This Guide has been written to provide guidance for individuals involved in curriculum design who wish to develop research skills and foster the attributes in medical undergraduates that help develop research. The Guide will provoke debate on an important subject, and although written specifically with undergraduate medical education in mind, we hope that it will be of interest to all those involved with other health professionals' education. Initially, the Guide describes why research skills and its related attributes are important to those pursuing a medical career. It also explores the reasons why research skills and an ethos of research should be instilled into professionals of the future. The Guide also tries to define what these skills and attributes should be for medical students and lays out the case for providing opportunities to develop research expertise in the undergraduate curriculum. Potential methods to encourage the development of research-related attributes are explored as are some suggestions as to how research skills could be taught and assessed within already busy curricula. This publication also discusses the real and potential barriers to developing research skills in undergraduate students, and suggests strategies to overcome or circumvent these. Whilst we anticipate that this Guide will appeal to all levels of expertise in terms of student research, we hope that, through the use of case studies, we will provide practical advice to those currently developing this area within their curriculum.

SUMMARYA 48-yr-old female on immunosuppressive therapy for ®brosing alveolitis and polymyositis developed a septic arthritis of the left middle ®nger proximal interphalangeal joint, tenosynovitis of the left palm and osteomyelitis of the right hindfoot due to infection with Mycobacterium marinum. Such widespread and severe bone and joint involvement has not been described previously with this organism. CASE REPORTIn March 1994, a 48-yr-old woman presented with erythema and full-thickness ulceration over the left middle ®nger proximal interphalangeal joint (PIPJ) and a red nodule on the¯exor aspect of the right forearm. Biopsy of the nodule showed a pallisaded granuloma consistent with a rheumatoid nodule. She was known to have the Jo-1 syndrome with mild polymyositis, biopsy-proven severe ®bros-ing alveolitis and the presence of the Jo-1 antibody. Immunosuppressive treatment with oral cyclophosphamide (150 mg/day) and prednisolone had been commenced in September 1993. Following a deterioration in lung function, the dose of prednisolone was increased to 60 mg/day in December 1994. One month later, she presented with a 2 week history of pain and swelling about the right ankle and midfoot, and a swelling in the left palm.On examination in January 1995, she was cushingoid. There was purple macular discolouration over the metacarpophalangeal joints (MCPJ) of both hands. The PIPJ of the left middle ®nger was swollen, red and tender (Fig. 1). The left palm was swollen. There was a nodular erythematous rash over the¯exor aspect of the right forearm near the elbow. The right ankle and midfoot were swollen and painful to move.Investigations revealed a white cell count of 12.6 Â 10 9 /l (compared with a previous count of 9.3 Â 10 9 /l) with 11.4 Â 10 9 /l neutrophils, 0.5 Â 10 9 /l lymphocytes and an erythrocyte sedimentation rate of 50 mm in the ®rst hour. Radiographs of the left hand revealed joint space narrowing at the third PIPJ. X-ray of the right foot showed narrowing of the joint space between the navicular and medial cuneiform bones. Green turbid¯uid was aspirated from the right midfoot and bloodstained¯uid from the PIPJ of the left middle ®n-ger. Culture of the¯uid was sterile. The right ankle was injected with intra-articular steroids with temporary relief. Further aspiration gave frank pus containing acid-fast bacilli (AFB), eventually identi®ed as Mycobacterium marinum. The tendon sheaths of the left palm were incised and drained surgically. Mycobacterium marinum was again isolated.The patient kept tropical ®sh and cleaned the tank twice a year.Standard anti-tuberculous chemotherapy (rifampicin, isoniazid and pyrazinamide) caused intolerable nausea. Doxycycline, 100 mg b.d., was prescribed instead.Radiographs of the left hand 6 weeks later showed an erosion of the PIPJ of the middle ®nger. Computed tomography of the right foot showed joint space narrowing and erosions involving the navicular, cuboid and all three cuneiform bones consistent with septic arthritis and osteomyelitis of the entire midfoot (Fig. 2)...

Background: This study was completed as part of a project for the Quality Assurance Agency on the enhancement theme of 'Research teaching linkages: enhancing graduate attributes' in the disciplines of Medicine, Dentistry and Veterinary Medicine. The aims of this investigation were to elucidate a list of desirable research related graduate attributes for the disciplines of Medicine, Dentistry and Veterinary Medicine and provide evidence as to how they could be covered within such curricula.

Background-The clinical interactive role of medical microbiologists has been underestimated and the discipline is perceived as being confined to the laboratory. Previous studies have shown that most microbiology interaction takes place over the telephone. Aim-To determine the proportion of clinical ward based and laboratory based telephone interactions and specialties using a microbiology service. Methods-Clinical microbiology activity that took place during November 1996 was prospectively analysed to determine the distribution of interactions and specialties using the service. Results-In all, 1177 interactions were recorded, of which nearly one third (29%) took place at the bedside and 23% took place on call. Interactions involving the intensive treatment unit, general ward visits, and communication of positive blood cultures and antibiotic assays were the main areas of activity identified. There were 147 visits to 86 patients on the general wards during the study, with the number of visits to each individual varying from one to eight. The need for repeated visits reflected the severity of the underlying condition of the patients. Ward visits were regarded as essential to obtain missing clinical information, to assess response to treatment, and to make an appropriate entry in a patient's notes. Conclusions-Ward visits comprise a significant proportion of clinical microbiology interactions and have potential benefits for patient management, service utilisation, and education. (J Clin Pathol 1999;52:773-775)

Text messaging is an effective method of collecting good quality and timely evaluation from students on placements. The quality of information received provided placement organisers with sufficient information to respond to issues in a timely manner. The method is limited by the number of questions that can realistically be asked. The concerns that students would be unwilling to engage with this method seems unfounded.