Myocardial degeneration and cardiac arrest in squirrel monkey: physiological and psychological correlates.
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Biomedical subjects
Publications and source records attributed to J H Barber.
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The analysis of 1,098 calls to a commercial deputizing service during a period of four weeks is described. Approximately 20 per cent of the calls were for illnesses considered potentially life-threatening while in 22 per cent telephone advice was given and the patient was not visited by the deputy on call.
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The value of the signs and symptoms of pregnancy and of the pregnancy diagnostic test as predictors of pregnancy was estimated for 1,592 women seen in general practice. The presence of a sign or symptom alone is a poor pointer to a diagnosis of pregnancy. The combination of pairs of features improves the value, the best being breast signs combined with either the presence of signs of pregnancy on vaginal examination or a palpable fundus, both giving predictive values of 0.89. The pregnancy diagnostic test alone, however, had a predictive value of 0.91, a value of 1.00 indicating 100 per cent reliability.
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A programme of computer-assisted learning has been introduced for fifth-year medical students at Glasgow University during the teaching course in general practice. The programme allows students to make decisions on all aspects of patient care, and has the potential for combining a learning situation with an objective evaluation of skills and attitudes. The programme is popular with students and could have considerable potential in medical education.
In a study of attitudes towards the content of general practice teaching, it was found that there was good agreement between fifth year medical students and their general practitioner tutors. The social aspects of illness were considered the most important by students and both groups emphasized the value of seeing patients in their homes with time for discussion of cases. These findings are discussed in the context of the development of teaching in general practice at Glasgow University.
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We have introduced clinical teaching in general practice for students in their first clinical year. The students are present at the patient's initial consultation for an acute illness and thus see a wide range of morbidity which is seldom found in hospital. Log books are used to record such factors as the patient's presenting complaint, the diagnosis that is made and the presence of significant social and psychological aspects of the physical condition. Although there were only four two-hour teaching sessions, the frequency and the range of presenting complaints seen by students approximates to that in general practice. The opinions of both the tutors and the students to this form of teaching have been favourable.
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The attitudes of students, resident house physicians, and medical social workers towards 10 medical conditions were assessed in relation to both personal attitudes and the opinions expressed of the attitudes of the medical profession. Final-year students and house physicians showed unfavourable attitudes towards self-poisoning in contrast to fourth-year students and medical social workers. The fourth-year students were given the opportunity to admit patients referred to hospital with self-poisoning and visited the family doctor and the patient after discharge. After this exposure there was a subjective impression that the students became more interested in the problems of use self-poisoned patients, and this was supported by a review of their attitudes at the end of the teaching project.
The further development of a teaching course in general practice medicine for fifth year students at Glasgow University is described. Lessons learnt from a previous experimental course have been applied: eight afternoon sessions of a structured nature and related to prescribed objectives and a syllabus were given to small groups of students. Questionnaires showed that the in-depth study of selected patients in their own homes, with student involvement in the preparation of problem lists for group discussion were thought by the students to be valuable. An objective assessment of the course using the modified essay question technique showed an improvement in factual clinical knowledge (P less than 0.05) and more importantly in areas relating to the general practice content of the teaching (P less than 0.001).
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