Evaluating healthcare education: Issues and methods

This paper analyses the methodological issues inherent in evaluating healthcare education and considers approaches for addressing these.Recent policies have exhorted practitioners to base their practice on evidence; however in healthcare education the evidence base is not extensive. Whilst educational evaluation has advanced in the last decades, standardised designs and toolkits are not available. Each evaluation has different aims and occurs in specific contexts, thus the design has to fit the circumstances, yet meet the challenge of scientific credibility. Indicators of educational processes and outcomes are not scientifically verified; no toolkit of standardised ‘off-the-shelf’ valid, reliable and sensitive measures exists. The evidence base of educational practice is largely derived from small-scale, single case studies; the majority of measures are self-devised, unvalidated tools of unproven reliability, thus meta-synthesis is not appropriate and results are not generalisable. Healthcare educational evaluators need valid and reliable assessments of both knowledge acquisition and its application to practice. The need to establish and explain attribution, i.e. the relationship between educational inputs and outcomes is complex and requires experimental/quasi-experimental design. In addition, educational evaluators face the pragmatic challenge of practice in healthcare contexts, where confounding variables are hard to control and resources are scarce.     

Developing a model for clinical and basic science teaching skills

This report describes a model for identifying sets of teaching abilities considered to be effective for medical school teaching staff, based on roles teachers assume and functions they are expected to perform as instructors. The specification of these teaching abilities was the first step in the development of a comprehensive course on Medical Instruction at the Basic Institute of Medical and Agricultural Biology of the State University of Sao Paulo, Botucatu, Brazil, where the senior author is employed. The work was based on the assumption that medical school teachers are expected to assume a variety of teaching roles and that identification and specification of the abilities that define their roles can result in more effective and efficient teaching.     

EARLY EDUCATION AND CHILDREN WITH SPECIAL NEEDS

Changing issues in the field of preschool education will be discussed, set in the context of two of my studies which have been concerned with children with special needs in 'ordinary' preschool education, one 'pre-Warnock' in Scotland, and the other 'post-Warnock' in the West Midlands. The concept of special needs will then be widened to include children for whom English is a second language, and also gifted children. Finally, the discussion is extended to early education rather than preschool education with a discussion of the dangers of treating preschool education in isolation.     

高中一年级学生抑郁情绪及相关因素的研究

目的调查高中一年级学生的抑郁情绪及与其个性、心理健康水平、应对能力和家庭环境的关系。方法采用整群抽样方法和问卷式调查,共调查高一学生488名,资料填写完整者449人(92.01%)。结果449名高一学生SDS平均得分(标准分)为(47.27±10.86),抑郁情绪的发生率为37.86%,不同性别和文理科之间差异无统计学意义。抑郁情绪组性格内向、情绪稳定性差和精神质表现较为突出,其SCL-90的9个因子评分均高于对照组,个人积极应对能力和解决问题的能力差,消极应对和自责表现突出,家庭的亲密度、情感表达、娱乐性和组织性均较对照组差,矛盾性较对照组突出。结论抑郁情绪已是高一学生中较为常见而且需要关注的心理卫生问题,严重影响其心身健康发展,抑郁情绪与个性、心理健康评分、个人应对方式和家庭环境均具有显著关系。     

大学生心理素质与思想品德发展的关系

研究大学生心理素质与思想品德发展的关系，目的在于分析、发现个体在接受教育过程中的心理运动规律，从而提高思想教育的实效性。本文从马克思主义认识论和实践论的观点出发，依据教育心理学的原理，探讨了心理健康教育与思想品德教育的内在联系和相互作用，提出良好的心理素质是大学生思想品德发展的基础的观点。认为品德的形成与人的心理活动息息相关，个体如果没有良好的品德，将影响其心理素质的完善；同样，没有健全的心理素质，思想品德也不能得到很好的发展。只有思想品德教育与心理健康教育协调发展，共同作用，才能收到良好的教育效果。     

Influence of mattress characteristics on house dust mite allergen concentration

BACKGROUND: Exposure to a high level of house dust mite allergens (HDMAs) is considered as a risk factor for HDM sensitization and development of asthma in genetically disposed people. Mattresses are one of the most important sources of HDMA in people's living environment. OBJECTIVE: The aim of this study was to evaluate the association between mattress characteristics and HDMA concentrations on mattresses. METHODS: Dust samples of mattress surfaces were taken to evaluate the level of Der p 1 allergen. All participants filled in a questionnaire about the type of mattress, the type of covering (upper layer) of the mattress, dwelling characteristics and cleaning habits. Humidity and temperature of the bedroom were measured at the time of dust sampling. RESULTS: One hundred and sixty-eight questionnaires were filled in. Synthetic upper layer of the mattress was associated with a higher level of Der p 1 compared with cotton upper layer (2.6 vs. 0.8 microg/g Der p 1). Moreover, higher relative humidity (RH) was associated with significant higher concentrations and density of Der p 1. CONCLUSIONS: Two factors were associated with lower levels of Der p 1 found on mattresses, namely: a cotton upper layer of the mattress compared with a layer of synthetic material and lower RH at the time of sampling. As far as we know, the association between type of upper layer and concentration of Der p 1 has not been described before and could lead to the formulation of practical advices in order to reduce HDMA concentrations on mattresses.     

Choice of general practice for postgraduate training among medical graduates and undergraduates in Nigeria

A questionnaire survey of career choices was carried out among 112 medical graduates, after one year's internship (group I), during their National Youth Corps programme in Kaduna, Lagos, Cross River and Oyo states of Nigeria, and 365 final-year medical undergraduates (group 2) in the colleges of medicine in the corresponding states. A total of 13% in group I and 40% in group 2 were undecided as regards their first choice. Obstetrics and gynaecology was the most popular first choice in both groups. General practice ranked fifth among group I, but displaced surgery to rank second among group 2. The differences were statistically significant. A total of 41% of group I and 46% of group 2 preferred to work in a teaching hospital, reflecting the high preference for surgical specialties. Twenty-six per cent and 33.7% of respondents in groups 1 and 2 respectively wished to own their own practice or work in the private sector. General practice is a new specialty and its growth is supported by a national postgraduate training programme. A shift towards general practice is seen compared with previous studies of career preference among Nigerian medical graduates and students. This may be due to a changing balance of supply and demand in the medical work-force, or a better assessment of the nation's health problems and manpower needs.     

学习成绩、家庭环境对学龄儿童自我意识的影响

目的探讨学习成绩、家庭环境对儿童自我意识的影响。方法采用经验评估法、家庭环境量表和Piers Harris儿童自我意识量表对 9.5～ 12岁 2 87名儿童的学习成绩、家庭环境和自我意识进行评定。结果自我意识总分学习困难组 ( 5 8.76± 11.0 1) <学习中等组 ( 64 .5 9± 7.87) <学习优秀组 ( 69.80± 7.5 1) ,家庭环境量表中的亲密度、情感表达、矛盾性、知识性、娱乐性和控制性 6个因素与自我意识相关。结论学习成绩、家庭环境对学龄儿童自我意识的形成和发展起重要的作用 ,改善家庭环境、提高学习成绩 ,可有利于儿童自我意识的发展。     

Undergraduate psychiatry teaching in Ethiopia

Many epidemiological studies have shown the magnitude and seriousness of mental disorders in developing countries. However, mental health care remains unsatisfactory owing to lack of skilled manpower and many other social and medical priorities. General practitioners and other health personnel can significantly help in extending mental health care provided they receive adequate training during their medical curriculum. With this aim, the Department of Psychiatry at Addis Ababa University runs a 6-week full-time course for undergraduate medical students. Its chief objectives, teaching methods, achievements and shortcomings are discussed in the paper.