T England. The design used was cross-sectional survey research. The data collection method was a self-completion online survey. A total of 283 students participated in the study. The proportion of students using clinical photographs was 87%, p= 0.217. The medical subject discipline in which clinical photographs were considered by students as most useful were dermatology ( T V Qlibrary made available through their medical school was 92%. The main barrier to using existing photographic resources was awareness.

The PromptPR patient record originates from the research and development project DILEMMA (1992-94) and has been undertaken in the context of the research project PROMPT (4th Framework Health Telematics). Here we present the work undertaken with the doctors of the project RISA (Réseau d'Information de Santé en Aquitaine) in order to adapt the patient record to their various practical medical conditions. Effectively, there are implications for general practitioners, the private sector and hospital personnel. The richness of the workgroup and the adoption of a participative methodology, guided by the demands of the end-users allowed the creation of an electronic patient record (EPR) sufficiently simple and generic as to serve as a common base for both general practitioners and hospital medical staff. Independent of this system, the multimedia interface presented is based on frames, which enables visualization of the EPR either vertically or horizontally, with access to both the multimedia and external documentation of the patient. This web interface is the result of a consensus of opinion within the group.

Introduction: Capitalizing on the success of Simulation-Based Education (SBE) in residency-training programs, simulation has been gradually integrated into Continued Professional Development (CPD) programs for Emergency Physicians (EPs) in Canada. This study sought to characterize how Canadian academic emergency medicine (EM) departments have implemented SBE for CPD. Methods: We conducted two national surveys: 1) the National Faculty Simulation Status Assessment Survey, administered by telephone to the simulation directors (or equivalent) at 20 Canadian academic EM sites and 2) the Faculty Simulation Needs Assessment Survey administered online to all full-time EPs across 9 Canadian academic EM sites. Results: The response rates for the National Status and Needs Assessment Surveys were 100% (20/20), and 40% (252/635), respectively. The majority (60%) of Canadian academic EM sites reported utilizing SBE for CPD, though only 30% reported dedicated funding support. EPs reported participating in a median of 3 hours per year of SBE (IQR 1-6 hours). Reported incentivization offered in the form of continued medical education credits varied between simulation directors (67%) and EPs (44%). Simulation directors identified several significant barriers to SBE including a lack of faculty time, fear of peer judgment, and faculty inexperience. In contrast, EP-identified barriers included time commitments outside of shift, lack of opportunities, and lack of departmental. The three most common topics of interest for SBE by EPs were performance of rare procedures, pediatric resuscitation, and neonatal resuscitation. Interprofessional involvement in SBE CPD was valued by both simulation directors and EPs, with most EPs (79%) indicating it is useful. Conclusion: Most Canadian EPs and simulation directors recognize the value of SBE for CPD, yet it is only utilized, infrequently, by 67% of Canadian academic EM departments for this purpose. This may be explained, in part, by poor incentivization for participation. Simulation directors and EPs noted different barriers to SBE implementation for CPD suggesting the need for dialogue to improve utilization. As SBE for CPD is incorporated more frequently, and at more sites, content should be guided by local needs assessments with an emphasis on interprofessional participation.

The Wellcome Image Awards are celebrating their 20th year of bringing us the world's most incredible science and health images this year. The 2017 winners can be seen at exhibitions to be held simultaneously across the UK, in science centres from Aberdeen to the Eden Project, as well as in Russia and South Africa. Over the last 20 years many images have featured amongst the winners and this gallery showcases the images from the contemporary clinical collection that were successful during that time.

A reflection on past product advertisements which were created for earlier versions of this journal and were specifically targeted at the Medical Photographer.