Biomedical subjects
Publications and source records attributed to T S Murray.
Computer-assisted learning (CAL) has been introduced as part of the undergraduate teaching course in general practice during the penultimate year of the medical course. The student is given an opportunity to make clinical decisions and to manage a case over a significant time scale. The attitudes of the students are favourable to this method of instruction.
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Twenty-four general-practice trainees were assessed at the beginning and end of their training year. They improved significantly in their factual recall and problem-solving ability. Sixteen young principals who had had an unstructured training for general practice were assessed at the same time and were initially of the same standard but their results showed no difference over the same year.
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The undergraduate teaching of childhood illness in the community is described. This teaching includes a cross-section of acute childhood illness together with some contact with handicapped children in their own homes. Although there were only four teaching sessions, the frequency of conditions studied approximated to that in general practice
A system of recording booklets had been introduced for fifth-year students during their course of teaching in general practice. The booklets guide the student in his study of the development, presentation and future prognosis of patients with chronic and complicated disease in the community. The students abilities and the teaching were assessed using case histories in a system of computer assisted learning.
Undergraduate medical students improve their ability to make patient management decisions through using computer-assisted learning. With this problem-solving approach an improvement in their factural knowledge also occurs and they retain a significant amount of the content.
In a retrospective study, based on a biochemical survey of people aged 65 and over in a general practice, subjects taking a barbiturate preparation for indications other than epilepsy had a significantly lower serum calcium concentration than did those taking nitrazepam or diazepam. Ordinary doses of barbiturate may adversely affect vitamin D metabolism in the elderly.
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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.
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.
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 efficacy and tolerability of nisoldipine coat-core (nisoldipine CC 10, 20, 40 mg) and atenolol (50, 100 mg) were compared in 230 patients with mild to moderate essential hypertension. Treatment was titrated at two-weekly intervals as necessary to control blood pressure. After eight weeks of active therapy, the two treatments proved to be equally effective in reducing sitting diastolic blood pressure (13.7 +/- 8.3 mmHg and 14.2 +/- 9.1 mmHg for nisoldipine CC and atenolol, respectively), and provided equivalent reduction in systolic blood pressure and identical response rates (69%). Heart rate was reduced from baseline in the atenolol group but remained unchanged in the nisoldipine CC group (p < 0.001 difference between the two groups). Both nisoldipine CC and atenolol were well tolerated and had no detectable metabolic effects. Adverse events were minor and of the type commonly associated with drugs of these classes.