ISSN:0737-3805    

DOI:10.1111/j.1365-2923.1992.tb00166.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: OVID

摘要:

Summary.High standards of clinical teaching are essential in the training of medical students but greater prominence needs to be given to its importance. Strategies are described by which one medical school has raised the awareness of clinical teaching and supported those who deliver it.

ISSN:0737-3805    

DOI:10.1111/j.1365-2923.1992.tb00167.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: OVID

摘要:

Summary.The expatriate adviser or ‘expert’ working in Indonesian medical education will require a complex range of personal and professional qualities if he or she is to be effective. Personal qualities refer particularly to the nature of the relationships that are established. Professional qualities include expertise in the discipline as well as expertise in teaching and education more generally. None of the qualities identified in the study is simple or unidimensional. The qualities are complex and are also likely to vary among educators according to their own level of education and cross‐cultural exper

ISSN:0737-3805    

DOI:10.1111/j.1365-2923.1992.tb00168.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: OVID

摘要:

Summary.A pilot interviewing course was offered as an elective to first‐year medical students in the spring of 1985. A quasi‐experimental pre‐test/post‐test control group demonstrated that students who took the course exhibited a significant increase in interviewing skills. Subjects, 15 in the experimental group and 11 in the control group, were assessed in each of the following 3 years. Data consisted of five 10‐minute videotaped inteviews with real or simulated patients for each subject and subject's responses on a degree of confidence, familiarity and anxiety scale. Interviews were rated on 43 behaviours by two independent coders with a 90% simple agreement. The experimental group did not maintain their scores on interviewing skills and both groups showed a significant decline in nine skills comprising empathy. The only significant difference between the groups in fourth year was on the degree of confidence experienced. While interviewing skills can be learned they decline in the clinical years as students learn medical problem‐solving. If medical students are to graduate with their original empathy intact, a follow‐up course in fourth year

ISSN:0737-3805    

DOI:10.1111/j.1365-2923.1992.tb00169.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: OVID

摘要:

Summary.The College of Medicine at the Sultan Qaboos University (SQU) in Oman took up the challenge of moving away from a didactic emphasis in the teaching of family and community health by actively involving students in health care, requiring some clinical skills, as early as possible.This paper describes the experience of the Department of Family and Community Health at SQU of the feasibility of training first‐year medical students in the measurement of blood pressure within a few days. Our experience showed that proper training before starting fieldwork can teach clinical skills to students who have had no prior exposure to medical subjects. There was a strong correlation between the measurements of blood pressure of 638 individuals by the students and the supervisors.This experience at SQU has encouraged us to implement the idea of family‐ and community‐based clinical exposure for every class. Teaching of clinical skills is feasible in the field for new entrants, provided there is adequate orientation beforehand and skilled supervision of the students in small g

ISSN:0737-3805    

DOI:10.1111/j.1365-2923.1992.tb00170.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: OVID

摘要:

Summary.Medical students' attitudes to the elderly were compared at the start and finish of a 5‐week clinical attachment in health care of the elderly at the Christchurch School of Medicine. The study investigated students in their first clinical year (fourth year of their medical course) over five terms using a questionnaire employing a Rosencranz‐McNevin semantic differential scale to measure general attitudes to old age and a Likert scale to measure attitudes to medical care. A question was also asked about career preferences.There was significant improvement in attitudes measured by both scales (Rosencranz‐McNevinP<0.001, LikertP<0.001). Students also showed an increase in interest in health care of the elderly as a career choice. When compared with two cohorts of students from Nottingham Medical School, attitudes were significantly better in the Christchurch group at the commencement of the run. Students at both schools showed an improvement in knowledge but this was more marked for Christchurch stu

ISSN:0737-3805    

DOI:10.1111/j.1365-2923.1992.tb00171.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: OVID

摘要:

Summary.Over the past two decades in the USA, bioethics has become an accepted component of medical education, whereas in Australia, 10 years or even less would encompass the history of most existing programmes. Given the legendary conservatism of medical schools in Australia and the intractability of the medical curriculum, this is still a remarkable achievement. But does the teaching of bioethics change the thinking and/or decision‐making behaviour of medical students or practitioners exposed to such courses? Those involved know only too well how difficult such courses are to design and evaluate since the connection between ethics education and practice is not known and may never be demonstrated to the satisfaction of critics.Critics not only seek answers to the questions of whether the teaching of bioethics makes a difference, which is a fair question, but they also seek answers to the question of whether bioethics should be taught in medical schools. Can bioethics be taught? Whose bioethics is being taught? What does the trained bio‐ethicist contribute? Some of these questions arise from misunderstanding and some reflect the still too dominant view in medical schools which divides disciplines into those which provide ‘practical skills’, and those which contribute only theoretical and therefore peripheral knowledge.The authors will address these questions in the light of their experience at Newcastle, Australia, where the Faculty of Medicine has been teaching bioethics for over a

ISSN:0737-3805    

DOI:10.1111/j.1365-2923.1992.tb00172.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: OVID

摘要:

Summary.An analysis of 596 multiple‐choice questions (MCQs) on human anatomy given at three First Professional Examinations for medical students is reported. The MCQ paper at each examination was 200 items long and consisted of three item‐types: A, K and T/F. Each A‐type item comprised a stem and five options, only one of the latter being the correct or best answer. Items of the K‐type consisted of a stem and four responses, any number of which may be correct. The T/F items were of the three‐response kind, the available options being ‘true’, ‘false’ and ‘don't know’. Test reliability was computed by internal analysis, using the Kuder‐Richardson 20 formula. Measures of concurrent validity were obtained by correlating the scores in the MCQ papers with the overall outcome of the First Professional Examination. Indices of item facility, discrimination and abstention were calculated. The effects of item‐type and the availability of the ‘don't know’ option on examinee performance were also determined. Reliability (alpha) and concurrent validity (Pearsonr) coefficients in the ranges of 0.71‐0.85 and 0.80‐0.93 (P<0.05) respectively were recorded. Regression analysis revealed the MCQ papers to be less sensitive predictors of the aggregate performance than the essay papers. The proportion of highly discriminatory and excessively difficult items was highest for the K‐type. When the same K‐type questions were re‐exhibited in the indeterminate format, the examinees performed significantly better. Higher scores were also recorded when candidates were required to respond to all the questions than when they were offered the ‘don't know’ option and the percentage gain was higher for the low‐scoring examinees.The appropriateness of multiple‐choice testing as a tool for assessing st

ISSN:0737-3805    

DOI:10.1111/j.1365-2923.1992.tb00173.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: OVID

摘要:

Summary.This longitudinal study compares the accuracy of self‐assessments of 22 students across four examinations during their first 2 years of medical school. The four examinations used a similar short‐essay format and covered many of the same basic science disciplines at similar levels of difficulty. Immediately after answering an average of 20 questions on each examination, students predicted their performance on those questions. After assigned subject matter experts had scored the questions, the differences between students' predictions and the experts' scores were calculated for each question. The degree to which students had over‐ and underestimated their performance across all questions was determined by separately averaging all positive and negative differences between students' and experts' assessments on each examination.The results of the study indicated that accuracy in self‐assessment improved from examination 1 to examination 3 (with less overestimation) and dropped on examination 4 (with more underestimation). The results revealed no relationship between self‐assessment estimations and actual scores received. Furthermore, the self‐assessment estimations tended to be statistically correlated between contiguous examinations (i.e., examinations 1 and 2, 2 and 3, etc.) but not between non‐contiguous ones (i.e., examinations 1 and 3, etc.).The results of the study are interpreted to suggest that the students in the study have a self‐assessment tendency towards over‐ or underestimation that is some what stable but that gradually evolves over time with experience, maturity and self‐assessment practice. The most frequent direction of change is towards decreased overestimation and increased underestimation. These results are consistent with the findings of other recent longitudinal self

ISSN:0737-3805    

DOI:10.1111/j.1365-2923.1992.tb00174.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: OVID

摘要:

Summary.This study assesses the relative importance of history, examination and investigations in paediatric diagnosis, in the Paediatric Out‐patient Department of the Central Middlesex Hospital, London, by means of a questionnaire‐based record of 94 consecutive referrals. A diagnosis identical to the final diagnosis was made in 76% of referrals after taking a history. The general practitioner had proposed a diagnosis in 45% in the referral letter. Clinical examination changed the diagnosis in only 15% but increased diagnostic confidence in 33%. Ninety‐one per cent of cases were diagnosed without recourse to investigations. Forty‐two per cent of children referred had investigations performed. In the majority of paediatric cases the provisional diagnosis reached after taking a history was identical to that after examination or results of investigations were known. Although examination provided a final diagnosis in only 15% of all cases it played an important role in adding confidence in 33%. More educational effort should therefore be directed at clinical history‐taking skills and the subsequent purpose of ex

ISSN:0737-3805    

DOI:10.1111/j.1365-2923.1992.tb00175.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: OVID