^60Co消毒与高温高压消毒胚胎骨的实验研究

在12只健康家兔下颌骨体部的两侧各造成0.7cm×0.5cm×0.3cm的骨缺损区，分别置入^60Co消毒的胚胎骨和高温高压消毒的胚胎骨，发现高温高压消毒可以替代^60Co消毒胚胎骨进行移植，为临床提供了一种新的用作同种异体移植胚胎骨的消毒方法。     

Teachers'' perceptions concerning the relative values of personal and clinical characteristics and their influence on the assignment of students'' clinical grades

Twenty senior teachers were asked to rank, in order of influence, the seven clinical and five personal characteristics used to grade third-year medicine clerks. Seventeen perceived themselves to be more influenced by clinical characteristics when assigning grades. Independently, the actual ratings completed over a 3-year period by these same teachers were analysed to measure the congruency between their perceived and actual grading behaviour. When actually rating students only nine raters were more influenced by clinical characteristics and just one half of the teachers displayed a congruency between their perceived and actual rating behaviour. The implications of these findings are discussed.     

Medical education for minorities at a US medical school

The University of Washington School of Medicine (UWSM) has initiated new efforts to build a regional minority applicant pool and to expand its educational programmes to accommodate students from disadvantaged backgrounds. Specific interventions include: establishment of medical career planner position to coordinate region-wide outreach; pre-entry education; and support activities once enrolled. This study describes specific services and presents sociodemographic and performance data on 56 minority and 280 majority students entering the UWSM between 1981 and 1985. Economic status and educational background of minority students were significantly below that of majority students, several flexible academic policies enabled most students to achieve mastery in courses and to progress through the curriculum. The educational data base utilized in this study, and those at other institutions, can assume important roles in the identification of problem areas in the education of disadvantaged students and in evaluation of the interventions attempted.     

Choosing a career in general practice: the influence of medical schools

Summary. This paper reviews the literature on career choice to investigate the undergraduate influences on the preference of Australian graduates for a career in general practice. Although isolation of influencing factors is difficult, admission criteria and undergraduate curricula may influence career preference. As the institutional environment of medical schools is weighted towards scientific research and specialized medicine, medical students may be socialized into choosing non-generalist careers. Medical schools should consider broadening selection criteria and curriculum exposure to produce graduates with a broad range of career interests.     

Detection of HLA-A*24 null alleles by DNA typing methods

Abstract: A number of cases have been identified (seven unrelated individuals from the Northern Ireland bone marrow donor registry and two family groups) where an HLA-A*24 allele fails to express the normal HLA-A24 antigen. Family information has revealed common haplotypes with respect to each non-expressed allele indicating that the occurrence of these mutations has been a recent event. Two methods for the clinical typing of these alleles have been evaluated - PCR-SSOP and PCR-SSCP analysis.     

House officers in general medicine: their perception of educational value of rotation components

Summary: As curriculum planners in general medicine residency training programmes we were concerned about house officers' anecdotal reports that hospital work requirements often overshadow individual learning goals. After each of five rotations, we asked residents to identify the educational 'usefulness' of certain rotation components which can be included in three categories; team members, work-related activities and educational events. Of 165 surveys distributed, 127 (77%) were returned. Data were analysed by residency year and by all years combined. The mean overall perception of learning was 3.9 out of a possible 5 points suggesting that residents do find some learning value. Results suggest that different residency years vary as to the significance of specific educational components. The importance of faculty/resident relationships to residents' perceptions of learning value was highlighted in particular.     

Students'' assessment of a course in obstetrics and gynaecology

A complete annual entry of 181 students were administered a questionnaire in which they were invited to make value judgements about all aspects of their 3-month course in obstetrics and gynaecology. The resulting performance indicators were used to compare individual staff and clinical firms.     

Communication skills training for medical students: an integrated approach

Skills of communication are not easily taught to medical students. Three main clinical departments (general practice, medicine and mental health) of the Medical Faculty of the Queen's University, Belfast, introduced an integrated course in January 1988 to teach the basic principles. The course is held at the beginning of clinical training and is an integral part of the introductory clinical course. It was introduced in response to the Report of a Working Party of the Education Committee of the General Medical Council (1987) which advocated the need for improved training in history-taking and communication. It is a 12-week course and every Monday and Friday afternoon from 1400 to 1700 hours 12 students are seconded from ward work, four to the Department of Medicine, four to the Department of General Practice and four to the Department of Mental Health. Hand-outs about information to be obtained and interview style are standardized and the principles to be followed are clearly defined in an aide-mémoire. Staff from the Departments of General Practice and Mental Health experienced in teaching communication by videotape feedback and analysis of consultations prepared 12 tutors for their role and responsibilities. Procedures to be followed were carefully explained to all students beforehand. General practice and psychiatry traditionally have established teaching programmes in communication but the inclusion of the Department of Medicine has made a significant impact. Students have come to realize that the taking of a good history demands as much skill as the physical examination of the patient and is an important aspect of any clinical assessment.     

Can communication skills be assessed independently of their context?

In many examinations, communication skills tend to be treated as if they are a single attribute independent of the context of the communication. However, it is clear that such assessments are confounded by candidates' knowledge or lack of knowledge of the medical issues about which they are communicating. In the 1990 Part One examination for Membership of the Royal New Zealand College of General Practitioners candidates were provided with all the essential knowledge relevant to the problem they were to communicate about. Despite this, performance was still seen to be context specific, demonstrating that such specificity is not purely knowledge related. Candidates completing the examination were observed to share information about the cases with candidates about to commerce. There was no evidence that performance was enhanced by such breaches in examination security.     

How do clinicians learn to request permission for autopsies?

A postal survey of 434 clinicians at four local hospitals was undertaken in order to identify the methods by which clinicians learn how to request permission for hospital autopsies and to assess the preferred techniques and timing of relevant communication skills training. The majority of 128 responding clinicians had learnt through personal experience with some assistance from senior colleagues and peers. Few clinicians appeared to have learnt through formal training. The preferred methods for the provision of communication skills training were training in small groups (such as seminars or tutorials) and observation of clinicians at work. The most desirable time for the provision of this training was considered to be between the beginning of the final undergraduate year and the end of the pre-registration house officer year. The communication skills training provided within medical education is in need of improvement. More emphasis should be given to clinical-task- or situation-specific applications such as requesting permission for autopsies.