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.     

2002～2006年广西大专新生乙肝病毒携带率观察

[目的]观察2002～2006年广西大专新生乙肝病毒携带率分布,为进一步防治乙型肝炎提供理论依据。[方法]收集2002～2006年大专新生入学体检资料,采用SPSS13.0软件进行整理、统计分析。[结果]2002～2006年5年中广西大专新生HBV携带率呈明显下降的趋势,平均每年以10%的速度下降,2006年乙肝病毒携带率比2002年下降了44%,尤其以2005年桂东南汉、壮民族下降最为显著。[结论]80年代中期广西普遍接种乙肝疫苗以后,乙肝疫苗阻断乙型病毒性肝炎在广西青少年母婴传播及水平传播效果已经显现。建议在广西各地区,尤其是在桂西北少数民族地区进一步加强乙型肝炎基因工程疫苗的接种工作力度,使乙型病毒性肝炎感染率控制到更低的水平。     

The structure of memorized knowledge in students and clinicians: an explanation for diagnostic expertise

This paper provides for the first time evidence of a consistent difference in the memory structures of novice and expert clinicians. The diagnostic performance of first- and third-year clinical medical students, senior house officers, registrars and consultants on four clinical problems in general medicine was studied. Comparisons were made of all diagnostic interpretations offered and the forceful features (personally important pieces of information which act as a key to particular memory structures which in turn give rise to the clinical interpretation) from which these were derived. Results demonstrate that the numbers of interpretations made and the numbers of forceful features identified did not differ significantly between groups (P greater than 0.05). However, the actual interpretations made in three out of four cases, and the actual forceful features identified in all cases, did differ significantly between groups (P less than 0.05). The numbers of interpretations made by all groups were large and demonstrated enormous variability. Highly individualized multiple responses to clinical information are associated with easy diagnoses. We conclude that there is no difference between groups of differing clinical experience in the breadth of thought but that there are marked differences in the precise content and structure of thought. This allows coherent explanation of variation in diagnostic expertise with clinical experience. The significance of the findings is discussed.     

医学生素质教育中几对关系的处理

当医学素质教育中广博、个性、创新等观念日益被教育者和教育对象接受的同时，常常又容易陷入另一个误区，即盲目接纳、肯定这些观念，高没有对其进行审慎、辩证的思考，文章通过素质教育中几对观念的辨析，以期对此形成客观、全面的认识。     

Teaching medical students about the appropriateness of social and sexual contact between doctors and their patients: evaluation of a programme

The purpose of this study was to assess the impact of an educational intervention on medical students' attitudes toward social and sexual contact with patients by doctors from three medical specialties (general practice, obstetrics/gynaecology and psychiatry). Medical students from two consecutive fifth year classes at one medical school participated in one 3 hour session that included instruction on the standards of the profession that prohibit doctor–patient sexual contact. Students were assigned to either intervention groups or control groups and responded to an anonymous questionnaire (overall response rate 66·8% ; n=141). As many as 14·5% of control group students thought it was (sometimes or usually) appropriate for general practitioners to date their own patients and at least 3% thought it appropriate for members of any of these three medical specialties to engage in sexual contact with their own patients. However, there were no significant differences in attitudes toward hugging, dating or sexual contact with current patients between those who had attended the seminar and the control groups. The session significantly influenced attitudes regarding obstetrician/gynaecologists and psychiatrists hugging and having sexual contact with former patients. These findings are discussed in relation to a need for expansion of such instruction.     

师范大学学生艾滋病知识现况调查及健康教育近期效果评价

目的 了解师范大学学生艾滋病相关知识及行为现状，为高校制定艾滋病健康教育规划提供参考。方法 抽取天津师范大学2000年入学新生，通过集体讲座，使用统一的调查问卷在教育前后分别调查学生艾滋病相关知识及态度，并利用EPIinf0软件进行分析。结果 天津师范大学一年级学生健康教育后对艾滋病性质、主要传播途径等的正确回答率都有所提高，能够正确对待艾滋病病毒感染者，教育前后学生对性行为的态度无明显改变。学生希望获得艾滋病知识的前4位方式均为电视、报刊书籍、卫生课和医生。结论 从国情和现实需要出发，在大学生中开展适时、适度、适量的性健康教育和健康行为教育，对预防性病艾滋病有着积极的意义。     

关于加强医学生实践能力培养的研究

文章比较科学系统地提出了三种有效培养医学院校大学生实践能力的途径与方法,即以课堂教学活动为基点、以实践教学环节为中心和以课外实践活动为辅助。以期为各医学高等院校就如何加强医学生实践能力培养的问题提供有益的借鉴。     

北京市宣武区中学生生殖健康知识调查分析

【目的】掌握青少年性发育特点,以便开展有针对性的青春期生殖健康教育,提高自我保护能力,使其健康的成长。【方法】重点高中2所、普通高中4所、职业高中3所,分别选择同年级、同号班级22个班的1 800名高中生,由专门调查员进班发问卷,要求学生在15 min内完成。学生填写问卷时,采用校方人员回避,问卷不记名方式,填写后当场封存,确保学生的隐私权。【结果】调查学生中生理知识知晓率达到70.74%,性病、艾滋病方面知识知晓率达53.9%,相关避孕知识知晓率15%,学生中的性活动发生率17.9%,缺乏保护意识的学生占25.4%,接触过淫秽品的学生43.5%,对婚前性行为的看法持开放态度的学生占38%。【结论】学生的性观念开放,综合自我保护能力较低,易受疾病和社会危险因素伤害,对其成长过程造成障碍。