A health promotion program for medical students.
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Biomedical subjects
Publications and source records attributed to K A Munning.
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The authors report on their study of the perceived acquisition of clinical skills by 151 second-year students in six required clerkships: surgery, internal medicine, pediatrics, obstetrics-gynecology, psychiatry, and family medicine. The students completed self-assessments of their clinical skills concerning 78 problems or procedures when taking the family medicine clerkship as their first and last rotations and when taking any of the other clerkships as their first rotation. Fifty percent of the 36 students who took the family medicine clerkship after completing all five traditional clerkships reported that they learned the management of some of the most common health problems, including osteoarthritis and hypertension, only during the family medicine clerkship. Overall, the skills of these 36 students increased from 60 percent to 89 percent of the items surveyed after taking the family medicine clerkship as their last required rotation. The principal contributions of the family medicine clerkship were in the management of common problems, performance of therapeutic procedures, and recommendation of health maintenance procedures.
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A new required clinical clerkship in family medicine at Duke University School of Medicine is described in terms of planning, implementation, and modification in response to students' evaluations. Seventy-five percent of the eight-week course involves direct clinical experience both in academic practices and community sites, and 25 percent is spent in small group seminars and workshops. Evaluations by students have been highest for the clinical experience, the clinical competence of the faculty, the teaching effectiveness of the faculty and house staff, and the overall learning experience. The ratings have been lowest for seminars, workshops, and required written projects. Several modifications made in the clerkship over a three-year period have raised the students' ratings to near their ratings of the five traditional clerkships. The data demonstrate that family medicine can be taught effectively as a core clinical rotation and can broaden the general education of medical students.
Negotiation, a common term in American society, is a process that can be especially useful to family medicine as a specialty that interfaces with many other clinical areas. The basic concepts of the negotiation process, including Maslow's need theory, terminology, and the three phases of the process (ie, planning, implementation, and follow-up), are applied to family medicine. A case study of a successful curriculum negotiation between family medicine and pediatrics is presented, and the use of need theory in the planning phase and during the strategic approach is analyzed. The negotiation process is also applied to faculty contracts, practice management training for residents, clinical teaching, and interdisciplinary relationships as indications of its broad usefulness within family medicine.
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