Medical student abuse. Incidence, severity, and significance

In a survey of the incidence, severity, and significance of medical student abuse as perceived by the student population of one major medical school, 46.4% of all respondents stated that they had been abused at some time while enrolled in medical school, with 80.6% of seniors reporting being abused by the senior year. More than two thirds (69.1%) of those abused reported that at least one of the episodes they experienced was of "major importance and very upsetting." Half (49.6%) of the students indicated that the most serious episode of abuse affected them adversely for a month or more; 16.2% said that it would "always affect them." Students identified various types of abuse and proposed a number of measures for the prevention and management of abuse in medical school. We conclude that medical student abuse was perceived by these students to be a significant cause of stress and should be a major concern of those involved with medical student education.     

Liberal arts and the premedical curriculum

Twenty-five leading physicians, medical educators, and humanists convened and affirmed the contributions of a liberal arts education to the study and practice of medicine. Participants agreed that overemphasizing technical expertise does have deleterious effects on premedical and medical education, which might be alleviated by encouraging a more broadly based undergraduate and medical curriculum. Admissions statistics show that approximately 50% of all applicants of medical school are admitted to some school and that there is no apparent bias against nonscience majors in the admissions process. Increased student awareness of these statistics should relieve anxieties and intense competitive pressures. A publication based on the conference recommendations will be made available to deans, advisors, and career counselors.     

Clinical practice of medical school faculties: an AAMC survey of problems and issues

This study reports the results of a survey by the Association of American Medical Colleges (AAMC) to identify the salient problems and issues regarding medical school faculty clinical practice in the views of faculty members and administrators in academic medical centers. The population surveyed consisted of university vice-presidents for health affairs, teaching hospital directors, and medical school deans, department chairmen, and faculty representatives. A content analysis of the narrative responses revealed that the apportionment of faculty time to create the appropriate institutional balance among teaching, research, and service missions was the most frequently mentioned concern. Other dominant themes included threats to the patient base needed for teaching and research and/or to future income posed by the new competitive and reimbursement environment and changes required in modes of faculty practice to respond to the new environment. The latter included the need for organizing practice activities into a "true group practice," a change that would accommodate growing demands of purchasers for integrated systems of care. Hospital directors were particularly concerned with issues of faculty-hospital relationships. Results of the survey provide an agenda for a recently formed AAMC ad hoc Committee on Faculty Practice, which will propose initiatives by the AAMC to assist its member institutions in responding to the issues raised.     

Response of faculty members to medical students' personal problems

In the study reported here, the authors examined the interpersonal helping behaviors of medical educators. Ninety-six faculty members from 12 randomly selected medical schools completed a detailed questionnaire providing data on the nature and frequency of their interpersonal behaviors with students experiencing personal problems. The faculty members reported spending an average of 48.6 minutes a week discussing personal problems with students. Student problems reported most frequently pertained to financial concerns, emotional health, and interactions with faculty members. Medical educators used various techniques to offer help; the most commonly reported techniques were listening, asking questions to draw the student out, offering support and sympathy, and offering empathy. Most medical faculty members felt positive about their role as "helper" and rated that component of their job as extremely important. The implications of these findings, especially for staffing and personnel policy, are discussed.     

Alberta euthanasia survey: 2. Physicians' opinions about the acceptance of active euthanasia as a medical act and the reporting of such practice.

OBJECTIVE: To ascertain the opinions of Alberta physicians about the acceptance of active euthanasia as a medical act (the "medicalization" of active euthanasia) and the reporting of colleagues practising active euthanasia, as well as the sociodemographic correlates. DESIGN: Cross-sectional survey of a random sample of Alberta physicians, grouped by site and type of practice. SETTING: Alberta. PARTICIPANTS: A total of 2002 (46%) of the licensed physicians in Alberta were mailed a 38-item questionnaire in May through July 1991; usable responses were returned by 1391 (69%). RESULTS: Although only 44% of the respondents considered active euthanasia morally "right" at least 70% opted to medicalize the practice if it were legal by restricting it to be performed by physicians and to be taught at medical sites. Even though active euthanasia is criminal homicide in Canada, 33% of the physicians stated that they would not report a colleague participating in the act of anyone, and 40% and 60% stated that they would not report a colleague to medical or legal authorities respectively. Acceptance or rejection of active euthanasia as a medical act was strongly related to religious affiliation and activity (p < 0.01). CONCLUSIONS: This survey about active euthanasia revealed profound incongruities in the opinions of the sample of Alberta physicians concerning their ethical and social duties in the practice of medicine. These data highlight the need for relevant modifications of health education policies concerning biomedical ethics and physicians' obligations to society.     

中美高等医学教育浅析

目的：对中关高等医学教育作初浅的比较,并对我国医学教育改革提出一些建议。方法：分析在美国医学院的交换经历和中国医学院的学习经历并进行比较。结果：美国医学院入学要求高,课程设置较合理,注重动手能力,重视医学教育评价,我们应该借鉴并进行改革。结论：希望更多的医学教育者能够从中美比较中取其精华,加强临床教学的力度,改革医学教育,培养教学意识。     

Reforming medical education in the United Kingdom: lessons for Australia and New Zealand

Medical education faces global challenges because of the changing health care needs of an ageing and more demanding society, and the consequent requirement for increased health care workforce capacity and different workforce models. In the United Kingdom, education reform has spanned the medical, nursing and allied health professions, and has introduced new health professions with specific roles within a new, team-based model of comprehensive health care. In medical education, the UK reforms span undergraduate, prevocational, vocational and continuing education, with the aim of providing a framework for faster, more flexible career development that can adapt to future changes in workforce need. While some reforms are controversial, most appear sensible and are supported by most observers. The Modernizing Medical Careers process suffered implementation difficulties in 2007: the national, web-based application scheme for vocational training posts could not cope with such a large process, disrupting both the recruitment of an appropriate workforce for hospitals and the career progression of many recent UK medical graduates. The main problem appears to have been in management of change--too much was attempted too quickly on too large a scale--resulting in a backlash against any significant change. There may be lessons for Australia and New Zealand, which face similar challenges and are considering broadly similar changes.     

Medical student's access to information and resources for the residency selection process

In the study reported here, the authors analyzed senior medical students' attitudes regarding the availability of information and resources pertaining to the residency selection process. Results of a nationwide survey of students showed that when the students had access to information from medical professionals (that is, faculty members, deans, house staff physicians), they felt they had greater access to information than did students who made greater use of other sources (official directories, classmates and the "grapevine"). Furthermore, the findings suggest that greater availability of information from medical professionals was related to higher levels of overall satisfaction with the residency match. While no evidence is presented that demonstrates that medical school faculty members and administrators were unwilling to devote attention to any particular group of students, the data suggest that these professionals provided information regarding the residency selection process more often to medical students at high-prestige schools, students who chose high-prestige specialties, and students who perceived themselves as having high class rank than to other students. Also, students in publicly supported schools felt the cost of travel for interviews to be more burdensome than did the students in private schools.     

医科院校合并后的医学人文学科建设

医学院校合并后的体制改革,直接关系着医学人文学科的生存与发展。促进学科间的交叉融合是高校合并的根本目的之一,以学科为基础的实质性融合是学科体制改革的基本点。只有建立起刚柔共济的学术机构,采取平稳过渡的基本对策,才能有利于学校的长远发展,有利于医学人文学的学科建设,有利于“两课”队伍的稳定与发展。     

The changing context of undergraduate medical education.

It has long been recognised that intensive efforts are needed to reform medical education in order to meet the future needs of populations worldwide. Pressure for changes to the organisation, content and delivery of both undergraduate and postgraduate medical education has greatly increased in the last two decades. The experience of innovative medical schools, the emergence of learner-centred teaching methods and the implications of health-care reforms in North America and Britain are major factors influencing calls for change. The pace of change has accelerated to such an extent in recent years that progress towards widespread reform appears to be more attainable than ever before. This article provides an overview of the changing context of health-care, some patterns of existing medical education and some strategies for change.     

See one, do one, then what? Faculty development in postgraduate medical education

Interest in the development of medical educators working in the postgraduate sector is running high. Driven by three interlinked trends--the professionalization of medical education, increasing accountability, and the pursuit of educational excellence--there is a growing need for high quality and sustained faculty development programmes across the network of education providers. Postgraduate medical education has a number of unique features that set it apart from undergraduate medicine, to which faculty development programmes need to cater. The key issue for the future will be how to engage the service in the business of education. Widespread cultural change is required and this will require effective and sympathetic leadership from postgraduate training institutions, hospitals and health authorities.     

医学本科生教育中的老年医学教育研究

人口老龄化社会的到来,迫切需要加强老年医学教育。目前,我国对于医学本科生的老年医学教育尚无统一的教学大纲。本文通过文献复习,借鉴和总结国际上老年医学教育的先进经验,提出医学本科生的老年医学教育的教学目的和要求、教学实施及教学评估建议,希望能引起更多的医学教育工作者参与讨论,以推动我国医学本科生的老年医学教学大纲的制订。     

医学教育改革热点及发展趋势

从教学模式、教学内容、教学方法和教学评估等几个方面介绍了国内外医学教育改革的热点,＂早期接触临床＂＂基础与临床课程整合＂以及＂以问题为中心的学习＂构成了半个世纪以来医学教育改革的核心内容,对医学教育改革产生了深远的影响。     

Medical education and society.

As health care changes under the pressures of restraint and constraint our vision of the future of medical education should be based on the medical school's responsibility to the community. The medical school is "an academy in the community": as an academy, it fosters the highest standards in education and research; as an institution in the community, it seeks to improve public health and alleviate suffering. The author argues that to better achieve these goals medical schools need to become more responsible and responsive to the population they serve. Medical schools have been slow to accept fully the social contract by which, in return for their service to society, they enjoy special rights and benefits. This contract requires that medical educators listen to the public, talk honestly and constructively with government representatives and assess the needs and expectations of the community.     

医学院校医学英语教育教学体系的重构与实践

为探索医学院校医学英语教育教学体系的重构与实践,本研究逐一访谈了23名国内医学院校外国语学院院长和综合院校开设医学专业的医学英语教学负责人,并收回西安医学院2 270份医学本科生有效问卷。医学院校医学英语教育教学存在的共性弊病为,医学英语师资医科知识严重不足、偏重医学英语教学、医学英语人文教育分量不足、医科英语教材偏重...     

General practice: a leading provider of medical student education in the 21st century?

General practice is well placed to become a major setting for medical student education over the next decade. New models of clinical education are required, to take account of changes in the patient population, disease profile and management strategies. While there has been an increase in general practice-based and other community-based education, there is the potential for further expansion. Evidence for the positive role of general practitioners and general practice in medical education is growing, including the benefits of prevocational training in general practice. If GPs are to assume a major role in community-based education of medical students, there will need to be changes in funding structures and supporting resources, particularly at this time of increasing medical student numbers and workforce shortage and maldistribution.     

Podiatric medical resources on the internet: a fifth update

An updated selection of high-quality Internet resources of potential use to the podiatric medical practitioner, educator, resident, and student is presented. Internet search tools and general Internet reference sources are briefly covered, including methods of locating material residing on the "invisible" Web. General medical and podiatric medical resources are emphasized. These Web sites were judged on the basis of their potential to enhance the practice of podiatric medicine in addition to their contribution to education. Podiatric medical students, educators, residents, and practitioners who require a quick reference guide to the Internet may find this article useful.     

医科院校研究生卫生法学课程学习现状调查

通过调查山西医科大学研究生卫生法学课程学习现状,分析研究生卫生法学学习过程及考核中存在的问题,为研究生法律素质培养、卫生法学高质量教学提供参考建议。随机抽取选修卫生法学课程的研究生280例,采用问卷调查的方法对卫生法学课程必要性认识、设置合理性认识、自身学习情况、考核方式等进行调查,利用epidata3.1软件录入数据,经SPSS17.0软件进行数据整理分析。37.7%的研究生在之前的教育经历中没有学习过相关课程,但是认为课程必要的却达到了98%的比例,而只有57.8%的学生认为课程设置合理,认同传统语言传递信息教学的仅占半数(54.5%),认为教学评估有助于教学的比例达到95.5%。虽然医科院校研究生认识到卫生法学的必要性,但是由于多方面的影响,导致卫生法学课程学习现状并不乐观,需要合理有效,真正适合医科院校研究生的教学手段、策略。