A comparative study of teachers' attitudes in the teaching of undergraduate medical students

Senior staff of the departments of medicine, surgery and general practice in each medical school in the United Kingdom were asked to annotate the same case studies which had been prepared by medical students. Analysis of the annotations showed that general practitioners demanded much greater consideration by the student of the patient, his family and his environment, whereas physicians and surgeons tended to be more disease orientated. Nevertheless, expectations and attitudes of teachers in similar departments are remarkably diverse and this highlighted the potential role of the case study as an educational tool for staff and students alike. Many departments need to clarify the difference between undergraduate and postgraduate teaching objectives.     

Medical education: views and opinions of teachers and students at the University of Athens

Athens University teachers' and students' views and opinions on general issues in medical education were recorded by the method of written questionnaires. This was undertaken in an attempt to have basic material necessary for possible reform of the present system. Eleven professors, fifty associate professors, eighty-three lecturers, 107 assistants, sixty final-year students and eighteen teachers, who had just finished a course in educational techniques, responded to the thirty-six items of a Greek-oriented questionnaire especially prepared for this purpose. Results were analysed and presented in topics such as evaluation, students' characteristics, ways of training, and characteristics of the effective university teacher. Commonly accepted issues were: frequent examinations; repeated orientation and guidance of students; examination to evaluate both students and teachers; smaller group tutorial teaching; student participation in curriculum planning; lesser factual details; teaching how to search into the sources of knowledge; inspiration of life learning. It is concluded that there are several key issues shared in common among both senior and junior teachers and students. Reform which is desirable can thus be widely accepted.     

In search of criteria for the assessment of medical education

This paper describes results of a study to asses whether an undergraduate educational curriculum is 'relevant'. The people surveyed comprised 290 individuals involved in medical education or health service administration. They were asked to suggest five major criteria for judging whether a medical undergraduate programme is relevant or not and to say whether they felt current curricula meet these criteria. Of those sampled, 40 % replied.
An analysis of the data from respondents showed that medical school professors and senior administrators of health services in Australia have roughly similar expectations of the outcome of medical education. Both groups were concerned that graduates be conscious of health care requirements and costs, that they have adequate clinical skills, knowledge in medical school subjects and skill in interacting with patients and managing their continuing education. On the various dimensions examined there were frequently strong expressions of dissatisfaction with current achievements.     

Evaluation of a sex education workshop

Thirty-two first year medical students who attended a 1 day sex education workshop and seven of their classmates who did not attend the workshop were given the Sex Knowledge and Attitude Test (SKAT) both 1 month before and 3 months after the workshop. The workshop group on retest had scores significantly higher than their pretest scores in the areas of sexual knowledge, autoeroticism and sexual myths. The scores of the no-workshop group did not change significantly on any of the parameters.
Evidently, knowledge can be increased and attitudes liberalized by means of an intensive day-long workshop and such changes may persist beyond the immediate period of the workshop.     

Attitudes towards the content of general practice teaching

In a study of attitudes towards the content of general practice teaching, it was found that there was good agreement between fifth year medical students and their general practitioner tutors. The social aspects of illness were considered the most important by students and both groups emphasized the value of seeing patients in their homes with time for discussion of cases. These findings are discussed in the context of the development of teaching in general practice at Glasgow University.     

The use of a questionnaire on medical terms as a teaching tool for medical students

Several authors have administered multiple choice type questionnaires about the definition of some medical terms in order to determine the range of answers given by patients in general ( Seligmann, McGrath & Pratt, 1957 ; Boyle, 1970 ; Cottrill et al. , 1973 ) and by University students of varying disciplines in particular ( Tring & Hayes-Allen, 1973 ). Some have tried to elucidate the influence of such factors as the age, sex, educational level and social class of the patient on the level of knowledge ( Seligmann et al. , 1957 ; Samora, Saunders & Larson, 1961, 1962 ; Boyle, 1970 ; Cottrill et al. , 1973 ). Samora et al. (1961, 1962) asked patients to perform the more difficult task of explaining the terms in their own words. All have clearly indicated the fact that laymen may be aware of, or have misconceptions about, the meaning of medical terms.
This paper illustrates the use of such a questionnaire as a tool to: (a) indicate to both clinical and pre-clinical medical students the range of answers given by patients. The results show clearly the misunderstandings which may occur if such words are used in a clinical interview without ensuring that both participants attach the same meaning to the term; (b) teach survey techniques as a meaningful practical exercise rather than only in theory; (c) produce results in which the students are sufficiently interested that they want to analyse it by using the appropriate statistical techniques; and (d) show students that, even at entry to medical school, there is a gap in understanding between themselves and patients on some, but not all, terms. Hopefully, when these students reach the clinical part of their course they will remember their own ignorance and so be more sympathetic towards patients' lack of knowledge than if they had not completed such a questionnaire.     

The effect of a spaced sex education course on medical students'' sexual knowledge and attitudes

This paper reviews the literature and emphasizes the rapid expansion of medical sex education, which has created a diversity of course content, curriculum timing and strategies. One variable of medical sex education programmes is whether they are massed or spaced courses. The authors conducted testing on 159 first year medical students who took a spaced sex education course. Significant changes in cognitive knowledge as well as attitudinal tolerance of others is reported. No changes were found in styles of thinking as measured by the Rokeach Dogmatism Scale.     

Career attitudes of preclinical medical students to the medical specialties

This study set out to investigate the attitudes of preclinical medical students to various specialties. It specifically aimed to measure a range of attitudes to nine medical specialties, by nearly 200 students. Multivariate analysis showed that the scale has various interpretable dimensions which measured such things as the way the specialty is taught in medical school, the recognized efficacy of treatment, type of patients, etc. Univariate analysis revealed numerous significant differences between the subjects' perceptions of the different specialties. It was concluded that the questionnaire provided a reliable, robust and valid instrument for the measurement of medical student attitudes to any or all specialties and may be particularly useful for research in this field.     

The influence of a lecture course in loss and grief on medical students: an empirical study of attitude formation

In this study the results of a questionnaire administered to medical students attending a lecture course on loss and grief are analysed. The focus of the inquiry was to determine whether attitudes towards death, dying and loss could be influenced by confrontation with factual information on bereavement. The results showed that the original idealized attitudes underwent a reality correction due to increased factual knowledge of bereavement processes. The defensive attitudes of students who experienced death in their family during the course are discussed. Intensity and temporality of one's involvement with death appear to be a determining factor in the formation of attitudes towards death. Typical male and female attitudes are also presented. It is concluded that the institutionalization of education in bereavement processes should receive priority in medical programmes and that the classical lecture deserves its place therein.     

Hospital postgraduate medical education facilities

A survey of facilities made available to support the training requirements of junior hospital doctors within the North Western Region of England revealed a general under-provision of certain facilities, significantly greater provision of some facilities in teaching hospitals as compared with other hospitals, significant evidence in some cases of special effort in non-teaching hospitals to improve facilities, and significant differences between specialties regarding efforts made to provide training facilities.     

Medical education: the observations of pre-clinical and clinical teachers

A questionnaire was distributed to staff who teach medical students at some stage in their 5-year course. Their views were sought on various aspects of medical education, including staff-student relationships and student problems. Differences between clinical and pre-clinical teachers were identified and their implications discussed. The views of the clinical teachers, when different from those of their pre-clinical colleagues, were frequently consistent with those of medical students.     

Smoking among the staff of a medical school

A postal questionnaire sent to the staff of Manchester Medical School ( n =483, response 86%) examined their smoking behaviour and views about smoking in relation to their students, thus completing the picture provided by earlier studies of smoking among the students. Twelve per cent of the staff were regular cigarette smokers and 32% smokers of all forms of tobacco, age being the characteristic with most influence on smoking rates. Long-term health risks and expense were the main reasons for trying to give up cigarettes, whereas the need to set an example, in particular to students, was not stressed. A minority smoked when teaching, but fewer smoked when with students than with their colleagues, A quarter allowed students to smoke during teaching sessions; more than half thought students should be offered no persuasion about smoking; and four out of ten considered that staff smoking does not deter students from giving up. Degree of contact with students and qualifications had some influence on these views, but age was more important. Smokers were no more likely to permit smoking during teaching but were less likely to value persuasion or to think staff smoking deters students from giving up. The ambivalent picture of staff behaviour and views as seen by the students in the earlier studies, was confirmed by this examination of the staff themselves, whose importance as role models was highlighted in the discussion.     

Medical students’ attitudes towards women: a sex-linked variable?

Two hundred and ten (95%) second-year clinical students at the London Hospital Medical College answered a questionnaire before and after their 2-month attachment in obstetrics and gynaecology, in an attempt to measure their attitudes to women and the subject being studied.
In only six of the thirty-two questions were there significant changes in the pre- and post-course responses, and these related to abortion, sterilization and obstetric practice. Students did not often answer 'don't know' to the questions, and the most striking finding was that the responses of male and female students differed, with statistical significance at the 1% level in twenty-six of the thirty-two questions. The male students were more likely to agree with statements which stereotyped women in a negative way and this suggests that, unless active steps are taken by medical teachers to help students to question their attitudes, women will continue to complain about the way they are treated by the medical profession, and women doctors will not fulfil their potential.     

The effect of medical education on the attitudes of medical students towards disabled people

The negative attitudes of society towards disability and the resulting prejudicial behaviour affects the lives of disabled people. One of the declared aims of the Faculty of Medicine of the University of Southampton is to improve attitudes. Hence, an attempt has been made to assess differences in the attitudes held by first- and fourth-year medical students, senior house officers and members of the general public towards disabled people. The measurement instrument used was the 'Attitudes Towards Disabled Persons (ATDP) Scale'. The total number of subjects in the survey was 428, of whom 263 (61%) responded. No significant differences were found between the attitudes of the four groups studied. However, a subpopulation of subjects who agreed with the statement that 'Disabled people cause more problems to doctors than non-disabled people' had attitudes which were significantly more negative.     

Performance criteria for evaluation of medical teachers

Evaluation of medical teachers must be related systematically to individualized objectives that are derived from a specific statement of the goals of the medical school. This paper describes the application of management-by-objectives to the problem of assessment of performance of medical teachers. The approach provides for the identification of significant objectives and rates performance in relation to achievement of outcomes rather than of activities.     

Utilization of feedback from student evaluation of teachers

Students who had completed a part of the medical course rated their teachers on a multiple choice-type questionnaire. Each teacher was provided with data from his own rating, and also the mean rating for all teachers, on each item. Six of these teachers were re-rated after a year by the next group of students who followed the same course. Positive change, often significant, was observed in the majority of instances. Such change was not, however, confined to behaviours previously hypothesized to be easily amenable to improvement on feedback. There was evidence of a tendency to unidirectional change within each teacher across most behaviours, some showing predominantly positive and others predominantly negative change at the second evaluation. These results are discussed in relation to the need for counselling following such evaluations.
The second evaluation lent itself to determining the possible existence of a 'halo effect' arising from students of one ethnic group evaluating teachers of the same ethnic group. Such an effect was found to be absent. The reliability of the measurements was tested in several ways.     

Assessment of insight change in medical student doing psychiatry

The development of 'insight' in medical students is considered a fundamental component of psychiatric undergraduate education. The use of an insight test at the beginning and end of a 6 week teaching programme in clinical psychiatry showed a significant increase in insight as measured by this test. There was also a significant correlation between the final insight score and the results of a traditional oral examination.     

Attitudes of health science students towards teaching practices, examinations, and other related issues

A brief multiple choice questionnaire explored the attitudes of students enrolled in several health science faculties (medicine, pharmacy, nursing, and physical and health education). A substantial proportion indicated a wish for more challenging lectures. On the other hand, the majority of students devoted less than one hour of personal study per week to required 'courses', interest in health-related 'courses' being particularly weak. Small textbooks with minimal references were desired, and relatively little use was made of free lecture handouts. Financial constraints had little influence on personal study, but affected textbook purchase. The demand for 'handouts' would have been reduced by a charge. Frequent term examinations as a stimulus to learning were favoured by all groups, as were full or challenging presentations by instructors. Team teaching, although favoured generally, was not equally appealing to all groups.     

Preclinical teachers and preclinical students

A survey in 1974 in Manchester University medical school of the preclinical teachers showed that they thought that the motives of students in studying medicine were not what they should have been. Medically qualified and non-medically qualified teachers agreed about the importance of nine suggested motives, but there were highly significant differences between the two groups about the motives they felt to be present in students. The non-medically qualified were very much more likely to see students as concerned with the financial and social rewards of medicine, and more likely to doubt students' desires to be professionally competent or to help individuals. Some anecdotal evidence possibly throws light on these findings, which may have serious implications for teaching as non-medically qualified staff make up an increasing proportion of preclinical teachers.