Most studies of sports-related injuries have been investigations of specific injuries resulting from specific, organized sports at the high school, college, or professional level. This study documented all types of sports-related injuries received by all school-aged children in a midwestern community of 100,000 for a 1-year period. Public and private schools, community sports programs, hospital emergency rooms, the schools' accident insurance company, and local physicians provided initial accident reports. Injuries were sustained by 3% of all elementary school students, 7% of all junior high school (grades 7 and 8) students, and 11% of all high school students. Nonorganized sports and physical education classes each produced nearly twice as many injuries as organized sports. One-fifth of the injuries were considered serious and one-fourth of all injuries could have been avoided had nominal safety precautions been observed.

Clinical training in ambulatory settings is an increasingly prominent topic in medical education, but most descriptions of internal medicine programs in the literature concern training for residents. The authors undertook a survey of departments of internal medicine to obtain and assess information about requirements for ambulatory clinical experiences for medical students. The results show that few departments (24% of the 101 departments responding) required ambulatory care experiences for undergraduates. Most of the required programs had a goal of broad exposure to ambulatory-patient problems; almost none had special educational interventions to complement students' care of patients. The experiences that were incorporated into the clerkship in a single block of time were more favorably rated than the experiences that occurred intermittently throughout the clerkship. Inability to provide continuity-of-care experience was an important concern of the departments. Most programs had logistical problems, the most serious and frequently cited being the lack of faculty time for teaching. The authors raise concerns about the educational effectiveness of many existing programs and, given the problems with faculty involvement, about the long-term viability of these programs.

The use of performance-based examinations consisting of standardized-patient (SP) cases has increased greatly in recent years. These examinations are typically long and thus require the presentation of the same SP cases to several consecutive examinee groups. Consequently, concerns have arisen about the potential for violations of test security whereby students who were tested early in the examination period pass on information to students tested later. These concerns are addressed using data from the SP-based examinations administered to five classes (1986-1990) of senior medical students at Southern Illinois University School of Medicine. Because of the length of the examinations, each class was randomly divided into five groups and the examination was administered to one group at a time, requiring three days of testing time per group and three weeks of testing time per class. The results showed no consistent, systematic changes in case means across the five groups tested at different times throughout the examination period, and thus provide no evidence of serious, widespread violations of test security.

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