Training issues in behavior therapy.
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Biomedical subjects
Publications and source records attributed to J S Ruggill.
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Thirty US citizen foreign-trained medical students (USFMS) and eleven US-trained medical students (USMS) were accepted with advanced standing to the University of Arizona College of Medicine (UACM) in September 1978. Each student was required to meet predetermined mastery criteria in physical diagnosis skills during a six-week intensive training program before entering clinical clerkships. On entrance, USFMS showed severe deficiencies in physical examination and medical interviewing skills compared with both USMS and sophomore students at UACM. By the completion of the program, all differences between the USFMS and the USMS were nonsignificant, except for factual knowledge of pathophysiology. The transfer students received lower ratings than the UACM students on preceptorship evaluations and patient write-ups. Deficiencies in clinical skills of USFMS were reduced by a brief, intensive training program characterized by specific mastery criteria.
To provide objective and reliable evaluation of students' physical diagnosis skills, nonphysician patient instructors (PIs) with stable findings were trained by physicians to function in the multiple roles of patient, teacher, and evaluator. The PIs were taught physical examination techniques and the significance of each of their positive findings. Each second- and third-year medical student examined a cardiovascular and pulmonary PI. At the completion of each examination the PI evaluated the thoroughness and proficiency of the student's examination technique and ascertained whether the student correctly identified and described the abnormal findings. Objective and reliable evaluation instruments were developed. Data are presented to indicate that PIs can be used to evaluate objectively physical diagnosis skills of medical students.
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Live models were introduced into the first-year gross anatomy course to provide medical students with an opportunity to apply to the living person what they learned from cadaver dissection. After each major segment of the cadaver dissection, clinical correlation sessions were presented for the students by clinicians using live models for demonstration, examination and correlation. At the completion of the course, an evaluation questionnaire was given to students. Their response indicated that the new teaching technique made anatomy seem more relevant to clinical medicine than using cadavers alone. Live models were rated superior to using cadavers, especially in demonstrating superficial anatomical structures and landmarks. On the basis of student response it was concluded that this programme provided medical students with a unique introduction to living human anatomy.
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All physicians who care for children require a knowledge of normal growth and development in order to detect and interpret abnormalities. Yet traditional instruction tends to focus on the ill child and rarely provides students the opportunity to follow up the cases of healthy children over a prolonged period of time. A new course was developed that enabled students to observe the longitudinal developmemt of a normal infant from birth to age 16 months. At the completion of the course, a multiple-choice examination covering developmental concepts from birth to age 6 years was administered to the students who participated in this course (experimental group) and to two comparison groups. The experimental group scored substantially higher than both comparison groups on items covering birth to age 18 months. The program offers an opportunity for medical students to observe the longitudinal development of a normal infant and appears complementary to other instructional methods.