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The capacity for wonder (CfW) is a personal disposition related to lifelong learning and moral character development, two highly valued characteristics of health professionals. We previously developed and validated a CfW measure among college students. Here we describe how the scale performs among medical students.We invited all students at a top-tier U.S. medical school (276 students completed the survey for an overall response rate of 58%. Factor analysis resulted in a 10-item scale with an alpha of 0.79 and an eigen value of 3.57. Factor loadings ranged from 0.43 to 0.77. The mean total score was 39.3 (SD = 8.9) out of a possible high score of 60. Total scores varied by year in school with significantly lower scores among 2nd year students (32.9 vs. 41.5;We confirmed the reliability of a 10-item CfW scale in 4 cohorts of medical students. Results suggest that the 2nd year of medical school poses the greatest risk to students' capacity for wonder. Efforts should be made to understand this phenomenon and develop interventions to mitigate it. Future research should explore the validity of the CfW scale, its utility in evaluating interventions designed to cultivate the capacity for wonder, its applicability to other groups of health professionals, and its association with ethical decision-making and practice.

Student feedback is a valuable asset in curriculum evaluation and improvement, but many institutions have faced challenges implementing it in a meaningful way. In this article, we report the rationale, process and impact of the Student Curriculum Review Team (SCRT), a student-led and faculty-supported organization at the Johns Hopkins University School of Medicine. SCRT's evaluation of each pre-clinical course is composed of a comprehensive three-step process: a review of course evaluation data, a Town Hall Meeting and online survey to generate and assess potential solutions, and a thoughtful discussion with course directors. Over the past two years, SCRT has demonstrated the strength of its approach by playing a substantial role in improving medical education, as reported by students and faculty. Furthermore, SCRT's uniquely student-centered, collaborative model has strengthened relationships between students and faculty and is one that could be readily adapted to other medical schools or academic institutions.

Recent reports have demonstrated clinical and histologic evidence of the potential benefit of fractional photothermolysis (1550 nm Fraxel SR laser) for the treatment of dermal vascular lesions. This report evaluated the potential efficacy of fractional photothermolysis for the treatment of matted telangiectasias.A 62-year-old female, Fitzpatrick skin type III, with matted telangiectasias on her right medial thigh underwent five successive treatments at monthly intervals with the 1550 nm Fraxel SR laser. Digital photographs were taken prior to each treatment and at 6 months after the last treatment. Clinical assessments were performed by a non-treating physician.Clinical assessment 6 months after the last treatment with the Fraxel SR laser revealed marked improvement in the clinical appearance of the matted telangiectasias. The patient's degree of satisfaction paralleled the physician's assessment of improvement. Side effects were limited to mild pain during treatment and mild, transient post-treatment erythema and edema.Fractional photothermolysis is a potentially effective modality for the treatment of matted telangiectasias and warrants further studies. No long-term adverse events were noted and the safety profile appears to be fairly broad.

Basal cell carcinoma, the most common type of skin cancer, can be treated successfully by a variety of methods. The most commonly employed techniques are curettage with electrodesiccation, scalpel excision, Mohs' chemosurgery, cryosurgery, and radiation therapy, all of which have advantages and disadvantages. The primary care physician needs to be aware of available forms of therapy, problems with recurrent lesions, and the importance of adequate follow-up.