Grade A oesophagitis with a small hiatus hernia. Mrs A was started on a proton pump inhibitor; however, her symptoms persisted and she asked to see a specialist.

Mr P was a 30-year-old high-earning banker, married with three dependants. He had a one-year history of rheumatoid arthritis, for which he took methotrexate.

Mrs J was unhappy with the appearance of her midriff and attended a cosmetic surgery clinic for advice. She was seen by a nurse who told her that she would be a good candidate for abdominal liposuction. After a brief consultation with Dr X, specialist cosmetic surgeon, Mrs J gave her consent to go ahead with the procedure.

Physicians often care for patients with extremely complex clinical presentations and multiple diagnoses. In such a situation, it can be hard to keep track of all the relevant problems and investigation results.