PubMed · 6553829
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F Jackson. Problems in assessing nursing students.. https://pubmed.ncbi.nlm.nih.gov/6553829/
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Patient care is shifting from an inpatient setting to an ambulatory setting. Despite this shift, most internal medicine clerkships provide the majority of medical student training in inpatient settings or in university tertiary care clinics, which are not representative of patient care in a community setting. We created a separate ambulatory clerkship that used volunteer community faculty at local and distant sites. The steps involved are described here, including finding time within the clerkship, reaching consensus within the department, defining the curriculum, identifying sites, and developing preceptors. Various parameters were measured to ensure quality in educational design. Comparisons of the 1-year pilot program, the full implementation program, and the inpatient program revealed that use of community sites does not affect cognitive knowledge acquisition but does influence students' satisfaction level.
This study evaluates the causes for a persistently discharging mastoid cavity and attempts to weight the importance of each identified factor. It consists of a temporal bone dissection to evaluate the anatomy of the facial nerve and a clinical prospective study measuring the factors that contribute to a wet cavity. The factors measured were height of the facial ridge, the size of the meatus, state of the tympanic membrane, and size of the mastoid cavity. The height of the facial ridge and the kidney shape of the cavity were found to be the most significant factors contributing to the state of the cavity. The tympanic membrane and size of the meatus were also found to significantly influence the state of the cavity, whereas the size of the cavity was not significant. These results illustrate the importance of the facial ridge in mastoid surgery and that most poor results in mastoid surgery are due to the surgeon, not the disease.
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