Students teaching students: a medical school peer tutorial programme

A peer tutorial programme which is available to all first- and second-year medical students has been in operation at Case Western Reserve University School of Medicine since 1972. A retrospective study of the classes of 1982, 1983 and 1984 was undertaken to assess the participation levels in the tutorial programme and to compare the participation level to available performance parameters. The analysis revealed that 54% of the first-year classes and 22% of the second-year classes participated in the peer tutorial programme. X2 analysis of the data demonstrated that the relationship between participation in the tutorial programme and performance on examinations reached statistical significance. The results suggested that an open peer tutorial programme responded to the needs, both cognitive and affective, of medical students.     

Changing the College AOD Environment for Primary Prevention

Identifying environmental factors reflected to alcohol use is important for program planning and evaluation in college alcohol and drug prevention programs. Little has been written concerning uses of data in environmental prevention efforts. This paper presents four brief interrelated case studies of how environmental modifications were used by a college alcohol prevention project to 1) change the marketing practices and service policies of a student-oriented bar, 2) alter the sales practices of a campus bookstore concerning alcohol paraphernalia, 3) to develop a campaign with the goal of reducing risk factors related to heavy drinking at private student parties, and 4) stop an unsafe bus from transporting students to bars in Mexico. Creative use of such environmental prevention approaches has potential benefit to colleges and universities concerned with the primary prevention of alcohol-related problems experienced by students.     

Effects of cadaver dissection on the attitudes of medical students

Summary: Summary. A study was conducted to determine whether the attitudes of medical students to death and caring changed during the 3 months following exposure to cadaver dissection. All first-year students were invited to complete a questionnaire immediately before their initial cadaver dissection experience, after 6 weeks, and after a further 3 months. The questionnaire reflected attitudes to death, violent death, death of someone known to the respondent and caring when someone known to the respondent is seriously injured. Ethnicity and previous exposure to dying has no effect on responses, but overall men students' reactions were significantly less than for women ( P < 0.001). The responses given on the final part of the questionnaire after 3 months were significantly lower than those to most questions in the first part of the questionnaire. The exceptions were those questions where the subject in the given scenario was known to the respondent, where reactions were rated significantly greater ( P < 0.001) in the follow-up questionnaire and can be explained on the basis that they were a personal referent.
Students rapidly develop a coping mechanism which enables them to view cadaver dissection as an occupation quite divorced from living human beings. During these early months of training solicitude decreases for those who die who are unknown to them, but concern for personal referents increases. Educators should be aware of the dramatic change of attitudes among students and the process of professionalization which might influence their caring of future patients.     

Independent learning among general practice trainees: an initial survey

Self-directed learning is a natural way for adults to learn. Vocational training for general practice is a preparation for unsupervised clinical work that will be supported, in the main, by continuing medical education. This study uses the Self-Directed Learning Readiness Scale to investigate factors influencing readiness for such learning among a sample of general practice trainees. Three principal factors emerged from analysis: enjoyment and enthusiasm for learning; a positive self-concept as a learner and a factor suggesting the possibility of a 'reproducing' orientation to learning. These factors may reflect approaches to learning in general rather than these adopted for professional learning, but offer helpful pointers for the development of both vocational training and of continuing medical education.     

无机汞对男工内分泌和大鼠睾丸微量元素的影响

应用放射免疫分析法（ＲＩＡ）和流行病学调查，对４０名接触汞和４０名非接触汞男工进行了血清甲状腺激素、性激素水平和生殖功能的测定。结果表明，接触组男工的阳萎、早泄、性欲减退发生率和男工妻子的早产、自然流产发生率以及血清甲状腺激素（ＦＴ３和ＦＴ４）含量明显增多，每周性交次数和血清睾酮含量显著减少。上述各项与对照组比较差异非常显著。应用火焰光度法，对氯化汞染毒后大鼠睾丸组织的微量元素进行测定，实验组的锌值明显降低。结果提示氯化汞能够影响甲状腺激素、睾酮和锌元素水平。     

糖尿病雄性大鼠性腺5α-还原酶Ⅱ型活性变化

目的 :探讨大鼠青春期和成年期糖尿病时性腺 5α 还原酶Ⅱ型的活性变化。　方法 :取 4 0d和 90d龄雄性Wistar大鼠各 30只 ,分别分为对照组 (C)、糖尿病组 (D)和胰岛素治疗糖尿病组 (ID)。采用薄层层析法测定各组附睾头、附睾尾、前列腺和睾丸组织内 5α 还原酶 Ⅱ型的活性。　结果 :①青春期大鼠性腺的各部位内 ,5α 还原酶 Ⅱ 型的活性D组均明显低于C组 (P <0 .0 1) ,而ID组明显高于D组 (P <0 .0 1) ;②成年期大鼠性腺的各部位内 ,5α 还原酶 Ⅱ型的活性在C、D和ID组各组间差异无显著性 (P均 >0 .0 5 )。　结论 :青春期大鼠性腺内 5α 还原酶 Ⅱ型的活性更易受代谢环境、激素水平及局部特异性因素的影响 ,而成年期大鼠性腺内 5α 还原酶Ⅱ 型的活性相对稳定     

超声检查在男性创伤性尿道狭窄诊断中的价值

目的探讨超声检查对男性创伤性尿道狭窄的诊断价值。方法对21例男性创伤性尿道狭窄患者进行超声检查,14例同时联合尿道造影检查,结果与术中所见进行对比分析。结果21例超声结果与术中所见一致。14例联合检查中,造影检查有2例前尿道狭窄漏诊,2例狭窄近侧结石未发现,2例正常后尿道误诊为狭窄,2例后尿道狭窄长度不能估计;2例会阴部瘘管造影清晰显示而超声显示不佳。结论超声在狭窄定位、长度测量、瘢痕范围估测及显示继发结石等方面优于造影,造影显示瘘管清晰,必要时两者应联合应用。     

涉外护理专业学生社区毕业实习效果评价

目的 探讨涉外护理专业学生社区毕业实习模式。方法 随机设定实验组(36人),参加慢性疾病调查、建立健康档案和进行相应的健康教育,结束时与不参加社区毕业实习的对照Ⅰ组(31人)、对照Ⅱ组(38人)的实习生同时接受基础知识和能力闭卷测试。然后统计调查问卷和健康档案的正确率,并将三组测试成绩进行比较。结果 实验组调查问卷和健康档案的正确率≥95％。实习生基础知识得分实验组(43.14±2.78)、对照Ⅱ组(42.53±1.96)与对照Ⅰ组(40.65±2.47)比较;能力得分实验组(47.00±2.34)与对照Ⅰ组(41.61±3.41)、对照Ⅱ组(41.42±3.52)比较;总分实验组(90.14±4.30)与对照Ⅰ组(82.26±5.33)、对照Ⅱ组(83.95±4.13)比较,均P<0.01,差异有极显著性意义。结论 社区毕业实习强化了实习生社区护理的基本知识,培养了实习生社区护理的相关能力。但有待于规范化。     

临床医学院教学管理工作的思考

临床医学院教学管理工作直接影响到临床教学质量。非直属临床医学院没有专职教师,教研室管理比较松散。做好非直属临床医学院的教学管理工作,进一步增强教学意识,改进教学方法,规范教学要求,对于保证临床教学任务的落实、确保教学质量显得十分重要。