Effective use of a computer-managed instruction program.
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Biomedical subjects
Publications and source records attributed to D O Anderson.
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Selected summary findings from the World Health Organization/International Collaborative Study of Medical Care Utilization are presented, based on data collected during a twelve-month period in 1968-1969 in twelve study areas in seven countries in the Americas and Europe. A household interview survey of almost 48,000 persons, representing a total population of about 15 million, elicited information on demographic characteristics, on perceptions of illness, its severity and character, and on attitudes toward and use of major components of health services. Information was also collected on the prevailing health care systems and resources available to the study population, as well as on socioeconomic characteristics of the study areas. Standardized rates for those defined as "healthy" and "functionally healthy" are quite similar across the twelve study areas, as are the rates for persons who reported being sick within two weeks. Rates for the volume of sick days within two weeks vary widely, and levels of chronicity with disability are much higher in the four continental European study areas. Rates for volume of physician contacts within two weeks vary considerably across study areas, but rates for persons with contacts are more stable, although for persons with perceived morbidity of high severity, the corresponding rates are lower in the four continental European study areas. By contrast, the rates for persons with an administrative reason for their most recent physical examination within twelve months are substantially higher in the latter. Where unmet need for a physician contact is greatest, the volume of hospital nights used is also greatest; a direct relationship between these two measures is evident without regard to the ratio of hospital beds available to the population. Wide differences are observed between the extremes of the measures of need, resources, and use employed in the study, raising questions about the ways in which resources are organized to provide services and about the effectiveness and efficiency of these services.
In this investigation an attempt has been made to determine the relationship between the staining of permanent teeth by tetracycline administered during the period of tooth formation with the dosage of the drug and the duration of therapy. Of 238 subjects whose hospital records indicated ingestion of stated doses of tetracycline, some 49 were seen to have staining which was confirmed by fluorescence, and a further six had staining which did not fluoresce and hence could not be confirmed. A definite relationship between total dosage and staining and duration of administration and staining was established; the condition occurred with greater frequency (in more than one-third of the children) when the total dosage exceeded 3 g. or the duration of treatment was longer than 10 days. However, as staining was seen at all dosage levels, whatever the duration, physicians should continue to follow previous advice and prescribe other antibiotics where possible for children under 8 years of age or for women in the last trimester of pregnancy.
This study was planned to determine the extent to which the emergency service of a large general hospital in Vancouver was providing a primary medical care function for children and adolescents. The data were collected during 14-day study periods in each season of the year. Medical data and physician urgency rating were obtained on all patients. Demographic and socioeconomic data and data pertaining to patterns of medical care were obtained by interview of a one-third sample.The study identified a group of patients receiving primary medical care for non-urgent and non-traumatic conditions. This group resided close to the hospital and had lower socioeconomic indices than the remainder of the patients.The trend to utilize the emergency department for reasons other than the accident and emergency function was confirmed. These findings will be incorporated in the planning of the New Children's Hospital in Vancouver with the provision of separate facilities for the care of non-urgent attenders.
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A study of the career decisions of all students in a single matriculation cohort was undertaken in 1965 at the University of British Columbia. Studied were 64 premedical students, 112 ex-premedical students and 87 science students who had completed at least their second year. It was found by means of a questionnaire that medicine remained the career of high prestige for the three groups of students. In general the values and needs of the ex-premedical student were more similar to those of the science student than the premedical student. The loyalists to medicine were found to be more committed, self-assured, and orientated towards people and service. In addition, the premedical student was more concerned about his academic achievement but was also more confident of his progress. He emerged at the end of his training as the committed student who had chosen medicine at an early age and had remained loyal to his chosen career goal.
Students who entered their freshman year for the first time in 1958 and in 1959, from all medical schools in Canada, and those entering the four Western schools in 1960 were studied from the time they matriculated until they either graduated or withdrew from medical school. The rate of attrition is about 15% of matriculants each year, with the lowest rate at the University of Western Ontario (1.7%) and the highest at the University of Ottawa (33.6%) over the time period studied. Attrition was classified as academic and non-academic. Significantly higher rates were found in the case of non-academic attrition for women and in the case of academic attrition for Commonwealth students. Significantly higher rates for both types of attrition were found for older students and students who had attended undergraduate colleges different from their medical school colleges. It would appear from available statistics that the factors which combine to produce attrition are the intellectual and personality characteristics of the student, school promotional policies and evaluation methods.
The methods employed in the selection of medical students for the 1964-65 class of freshmen at the four Western medical schools are described and recommendations are made for improving the procedure. The structure and functions of the various selection committees varied from school to school but their prime purpose was the same-the selection of "good students" who would later become "good physicians". Not surprisingly, academic achievement and confidence in estimating this ranked highest in importance, and while non-intellectual characteristics ranked almost as high, committee members had no confidence that they could evaluate these qualities.It is suggested that the ideal selection committee would be a "high-priority" committee consisting of six to eight members who would meet at least twice a year, have tenure of at least four years, be trained in interviewing applicants, consider Medical College Admission Test scores, review applications before each meeting, and establish research committees to investigate the students they choose.
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