Eight years'' experience with a structured clinical examination

A structured clinical examination has been an integral component of the final-year examinations conducted by the Departments of Medicine and Surgery at the University of Adelaide for the last 8 years. It has been used as an alternative to the traditional clinical examination. This paper describes the results of ongoing student and examiner surveys carried out to determine their views and satisfaction with this new approach. It also briefly discusses the feasibility of introducing such an examination into a conventional medical school environment. The surveys showed a remarkable level of acceptance and support by both students and examiners. This positive reaction has been maintained over the 8-year period. The main reasons seem to be its perceived relevance and fairness. Students also appear to be directing their learning in a direction thought desirable by teachers. No significant problems have been encountered with the practical implementation of the method.     

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.     

奥明格健脑口服液改善小鼠记忆的作用

目的观察奥明格健脑口服液对改善小鼠记忆作用的影响。方法断乳小鼠，体重１２～１４ｇ，每组１４～１６只。把实验动物随机分为正常对照组、高剂量组、中剂量组和低剂量组，连续给样３０ｄ，进行跳台和水迷宫试验，以上试验按同样方法重复一次。结果两次小鼠实验表明，灌胃奥明格健脑口服液１ｍｏ后，跳台试验中受电击动物数和错误总数，各试验组均低于对照组，其中高剂量试验组显著低于对照组，而且潜伏期显著延长。水迷宫试验中，动物到达终点所需时间和错误总数，高中剂量组试验组均显著低于对照组。结论奥明格健脑口服液具有改善动物记忆的作用。     

Attitudes and Approaches of Influential Role Models in Clinical Education

The influence of a role model is a frequently cited factor in choosing a specialty choice among medical students, particularly primary care oriented students. While many studies have looked at role modeling from students' perspectives, very few have considered role modeling characteristics from the perspective of the role models. This study, using the principles of Bandura's social learning theory, determined and illuminated the characteristics and teaching methods associated with positive role modeling in clinical education from the perspective of the role model. A qualitative approach employing interviews and observations was used. Five themes emerged: the role models' approaches to teaching, their attitudes towards teaching and learning, their emphasis on clinical competence in their teaching, their roles external to their specific responsibilities, and their general affect. We found that role models were similar in their views of teaching and working with students. Also, their teaching characteristics were similar to the recommended approaches found in the literature and adhered to the principles of social learning theory. Role models were attentive to the needs of the students and tailored their teaching appropriately. They provided students with ample patient interaction so that students could apply their classroom knowledge. They also demonstrated how rewarding being an effective physician can be. This revised version was published online in June 2006 with corrections to the Cover Date.     

An obstetric and gynecologic clerkship''s influence on a medical community: The Washington, Alaska, Montana, and Idaho Anchorage obstetric and gynecologic clerkship

OBJECTIVES: Our purpose was to explore the influences of an obstetric and gynecologic medical student clerkship on a remote medical community. Return of physicians to Alaska and faculty perceptions of their experience were central foci.STUDY DESIGN: Data were obtained on former clerks to determine choice of speciality and location of practice. Data regarding all physicians new to Alaska was correlated with the University of Washington Medical School graduate data. Additionally, a questionnaire with a Likert-type scale evaluated the 10 clinical faculty members participating in the clerkship.RESULTS: Between 1978 and 1991 we trained 266 clerks. A total of 77 of 374 (21%) new physicians in Alaska (1978 to 1991) were graduates of the University of Washington; 26 of those 77 (34%) were our former Anchorage obstetrics and gynecology clerks. The clinical faculty reported both positive and negative effects of their participation in the clerkship.CONCLUSION: The desired benefit, the return of new physicians to Alaska, seemed supported. Questionnaire results hinted at additional benefits for the supervising faculty physicians in this isolated community. The formal affiliation effected by the clerkship seemed to have a positive impact on patient care, communication, consultation, and shared action among the participating physicians. (Am J Obstet Gynecol 1997;176:1363-7.)     

A model for faculty mentoring in academic radiology

RATIONALE AND OBJECTIVES: The purpose of this report is to describe the development and implementation of a faculty mentoring program in radiology designed to promote the career development of junior faculty and enhance communication in the department. MATERIALS AND METHODS: The mentoring program was implemented in five stages: organizational readiness, participant recruitment, mentor matching and orientation, implementation, and evaluation. Evaluations were based on Likert scale ratings and qualitative feedback. A retrospective analysis was also conducted of the annual performance reviews of junior faculty in the areas of research, teaching, patient care, and overall performance. RESULTS: An average of 83% (19 of 23) of the junior faculty participated in the pilot phase of the mentoring program. During five rounds of testing, the median rating (1 indicates not important; 10, extremely important) from responding junior faculty was 10 for overall value of individual mentoring meetings; the median rating for the mentors responding was 8.75. Research and academic development were identified as the areas of greatest importance to the faculty. Research and patient care were most improved as assessed by faculty peers during performance reviews. The schedule of semiannual formal mentoring meetings was reported to be optimal. CONCLUSION: The program was implemented to the satisfaction of junior faculty and mentors, and longitudinal performance suggests positive effects. Issues to be contended with include confidentiality and the time needed for mentoring beyond already saturated schedules. Overall, the authors propose that mentoring programs can be an asset to academic radiology departments and a key factor in maintaining their vitality.     

创建中医基础理论精品课程的思路与举措

通过加强师资培养,建设合理梯队;加强教材建设,选用精品教材;深化教学改革,重在方法创新;加强效果评价,注重总结分析;加强网络建设,开创自学平台5个方面,阐述了创建中医基础理论精品课程建设的思路,并强调了精品课程建设的重要性和长期性.     

Interprofessional Education and Practice Guide No. 2: Developing and implementing a center for interprofessional education

Abstract

The complexity of implementing interprofessional education and practice (IPEP) strategies that extend across the learning continuum requires that institutions create a structure to support effective and organized coordination among interested administrators, faculty and staff. The University of Virginia Center for Academic Strategic Partnerships for Interprofessional Research and Education (UVA Center for ASPIRE) was formally established in 2013 following five years of dramatic growth in interprofessional education at the School of Nursing, School of Medicine and the UVA Health System. This guide briefly describes the steps that led to the creation of the Center and the key lessons learned that can guide other institutions toward establishing their own IPE centers.     

For Everything There Is a Season

Describes the “seasons” of professional life and conscious decision-making regarding role changes.     

Positive Outcomes of Optimizing Student–Preceptor Continuity in a Traditional Block Clerkship

Problem: Student–preceptor discontinuity during 3rd-year clerkships limits the quality and quantity of supervision, teaching, and feedback. Although longitudinal integrative clerkships increase continuity and are associated with improved student and preceptor experience, they require schoolwide curricular reform. Alternative innovations enhancing student–preceptor relationships within the constraints of a traditional block clerkship may demonstrate similar benefits. Intervention: We piloted a continuity-enhanced general pediatric ambulatory schedule during 2 consecutive clerkship blocks in 2013. Students in the continuity-enhanced model (n = 29) were assigned 1–3 primary clinic preceptors, whereas those in the traditional model (n = 30) worked with 5–8. Data were gathered from student assessments and anonymous student and preceptor surveys. We used t and Fisher's exact tests to compare the two groups and performed thematic analysis of free-text survey comments. Context: Our school utilizes a block clerkship model with approximately 30 students rotating through the pediatric clerkship every 8 weeks. During the 3-week ambulatory portion, students spend 8 half days in the general pediatric ambulatory clinic. At the conclusion of each clinic, attendings completed brief student evaluation cards. Traditionally, student and attending schedules were created independently, resulting in transient supervisory relationships and dissatisfaction with clinical engagement, feedback, and evaluation. Outcome: Seventy-three percent (43/59) of the students completed the survey. Ten general ambulatory attendings collectively completed 87.5% (35/40) of the monthly surveys. Continuity students received significantly more narrative evaluation comments (10.6 vs. 5.8, p <. 001) from general ambulatory clinic attendings and were more likely to have at least one general ambulatory clinic attending endorse being able to provide meaningful feedback and evaluation (n = 29, 100% vs. n = 20, 66.7%, p <. 001). Continuity students were also more likely to endorse being able to ask at least one of these attendings for a letter of recommendation (71.4% vs. 9.1%, p <. 001) and to have at least one general ambulatory clinic attending endorse being able to provide a meaningful letter of recommendation if asked (62.1% vs. 3.3%, p <. 001). Students (88.4%) and attendings (85.7%) preferred the continuity-enhanced schedule. The most frequent theme of both student and attending free-text survey remarks were relationships and assessment. Lessons Learned: Intentional scheduling of clerkship students to enhance preceptor continuity resulted in significant positive outcomes echoing the relationship-based educational benefits of longitudinal clerkships, particularly in regards to student assessment and feedback. Clerkship directors and other medical educators should consider implementing small changes within block clerkships to maximize student–preceptor continuity.