IntroductionSleep abnormalities, including narcolepsy and cataplexy, are a common feature of Prader-Willi syndrome. Long-term treatment with the central nervous system stimulant modafinil has not been reported. In this case report we present a longitudinal perspective of sleep abnormalities in a nine-year-old Caucasian girl with Prader-Willi syndrome from age two to age nine, and detail the response to treatment with the central nervous system stimulant modafinil.Case presentationOur patient presented at two years of age with hypersomnia and narcoleptic episodes with cataplectic features. Initial polysomnograph testing revealed adequate sleep efficiency, but increased sleep fragmentation especially during rapid eye movement sleep. The narcoleptic episodes continued and a repeat polysomnograph at age five years confirmed features consistent with narcolepsy. Further sleep studies at six years, including a multiple sleep latency test, demonstrated signs of excessive daytime sleepiness. Treatment with modafinil was initiated at age seven years six months due to persistent hypersomnia and narcoleptic symptoms. Two polysomnograph studies were performed following treatment with modafinil, at age eight years six months and nine years three months. These studies showed excellent sleep efficiency and improvement of rapid eye movement sleep parameters, supporting the beneficial effects of long-term modafinil therapy.ConclusionsLong-term modafinil therapy may ameliorate the sleep disturbances of Prader-Willi syndrome and should be the focus of future clinical trials.

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Introduction: Imperative to medical training is the observation and provision of feedback. In this era of competency-based medical education, feedback is one of the core components of this new model. A better understanding of the medical faculty's attitudes and experiences when providing feedback is essential. Currently, there are limited qualitative studies that have explored attitudes and experiences of faculty members when giving corrective feedback to medical trainees. Methods: To allow an in-depth exploration of this phenomenon, a hermeneutics phenomenology approach was used, by conducting semistructured interviews with 10 faculty members representing six disciplines and used thematic analysis to create data-driven codes and identify key themes through an iterative consensus-building process. Results: Four themes were identified by the authors: (1) Elements of effective feedback, (2) Faculty members' perception of giving corrective feedback, (3) Challenges as it relates to the assessment culture of the institution, and (4) Providing effective corrective feedback as a mutual process focused on relationship building between learners and preceptors. Discussion: By exploring faculty members' perceptions of providing perceived corrective feedback, we identified actionable recommendations based on the study participants' experiences, expectations, and challenges which could be addressed involving future faculty development with the focus on modifying concepts of feedback and institutional changes that will promote an attitudinal and a cultural shift.