Improving the effectiveness of a paediatric handbook for new house officers

Background and objectives: To help house officers adjust quickly to their new responsibilities, a departmental handbook is provided. As this had not been updated recently and was underutilised, a quality improvement project was undertaken to improve this resource. Methods: The handbook was updated and new material added based on feedback from house officers and senior medical staff. Subsequently, house officers were surveyed on their utilization rate of the new handbook and its usefulness in various clinical scenarios. An open-book clinical quiz was administered to gauge their clinical competency. Results: There was a 26.8% increase in the proportion of house officers who used the handbook more than once every 2–3 days compared to pre-intervention. There was a significant improvement in quiz scores from 26.7/40 to 31.1/40 between the pre-intervention ( n=19) and post-intervention ( n=37) groups ( p<0.001), as well as perceived usefulness of the handbook in various clinical scenarios as measured on a 10-point Likert scale. Conclusions: We find that improvement in the quality of a handbook for paediatric house officers is associated with increase in its utilization and benefits to their clinical competency and confidence level, especially on call. To increase the utilization rate of the handbook, both the user interface and content need to be improved.

Clinical Quiz—A Rare Case of Anal Canal Duplication in the Context of Currarino Syndrome

Currarino syndrome (CS) is a rare condition that presents with any combination of a sacral defect, a presacral mass, and an anorectal malformation. This collection, referred to as Currarino's triad, may not necessarily present as all three abnormalities in the diagnosis of the syndrome. Anal canal duplication (ACD) is an even rarer occurrence. We present a case that lies on the CS spectrum with an associated ACD and discuss a complex surgical challenge that necessitated a customized management plan, devised through a multidisciplinary approach.

A Patient with Finger Gangrene

The following clinical quiz demonstrates that capillaroscopy is useful in the assessment of patients suffering from Raynaud’s phenomenon in systemic sclerosis (SSc) spectrum diseases.

Clinical Quiz: Reconstructive Strategies in a 5-Month-Old Infant with a Cloaca

Herein we present a case of 5-month-old female born with a cloaca. She underwent a colostomy at birth and then underwent endoscopy and cloacagram to plan for the definitive reconstruction. The case is presented with a focus on the reconstructive strategies, and questions for the readers are posed in a quiz format.