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Ample evidence suggests that emotional arousal enhances declarative/episodic memory. By contrast, there is little evidence that emotional enhancement of memory (EEM) extends to procedural skill based memory. We examined remote EEM (1.5-month delay) for cognitive skill learning using the weather prediction (WP) probabilistic classification task. Participants viewed interleaved emotionally arousing or neutral pictures during WP acquisition. Arousal retarded initial WP acquisition. While participants in the neutral condition showed substantial forgetting of WP learning across the 1.5-month delay interval, the arousal condition showed no evidence of forgetting across the same time period. Thus, arousal during encoding determined the mnemonic fate of cognitive skill learning. Emotional enhancement of WP retention was independent of verbally stated knowledge of WP learning and EEM for the picture contexts in which learning took place. These results reveal a novel demonstration of EEM for cognitive skill learning, and suggest that emotional arousal may in parallel enhance the neural systems that support procedural learning and its declarative context.

SUMMARY Background: The UK General Medical Council has recommended that medical students be taught how to teach; however, the current state of teaching skills training in England has not yet been investigated. Aims: To explore the current state of undergraduate teaching skills training at medical schools in England. Methods: A questionnaire survey was sent to all 24 medical schools in England, enquiring about the basic structure, content areas, staffing, delivery and assessment methods of compulsory courses. Results: A response rate of 22/24 (92%) was achieved, and 18/22 (82%) of the responding institutions offered some form of teaching skills training. The most frequently covered content areas were small group facilitation skills, large group teaching skills and use of effective feedback. Teaching was delivered by a combination of hospital doctors, non-physician educators or general practitioner educators in the majority of courses. Six of the nine (67%) compulsory courses featured student assessments. The main barriers to implementing these courses were staffing limitations, insufficient time and lack of student engagement. Conclusions: Our study demonstrates both the similarities and variation between undergraduate teaching skills courses across England. However, further research will be necessary to determine whether the long-term impact of such training will result in better educators, and ultimately in improved patient care.

To examine the association between in-hospital mortality and the BIG (composed of the base deficit [B], International normalized ratio [I], Glasgow Coma Scale [G]) score measured on arrival to the emergency department in pediatric blunt trauma patients, adjusted for pre-hospital intubation, volume administration, and presence of hypotension and head injury. We also examined the association between the BIG score and mortality in patients requiring admission to the intensive care unit (ICU).A retrospective 2001-2012 trauma database review of patients with blunt trauma ≤ 17 years old with an Injury Severity score ≥ 12. Charts were reviewed for in-hospital mortality, components of the BIG score upon arrival to the emergency department, prehospital intubation, crystalloids ≥ 20 mL/kg, presence of hypotension, head injury, and disposition.50/621 (8%) of the study patients died. Independent mortality predictors were the BIG score (OR 11, 95% CI 6-25), prior fluid bolus (OR 3, 95% CI 1.3-9), and prior intubation (OR 8, 95% CI 2-40). The area under the receiver operating characteristic curve was 0.95 (CI 0.93-0.98), with the optimal BIG cutoff of 16. With BIG16, death rate was 3/496 (0.006, 95% CI 0.001-0.007) vs 47/125 (0.38, 95% CI 0.15-0.7) with BIG ≥ 16, (P.0001). In patients requiring admission to the ICU, the BIG score remained predictive of mortality (OR 14.3, 95% CI 7.3-32, P.0001).The BIG score accurately predicts mortality in a population of North American pediatric patients with blunt trauma independent of pre-hospital interventions, presence of head injury, and hypotension, and identifies children with a high probability of survival (BIG16). The BIG score is also associated with mortality in pediatric patients with trauma requiring admission to the ICU.