PubMed · 1707375
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K H Porter. 1990. Who me? Present a CE program?. https://pubmed.ncbi.nlm.nih.gov/1707375/
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Teachers often develop unique methods to help students learn, but these techniques may be lost when they retire from the profession. In the 15 years that they have conducted the Effective Teaching Workshop: Improving Your Skills, the authors of this paper have observed presentations of many innovative teaching methods. The article describes five methods recently presented at the annual workshop: the use of a flipchart with slides; the use of Polarmotion overhead transparencies; an asthma simulation; a breast-mass simulation; and teamwork and game-playing. The authors present these techniques in the hope of reaching a broader audience, and to stimulate other teachers to submit descriptions of innovative teaching methods for possible publication in the Ideas for Medical Education column.
PURPOSE: We assessed whether genital and audiovisual sexual stimulation following 1 or 2 intracorporeal injections caused the greatest changes in penile hemodynamics as recorded by color Doppler sonography. MATERIALS AND METHODS: A total of 50 impotent patients underwent multiphasic color Doppler sonography of the cavernous arteries before and after intracorporeal injection (phase 1), subsequent genital and audiovisual sexual stimulation (phase 2), a second injection (phase 3) and repeat genital and audiovisual sexual stimulation (phase 4). Peak systolic velocity, end diastolic velocity, resistance index and erectile response were studied. RESULTS: Penile erection after injection 1 was upgraded in 41 patients (82%) by genital and audiovisual sexual stimulation. Further upgrading due to injection 2 with stimulation was noted in 11 patients (22%). Among the patients who completed the 4 phases of the test the maximal peak systolic velocity was noted after 1 and 2 injections in 20 (59%) and 14 (41%), respectively. The resistive index was always increased by genital and audiovisual sexual stimulation compared to post-injection values. The maximal resistive index occurred after initial and repeat genital and audiovisual sexual stimulation in 15 (48%) and 16 (52%) patients, respectively. After injection 1 with genital and audiovisual sexual stimulation, impotence was diagnosed as nonvasculogenic in 14 patients (28%), arteriogenic in 9 (18%), venogenic in 17 (34%) or mixed arteriovenogenic in 10 (20%). After injection 2 with stimulation these results were noted in 18 (36%), 9 (18%), 13 (26%) and 10 (20%) patients, respectively. Thus, there were 4 false-positive cases (8%) of venogenic impotence. CONCLUSIONS: To study cavernous artery inflow and veno-occlusive function, color Doppler sonography should be performed after injection plus genital and audiovisual sexual stimulation. When the erectile response does not equal the maximal physiological erection reported by the patient, a second injection with stimulation should be given.