Up to 19% of patients who undergo surgery for an acute hip fracture are readmitted to the hospital within three months of the index operation. We aimed to identify risk factors for unplanned clinic attendance, readmission, and mortality within the first 12 months postoperatively and subsequently determine if there is a role for routine follow-up. Patients greater than 65 years old who underwent hip hemiarthroplasty using an uncemented Thompson implant for treatment of a traumatic non-pathological hip fracture were identified from a prospectively maintained database at a single institution between August 2007 and February 2011. Patient demographics, comorbidities, place of residence, mobility status, unplanned attendance to an orthopaedic clinic with symptoms relating to the respective limb, readmission, and mortality were recorded.Abstract
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Methods
YouTube is one of the main sources for learning clinical skills. This study aims to assess the educational outcomes of medical students from self-directed learning about knee arthrocentesis through searching and using YouTube videos in comparison to traditional supervisor-led sessions. Seventy-one medical students were randomly assigned in three groups. Group A had a classic supervisor-led clinical session, where the supervisor demonstrated the procedure. Group B students were provided with links to YouTube videos of knee arthrocentesis that were deemed of high educational quality, while group C searched and learned from any YouTube video they found appropriate based on the learning objectives provided. The students' performance pre- and post-feedback was examined using a checklist that was based on the guidelines of the American Academy of Family Physicians on knee arthrocentesis. Pre-feedback, statistically significant higher mean scores for group A were noted in identification of an appropriate puncture site (p = 0.015), puncture site sterilization (p = 0.046), wearing sterile gloves (p < 0 .001), and direction of needle insertion (p < 0.001). The overall mean scores before feedback for group A, group B and group C were 17.9 ± 1.9, 14.9 ± 2 and 15.4 ± 1.8, respectively (p < 0 .001). None of these scores was below 60% of the total possible score (total score = 21). The overall mean scores after feedback for group A, group B and group C were 21, 20.9 ± 0.3 and 21, respectively (p = 0.037). Without appropriate feedback to the learners from an instructor, YouTube videos cannot replace traditional supervisor-led sessions in learning knee arthrocentesis.
