Medical education follows the clinical drive toward patient-centered care and, therefore, puts strong emphasis on the development of empathy by medical students. It has, however, been found that there is a decline in empathy throughout a student’s education. Students’ participation in role-play as the doctor has been proved to improve patient care in a clinical capacity. Here, it is proposed that patient role-play can enhance patient care holistically, by enhancing key communication skills and student’s empathy.

BackgroundThe impact of COVID-19 on pregnant inflammatory bowel disease (IBD) patients is currently unknown. Reconfiguration of services during the pandemic may negatively affect medical and obstetric care. We aimed to examine the impacts on IBD antenatal care and pregnancy outcomes.MethodsRetrospective data were recorded in consecutive patients attending for IBD antenatal care including outpatient appointments, infusion unit visits and advice line encounters.ResultsWe included 244 pregnant women with IBD, of which 75 (30.7%) were on biologics in whom the treatment was stopped in 29.3% at a median 28 weeks gestation. In addition, 9% of patients were on corticosteroids and 21.5% continued on thiopurines. The care provided during 460 patient encounters was not affected by the pandemic in 94.1% but 68.2% were performed via telephone (compared with 3% prepandemic practice; p<0.0001). One-hundred-ten women delivered 111 alive babies (mean 38.2 weeks gestation, mean birth weight 3324 g) with 12 (11.0%) giving birth before week 37. Birth occurred by vaginal delivery in 72 (56.4%) and by caesarean section in 48 (43.6%) cases. Thirty-three were elective (12 for IBD indications) and 15 emergency caesarean sections. Breast feeding rates were low (38.6%). Among 244 pregnant women with IBD, 1 suspected COVID-19 infection was recorded.ConclusionIBD antenatal care adjustments during the COVID-19 pandemic have not negatively affected patient care. Despite high levels of immunosuppression, only a single COVID-19 infection occurred. Adverse pregnancy outcomes were infrequent.

Technology advances in medicine have led to increased usage of smartphones and applications in facilitating provision of care. As the increased power of technology paves the way for advances, it is fundamental that ethical considerations are comprehensively explored. This paper explores the importance of consent, confidentiality, and data security in use of smartphone applications for transferring medical information.

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Technological advancements have revolutionized modern medicine and smartphones are now ubiquitous among health care professionals. The ability to look up information promptly is invaluable to doctors and medical students alike, but there is an additional contiguous benefit to patients. Queries can be answered more accurately through fingertip access to evidencebased medicine, and physicians have instant access to emergency care protocols. However, is consideration always extended to the patient's perception of the use of smartphones by doctors? Do patients know why we use smartphones to assist us in their care? What do they think when they see a doctor using a smartphone?An independent question, conducted within a wider service evaluation (ethical approval not required, full verbal and written electronic consent provided by all patients) at St. Mary's Hospital, London, indicated that although the majority (91.0%) of patients owned a smartphone, many (61.6%) did not agree that the use of smartphones at work by doctors is professional. This highlights the potential for damage to the doctor-patient relationship. There is a risk that these patients will disconnect with care services with possible detriment to their health. Additionally, it is notable that a larger proportion of those patients aged >70 years found the use of smartphones by doctors at work unprofessional, compared with patients aged <70 years.Adequate communication between the doctor and patient is critical in ensuring that doctors can make use of modern technology to provide the best possible care and that patients are comfortable with this and do not feel isolated or consider the doctor ignorant. It is suggested that moves are made to educate patients of the importance of the use of technology by doctors and to ensure that patients are aware of the reasons for which doctors use smartphones at work. Keywords: telehealth, smartphone, doctor-patient relationship, patient self-determination act Technological advancements have revolutionized modern medicine. Robot-assisted surgery has drastically enhanced a surgeon's performance, 1 while the automation of biochemical analysis and the recording of observations attempts to eliminate the potential for human error. While there is no doubt that technology improves clinical outcomes for patients on the whole, we question whether or not this aligns positively with holistic, patient-centered care.Smartphones are ubiquitous among health care professionals, and the number of health care applications (apps) available for clinical use is fast growing. As final year medical students, we are encouraged by clinical tutors to familiarize ourselves with