Within the arena of medical education, it is generally acknowledged that assessment drives learning. Assessment is one of the most significant influences on a student's experience of higher education and improving assessment has a huge impact on the quality of learning (Liu, N. and Carless, D, 2006). Ideally we want to enhance student's capacity for learning and engagement with the curriculum (ACGME Outcome Project, 2000). However, this doesn't always happen as it is heavily dependent on the form of assessment used and whether or not timely comprehensive feedback is given. This paper focuses on the challenges associated with assessment in medical education and looks at the current trends. Well-designed formative assessment can focus students on effective learning and divert them away from summative assessment, which focuses attention on grades and reproductive thinking (Liu, N. and Carless, D, 2006). Whether one decides to utilise summative or formative assessment methods, both methods of assessment are useful when applied in the correct setting and at an appropriate stage of learning.It is apparent that assessment is the gatekeeper of higher learning and we need to embrace new methods of assessment in order to meet the challenges associated with 'Generation Y'. Novel assessment methods such as self and peer assessment are growing in popularity. Students who participate in these forms of assessment may initially feel that it is challenging but worthwhile overall, as it helps to develop their critical thinking skills. Incorporating complimentary assessment components could benefit student's learning without sacrificing the integrity of the curriculum.

To identify the determinants of in-hospital mortality post hip fracture in Ireland 2013-2017. FindingsOlder males with poor pre-fracture mobility who were not mobilised on the day of/after surgery had the highest risk of in-hospital mortality. MessageEarly mobilisation on the day of/after surgery should be added as a new formal hip fracture standard of care in keeping with best international practice.

Hip fractures continue to be one of the most serious and costly injuries suffered by older people globally. This paper describes the development of a national hip fracture audit and summarizes the first six years of data from the Republic of Ireland. This can help inform care, standards and outcomes of hip fracture patients.

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Cystic fibrosis (CF) is the most common autosomal recessive disease of the Caucasian population worldwide, with respiratory disease remaining the most relevant source of morbidity and mortality. Computed tomography (CT) is frequently used for monitoring disease complications and progression. Over the last fifteen years there has been a six-fold increase in the use of CT, which has lead to a growing concern in relation to cumulative radiation exposure. The challenge to the medical profession is to identify dose reduction strategies that meet acceptable image quality, but fulfil the requirements of a diagnostic quality CT. Dose-optimisation, particularly in CT, is essential as it reduces the chances of patients receiving cumulative radiation doses in excess of 100 mSv, a dose deemed significant by the United Nations Scientific Committee on the Effects of Atomic Radiation. This review article explores the current trends in imaging in CF with particular emphasis on new developments in dose optimisation.

Key summary points Aim To identify the impact of COVID-19 on case-mix, care standards and outcomes of hip fracture patients in Ireland for the first 6 months of the COVID-19 pandemic. Findings There was a 15% reduction in admissions per month during the first 6 months of the COVID-19 pandemic. There was a reduction in compliance with many of the Irish Hip Fracture Standards following the COVID-19 pandemic. Message Every attempt should be made to preserve the multidisciplinary team involved in the care pathway for hip fracture patients throughout any subsequent waves of the COVID-19 pandemic.

To identify factors influencing Discharge Directly Home (DDH) from an acute hospital following hip fracture, as opposed to Discharge to an Alternative Location (DAL). FindingsYounger patients who were independently mobile pre-fracture were more likely to be DDH. Timely surgery with early post-operative mobilisation and a shorter length of stay increased the odds of DDH. MessageThe Irish Hip Fracture Standards incorporate 2 out the 3 modifiable factors identified in this paper, which reinforces the importance of the IHFS in improving patient outcomes.

There are various influences and obstacles when planning an educational curriculum. The imprint of globalisation on the landscape of Irish medicine highlights the importance of delivering a diverse curriculum with international dimensions so that knowledge and skills can transfer across borders. It is also clear that medical emigration has a negative impact on the delivery of services in Ireland and in maintaining a sustainable workforce. In addition, financial constraints will always play a role in the logistics of medical education and it is important that more cost effective virtual learning modules are incorporated into to the traditional classroom based approach.Further research is needed into career satisfaction within medicine. One needs to try to understand what motivates doctors to stay within the Irish medical system, so that a curriculum with retention of graduates in mind can be designed. If a culture of education, guidance and support is fostered in our universities and hospitals, there is hope that a strong, competent and resilient breed of doctors will emerge to serve future generations.