ISSN:0737-3805    

DOI:10.1111/j.1365-2923.1996.tb00823.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: OVID

摘要:

SUMMARYThe increasing international mobility of medical students has inspired the search for an international assessment format. As one step along this line, kinetics of knowledge acquisition and final cognitive levels of students were compared among one Dutch, one German and four Italian medical faculties. For this comparison, the Maastricht Progress Test (MPT) was used. For four out of the six participating faculties, it was possible to compare the level of knowledge of sixth‐year students. These data showed no significant differences on the test as a whole. On the other hand, as judged from cross‐sectional data on students from all study years, the kinetics of knowledge acquisition showed different trends. In one school applying problem‐based learning, acquisition of knowledge by students occurred almost linearly. In another school, over the first 2 years, acquisition of knowledge occurred only in the basic sciences but not in clinical or public health/behavioural sciences. In two other schools over that same period, students seemed to gain no knowledge at all. In some faculties, a marked boost in knowledge was noted with third‐ or fourth‐year students. These findings may be explained by peculiarities of the respective curricula, selection of students during their studies, and national or local assessment procedures. It is preliminarily concluded that the different educational approaches and assessment systems in medical education in Europe seem to have only limited influence on the final level of knowledge of the graduates. On the other hand, these differences may influence the kinetics of knowledge acquisition, especially in distinct domains like basic or clinical sciences. Therefore, the MPT may not be suitabe to solve the problem of assessment of individual international exchange students, but it may be helpful in identifying corresponding cognitive levels on, for example, basic sciences for students in different

ISSN:0737-3805    

DOI:10.1111/j.1365-2923.1996.tb00824.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: OVID

摘要:

SUMMARYThis study of first and fifth year medical students found a general recognition among male and female students that gender affects future career choices and the ability to reach career goals. Females were seen as being disadvantaged both in terms of career choice and their ability to achieve career goals. These views are less abstract and more based upon the reality of personal experiences in clinical attachments among fifth year students. While both male and female students describe negative experiences of clinical training, female students were more likely to suffer discrimination because of their gender in certain specialties, such as surgery, and to be dissuaded from pursuing a career in that specialty. Despite the general awareness of the effects of gender in medicine this did not appear to have an effect upon personal career choice. However, some female students were considering career choices at an early stage in their career based on accommodating their future desire to have a family life. Over half of all male and female fifth year students reported that having time for their family was an important consideration in choosing a career.

ISSN:0737-3805    

DOI:10.1111/j.1365-2923.1996.tb00825.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: OVID

摘要:

SUMMARYDespite increasing interest in medical malpractice in the UK, there is very little empirical research on doctors' own concerns. This paper explores first and fifth year medical students' knowledge about malpractice, their attitudes toward litigation and its perceived significance for their future practice.

ISSN:0737-3805    

DOI:10.1111/j.1365-2923.1996.tb00826.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: OVID

摘要:

SUMMARYLimitations of the traditional final medical examination for the assessment of clinical competence led to such developments as simulated patients and the Objective Structured Clinical Examination (OSCE). An interdisciplinary OSCE incorporating simulated patients and involving nine disciplines was introduced into the final examination in the Auckland School of Medicine to supplement the written papers and the long case. Six‐hundred and eight students were assessed over a 6‐year period. Each of the three examination modes provided good discriminatory power. Significant correlations were found between the tests, but this does not mean one or more is redundant. Principal component analysis showed that a single significant factor accounted for over half the variance in the final assessment. This factor was equally weighted to the three examinations. A variety of evaluative methods are necessary to assess a student's competence and greater emphasis should be placed on those methods which encourage the learning of clinical skills and concurrently provide an appropriate mechanism for assessing them. The changes introduced have been supported by students and teachers and have fostered the learning of important clinical skills. Efforts to standardize the single long case have not overcome the criticisms surrounding its use, particularly in summative assessm

ISSN:0737-3805    

DOI:10.1111/j.1365-2923.1996.tb00827.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: OVID

摘要:

SUMMARYThis paper describes an experiment at the University of Western Australia (UWA) medical curriculum, in which the focus of the 1 week of face‐to‐face teaching in public health in the 3‐year clinical rotation was changed from important health problems affecting whole communities to one emphasizing the use of epidemiological principles to enhance doctors' decision‐making. The students are now left to choose the clinical subject matter, and instead of being presented with predetermined readings selected by the teaching staff, the students have assumed responsibility for discovering the latest relevant information on the topics they choose and of presenting this to the class. The teacher now spends much less time in front of the class, providing only mini‐tutorials each day on presenting to small groups, and on the skills required to understand the published literature on the aspects of the diagnosis, investigation, management and prognosis of individual patients.The topics chosen by students for exploration differ little, either in terms of the nature of the health problems concerned or the epidemiological principles at issue, from those covered previously when the programme was set entirely by the staff. However, attendance at the course has improved sharply, the short time between mini‐tutorials and application of the material they cover has increased the perceived relevance of the teaching, and feedback collected systematically from successive classes of students has been very positive. Any anxiety on the part of the staff at relinquishing control of the curriculum has proved unfounded while the new programme has much to recommend it as a model of self‐dire

ISSN:0737-3805    

DOI:10.1111/j.1365-2923.1996.tb00828.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: OVID

摘要:

SUMMARYIn medical education the problem‐based approach to learning can be considered as the most significant educational innovation in the past two decades. This paper examines the ways and extent to which health problems have been designed for implementation of problem‐based curriculum. Content analysis of curriculum documents of three problem‐based schools was carried out in a systematic way from identification of unit of analysis, categorization, sampling, data analysis and interpretation. The comparative study revealed common areas in curriculum organization, arrangement of problems in stages, problem selection criteria, and basic concepts in the early stages of the curriculum. About one‐third of the health problems were found to be similar in the schools compared. However, there was no uniformity in the sequence of organ‐systems or the health problems. This study provides a framework for the development of problem‐based curriculum in three stages with essential concepts identified for the first stage. Criteria for a balanced selection of problems and problem design features which affect the quality of health problems have been identified. These findings could be of value for those who are in the process of developing or revising a problem‐bas

ISSN:0737-3805    

DOI:10.1111/j.1365-2923.1996.tb00829.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: OVID

摘要:

SUMMARYMany doctors rate themselves as ineffective smoking cessation counsellors. It is logical to initiate training efforts with medical students. We incorporated smoking history‐taking in the physical diagnosis course at the University of North Carolina at Chapel Hill using a simple method to teach smoking history‐taking skills and to assess its effectiveness as an educational intervention. The principal intervention was the distribution of a one‐sheet Smoking‐History Taking and Counseling Guide, adapted from the American Lung Association'sFreedom From Smoking for You and Your Familyself‐help manual. The second intervention was a single prompt for 50% of the course preceptors. Students' smoking history‐taking skills were evaluated in the Objective Structured Clinical Examination (OSCE) at the end of the course. Students who received the guide did significantly better on the OSCE, even after controlling for having discussed taking a smoking history with their preceptors. A simple guide combined with a one‐time prompting of preceptors has a positive effect on the acquisition of smoking history‐taking skills by the medical students. This strategy may also be useful for teaching and evaluating smoking‐cessation counselling skills, for which good smoking history‐taking i

ISSN:0737-3805    

DOI:10.1111/j.1365-2923.1996.tb00830.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: OVID

摘要:

SUMMARYA 3‐hour seminar on tobacco was introduced to second year (pre‐clinical) medical students in Hong Kong in 1994. The differences in knowledge and attitudes were measured by a self‐administered and anonymous questionnaire with 14 items before the seminar (n = 145), and again 2 weeks after the seminar (n = 151). The students also completed an evaluation form at the end of the seminar. Before the seminar, the students were most deficient in their knowledge on the exact magnitude of the risks from smoking and on the risks from smoking relative to the risks from air pollution and asbestos. After the seminar, their knowledge increased significantly (P<0.005). As for attitudes, in the pre‐test 35% strongly agreed that tobacco advertising should be completely banned, and 50% did so in the post‐test (P= 0.02). The corresponding figures for banning of all forms of tobacco promotion were 26% and 43% (P<0.005). In the pre‐test, one in four students strongly disagreed that doctor's advice to their patients to stop smoking is totally ineffective, with this proportion increasing to 70% in the post‐test (P<0.005). The majority of the students stated that the seminar was useful. The preclinical medical curriculum should, at the very least, include a tobacco seminar. Our survey shows that it is effective in improving students' knowledge and attitudes on to

ISSN:0737-3805    

DOI:10.1111/j.1365-2923.1996.tb00831.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: OVID

摘要:

SUMMARYCross‐sectional imaging such as CT and ultrasound have rapidly developed a central role in diagnostic medicine. However, cross‐sectional anatomy has lagged behind in its incorporation into medical school education, often leaving students without even a basic understanding of these images. At Hannover Medical School, we have successfully combined hands‐on ultrasound workshops performed by medical students on other students with our anatomy course. This interactive component of our anatomy courses improves our students' understanding of clinical anatomy and introduces them to ultrasound im

ISSN:0737-3805    

DOI:10.1111/j.1365-2923.1996.tb00832.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: OVID