ISSN:0737-3805    

DOI:10.1111/j.1365-2923.1993.tb00220.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.tb00221.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: OVID

摘要:

Summary.Concern is often expressed about the English language proficiency (ELP) of students engaged in professional training. This report assesses the ELP of the 1990 and 1991 intakes into medicine at the University of Sydney. A quick screening test and individual in‐depth tests were used in a two‐stage design. Admission to the course is highly competitive and most students are selected from the top 0.75% of Higher School Certificate results but 15% and 19% of the year cohorts were found to be below average in ELP. English proficiency was found to be consistently correlated with first‐ and second‐year university results. Initiatives taken to support students with language disadvantages and to ensure that graduates will be able to communicate effectively with patients are o

ISSN:0737-3805    

DOI:10.1111/j.1365-2923.1993.tb00222.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: OVID

摘要:

Summary.Successful innovation and change in the way medical students are prepared are notoriously difficult. The relationship between the administrative structures of the medical school and its teaching hospitals, other responsibilities of its teachers and administrators, and the intricacies of the curriculum as a system of interrelated components, mean that any real change has wide repercussions. An opportunity for evaluation of a curriculum undergoing change was presented at the University of New South Wales, when the Faculty of Medicine introduced a new 6‐year medical curriculum in 1988. The change was made to address a number of problems experienced with the old 5‐year curriculum. The Course Evaluation Committee was in a unique position to conduct an ongoing evaluation of the new curriculum, year by year, as it was being introduced. A method for obtaining feedback from both staff and students on a medical curriculum undergoing change, is described. While some sample results are presented, the paper concentrates on the advantages and disadvantages of, and our experiences with, this method. Advantages include the specificity and timing of the information collected, and the high response rate. One disadvantage was the repeated use of the same cohort of students. Some staff still perceived the evaluation process as a threat, or were sceptical about the value and validity of student feedback. Whether staff acknowledged ownership of the new curriculum also affected the use of feedb

ISSN:0737-3805    

DOI:10.1111/j.1365-2923.1993.tb00223.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: OVID

摘要:

Summary.This study determined the relationships of grades in A‐level biology and chemistry with examination success or failure during the medical course. By inspection of medical student records, A‐level grades at entry to medical school and examination performance were obtained for 128 (91%) of the students who sat their final MBBCh examination at the University of Wales College of Medicine in June 1988. The majority, 92 (72%), completed their medical school careers with no professional examination failures; 15 failed examinations just in the period up to 2nd MB; 11 failed examinations in the clinical period only and 10 failed examinations in both periods. Whereas grade achieved in A‐level chemistry was not associated with undergraduate examination performance, students with a grade A or B in A‐level biology were less likely to have problems than the others (21% compared with 47%; the difference of 26% has a 95% confidence interval of 7% to 44%). Specifically, there appears to be a strong relationship between a low grade in biology and difficulties in the preclinical examinations. Moreover, for those who have difficulties at this stage, this association continues later in the

ISSN:0737-3805    

DOI:10.1111/j.1365-2923.1993.tb00224.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: OVID

摘要:

Summary.Medicine endorses a code of ethics and encourages a high moral character among doctors. This study examines the influence of medical education on the moral reasoning and development of medical students. Kohlberg's Moral Judgment Interview was given to a sample of 20 medical students (41.7% of students in that class). The students were tested at the beginning and at the end of their medical course to determine whether their moral reasoning scores had increased to the same extent as other people who extend their formal education. It was found that normally expected increases in moral reasoning scores did not occur over the 4 years of medical education for these students, suggesting that their educational experience somehow inhibited their moral reasoning ability rather than facilitating it. With a range of moral reasoning scores between 315 and 482, the finding of a mean increase from first year to fourth year of 18.5 points was not statistically significant at theP≤ 0.05 level. Statistical analysis revealed no significant correlations at theP≤ 0.05 level between the moral reasoning scores and age, gender, Medical College Admission Test scores, or grade point average scores. Along with a brief description of Kohlberg's cognitive moral development theory, some interpretations and explanations are given for the findings of the st

ISSN:0737-3805    

DOI:10.1111/j.1365-2923.1993.tb00225.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: OVID

摘要:

Summary.This paper reviews the issues regarding an increased emphasis on medical education and practice in the ambulatory care setting. A paradigm for ambulatory medicine is offered which combines the elements of ‘traditional’ medical care and teaching with the more ‘distinctive’ elements representative of the ambulatory setting. The former includes aetiology, history, physical examination, laboratory tests and therapy; while the latter includes continuity, context, health education, economics and responsibility. The paradigm is illustrated in relation to the problem of hypertension. The ambulatory medicine paradigm is further discussed with respect to potential barriers to its acceptance. These include: (1) the assumption that ‘traditional’ medical education does teach all 10 elements of the paradigm; (2) the axiom that if one learns to care for the sickest patients, the less ill ones should be manageable; (3) the intuitive aspects of the ‘art’ of practising ambulatory medicine; (4) the recognition that this teaching will require a longitudinal experience; and (5) perception that the five distinctive elements are not ‘hard’ science and objectively measurable. Nevertheless, the changing face of medical practice requires the adoption of an ambulatory medicine paradigm i

ISSN:0737-3805    

DOI:10.1111/j.1365-2923.1993.tb00226.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: OVID

摘要:

Summary.One aim of the course in general practice and public health medicine during the final year at the University of Sheffield is to help students to develop further their interpersonal communication skills with particular reference to their skills in interviewing patients. During the course students meet twice in small groups with a tutor in order to review audiotape recordings of interviews with patients seen during their general practice attachments. The main activity during these tutorials is group discussion of the interviewer's behavioural options at significant points during the interview. Students also listen individually with a tutor to an interview that they have recorded, discuss this interview and assess it against a set of explicit criteria as part of their summative course assessment. In response to an anonymous end‐of‐course questionnaire, 85% of students felt that their interview skills had been improved by the teaching and 68% that listening to their own recordings had been the most helpful aspect. During interviews with simulated patients recorded at the end of the course, students asked more open questions, fewer questions referring to physical symptoms, more questions referring to feelings, beliefs or behaviour and fewer questions of a check‐list type than during interviews recorded at the start. A number of students also requested examples of specific events during the end‐of‐course interviews although none had done so at the beginning of the course. All of these changes were statistically significant and were in directions that were consistent with the teaching in the small‐grou

ISSN:0737-3805    

DOI:10.1111/j.1365-2923.1993.tb00227.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: OVID

摘要:

Summary.Medical students on an in‐patient service and residents working in an ambulatory care clinic have regularly evaluated their clinical tutors over the 5 years 1985‐1989. Both groups of raters reliably and predictably evaluated their tutors and both emphasize between‐tutor comparisons more than actual rating values for individual tutors. Tutors active in both contexts regularly receive higher ratings from the medical students than from the residents. Mid‐course feedback to tutors in the medical course had no impact on end‐of‐course ratings. In neither context did tutor ratings improve from one evaluation to the next. Both groups reliably discriminate between the teaching skills and the personality traits of indivi

ISSN:0737-3805    

DOI:10.1111/j.1365-2923.1993.tb00228.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: OVID

摘要:

Summary.Despite changes in modern medicine the role of the clinical teacher remains central to medical residents' education and rotations continue to be their dominant educational context. Residents have strong positive feelings for clinical teachers who are perceived as interested in teaching and for those rotations that provide a balance of educational opportunities and patient care responsibilities. Research in residency education has focused on teacher behaviours used to teach medical residents clinical information or patient care skills but has neglected teacher behaviours used to facilitate effective learning relationships with residents. To explore the impact of clinical teachers' use of facilitative behaviours on residents' educational experience, we use concepts stemming from the psychologist Carl Rogers' work previously shown to be associated with positive learning outcomes — empathy, unconditional positive regard, and congruence. These constructs are measured by the use of the four scales of the Barrett‐Lennard Relationship Inventory (BLRI) — level of regard, unconditionality of regard, congruence and empathy. Our study measures the correlation between residents' perceptions of clinical teachers' use of facilitative behaviours and residents' evaluation of the learning value of rotations. Thirty‐three residents completed the BLRI on a different clinical teacher for each of six monthly rotations. A total of 158 surveys were returned. There were strong positive correlations between three of the BLRI variables and residents' perception of the learning value of rotations. Potential uses of these findings are di

ISSN:0737-3805    

DOI:10.1111/j.1365-2923.1993.tb00229.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: OVID