摘要:

Summary.A set of criteria to observe clinical teaching was developed and used to describe and evaluate the teaching behaviour of 24 tutors of medical students in their initial clinical skill term. The tutors had no previous instruction in teaching techniques, nor had their teaching been previously evaluated. The criteria used focus on six basic dimensions: the teaching/learning environment; the degree of intellectual challenge; the degree of interaction; the logical structure of teaching sessions; the quality of teaching skills; and the modelling of professional skills and attitudes. A continuum of teaching behaviour was observed in each dimension, with most tutors demonstrating adequate levels of performance in each. The tutors all strongly supported the evaluation and the feedback they received. Their subsequent teaching behaviour will be reviewed to assess the impact of this feedback.

ISSN:0737-3805    

DOI:10.1111/j.1365-2923.1993.tb00230.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: OVID

摘要:

Summary.In 1991, the Fiji School of Medicine restructured the training of its medical students, dividing the 7‐year course into two phases. Students now undertake a 3‐year community‐oriented primary care practitioners course, after which they may elect to continue practice in a primary health care role, or to undertake further hospital‐based training to complete their medical degree. The course responds to the health needs of the South Pacific, and the local patterns of morbidity and mortality, rather than measuring itself against the curricular demands of its more developed neighbours, Australia and New Zealand. At the same time, the Tropical Health Program of the University of Queensland Medical School responded to demands from the Aboriginal and Torres Strait Islander community to develop primary health care training at degree level. This was intended to complement other strategies undertaken by the Aboriginal and Torres Strait Islander Studies Unit such as the recruitment and support of indigenous students through mainstream health professional education. There was a need to address health priorities that are very different to those of the Australian population as a whole, as well as the sociopolitical and cultural context as it affects both students themselves and health issues in their communities. Both institutions have chosen problem‐based teaching/learning as appropriate to their courses, and content is also similar, though with emphases that reflect the differing contexts. The two courses are examples of innovative responses by centres with university medical faculties to specific issues in health

ISSN:0737-3805    

DOI:10.1111/j.1365-2923.1993.tb00231.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: OVID

摘要:

Summary.An unprecedented wave of immigration of doctors to Israel, mainly from the former Soviet Union, posed for Israeli health leaders the problem of bringing them to a common and accepted Western level of performance. Stemming from the deep commitment which Israel has towards the immigrants, the state offers them a training opportunity to enhance their chances of being licensed and finding jobs in their profession. A 6‐month programme was launched by Ben‐Gurion University, later adopted by other medical schools and supported by the Government of Israel. The programme was designed to provide effective responses to the specific problems of the immigrant population, which are: lack of knowledge of local language, both everyday and professional; overspecialization in too narrow specialties; possession of clinical specialties which do not exist in the new country; insufficient updating in medical sciences and technology; unawareness of economic implications of health care; difficulty in originating new solutions to clinical problems, and lack of skill in answering objective test items. The programme is characterized by a protective environment, problem‐oriented learning, small‐group activities and emphasis on learning languages. The clinical problems are designed to emphasize the general practitioner's point of view of both common and emergency situations. The programme has achieved its goals, as judged by the success rate of its graduates in the National Licensing Examination as compared with the success of immigrant doctors who chose not to participate in the training. This success proves that training of immigrant doctors can be attained by a short programme if the learners’ needs are carefully analysed, the programme appropriately designed, and the staff is enthusiastic, devoted and d

ISSN:0737-3805    

DOI:10.1111/j.1365-2923.1993.tb00232.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: OVID

摘要:

Summary.A model of planned appointments to the training and consultant grades in the National Health Service is proposed. Contracts in each grade would begin and end at fixed dates. The aim of the model is to provide a coherent educational and career plan for each doctor with minimal disruption of the clinical service. It is proposed that a phased introduction of the scheme would allow the process of change to be acceptable and the model to be evaluated before a commitment to its full introduction is made.

ISSN:0737-3805    

DOI:10.1111/j.1365-2923.1993.tb00233.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: OVID

摘要:

Summary.Documentation of the decision‐making process leading up to an outcome of procedures is essential for assessing quality of patient care, supporting reimbursement, determination of appropriate utilization, and discernment of practitioner competence. Currently, doctors document interventions conducted outside the operating room in narratives within the daily progress notes. The free‐form narrative typically includes the practitioner directly involved, procedure performed, technique used and outcomes. While hospitals encourage conformity to these documentation standards, the quality and content of the narratives vary greatly by practitioner, frequently leaving significant information missing. Therefore, to improve both quality of documentation in procedure notes and ease of monitoring non‐operating room procedures, we developed a multicopy standardized procedure note. The form contains lines for recording the type, location, indication, anaesthesia, findings, and complications of the procedure, plus the persons performing, supervising and undergoing the procedure. Practitioners complete the multicopy note instead of the usual narrative note. We encode all the information from the standardized note into a data base that accumulates information on all procedures done throughout the hospital. The data base is used to generate summary reports to provide feedback to residents, residency directors and practitioners on procedural proficiency. The major advantage of this system is that it simultaneously improves the quality of documentation and ease of tracking non‐operating room procedures at our hospitals. In addition, the system collects the information needed for reimbursement coding, hospital quality assurance and utilization review, and practitioner and resident credentialling p

ISSN:0737-3805    

DOI:10.1111/j.1365-2923.1993.tb00234.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: OVID

摘要:

Summary.The Meningitis Hypertext Case Study is a computer‐assisted learning module developed by the Liverpool Epidemiology Programme as part of a comprehensive set of modules and case studies to assist health workers to learn epidemiology. The objectives of the case study are to highlight important concepts in diagnosing an epidemic of meningitis. It has been developed using hypertext software (LINKWAY) which allows interactions with other epidemiological software (EPI INFO) for the analysis of the data. The case study makes extended use of graphical displays, has a ‘user‐friendly’ presentation and can be used by individuals and groups. Our initial experience indicates that this form of computer‐assisted learning has considerable potential by providing users with an organized path through a series of problems set in a realistic environment. This could prove to be potentially useful in developing countries where up‐to‐date learning materials are ofte

ISSN:0737-3805    

DOI:10.1111/j.1365-2923.1993.tb00235.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: OVID

摘要:

Summary.This article discusses a very early clinical trial from the Old Testament. One of Daniel's and his companions' tribulations in Babylonia is explicated within the framework of the modern clinical trial. Even if many, or maybe even most, guidelines for good clinical trial practice are violated (it can even be argued that this is not really a clinical trial), a discussion of this biblico‐historical episode in, for example, a problem‐based course in (clinical) epidemiology or a course in the critical appraisal of the literature, can be a useful (and possibly entertaining) exerc

ISSN:0737-3805    

DOI:10.1111/j.1365-2923.1993.tb00236.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: OVID

ISSN:0737-3805    

DOI:10.1111/j.1365-2923.1993.tb00237.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: OVID

ISSN:0737-3805    

DOI:10.1111/j.1365-2923.1993.tb00238.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: OVID

ISSN:0737-3805    

DOI:10.1111/j.1365-2923.1993.tb00239.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: OVID