A skills programme for preclinical medical students

An education programme in which preclinical medical students are introduced to common procedural skills is described. This programme is presented by a multidisciplinary health care team using short lectures, demonstrations, mannequin practice, and, in selected instances, practice on class-mate volunteers. The programme was evaluated by the students immediately following the presentation and for one class during their clinical activities one year later. The students' support for this programme was generally enthusiastic and remained undiminished upon reflection 12 months later.     

Teaching sociology to medical students

A recent change in many medical curricula has been the introduction of courses in the behavioural sciences. These courses, while introduced with the intention of emphasizing interpersonal and behavioural skills, have not been shown to lead to any of the changes towards which they are directed. Rather, there is evidence that students find these courses 'waffly' and boring. If the sociology component of these courses is to lead to change, then there is the need for a continuing process of evaluation and modification. In this paper we report upon one medical sociology course, its evaluation, subsequent modification and re-evaluation. Our evidence would suggest that sociology courses can lead to changed attitudes and values, but that such changes are contingent upon the overt application of relevant sociological concepts to the health care field.     

A programme for treating chemically dependent medical students

Summary. The first American programme for chemically dependent medical students at the University of Tennessee, Memphis is described. The goals of the Aid for the Impaired Medical Student (AIMS) Program are to provide confidential treatment for chemically dependent medical students, to assure that recovering students are able to resume their education, and to protect patients and others from the harm that may be caused by impaired students. The Program is administered by the AIMS Council, consisting of medical professionals and elected student representatives. The Council oversees the management of cases, including investigation of students who may be impaired, intervention when chemical dependency is suspected, diagnostic evaluation, treatment and aftercare, and post-recovery advocacy for students. The Program's experience includes 18 cases of suspected chemical dependency, with four self-referrals and 14 students referred by third parties. Eleven students have been diagnosed as chemically dependent and have completed treatment programmes. Nine have maintained recovery and eight have graduated. One student subsequently relapsed and committed suicide. Obstacles in programme implementation have involved absence of perceived need, the view that chemically dependent students should be dismissed from school, and reluctance of students to report classmates. Resources have included highly respected student representatives, a supportive administration, assistance of the impaired physicians programme, and medical insurance and professional courtesy to defray costs. Although the number treated has been modest, the AIMS Program is an important vehicle for training students regarding chemical dependency and their professional obligations toward impaired colleagues.     

Do we need a strong programme in medical sociology?

Medical sociology has traditionally been concerned with the ways in which medical knowledge is applied. Less work has been done on the construction of knowledge in the laboratories of the basic medical sciences. This paper aims to extend the field of interest of medical sociology by introducing some recent developments in the sociology of science and technology (the ‘strong programme’).     

Population Studies: an integrated course in epidemiology and sociology for medical students

At the Royal Free Hospital School of Medicine, London, an integrated course in epidemiology and sociology for preclinical students was introduced in 1979. The course--Population Studies--is taken by the 100 second-year medical students in the summer term before they enter their clinical years. It occupies one full day and one half day each week for 8 weeks--approximately 80 hours of tuition. Population Studies is unusual in two respects. Firstly, it introduces a substantial amount of epidemiology into the preclinical curriculum. And, secondly, this is the only London medical school to integrate the teaching of sociology and epidemiology into the one course.     

Identifying with the patient: an intensive programme for medical students

An intensive programme called 'Hospitalization Week' was developed at the medical school of the Ben-Gurion University of the Negev in Israel. The main goal of the programme is to give first-year medical students an opportunity to understand the complexity of the needs and problems of hospitalized patients. To achieve this goal each student accompanies two patients from their arrival at the emergency room throughout their stay in the hospital. The goals and methods of the programme are described and evaluated.     

An inter-university community child health clinical placement programme for medical students

BACKGROUND: Inpatient teaching no longer reflects the full spectrum of paediatric practice and community-based programmes with clearly defined aims and evaluation of learning are becoming increasingly important. Competition for community resources poses threats to the delivery of effective community child health learning programmes by individual medical schools. OBJECTIVES: To develop and evaluate a combined inter-university, child-focused, active learning programme in community child health. METHODS: A total of 55 postgraduate-entry medical students from the Flinders University of South Australia and 97 undergraduate-entry University of Adelaide students were placed with 25 community child health agencies and instructed to assess services from a client perspective by tracking one child and family through multiple agency contacts. Following each placement, achievement of specific programme aims was evaluated by students and agency staff using a 7-point Likert scale. RESULTS: Students and agency staff indicated substantial achievement of programme aims. Mean agency ratings were significantly higher than student ratings for three aims: students' experiencing a wider spectrum of health care problems than in teaching hospitals (5.7 +/- 1.5 versus 4.9 +/- 1.6, P < 0.001); the importance of social and environmental factors (5.9 +/- 1.0 versus 5.2 +/- 1.4, P < 0.001), and the importance of coordinating care (6.0 +/- 1.0 versus 5.2 +/- 1.2, P < 0.001). Ratings from undergraduate-entry students differed from those of postgraduate-entry students only with respect to the importance of social and environmental factors (4.8 +/- 1.4 versus 5.7 +/- 1.1, P < 0.001). CONCLUSIONS: The new collaborative Community Child Health Programme substantially achieved learning aims and demonstrated effective integration of postgraduate- and undergraduate-entry medical students from two universities.     

Short-term outcomes and long-term impact of a programme in medical education for medical students

Objectives  There is growing appreciation of the value of early preparation of future medical educators. Staff development programmes, conferences and workshops pertaining to the training of educators may be crucial to the pursuit of a school's larger educational mission to educate students, doctors and scholars and to provide comprehensive knowledge, research, patient care and service. This study examined the efficacy of a 1-week educational intervention aimed at preparing medical students to become effective doctor educators by building skills early in their careers. The study asked whether participation in a 5-day teacher training programme led to increased knowledge of instructional methods, more favourable attitudes towards teaching, and the integration of structured instructional design methods in a student-developed teaching project.
Methods  A mixed methods research design was employed with quantitative data captured through pre- and post-test inventories, qualitative components captured through written comments, and a 2-year post-intervention survey. Quantitative analyses included pre-/post-intervention repeated measures with calculated effect sizes. Qualitative analysis was conducted using constant comparative methods.
Results  Subjects demonstrated improved content knowledge and more positive attitudes towards motivation, teaching confidence, teacher roles, varied pedagogy, and use of assessment, instructional planning, and evaluation. Subjects were able to incorporate the programme's teaching theory and methods into their teaching projects and assessment of peers' and others' teaching in their own institutions 2 years post-training.
Conclusions  This study demonstrates that a well-designed programme for teacher preparation can be pedagogically effective for training medical students to become better educators and that this learning can be incorporated into long-term practice.     

Selection of medical students: an affirmative action programme

An affirmative-action programme was introduced in Auckland in 1972 to increase the proportion and absolute number of entrants to medical school from the indigenous or Maori population and those of Pacific Island ancestry. One hundred and forty-seven students have entered the course through this programme, the percentage of females being higher than that of the non-affirmative category. Seventy-five have graduated – a graduation rate of 78%. Twenty-seven (18%) have been lost from the course mainly through academic failure, This loss is much higher than the 8% found for the remaining medical student population. The subsequent careers of those lost from the course has been satisfactory, some graduating from other faculties and some from polytechnics. Although such a programme remains controversial it has enabled a large number of persons to enter medical school who would not have been able to do so through the standard admitting process.     

Interprofessional education for medical and nursing students: evaluation of a programme

This paper reports and evaluates a programme of interprofessional education for final-year medical students and fourth-year undergraduate BSc nursing students. The programme was designed in the light of social psychological studies of intergroup behaviour (the contact hypothesis). Key features included opportunities to work as equals in pairs and small groups on shared tasks in a cooperative atmosphere. Topics included communication between nurses, doctors and patients, deliberate self-harm by patients, and ethical issues in clinical care. A comprehensive evaluation of the effects of the programme on one cohort of 39 participants revealed that overall attitudes towards the other profession had improved. Participants reported increased understanding of the knowledge and skills, roles and duties of the other profession. The programme was positively evaluated by both groups of participants.     

Behavioural assessment of the effectiveness of a communication programme for medical students

Summary. This study evaluated the effectiveness of a communication programme taught to medical students at the University of Melbourne in their preclinical years. The effectiveness of the programme was assessed by comparing videotaped history-taking interviews completed by a cohort of first-year clinical students in 1986, who had not undertaken the communication programme, with a similar cohort of first-year clinical students in 1992 who had undertaken the programme. The students from the 1986 cohort who had not undertaken communication training in their preclinical course completed their videotaped interviews as part of the experimental evaluation of a consulting skills training programme carried out in 1986-87. A comparison of ratings given by two experimentally naive, independent observers revealed that the 1992 student cohort demonstrated some significantly better skills at questioning and facilitating communication with patients. By contrast, the 1986 student cohort showed significantly greater skills at maintaining relevance in their interviews and greater capacity to explore patients' psychosocial concerns. These data suggest that students acquire the most effective interview skills when interacting with patients during their clinical training.     

A home visit programme to teach medical students about children with special needs

OBJECTIVES: During an 8-week clinical rotation in paediatrics and child health, fifth-year medical students at the University of Cape Town are required to visit children with special needs in their homes. The home visit allows students to learn, first-hand, from children with special needs and their families about living with chronic disease and disability. DESIGN: During 1998 students anonymously completed home visit evaluation questionnaires (90% response rate, 160/177). Through verbal presentations, students are assessed on their ability to make a comprehensive evaluation of the impact of chronic disease and disability on a child and family. SETTING: University of Cape Town Medical School. SUBJECTS: Fifth-year medical students. RESULTS: A content analysis of verbal presentations found students were more likely to identify medical, psychosocial and economic than spiritual and ethical issues. As a learning experience, 37% (n=57) of students rated the home visit as 'extremely worthwhile', 62% (n=100) found it 'worthwhile' and only 2% (n=3) felt it was 'a waste of time'. Most (97%, n=155) students felt the programme should continue in the future. CONCLUSIONS: As an educational tool, home visiting grounds learning in families' experience and encourages reflection beyond the medical aspects of care for children with special needs.