<span>While the potentials of virtual worlds to support experiential learning in medical education are well documented, assessment of student learning within these environments is relatively scarce and often incongruent. In this article, a conceptual framework is proposed for formatively assessing dispositional behaviours in scenario-based learning within a virtual world. The framework was devised for use with medical students playing the roles of junior doctors as they solve open-ended clinical cases within an environment called the </span><em>Otago Virtual Hospital</em><span>. Drawing upon Perkins, Jay and Tishman's (1993) dispositional theory of thinking, it is proposed that the assessment of dispositional behaviours in scenario-based activities can be carried out by measuring the number of times students either seize or miss an opportunity to engage in a particular dispositional behaviour. The approach can potentially also be used for assessing scenario-based learning in other disciplines (e.g. law, business, military).</span>

Using clinical practice improvement methodology, a project was undertaken to reduce the incidence of surgical wound infections following elective hip and knee replacement surgery. A team was established, key measures for improvement were identified, strategies for change were developed and an action plan was implemented. Outcomes for this project included a reduction in the rate of clean surgical wound infection for joint replacement surgery from 28% to zero. Average length of stay for total hip replacement surgery was reduced from 13.9 to 9.3 days and from 14.6 to 10.4 days for total knee replacement surgery. Guidelines for patient selection were developed along with a protocol for the management of preparation to prevent urinary tract infections. Post-discharge surveillance and a preoperative rehabilitation and exercise programme have been implemented. There is potential for wider uptake and implementation of the quality principles described herein.

Environmental issues are topical not only in the news but in many chemistry courses, where they are used to connect the concerns of chemistry to concerns familiar to students. As such, environmental issues provide a context for understanding and learning chemical principles. However, in an environmental chemistry course for nonscience majors, we found that the mere presence of environmental topics in the curriculum was not enough to establish and reveal the connections between the students' environmental interests and chemical principles. For the environmental issues to function effectively as context, they had to be integrated into the curriculum in those places where students look for contextual information. This integration demanded restructuring the entire course to sustain the environmental focus, using principles derived from scientific rhetoric and communication. Although this course was designed explicitly for non-science majors, our experience in blending concern for communication with concern for chemistry has implications for all areas of chemical education.

For as long as there has been a scienti c literature, scientists have complained about it. R easons for complaint are easy to nd; not only is the literature, as John M addox, a former Editor of N ature, described it, 'impenetrable, often to its users',1 it has increased steadily in specialisation2 and grown overwhelmingly in volume3 and in its demands on users.4 Yet despite the regular cycle of complaints, the problems persist, which, as well as frustrating, is puzzling. If the literature is so obviously broken, why don't we x it?The challenge of writing well