ISSN:0737-3805    

DOI:10.1111/j.1365-2923.1996.tb00723.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: OVID

摘要:

SUMMARYEffective communication between doctor and patient is a core clinical skill. It is increasingly recognized that it should and can be taught with the same rigour as other basic medical sciences. To validate this teaching, it is important to define the content of communication training programmes by stating clearly what is to be learnt. We therefore describe a practical teaching tool, the Calgary‐Cambridge Referenced Observation Guides, that delineates and structures the skills which aid doctor‐patient communication. We provide detailed references to substantiate the research and theoretical basis of these individual skills. The guides form the foundation of a sound communication curriculum and are offered as a starting point for programme directors, facilitators and learners at all levels.We describe how these guides can also be used on an everyday basis to help facilitators teach and students learn within the experiential methodology that has been shown to be central to communication training. The learner‐centred and opportunistic approach used in communication teaching makes it difficult for learners to piece together their evolving understanding of communication. The guides give practical help in countering this problem by providing:• an easily accessibleaide‐mémoire;• a recording instrument that makes feedback more systematic; and• an overall conceptual framework within which to organize the numerous skills that are discovered one by one as the communicatio

ISSN:0737-3805    

DOI:10.1111/j.1365-2923.1996.tb00724.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: OVID

摘要:

SUMMARYA central task in clinical teaching is organization of the students' experience in clinical perception — the ability to observe, to recognize, to discriminate and to interpret clinical evidence. We cannot teach sensory perceptual experience. Students must experience the clinical phenomena for themselves. But we can ensure that what the student experiences is most likely to be turned into clinical learning. This paper dissects the learning task in order to derive plans for teaching clinical perception. A major purpose is to encourage closer study of physical examination, which has largely been upstaged by investigations.Students learn inductively from their experiences of examining patients, cumulating a ‘clinical memory’ of images of patients with diseases. Reflection on that experience with the clinical teacher translates the sensory evidence into words. Teachers link the clinical observations of ‘disease in patients’ with previously learned images of ‘diseases in organs’, to ensure that clinical features and underlying basic science knowledge are clearly integrated.Perception is an active process, not a passive reception of observational data. Learning and teaching clinical perception uses both the student's direct ‘sense’ experiences and the teacher's guidance in ‘ma

ISSN:0737-3805    

DOI:10.1111/j.1365-2923.1996.tb00725.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: OVID

摘要:

SUMMARYAll students at the Royal Free Hospital School of Medicine (n= 508) were surveyed on their self‐reported smoking and drinking habits, attitudes to disease prevention and health promotion in general, attitudes towards the teaching of disease prevention and health promotion, and their perception of what was taught at the beginning of the 1993–1994 academic year (response rate 75.2%). The teaching staff (n= 271) were also surveyed on their attitudes towards the teaching of disease prevention and health promotion, and their perception of what was taught (response rate 74.2%). Seventeen per cent of the students reported they were current smokers and 81% drank alcohol. Four factors were extracted from the responses to the items on disease prevention and health promotion in general and these represented the importance of health, a patient‐centred approach, patient responsibility and a doctor‐centred approach. Clinical students and those who were older were more likely to have a ‘patient‐centred’ approach to disease prevention and health promotion. Sixty per cent of clinical and 44% of pre‐clinical teachers aimed to teach about disease prevention and health promotion. The topics reported by students as most likely to have been taught in detail are smoking and health, alcohol and health, immunization, and breast and cervical screening. However, all these topics were reported as having been taught in detail by less than 50% of the students. The majority of students and teachers believe that teaching about disease prevention and health promotion should be integrated into all years of the curriculum and all clinical firms. Teachers were significantly less likely than students to believe that students should learn more about disease prevention and health promotion, and that learning about prevention is as important as learning about diagnosis and treatment. We believe that, in order to build on the positive features highlighted in this study, agreed aims and objectives should be developed and teaching about disease prevention and health promotion should be integrated both horizontally and vertically throughout

ISSN:0737-3805    

DOI:10.1111/j.1365-2923.1996.tb00726.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: OVID

摘要:

SUMMARYThis paper describes several examples of the use of journals in a Bachelor of Dental Surgery course. The examples cover: the use of journals in first year subjects and in later‐year clinical subjects; the effect of changes in policy and practise as a result of experience with journals; and student views on their experiences with journals. The use of journals offers a means of achieving some of the more important goals of problem‐based learning (PBL), particularly those requiring students to reflect upon and evaluate their experiences. When effectively integrated in a PBL course, journals have several functions: to formalize reflection; an outlet for personal feeling; an opportunity for feedback about a student's progress and about the course; to provide the student with a summary of the year's work; and a means whereby students and teachers gain insight into the learning process. However, our experience in Dentistry raises several contentious issues, especially with regard to confidentiality and assessment. We make several recommendations for the effective use of journals based on the need for frequent communication between students and staff, the development of an environment of trust, and the need for staff and student education in journal

ISSN:0737-3805    

DOI:10.1111/j.1365-2923.1996.tb00727.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: OVID

摘要:

SUMMARYThis paper concerns the information technology course now running in year 1 of the undergraduate curriculum of the medical school of Leeds University. The background and objectives of the course are described, and the course content is outlined in terms of knowledge and practical skills. By the end of the course, 95% of students could successfully accomplish 95% of the skill tasks taught. As regards attitudes to IT, independent studies comparing two randomly selected groups suggested students who had taken the course (a) used IT more frequently, and (b) viewed IT more favourably than their counterparts.

ISSN:0737-3805    

DOI:10.1111/j.1365-2923.1996.tb00728.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: OVID

摘要:

SUMMARYIn more traditional medical education, medical students took a patient's medical history by asking a series of sequenced, routine questions, covering presenting medical problem(s); medical history; social and personal history; systems review; and physical examination. Following this process, the student then attempted to derive the patient's medical problems. This inductive problem‐solving paradigm may not assist students to prepare for their future interviewing needs, given doctors use a hypothetico‐deductive, problem‐solving approach when interviewing patients and numerous researchers have developed specialized communication skills training programmes designed to enhance students' interviewing skills.Students given specific consulting skills training have tended to show significantly greater interpersonal effectiveness and improved interview behaviours compared with students who experience traditional patient clerking training. These improvements in interviewing tend to persist over the period of students' medical training.The aim of the present study was to determine whether specialized communication skills training helped students elicit greater quantity and quality of information from patients and if so, whether such information assisted students in improving their diagnostic skills. Videotaped history‐taking interviews conducted by students trained in communication skills and untrained (control) students were rated for their interview efficiency.A comparison of ratings given by experimentally naive, independent observers revealed that trained students were more efficient, but took no longer than their control group counterparts to elicit fuller, more relevant information. However, the student groups did not differ in the accuracy or scope of their medical diagnoses. It is argued that students' lack of medical knowledge in this early phase of their clinical training militated against their being able to use their interviewing competence to derive more potentially accurate medical di

ISSN:0737-3805    

DOI:10.1111/j.1365-2923.1996.tb00729.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: OVID

摘要:

SUMMARYPharmacists have become increasingly involved in influencing prescribing. Pharmaceutical education has changed accordingly, with increased teaching in therapeutics, partly on hospitals wards, giving students an insight into diseases and helping communication with clinicians. To extend this idea we have designed joint therapeutics teaching sessions with pharmacy and medical students. The scheme involves final year pharmacy students who have completed a course in clinical pharmacy and medical students who have completed their second MB. Interdisciplinary pairs of students are assigned a patient with common medical and therapeutic problems, such as arthritis, diabetes and cardiac failure; patients on multiple drug treatments are preferred. They jointly obtain a history: the medical student performs basic clerking, while the pharmacy student obtains the medication history. The medical student subsequently presents a brief medical history, with a summary of the patient's current problems. For each problem, the pharmacy student presents the current therapy, its rationale and how it is to be monitored. Experience with 73 students over 3 years has shown that almost all found sessions with students from another discipline useful. Few felt that members of the pairs contributed unequally. The main problem appeared to be insufficient time (although 2 1/2 h were allowed). Most students favoured more such sessions. Little difference in ability appeared between the two disciplines; there was considerable co‐operation and little nascent ‘professional rivalry’. The medical students were more comfortable interviewing patients, and the pharmacy students more confident analysing drug therapy. It is concluded that such interdisciplinary sessions are a successful method of clinical teaching and should be encou

ISSN:0737-3805    

DOI:10.1111/j.1365-2923.1996.tb00730.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: OVID

摘要:

SUMMARYThe study assessed the effectiveness of a programme aimed at increasing medical students' skills in counselling patients presenting for HIV testing/AIDS information. Senior medical students were randomly assigned to receive a short course in pre‐ and post‐test counselling, or to a control group which received the usual curriculum. The students' performance in counselling simulated patients was videotaped at baseline and after 3 months. A subsample was also assessed at 12 months. Students receiving the programme showed significantly greater improvement in pre‐ and post‐test counselling skills over 3 months than did the controls. For the subsample continuing to 12 months, a significant effect over time was found; however, there was no significant difference between the groups. This may have been influenced by the small sample sizes used for the 12‐month assessment. General interactional skills improved for the overall sample over 3 and 12 months, but again there were no significant differences between groups. Those exposed to the programme did not show significantly greater changes in either knowledge or attitude scores over either time frame, compared with controls. When taught in addition to the usual undergraduate curriculum at Newcastle University, this short interactional skills course significantly enhanced students' ability to provide pre‐ or post‐test counselling

ISSN:0737-3805    

DOI:10.1111/j.1365-2923.1996.tb00731.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: OVID

摘要:

SUMMARYMany factors play a part in determining the performance of students in examinations, but the extent to which students use library facilities does not appear to have been recently considered as a factor, in medicine or in any other academic subject. In this study, the number of books borrowed from the library by undergraduate medical students was used as a simple measure of library use, and significant differences in book‐borrowing levels were found between students in different years of the medical course, students from different regions of the world, and men and women students. In the first year of the course, students who borrowed most also performed best in their end‐of‐year examinations, and this association was only partly explained by regional differences. No such association was found among final‐year students, suggesting different study habits and different assessment criteria in the clinical years of the

ISSN:0737-3805    

DOI:10.1111/j.1365-2923.1996.tb00732.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: OVID