An international survey of medical school programmes on nuclear war

Many medical organizations have acknowledged the responsibility of doctors to educate health professionals and the public about the medical, social and ecological consequences of nuclear war. Medical schools have begun the development of programmes on these topics. A total of 1130 medical schools in thirty-one countries were surveyed about their presentation of nuclear-war-related subject matter. Eighty-three (49%) of the 168 schools that responded indicated that they offered an activity on medical aspects of nuclear war. Thirty-two per cent of the programmes consisted of one or more hours in an existing required course. Twelve per cent offered an elective course solely concerned with nuclear war. Although only 15% of the schools responded many of the replies indicated interest in learning more about the programmes of other schools and inquired if curriculum or teaching materials were available. Through the survey it was learned that textbooks and other learning resources have been prepared. Survey information suggests that knowledge of nuclear weapons effects is associated with a reluctance to countenance nuclear war.     

论药理学在中等中医专业的教学方法

药理学是桥梁科学,本文就三年制中等中医专业药理学的教学问题进行了探讨,其主要观点是:重视理论、讲好第一堂课;精选内容、各有侧重;结合临床,加强记忆;适当补充中药药理学知识;加强课堂提问,开展课堂讨论;作好小结,加深理解.     

Integration of pharmacology into a problem–based learning curriculum for medical students

The purpose of this study is threefold: (1) to describe a method of integration of pharmacology subject matter with other disciplines, in a problem-based learning (PBL) curriculum employed at the Northwest Center for Medical Education (NWCME), Indiana University School of Medicine; (2) to present various evaluation methods employed to assess students' learning of pharmacology knowledge; and (3) to compare the academic performance of students who underwent a traditional curriculum versus the PBL curriculum in terms of class evaluations and the standard national board medical licensure examinations. The PBL curriculum is designed for the first 2 years of medical education and consists of six sequential steps: steps 1 and 2 deal with biochemistry and anatomy respectively; steps 3, 4 and 5 deal with physiology, neuroscience and general pathology/microbiology respectively; and step 6 is a multidisciplinary step, which integrates basic science subjects with clinical medicine, emphasizing the mechanism of disease in an organ-system approach. In the PBL curriculum students start learning pharmacology within 6 months of admission. The content and process of pharmacology are spread across the first and in the second year. The pharmacology content is divided into three segments, each of which is integrated with other basic science subjects that have maximum mutual relevance. The three segments are as follows: the general and systemic pharmacology (50%) was included in step 3; the neuropharmacology and toxicology (35%) part was included in step 4; the third segment consisted of antimicrobial agents, anticancer and antiinflammatory agents (15%) and was included in step 5. The class evaluation of student performance in the PBL curriculum consisted of two elements, the content examinations and the process evaluations, which include the tutorial and the triple-jump evaluations of problem-solving skills. In order to assess the overall academic performance of the PBL curriculum and traditional curriculum groups, three classes of students who took the PBLC were compared with three classes of students who underwent a TC for performance in terms of class grades and scores of National Board examinations (NBME I and/or USMLE I). The PBL curriculum students performed as well as or better than the TC students as measured by the NMBE I and/or USMLE I. The gain in pharmacology knowledge of PBL students is accompanied by the presence of a positive experience that learning pharmacology is enjoyable. Our experience suggests that the segmental integration approach of instruction coupled with a system of content (internal and external examinations) and process (tutorial and triple-jump) evaluations, as outlined in this paper is a contextualized learning method that offers an effective way of imparting pharmacology knowledge to medical students.     

浅谈中职护理对口升学班药理学课堂教学模式改革

对于中职护理对口升学班的学生来说,药理学是护理专业必修的一门课程,也是对口升学考试科目之一。药理学是连接医学基础学科和医学临床学科的桥梁,虽然内容繁琐、药理学基础知识抽象、药物种类多、药名难记,但却是护理系的学生在之后的工作中,能否顺利工作、稳定工作的要点和重点。因此,该文是对中职护理对口升学的药理学课堂教学进行改革的阐述和研究。     

结合护理专业特点提高药理学教学质量

药理学是护理专业学生接触药学知识唯一的一门课程,结合护理专业特点,通过多种教学方法和手段提高药理学教学质量.     

Rational education for rational therapy.

A sound knowledge of pharmacology and clinical therapeutics could help future prescribers in India to master the principles and practice of rational therapy. The teaching of pharmacology in medical schools should be restructured accordingly, and greater attention should be given to the applied aspects of the subject. Practicals in experimental pharmacology and dispensing pharmacy should be discontinued and useful exercises should be introduced. Methods of evaluation should be modified.     

Comunicación médico-paciente: una de las competencias básicas pero diferente

Effective communication skills form part of being a good doctor. Today there is solid evidence to support the teaching of effective communication skills in all medical schools.This article describes how communication is different from the other skills that medical students and residents need to learn, how this affects teaching and learning, and the application of these ideas in a Chilean medical school.We describe the premises that need to be taken into consideration when planning teaching communication in medicine and illustrate how these affected the development of our teaching of communication in our undergraduate curriculum.All medical education programmes should include formal teaching on the doctor-patient relationship, but must take into consideration the aspects of communication teaching that make it different from teaching other aspects of medicine.     

Behavioural objectives for medical auxiliary training in Tanzania: 9 years'' experience with an education model

The behavioural objectives model of curriculum design was introduced to the Medical Auxiliary Training Sector in Tanzania during the 1970s while problems of expansion, novelty and economic stress were abundant. Experience in a relatively privileged school, Rural Medical Training Centre, Sengerema, shows that the model did not result in more practical teaching time, due mainly to various constraints. The students did, however, appreciate the 'sharing of objectives' at the onset of a teaching block as a great help for their (theoretical) learning. Due to unfamiliarity of teachers with new subject matter related to primary health care, the model has failed thus far to result in a relevant practical course in public health promotion. A more problem-oriented approach to curriculum development is recommended.     

The tracer method of curriculum analysis: identifying changes in oncology subject matter in medicine

Changes occurring in oncology subject matter in an undergraduate medical curriculum over a 5-year period were documented using the tracer method of curriculum analysis. The tracer method is an empirical approach somewhat analogous to tracing one thread through a tapestry, as a way of following a subject matter interwoven throughout a curriculum. Advantages of the method can be to bring particular material to the attention of teaching staff and students, to facilitate more efficient instruction, and to introduce peer review of educational material.     

A process evaluation of medical ethics education in the first year of a new medical curriculum

BACKGROUND: Despite the recent increase in activity in the field of medical ethics education, few evaluative studies have been carried out. Most studies have taken place in North America, in curricula where teaching is discipline-based, and have concentrated on outcome rather than on the curricular processes adopted. AIM: To evaluate the process of medical ethics education in the first year of a new learner-centred, problem-based, integrated medical curriculum. METHOD: A qualitative, multi-method approach was adopted using open questionnaires, focus groups and tutor evaluation rating scales. The study involved all 238 students in the first year of the new medical curriculum, and the 30 clinical tutors who facilitated ethics learning. A stratified sampling technique was used to choose focus group participants. RESULTS: Small group teaching proved highly acceptable to both students and tutors. Tutors' teaching skills were central to its effectiveness. Tutors played an important role in promoting students' appreciation of the relevance of medical ethics to clinical practice, and in establishing a climate where constructive criticism of colleagues' actions is acceptable. Course integration, including the provision for students of clinical experiences on which to reflect, was an important aid to learning. Students and tutors were noted to be driving the ethics curriculum towards having a contextual rather than theoretical base. CONCLUSION: This evaluation identified those aspects of the medical ethics course which contributed to its effectiveness and those which detracted from it. This information will be used to inform future development.     

Towards effective outcomes in teaching, learning and assessment of law in medical education

Medical Education 2011: 45 : 339–346 Context Law is slowly emerging as a core subject area in medical education, alongside content on the ethical responsibilities of doctors to protect and promote patient health and well‐being. Curriculum statements have begun to advise on core content and methods for organising teaching and assessment. However, no comprehensive overview of approaches to the delivery of this law curriculum has been undertaken. Objectives This paper reports an assessment of the nature and strength of the published evidence base for the teaching, learning and assessment of law in medical education. It also provides a thematic content overview from the best available literature on the teaching of law to medical students and on the assessment of their legal knowledge and skills. Methods A systematic review of the evidence base was completed. Detailed scrutiny resulted in the inclusion of 31 empirical sources and 11 conceptual papers. The quality of the included material was assessed. Results Significant gaps exist in the evidence base. Empirical studies of the teaching of law are characterised by insufficient sample sizes and a focus on individual study programmes. They rely on measures of student satisfaction and on evaluating short‐term outcomes rather than assessing whether knowledge is retained and whether learning impacts on patient outcomes. Studies reveal a lack of coordination between pre‐ or non‐clinical and clinical medico‐legal education. Although evidence on the development of students’ knowledge is available, much learning is distant from the practice in which its application would be tested. Law learning in clinical placements appears to be opportunistic rather than structured. Conclusions The place of law in the curriculum remains uncertain and should be more clearly identified. A more robust knowledge base is needed to realise the aspirations behind curriculum statements on law and to enable medical students to develop sufficient legal literacy to manage challenging practice encounters. Further research is needed into effective methods of teaching, learning and assessing legal knowledge and skills during and following initial medical education.     

Barriers and solutions to implementing a new curriculum: lessons from the women's health education program at MCP Hahnemann School of Medicine

The integration of new knowledge into the medical school curriculum is a difficult process. This article proposes effective strategies for overcoming obstacles to curricular integration of women's health and sex and gender topics. Some techniques developed to overcome barriers to the integration of new material into an existing curriculum include faculty development, faculty rewards, development of competencies and assessment tools, interdisciplinary team teaching, standardized patients, and reference resources. An interdisciplinary approach to implementing women's health education, as with most new curricular material, is endorsed for integration of the new field into the medical school curriculum. This proposed model results in general institutional participation and support, especially from senior level leadership. The outlined process enables students and faculty to learn techniques for incorporating emerging information in all disciplines, helping them to become "life-long learners."     

The essential role of the student in curriculum planning

Medical school curricula are planned, written and organized by academic and clinical staff within medical schools. While these medical educators may well be experts in their given field, they lack first-hand experience of what it is to be a medical student in 1995. For a medical curriculum to be an effective means of learning for today's students, it must be written with a knowledge of their priorities, needs and abilities. The way in which this can be best achieved is by the inclusion of current students in all stages of designing a new curriculum.
In my second year of medicine at Flinders University, I became involved in planning for the new Graduate Entry curriculum. In the role of student advocate, I have found I am able to offer teaching staff a unique perspective, the student perspective , on various issues.
Students, through experience from their own education, are able to give advice on student resources and facilities and are in a favourable position to judge other aspects of curricula, such as the balance and relevance of course content and assessment. Students need to realize the valuable insight they have to offer their faculties and the way in which this can benefit future students. It is by actively seeking student involvement and using their input, that faculties will be able to create a consumer-friendly curriculum.     

The Medical Skills Centre at the University of Calgary Medical School

The aim of the Medical Skills Centre at the University of Calgary is to provide a predictable learning environment and standardized teaching methods in the area of clinical skills teaching. The centre uses volunteer patients and trained actors for all levels of medical education and evaluation. A computer database enables easy access to groups of patients and varying medical issues. This article describes the organization and operation of the Medical Skills Centre and notes a variety of courses which use the unique facilities of the centre.     

Attitudinal aspects of medical competence

A pre-conference workshop was held on 30 August to 1 September 1980, prior to the Annual Conference of AMEE at Nijmegen, at which twenty invited participants discussed attitudinal aspects of the assessment of competence in medical education, under the chairmanship of Professor Heert Dokter.
This workshop heard introductory papers and discussed the issues in teaching and assessing competence in the emotional awareness developed by the medical student and the newly trained medical practitioner. Three aspects were given particular attention: (a) The concepts of psychosocial medical awareness complementary to knowledge of somatic principles, and recognition of the relevance of such factors in making an adequate diagnosis and in planning treatment programmes. (b) The teaching programmes necessary for incorporating such concepts in the range of students' experience; it is equally important to ensure that teachers also have an awareness of these principles. (c) Scientific research in this field is essential, both to identify those behaviours and attitudes which are important contributions to the well-being of the patient and and family; curriculum development must be planned accordingly and the establishment of appropriate attitudes in students measured.     

Effects of Problem-Based Learning Curricula on Faculty Learning: New Lenses, New Questions

Literature on the impact of problem-based learning (PBL) in medical education has short-changed important questions about the effect of PBL curricula on faculty learning and on faculty knowledge of their subject matter. This paper opens up new questions about the impact of PBL in medical colleges and other health sciences by focusing attention on its effects on faculty learning, on collegial networks in medical colleges, and, consequently, on other scholarly work by faculty. A brief review of research on the effects of PBL on faculty and faculty development is followed by a synthesis of relevant research findings from research on teaching and faculty learning in other disciplines. A new conceptual framework, drawn from the educational paradigms, methods and empirical findings from those other areas of higher education research and research on secondary school teaching, is applied to designing, examining, and evaluating problem-based learning. Viewing faculty as learners prompts a new research agenda including questions such as: What do faculty members learn by participating in integrative, interdisciplinary problem-based learning courses? How? How is that learning related to or integrated with other aspects of their scholarly work?     

浅谈临床医学教学资源不足的解决方法

随着教育体制改革的进一步深化,医学生人数急剧增加,教学要求的病人越来越多,教学任务加重,教学病人不足的矛盾日益尖锐。我们在教学课程及教学理念的改革基础上,尝试了多种教学模式：通过建立标准化病人（SP）库,建立教学真实病人病例库和建立教学多媒体病例库来增加教学资源;同时根据不同专业特点和医学生个人发展的需要,对医学生临床学习进行分流来充分利用教学资源。因此较好地解决了学生人数急剧增加与临床教学资源的相对减少之间的矛盾。     

浅谈临床医学教学资源不足的解决方法

随着教育体制改革的进一步深化,医学生人数急剧增加,教学要求的病人越来越多,教学任务加重,教学病人不足的矛盾日益尖锐。我们在教学课程及教学理念的改革基础上,尝试了多种教学模式:通过建立标准化病人(SP)库,建立教学真实病人病例库和建立教学多媒体病例库来增加教学资源;同时根据不同专业特点和医学生个人发展的需要,对医学生临床学习进行分流来充分利用教学资源。因此较好地解决了学生人数急剧增加与临床教学资源的相对减少之间的矛盾。     

Culture in medical education: comparing a Thai and a Canadian residency programme

Medical Education 2011: 45 : 1209–1219 Context Globalisation initiatives in medical education are premised on a universal model of medical education. This study was conducted to challenge this premise by empirically examining the impact of culture on the practice of medical education in anaesthesia residency training programmes in Thailand and Canada. Methods Using a mixed‐methods comparative case study research approach, one Thai and one Canadian anaesthesia residency training programme were examined with respect to curriculum, educational practices and teacher beliefs. Data sources included observations of academic and clinical teaching, programme document analysis, surveys and faculty interviews. Recruitment resulted in a 76% survey response rate and 13 interview participants at the Thai site and a 61% survey response rate and 16 interview participants at the Canadian site. Multiple linear regression analysis was used to compare survey responses between the two programmes. The qualitative analysis consisted of primary coding, clustering into pattern codes, and identifying themes and sub‐themes. The integration of quantitative and qualitative data for each case was followed by a cross‐case analysis. Results The two programmes were similarly organised and had similar curricular content. However, important differences emerged in curricular emphasis, educational practices, and teacher beliefs and values. Thai faculty staff emphasised knowledge and scholarship, described the faculty–resident relationship as ‘familial’ and focused on ‘teaching methods’. Canadian faculty members emphasised clinical abilities, described the faculty–resident relationship as ‘collegial’ and focused on ‘learning environments’. These findings were related to broader cultural differences that influenced how the curriculum was interpreted and enacted at each site. Conclusions This study shows that although the scientific and knowledge base of medical education is universal, its enactment may be influenced by culture and context. Globalisation initiatives in medical education must be tempered by recognition of these considerations.     

The first batch of graduates of a new medical curriculum in Asia: how their teachers see them

OBJECTIVE: To examine teachers' views of the first batch of graduates of a revised medical curriculum in Asia. METHODS: A cross-sectional study using a structured questionnaire was carried out to obtain the views of all the clinical teachers involved in teaching final year students of the old curriculum in 2000-01 and the new curriculum in 2001-02 at the University of Hong Kong, which commenced curricular reform in 1997. RESULTS: Nearly 62% of respondents felt that better graduates were being produced with the new curriculum. The majority of them rated the new curriculum students better in nearly all the major goals of the new curriculum, such as self-directed learning initiative, problem solving skills, interpersonal skills and clinical performance in patient care. However, the core knowledge of the new curriculum students was of concern to some teachers. CONCLUSION: This study focused on the first complete cycle of a revised medical curriculum in Asia. Teachers' views of the new curriculum students were highly positive and they felt that better graduates were being produced.