General practice in the undergraduate curriculum: 20 interviews with Southampton final-year students

The Primary Medical Care Group at the University of Southampton contributes to the medical curriculum in the first, third and final years. A visiting lecturer from Sweden took the opportunity to interview a sample of 20 final-year students using a qualitative approach. Questioning centered on the impact of the primary care course both in relationship to medicine as a whole and to general practice. It was found that primary medical care was often not seen as a central or integral part of the curriculum but many students acknowledged its important contribution to seeing the patient as a whole and in integrating the various other parts of the curriculum, with significant opportunity for role modelling and informing career choice. A hidden curriculum emerged of attitudes which provided a conflict for some students. Improvements should include clearer dovetailing of primary medical care with other curricular components, limitation of aims with more specific and rigorous assessment and a wide strategy of staff development not confined to those directly involved in general practice attachments.     

Breastfeeding Care in Ohio Hospitals: A Gap Between Research and Practice

Objective: To assess current breastfeeding care in Ohio hospitals and compare that care to research-based principles.
Design: Survey.
Setting: Ohio hospitals that provide maternity care.
Participants: All 141 Ohio hospitals that provide maternity care were invited to participate. One-hundred sixteen (83%) hospitals returned usable surveys completed by obstetric nurse managers.
Main Outcome Measure: A 38-item questionnaire provided data on hospital demographics and information regarding the care of breastfeeding mother-infant dyads.
Results: Research-based practices common in Ohio's hospitals include demand feeding, breastfeeding education, and breastfeeding as the initial neonatal feeding. Common non-research-based practices include supplemental fluid administration, postpartum nipple treatments, mandatory initial nursery stays, limited sucking time, restricted maternal-infant contact, distribution of formula packs, minimal follow-up care, and the suspension of breastfeeding for hyperbilirubinemia.
Conclusions: Despite positive changes in perinatal care, a number of non-research-based practices persist in Ohio hospitals for the care of the breastfeeding mother-infant dyad.