Journal of medical education
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To learn some of the reasons why anesthesiology as a specialty is not preferred by more graduating medical students and to determine the effects of various factors on their specialty choice, the authors studied the number of medical students who chose anesthesiology as a specialty after graduation and the quality of clerkships available in various departments. The study established that medical students do not find anesthesiology as attractive as other specialties and that several factors are related to the students' choice of anesthesiology. Most surprising was the negative effect of the presence of certified registered nurse anesthetists on the operating room floor. These results suggest the need for a thorough study of the use of nurse practitioners, physician's assistants, and nurse-clinicians, at least where teaching of medical students is taking place.
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In an academic medical center, patient care is primarily the business product of the hospital and its organized medical staff, while education and research belong primarily to the medical school dean and the faculty. Each unique business--patient care, education, or research--must be managed with regard for the others, but first it needs to be considered separately and operated for results related to its primary goal. It is essential that governing bodies understand the business they govern. ⋯ Ten principles seem reasonable for governance and management of academic medical centers. They recognize the businesses, define potential problems, set tasks, and, if every person fulfills his difficult work, provide the organizational means for resolving conflict. The principles are listed in this paper.
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The authors challenge the assumption that the passive lecture-based curriculum that dominates most preclinical medical education optimizes learning for all students. For this reason, an experiment was conducted in which medical students were given the option of taking some courses as small groups in a Socratic format rather than in lectures; 67 percent of the students applied for the small-group option. ⋯ Most students and faculty members found the experience profitable; a significantly greater proportion of students of the intuitive-feeling personality type reacted positively to the experience than did other personality types. The small-group classes required more faculty time than did lectures, and this often prevented faculty support of the Socratic approach.