ISSN:0737-3805    

DOI:10.1111/j.1365-2923.1992.tb00149.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: OVID

摘要:

Summary.Health promotion and disease prevention programmes improve the health status of populations, preserve freedom, and empower individuals. Yet, despite important advances in many countries, including a more health‐conscious public, it would be beneficial in the United States and in other countries to have a comprehensive plan to make health promotion and disease prevention personal and societal priorities. I have called this climate a ‘culture of character’, a climate of individual responsibility to encourage healthy behaviour. I want to encourage the readers ofMedical Educationto participate in the formulation of plans to implement greater health promotion and disease prevention efforts. Such a climate of personal responsibility could be created if doctors, educators and policy‐makers agreed on some workable, positive goals and steps that would help meet realistic national goals over a defined period of time. If there were such agreement, then doctors could more clearly focus their own efforts with their patients, in concert with other health professionals, and with policy‐makers who have the same goal—healt

ISSN:0737-3805    

DOI:10.1111/j.1365-2923.1992.tb00150.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: OVID

摘要:

Summary.This study assessed the hypothesis that the formal teaching of medical ethics promotes a significant increase in the growth and development of moral reasoning in medical students. Results indicated a statistically significant increase (P ≤ 0.0005) in the level of moral reasoning of students exposed to a medical ethics course compared to the control group that was not exposed to the medical ethics course. When the posttest scores were adjusted by subtracting the pretest scores, the differences were even more significant (P ≤ 0.0002). This study confirmed similar findings of another study using a different instrument of assessment. Brief discussion is given of the fundamental premise that the appropriate function of teaching medical ethics in our modern pluralistic society is to improve students’ moral reasoning about value issues regardless of what their particular set of moral values happens

ISSN:0737-3805    

DOI:10.1111/j.1365-2923.1992.tb00151.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: OVID

摘要:

Summary.Medical ethics as taught by members of the Department of Forensic Medicine in three of five medical colleges in Sri Lanka is a ‘rule ethic’ (‘normative ethic’) based on ‘traditional’ or ‘classical’ ethics. Instruction includes the teaching of moral principles, illustrated with examples. Also included are aspects concerning the functions of the Sri Lanka Medical Council. The topic is evaluated in the essay, multiple choice question and oral components of the third MBBS (Part II) examination (end of fourth year).As presently taught the syllabus is thoroughly inadequate for dealing with modern (medical) ethical issues. The shortcomings and limitations in the present programme are pointed out and requisite improvements suggested. A case is made for an eclectic view of ethics, in which a ‘situation ethic’ would play a part. Finally, the training of a highly moral responsible medical profess

ISSN:0737-3805    

DOI:10.1111/j.1365-2923.1992.tb00152.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: OVID

摘要:

Summary.The Sherbrooke School of Medicine, Quebec, has restructured its entire curriculum to make problem‐based learning (PBL) the main instructional format. This complete reform is explained both in terms of process and content. The curriculum problems were clearly identified and overcome by a major structural shift‐over following the stages of a strategic planning of change. Implementation over a period of 7 years is described according to a four‐stage framework: need for change; selection of the PBL solution; planning for implementation; and the full‐scale adoption of the PBL method. The programme is described in relation to the congruence of goals, learning and evaluation activities. Initial impact on student learning and evaluation, attracting better quality students, academic staff roles, and on financing the operation are discussed. Changing the undergraduate programme has become an institutional project directed by the Office of t

ISSN:0737-3805    

DOI:10.1111/j.1365-2923.1992.tb00153.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: OVID

摘要:

Summary.In a second‐year family medicine course taught using simulated patients the students commented most favourably on the clinical relevance of the topics, the enthusiasm of teachers, and the opportunity to interview simulated patients with their fellow students, in contrast to their basic science courses, which did not give them patient contact. They felt most confident about skills acquired in relation to diseases with a limited number of key symptoms, signs and treatments (meningitis, otitis) and less confident about diseases with many symptoms and treatments (diabetes, trauma, arrhythmias). They made few comments about alternative cases which might have been selected. Their adverse comments were about the workload.During tutor meetings over 4 years, a key concern which emerged was to find cases with a level of complexity suitable to the students. The tutors emphasized these principles of case selection: the cases should be based on real life and include most of the signs and symptoms of the disease; contain one or at most two foci; have nodal decision‐making points; emphasize clinical reasoning; reinforce prior knowledge; permit the transfer of knowledge to other cases; and permit the assessment of associated technical ski

ISSN:0737-3805    

DOI:10.1111/j.1365-2923.1992.tb00154.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: OVID

摘要:

Summary.The recommended techniques to measure blood pressure for assessment of hypertension are seldom followed in the ambulatory care setting. This study has found that interns and first‐year family practice residents have significant deficits in their knowledge and use of the recommended techniques to measure blood pressure. The results suggest that inadequacies exist in the teaching of blood pressure measuring techniques in our medical schools, the consequences of which are misdiagnosis and improper treatment of high blood pressur

ISSN:0737-3805    

DOI:10.1111/j.1365-2923.1992.tb00155.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: OVID

摘要:

Summary.The Medical Faculty of the University of Limburg in Maastricht, The Netherlands pays special attention to extramural care. The extramural profile of the Medical Faculty also manifests itself in the curriculum. Since 1978, a 12‐week clerkship in practical medical training in general practice (PMT‐GP) has been offered to fifth‐year students. The general aim is to acquaint students with general medical aspects as well as specific primary care aspects of health care. The programme started in the autumn of 1978 with 24 students and 24 GP teachers. At present more than 100 GP teachers, working in about 70 practices, train 120‐130 students a year. The model of the PMT‐GP system is characterized by six features: a ratio of one GP teacher to one student; autonomous examination by the student of at least 15 patients a week; daily follow‐up discussion on the basis of patient records prepared by the student; opportunities for self‐study by the student; one tutorial day a week at the Medical Faculty; intensive contacts between the Faculty and GP teachers. Key activities of the PMT‐GP include autonomous contacts with patients, written records and daily follow‐up discussions wi

ISSN:0737-3805    

DOI:10.1111/j.1365-2923.1992.tb00156.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: OVID

摘要:

Summary.During the course of a larger study aimed at relating staffing levels of junior doctors in general medicine to the safety of the care provided, it became clear that consultant doctors considered thequalityof their junior staff as being at least as important as thequantity.This paper describes several attempts to develop a feasible and valid method of measuring the quality of senior house officers (SHOs) and registrars using routinely available data.Having rejected three methods and had difficulties with three other methods, a modified Delphi survey was used to explore the extent to which consultants agreed on the key attributes of a high quality SHO or registrar. Sixty‐seven (60%) of all consultants in the South‐West Thames and Trent regions responded to two rounds of questionnaires which revealed communication skills as being consistently the most significant factor. This was confirmed in a second, anonymous survey of 198 (78%) SHO and registrar posts in the North‐West Thames region. It also became clear that consultants viewed the quality of their own SHOs and registrars as generally high. This being so it is argued that the requirement to adjust for quality, when comparing SHO and registrar levels between hospitals, is of minor importance. These results also suggest that the explicit teaching of communication skills should have a high priority in undergraduate and postgraduate educ

ISSN:0737-3805    

DOI:10.1111/j.1365-2923.1992.tb00157.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: OVID

摘要:

Summary.The attitudes of British postgraduate deans and senior medical students to the introduction of a national pre‐registration house officer allocation scheme were investigated by postal questionnaire. Several postgraduate deans expressed interest, but most were not in favour of the proposal. Students held similar views. The advantages and disadvantages of a national scheme are discusse

ISSN:0737-3805    

DOI:10.1111/j.1365-2923.1992.tb00158.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: OVID