Journal of cancer education : the official journal of the American Association for Cancer Education
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Comparative Study Clinical Trial Controlled Clinical Trial
Changes in students' attitudes following a course on death and dying: a controlled comparison.
This study evaluated the effect of a death-education course on the death-related anxiety and attitudes toward death of 71 medical students not yet exposed to clinical rotations and four health care professionals. The Collect-Lester Fear of Death Scale and a semantic differential technique measuring attitudes toward the dying patient and his or her family were administered to course attendees before and after the course and to freshman students not taking the course. ⋯ Semantic differential scales showed no change for controls but a marked improvement in attitudes toward "treating the dying patient" and "dealing with the dying patient's family" for attendees (p < 0.001 for both). In summary, course participation resulted in improvement in students' attitudes toward dealing with death.
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The availability of new technologic tools has greatly changed differential diagnosis. To assess the importance of these tools in current clinical practice, the authors determined the frequencies of use of new imaging methods in diagnosis, staging, and follow-up in 71 oncology cases. The new methods were found to have replaced traditional diagnostic procedures to a substantial extent. ⋯ Two years later, after their initial exposure to clinical practice, the 42 students remaining in the group answered a questionnaire regarding the usefulness of the sectional anatomy segment of their anatomy training. Of these 42 students, 14 rated the sectional anatomy exposure "very helpful" to comprehension in the clinical internship and 21 rated it "helpful." The students suggested that the program be reinforced by an integrated textbook. This preliminary study suggests that basic preclinical courses should be modulated to reflect new methods that come into routine use in clinical practice.
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The fourth year of the medical student curriculum remains of questionable educational value at most medical schools. The training needs of generalists include the acquisition of knowledge and skills in broad areas of general surgery and the surgical subspecialties. ⋯ One such model was recently implemented at The Medical College of Pennsylvania. Advantages of this type of program include support of the training of generalists using contemporary teaching strategies and provision of a meaningful educational experience to medical students during the fourth year.
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The Clinton Health Security Act calls for a major shift in the emphasis of medical training. While family practice, general pediatrics, general internal medicine, and obstetrics and gynecology stand to benefit, other specialties will see decreases in their programs and their residency slots. In light of the present sparsity of programs in family practice and the prevalent student disinterest in the specialty, only heroic efforts will make possible achievement of the 55/50 ratio of primary care physicians to other specialists outlined by the Clinton plan. Problems inevitable in the transition are described and incentives for change suggested.