Medical education
-
Although medical ethics has become a part of the curriculum of almost every medical school, medical students' perceptions of the value of medical ethics have not been documented. This paper reports the evaluations given by 137 preclinical and 216 clinical medical students to different levels of medical ethics teaching at the College of Human Medicine and the College of Osteopathic Medicine of Michigan State University. The results indicate (1) that students' satisfaction with medical ethics teaching is directly linked to how much they receive, (2) that students overwhelmingly prefer the input of both ethicists and doctors to teaching by either alone, and (3) that a preclinical medical ethics course followed by explicit medical ethics teaching in clinical training is a promising model for achieving an adequate level of medical ethics teaching within medical education.
-
A review of the literature on the assessment of medical problem-solving by means of written tests reveals serious short-comings. Most important is the low correlation repeatedly found among cases, which suggests the inability of the measures to assess a general problem-solving ability. The literature further suggests that instruments should focus on the brief period of time after the first encounter of a clinical problem and warns against the effects of cueing. ⋯ This test, called Simulation of Initial Medical Problem-Solving (SIMP), consists of a number of short case histories, followed by an open-ended question. Reliability analysed by means of generalizability theory proved satisfactory and concurrent validity was established by a significant correlation with a global judgement of performance in a simulated patient encounter. The moderate correlation between cases is interpreted as an acceptable correlation among test items and leads to the conclusion that a reliable and valid test of clinical problem-solving should consist of a substantial number of different cases.
-
The study aims at measuring doctors' performance while giving therapeutic instructions and testing the effectiveness of an educational technique for affective objectives. For this purpose doctors' performance was analysed into nine components. Twenty-five trainees in internal medicine were observed and rated regarding the nine components, while instructing 40 patients with a chronic disease. ⋯ However, sufficient doctor-patient concordance regarding the verbal components of the behaviour significantly predicted patient compliance. Following the seminar, significant improvement was noted in doctors' performance, in doctor-patient communication and in patient compliance. It is concluded that observing the doctors' behaviour independently of the patient does not predict patients' compliance; the analysis of the total doctors' behaviour into components is valid in predicting patient compliance if it is used in order to assess doctor-patient communication; and a programme based on audiotape-assisted education is both simple and effective in improving the trainees' behaviour and communication skills.
-
Many American universities now support combined premedical-medical programmes which shorten and integrate the education of doctors. This paper reviews combined baccalaureate-MD programmes at four institutions: Boston University, the City College of New York, The University of Michigan-Ann Arbor, and the University of Missouri-Kansas City. In comparison to most US medical schools, the combined programmes have admitted and educated larger portions of women students. In addition, some have had large proportions of graduates choosing primary-care careers.
-
A total of 196 intern medical officers who had graduated from the four medical schools in Sri Lanka in 1984 indicated their attitudes towards anaesthesia as a medical specialty in response to a postal questionnaire. Eighty per cent of the graduates considered anaesthesia to be an established specialty in Sri Lanka, while 17% felt that the specialty had limited clinical application. A total of 62% of the graduates were not aware, prior to their entry to medical school, that anaesthesia was related to medical practice. ⋯ Anaesthesia was chosen as the first career preference by 1.5%. The dominant reasons for not selecting anaesthesia as a career specialty were: minimal patient contact and patient recognition (62%), and lack of recognition of the specialty by society (54%). Anaesthetists in Sri Lanka are challenged to alter the perceptions associated with the specialty, which are probably a result of chronic staff shortages restricting practice to the confines of operating theatres.