Medical education: assessment of a regent scheme

As part of a project concerned to identify the emotional and psychological problems experienced by medical students in the Medical School of Aberdeen University and to evaluate the services organized to respond to these, the present study is an assessment of one of these services, the regent scheme.
The results of a questionnaire issued to current regents and to students in the second and third years of their course, show discrepancies in the views of the members of the two groups about selection of regents, the matching of regents and regentees, guidance offered about the use of the scheme, assessibility of regents and payment to regents. Comments from both groups indicate dissatisfaction with the scheme and also the wish to see it continue.
This study explores some of the reasons for these opinions and for the use of the scheme by only a minority of students; and shows the need for a revision of the scheme.     

Medical education: a student perspective

Discussions with a sample of final year students generated a questionnaire designed to elicit a phenomenological account of their experiences at medical school. Sources of dissatisfaction and stress were identified and the students also offered recommendations for improving the system.     

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.     

Medical education and experience affecting intra-observer variability

Intra-observer variability for history and simple test evaluation was assessed in a group of 10 final-year medical students and in five senior hospital staff members. Substantial agreement between the results of two evaluations made 7-10 days apart was found in 20 out of 30 instances for staff and in 17 out of 60 instances for students. However, there were instances when variability seemed to be unrelated to the academic standard of students or to the training and experience of staff. It is concluded that the nature of diagnostic procedure and present training in medical school or long-term experience may not be the only factors that affect intra-observer variability in everyday simple diagnostic applications.     

Medical student attitudes to computer-assisted learning in anaesthesia

Two methods of data entry for computer-assisted learning (CAL) programs were assessed and the acceptability of two forms of CAL to 100 medical students determined. Sixty-two per cent preferred keyboard entry of data compared with 26% who preferred the light-pen. There was not preference for dynamic simulation programs over patient management programs. The majority of the students preferred using CAL in groups with a supervisor to provide further explanation when required. Ninety-three per cent of students favoured more teaching using this method.     

Medical education and the corresponding professional needs of young doctors: the Finnish Junior Physician 88 Study

Summary. The Universities of Kuopio and Tampere in collaboration with the Ministry of Social Affairs and Health and Finnish Medical Association carried out the 'Junior Physician 88' study in 1988, the purpose of which was to shed further light on the life situation and future plans of young doctors and their views concerning undergraduate and postgraduate medical education. The study concerned all the doctors registered during the years 1977–1986 in Finland (   n = 5208  ). After randomization, a postal questionnaire was sent to one half (   n = 2631  ) of these doctors. After the first reminder letter, 1745 questionnaires (66.3%) were returned. According to the views of the respondents undergraduate hospital teaching was adequate but the teaching of practice in health centres, school health care, team-work, health care of the elderly, home health care, rehabilitation, environmental health care and administration did not meet the professional needs of doctors. All doctors were satisfied with the hospital teaching in their undergraduate curriculum. However, only the doctors who graduated from the two modern universities in Kuopio and Tampere were satisfied with their undergraduate health centre teaching.     

Medical students'' evaluations of different levels of medical ethics teaching: implications for curricula

Although medical ethics has become a part of the curriculum of almost every medical school, medical students' perceptions of the value of medical ethics have not been documented. This paper reports the evaluations given by 137 preclinical and 216 clinical medical students to different levels of medical ethics teaching at the College of Human Medicine and the College of Osteopathic Medicine of Michigan State University. The results indicate (1) that students' satisfaction with medical ethics teaching is directly linked to how much they receive, (2) that students overwhelmingly prefer the input of both ethicists and doctors to teaching by either alone, and (3) that a preclinical medical ethics course followed by explicit medical ethics teaching in clinical training is a promising model for achieving an adequate level of medical ethics teaching within medical education.     

Information technology in postgraduate medical education

Summary. Information technology in postgraduate medical education has developed rapidly over the last 5 years. This report describes the experience of setting up a computer-based information system in postgraduate centres in the West of Scotland. It includes a viewdata service, library facilities, computer-assisted learning, word processing, and statistics. An electronic mail system provides rapid communication between users. The costing and some of the problems in setting up such systems are discussed.     

某医学院校新生生活应激与心理健康的关联性研究

目的 探讨安徽省某医学院校本科一年级新生心理健康水平与生活应激的关系.方法 采用分层整群抽样的方法,对安徽省某医学院校本科一年级1 152名新生进行问卷调查,通过多因素Logistic分析,探讨大学生心理健康与应激之间的关系.结果 该医学院本科新生中有52.7％(596/1 132)的新生存在不同程度的心理问题,其中有19.0％(215/1132)的新生可能存在严重的心理问题.Logistic回归分析显示独生子女和单亲家庭的学生心理问题较为严重,而挫折、压力和情绪反应是严重心理问题的危险因素,且挫折、压力与情绪反应的产生存在相关性.结论 该医学院校本科新生存在较为严重的心理问题,应针对大学新生进行心理筛查,对存在心理问题的学生尽早提供心理咨询及危机干预.     

Medical student attrition: a 10-year survey in one medical school

Medical student wastage leads to adverse emotional and social consequences for individual students and financial difficulties and morale problems for medical schools. This study retrospectively assessed the records of all students at Leeds School of Medicine who left the course prematurely between 1983 and 1992. The demographic data of the leavers were compared with those of all students entering the school during the 10 years studied. A-level examination choices and results of the leavers were compared with those of a control group of all students who entered the school in 1990. The attrition rate over the 10 years was 14% (283 students), with more males than females leaving. Fewer mature students than expected left the course. More leavers had A-level physics and lacked A-level biology compared with the control group. The leavers were academically less able than the controls. Fifty-three per cent of leavers were asked to withdraw from the course for academic reasons; the rest left voluntarily. Thirty per cent had personal problems, 9% had a combination of academic and personal problems and 8% had health problems (psychological difficulties were the commonest). Seventy-one per cent of leavers entered another degree course; science degrees were the most popular. Reasons for medical student wastage and possible solutions are discussed.     

Medical students in a time of HIV: education and the duty to treat

This article concerns medical education about the ethics of professional duties and treatment of HIV-infected patients. The issue at hand is not whether medical students have a duty to treat HIV-infected patients, since it is a matter of consensus that they do. Medical schools have reasserted that risks are inherent in medicine, and that medical school admission should be based on the willingness to accept some risks, in addition to intelligence and personal skills. Those who wish to avoid risks are free to enter other professions. While it is imperative to assert a duty to treat, this requires thoughtful explanation to match the understandably high anxiety levels of many medical students.     

Medical students' perceptions of medical malpractice

Despite increasing interest in medical malpractice in the UK, there is very little empirical research on doctors' own concerns. This paper explores first and fifth year medical students' knowledge about malpractice, their attitudes toward litigation and its perceived significance for their future practice.     

Relevance and resources in medical education: an African view

The worldwide economic crisis enjoins all planners of social services to a principle of relevance and efficiency in the deployment of scarce available resources. On the continent of Africa this is more crucial for the compelling influence of natural disasters and the population explosion. In the field of medical education relevance implies commitment of training programmes to the health needs of the society and in Africa this means addressing crude birth rates of 46 per 1000, death rates of 22 per 1000, maternal mortality of 17 per 10,000, infant mortality of 112 per 1000 and a life expectancy of just under 50, statistics which represent the most dismal health indicators for the five continents of the world. The training of the African doctor should therefore ensure intimate familiarity with the environmental and sociocultural influences on health, placing a premium on capability for management of human, material and financial resources and a plan for team-work. It must also inculcate the appropriate learning strategy which emphasizes the searching and enquiring mind, applying this problem-solving attitude to the life-long practice of medicine. It is now accepted by most observers that these objectives are achievable most readily through a translation of the principles of primary health care into educational strategies. The planning of medical educational policy in Africa is thus a formidable task as it is to be done against a background of diminishing resources in real terms and the modern explosion of knowledge in science and technology. Selectivity which is sensitive to the service to which education is to be put is currently the most promising means to achieve relevance and efficiency.     

Medical education and economics

The time available to medical students for learning is scarce in relation to the knowledge they are asked to absorb. New material should not therefore be added to medical curricula without careful consideration of the benefits of the extra knowledge compared to the costs of obtaining this knowledge. In this paper a justification for integrating economic principles into medical education is presented. It would benefit society by encouraging the practice of efficient medicine, and benefit students by giving them the ability to absorb the growing economic content of the medical literature and by encouraging an appreciation of why economic factors will influence their clinical decision-making. These benefits would accrue at little cost because only a limited number of economic concepts need to be absorbed by medical students. The critical concepts are outlined and some of the obstacles to students applying this knowledge in practice are considered. The paper concludes by suggesting that the impact of teaching economics to medical students should be evaluated, but this will require further research into ways of evaluating the outcome of medical education programmes in general.     

Medical teaching at a peripheral site by videoconferencing

The departments of Child Health and Mental Health of Aberdeen University's Medical Faculty recently took part in a 3 month trial assessing the potential of video-conferecning as a medium for teaching students on peripheral hospital attachments. The equipment used was British Telecom's VC7000 Videoconferencing System and an ISDN2 (integrated services digital network) connection, which was installed between two sites. The locations used were a teaching room in the Royal Aberdeen Children's Hospital and the Paediatric Unit at Raigmore Hospital in Inverness. This paper describes the resources required to support the trial, the methods used to run it and the results of staff and student evaluation of the trial. Evaluation forms were completed and returned by eight members of staff and by 30 fourth- and fifth-year medical students. The results indicated that, although after this particular trial both staff and students rated the overall usefulness as low, they attributed this to technical problems and limitations specific to the type of equipment used rather than to the method itself. The overall impression was that videoconferencing with ISDN has potential as a teaching tool in the medical undergraduate course but that further improvements in image quality and voice switching are required.     

The Consortium of Graduate Medical Schools in Australia: formal and informal collaboration in medical education

CONTEXT: In 1996-97 three Australian medical schools adopted 4-year graduate medical courses. The schools formed a consortium to establish common admissions processes and to collaborate on curriculum and staff development. OUTCOMES: ADMISSIONS: Outcomes in admissions included the construction of an entry test and agreement on common application procedures. Structured interviews and measures of prior tertiary performance were adopted in each school with some local variations. Formal structures were put into place to manage the development of the test and admissions procedures. OUTCOMES: CURRICULUM AND STAFF DEVELOPMENT: No formal structures were put into place for curriculum and staff development. While the advantages of common approaches were recognised, it was accepted that it was also important to generate local ownership and commitment to the new courses. Outcomes of educational consortia should not be judged solely by the nature of joint ventures but by the way in which membership of the consortium changes the priorities and practices within the institutions. Examples of the operation of this principle within the three schools include: use of visiting experts to refine and modify approaches to problem-based learning; use of staff from partner institutions to facilitate implementation of the courses; sharing information technology expertise; cooperation in the construction of feedback mechanisms, and sharing advice on fulfilling accreditation requirements. CONCLUSION: The Consortium has had an important impact on Australian medical education. There is a need for further analysis of the two methods of operation of the consortium, formal and informal, and their relation to its overall functioning.     

Medical education and medical education research and development activities in modern China

The development of medical education in China occurred quite differently to medical education in the rest of the world. A review of the literature has been presented regarding the historical development and the evolution of medical education research and development (MERAD) units in modern China. The history of medical education in modern China has been divided into three periods: (1) the 17 years before the 'Cultural Revolution' (1949-1966); (2) the period of the 'Cultural Revolution' (1966-1976); (3) the post 'Cultural Revolution' period (1976 onwards). Although a number of MERAD activities had existed on China's medical campuses since 1949, there was no formal organizational structure for MERAD before 1978. The change of the political situation in 1978 led China to seek modernization, with education as its basis. In the process of health care system modernization, medical education was given priority, and the Western model of establishing MERAD units as a means of improving the training of health professionals was introduced. The evolution of medical education research and development in modern China appears to be following the Western pattern due to the multitude of Western consultants and fellowships in Western countries provided to Chinese medical education leaders. A group of people from medicine is gathering in the MERAD field and MERAD units are beginning to take shape in modern China.     

Medical education on tobacco: implications of a worldwide survey

Summary. This report considers the implications for medical education of a global survey of the knowledge, behaviour and attitudes of medical students regarding tobacco. This was conducted in 42 countries derived from all continents. A total of 9326 students (44% women) from 51 medical schools replied anonymously to a multiple choice questionnaire administered in the local language.
Student smoking rates varied greatly between countries/regions: daily smoking in men from 2% (Australia) to 48% (one centre in the former USSR); in women from nil in some Asian medical schools to 22% in one European.
Though there was some variation between countries and medical schools, there was widespread ignorance of the causal role of smoking in specific diseases; notably coronary artery disease, peripheral vascular disease, emphysema, bladder cancer and neonatal mortality. There were widespread defects in knowledge and motivation regarding counselling patients to quit smoking, with a common failure to appreciate a doctor's responsibilities in prevention. Very few students knew the value of tobacco taxation in reducing consumption.
Following our survey we were asked to advise the World Health Organization on a summary of the desirable tobacco content of medical curricula, which has now been issued. The International Union against Tuberculosis and Lung Disease, in cooperation with the European Region of WHO, has circulated the Deans of all European medical schools with a summary of the deficiencies revealed by the European component of the survey, together with a questionnaire on proposed action. A similar initiative is being considered in cooperation with the Western Pacific Region of WHO.