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PubMed1999

Science education partnership between the University of Colorado and a Denver High School.

The authors describe a partnership, begun in 1997, between Manual High School, a school in which about 85% of the students are African, American or Hispanic, and the University of Colorado Health Sciences Center in Denver. There are three partnership goals: help teachers transform a lecture-based curriculum into an inquiry-based curriculum, help students build their science knowledge, and give students opportunities to learn--and become excited--about careers in medicine. The current emphasis of the partnership is at the ninth-grade level. The first unique aspect of the partnership is the Medical Explorers program. One portion of the program begins when a hypothetical teenage car-crash victim arrives at the emergency room; over the next six weeks, practicing health care professionals dramatize their medical responsibilities to this patient and discuss the academic training necessary to fulfill those responsibilities. In addition, the Medical Explorers students travel to the Health Sciences Center, where they tour laboratories and clinics, help conduct experiments, and explore computer-based surgical simulations. The second unique program is a service learning project in which ninth-grade students assist with an activity that gives elementary school students a chance to participate in the process of scientific inquiry and to discover the wonder of real hearts and lungs; the ninth-graders assist with logistics (e.g., they distribute newspapers), and, more important, interact with the younger students by asking thoughtful questions of them. The partnership plans to incorporate the elementary and middle schools that graduate their students to Manual High School in order to encourage the implementation of inquiry-based science curricula and to provide sustained support to teachers throughout the entire K-12 educational pathway. If medical colleges can help teachers provide a consistent classroom draw for student fascination in science and medicine, then the colleges are more likely to help create a rich diversity of students who pursue careers in medicine.

Adolescent↗
PubMed1996

Attitudes and knowledge regarding breast-feeding: a survey of obstetric residents in metropolitan areas of South Korea.

A 15-minute, 6-page questionnaire on breast-feeding was administered to the obstetric residents in four metropolitan academic training programs in Korea to assess their attitudes toward and knowledge about breast-feeding and their confidence in managing breast-feeding problems. The questionnaires were self-administered and confidential, and the participation rate was 84% (n=76). Overall, the study participants indicated a neutral attitude toward breast-feeding (2.9 on a 6-point scale, where 1 equals the most positive attitude and 6 equals the most negative attitude). Their self-confidence was inappropriately high, with 49% of the total sample describing themselves as "confident" or "very confident" to manage common breast-feeding problems. Female residents had a higher confidence level than male residents. Although high in self-confidence about breast-feeding, the residents in this study were not knowledgeable about breast-feeding management, answering only 38% of the questions correctly. To be truly supportive of breast-feeding, obstetricians should receive didactic and clinical training in breast-feeding management.

Breast Feeding↗
PubMed1989

Current trends in neurosurgical critical care medicine.

We conducted a survey of neurosurgeons to discover how they manage specific problems commonly seen in critically ill neurosurgery patients and compared the responses with relevant investigations published in the neurosurgical literature over the past 10 years. The 101 Chiefs of Neurosurgery of every North American academic training program were sent copies of two consecutive surveys for distribution to their attending staff. Among the topics covered were indications for steroid administration, prophylaxis of gastrointestinal bleeding, indications for insertion of ICP monitoring devices and use of prophylactic antibiotics while they are in place, and fluid restriction in patients with cerebral edema. Replies were strictly anonymous. A Medline Computer search for the period 1976-1989 was carried out for each topic. We received 136 and 67 replies each to our two surveys. Over 90 clinical and laboratory studies published in major medical journals, many randomized and prospective, were reviewed. Two trends were evident: (a) a noticeable lack of uniformity among neurosurgeons with respect to management of the same problem; (b) little or no basis of support in the literature for many management practices. Based on these studies and the responses to our survey, we suggest an examination of current clinical practices.

Journal Article↗
PubMed1990

The approaches to learning of specialist physicians.

Recent studies have provided information about the approaches to studying and learning used by medical students. However, no published work is available on the approaches of practising doctors. The Adelaide Diagnostic Learning Inventory for Medical Students (ADLIMS) was modified and administered to a random sample of 308 physicians (internists). Generally speaking, physicians seem to have lower scores on surface approach and higher scores on deep approach than students. Level of clinical experience did not appear to influence this finding. However, marked differences were apparent between the approaches adopted by physicians with additional postgraduate academic training and those without. The former had a much stronger tendency to use the more desirable deep approach. The latter seemed to rely more on the less desirable surface approach. Further longitudinal studies will be required to determine whether this difference is attributable to self-selection of those who have already developed a deep approach or is causally related to a training in research. Although these findings must be interpreted with caution, some implications are clear. Physicians should become more aware of the way they learn and about the way they teach. Inappropriate patterns of learning may be entrenched during the undergraduate and immediate postgraduate years. If validated, these findings may provide support for the inclusion of research projects in medical school and during specialist training.

Australia↗
PubMed1995

MR imaging: quality assessment method and ratings at 33 centers.

PURPOSE: To outline a quality assessment method with peer review for magnetic resonance (MR) imaging. MATERIALS AND METHODS: Thirty-three providers in the Philadelphia area were rated on a random sample of 132 brain, 124 cervical spine, and 113 lower extremity MR imaging examinations performed during 1990. Blinded peer review was performed by panels of three subspecialty-trained academic radiologists. Technical performance, completeness, and report appropriateness of each MR imaging examination were evaluated. Aggregated scores were calculated to rate provider performance for each of the three parameters of quality. RESULTS: Two or three panelists assessed technical performance as inadequate in 15 cases, completeness as incomplete in 58 cases, and the interpretative report as inappropriate and affecting treatment in 72 cases. Eleven providers received an unsatisfactory rating on one or more parameters of quality. The association between unsatisfactory ratings and the use of low-field-strength (< or = 0.6-T) imagers was statistically significant (P < .008). CONCLUSION: Substantial deficiencies were identified in the performance of examinations and interpretation of MR images in the Philadelphia area in 1990. These findings indicate the need for a program to monitor quality of MR imaging.

Brain↗
PubMedDate not supplied

Emerging issues in Israel: commentaries in a global context.

Communication disorders in Israel is a well-established professional field, requiring academic training and dual certification in speech pathology and audiology. Entry level is a BA in communication disorders (comparable to a MA degree in the USA) and 1 year of work under supervision. It is possible to continue studies towards higher degrees (MA and PhD). We face the same problems as in the rest of the world with need for trained professionals in the social services and the need to deal with multilingual and multicultural issues.

Audiology↗
PubMed1984

Cognitive-psychomotor functions with regard to fitness for driving of psychiatric patients treated with neuroleptics and antidepressants.

In contrast to the usual type of drug studies it is not our intention to single out specific drug effects, but we are interested in cognitive-psychomotor functioning of psychiatric patients across various periods of therapy, whether due to drug treatment or to underlying mental-affective disorders. 3 groups of psychiatric male patients (7 anxious/inhibited depressives, 7 schizophrenics, 6 patients with psychotic episodes) matched for age (mean = 30 years) and education (no academic training) with a group of healthy controls (n = 7) were examined three times during the first 6-8 weeks of their ordinary clinical therapy. The major criterion for the inclusion of a patient next to these diagnostic categories was an initial favorable response to the specified drugs (amitriptyline for the depressives, haloperidol for the schizophrenics, and thioridazine for the patients with psychotic episodes). Each subject was tested in an experimental laboratory with respect to cognitive-psychomotor performance (vigilance, divided attention, choice reaction time), mood, subjective fitness for driving, depression, and paranoia. All groups of patients improved significantly between the acute and the chronic phase. However, healthy controls showed a sharper increase of achievement. While the depressives and the patients with psychotic episodes function on a level of questionable fitness for driving, schizophrenics vary greatly intra- and interindividually, generally on a lower level.

Accidents, Traffic↗
PubMed1980

Psychiatric residents' attitudes toward teaching.

The authors surveyed psychiatry residents in academic training programs to determine the amount of time they spent in teaching activities and to assess their attitudes toward teaching. They found that most residents spent from 1 to 2 hours per day teaching and felt they should do more. They tended to see themselves as capable teachers, and they valued traditional medical skills. They did not seem to value the use of audiovisual materials, written handouts, or self-instructional materials. Most of the residents had received no formal instruction designed to make them better teacher or direct feedback from faculty supervisors about their teaching skills.

Adult↗
PubMed1981

Problems in attracting and retaining psychiatrists in rural areas.

Efforts to eliminate the shortage of psychiatrists in rural areas have been relatively unsuccessful due to the special personal and professional problems facing the rural psychiatrist. The rural psychiatrist may feel personally isolated, encountering a somewhat foreign culture and living in uncomfortable proximity to patients and their families. He may feel professionally frustrated, for his physician colleagues are usually conservative and hold dear the medical model of care. He may suffer the typical frustrations of the psychiatrist working out of a community mental health center, and has little opportunity for professional growth. Academic training centers that train psychiatrists in region where they will work can more adequately prepare trainees for rural practice and can offer continuing education courses to professionals already practicing in the area. These centers should collaborate with mental health facilities to define and respond to manpower problems. Finally, opportunities for rural practitioners to make shifts in career emphasis over time should be created.

Attitude↗
PubMed1993

A consultative study as a catalyst for improving mental health services for rural children and adolescents.

The consultative study is one model of academic involvement in public mental health services. However, the effects of consultation and how it acts as a catalyst for change have been poorly documented. The authors describe a consultative study in which a team from a academic training center examined the system of mental health and related human services for children and adolescents in a semirural county in western Pennsylvania. They also present results of a six-year follow-up survey assessing the study's effects. Improvement in the system of care during the follow-up period included creation and maintenance of a children's unit and a partial hospital program for adolescents at the country's community mental health center. The consultative study and the follow-up survey were instrumental in establishing a comprehensive range of services, including intensive case management for severely disturbed youngsters and a home-based mental health services program.

Adolescent↗
PubMed1997

Rediscovering general psychiatry: creation of an academic division.

OBJECTIVE: To describe the rationale, origins, and goals of a newly created academic division of general psychiatry within a university setting. METHOD: Literature review, observation, and description. RESULTS: Within 2 years of its inception, the General Psychiatry Division of the University of Toronto has begun to realize some of its goals and further elucidate specific objectives. CONCLUSIONS: In an era of increasing academic subspecialization, the preservation of core skills in psychiatry and the recognition of the continuing public need for psychiatric generalists must be enshrined within academic training programs.

Career Choice↗
PubMed1988

Postgraduate academic desires: senior doctor of pharmacy students.

Senior Doctor of Pharmacy (Pharm.D.) students were surveyed by questionnaire to glean information about academic training, and residency, fellowship, or practice positions sought after graduation. There were 227 (27 percent of total surveys) responses. Of those responding, 71 percent were Bachelor of Science graduates, 29 percent were Pharm.D. primary degree students, and 18 percent completed a residency either before or during Pharm.D. training. Fifty percent had an average of three years of clinical services work experience prior to their Pharm.D. education. There was strong interest in postgraduate education by respondents: 41 percent for residencies and 26 percent for fellowships. Of resident candidates, 18 percent and 49 percent, respectively, considered research essential and important to the program. Areas of greatest interest in residencies were general medicine, infectious disease, and pharmacokinetics. Important to the selection of a fellowship was the research proposal and concurrent clinical practice. Pharm.D. students are interested in postgraduate training as residents (60 percent), fellows (38 percent), or both (2 percent). Desired activities are research and clinical practice independent of residency or fellowship interest.

Adult↗
PubMed2004

Application of the transtheoretical model for HIV prevention in a facility-based and a community-level behavioral intervention research study.

This article describes the application of the transtheoretical model of behavior change to prevention programs for women at risk for or infected with HIV. The focus of these multisite demonstration projects was to increase condom and contraceptive use. The model was operationalized for use in the following two different intervention approaches: facility-based interventions (individual counseling for women in clinics, shelters, and drug treatment centers) and community-level interventions (including production of small media materials, street outreach, and community mobilization). The authors found that interventions derived from a complex theory can be disseminated to frontline providers who have little prior HIV education experience or academic training. They suggest that the transtheoretical model has value for the design and implementation of HIV prevention programs.

Community Health Services↗
PubMed1976

The nurse and industrial hygiene.

In summary, the occupational health nurse and the industrial hygienist have much in common. Each must recognize the value of the other and work together for the good of the employee. Occupational health nursing is frequently what the nurse makes it. Her competency, interest, and motivation, and the demands of the job determine her role. To function effectively, every occupational health nurse should have a thorough working knowledge of the fundamentals of industrial hygiene. This knowledge can be acquired in several ways: through practical experience, by attendance at professional meetings and short courses, by participation in academic training, and through personal research.

Humans↗
PubMed1987

Physicians, reformers and occupational disease: the discovery of radium poisoning.

Teenage girls and young women, whose job it was to apply luminous paint containing radium to watches during World War I, were among the first industrial radiation poisoning victims in the United States. This paper recounts both the story of how their afflictions became "recognized" occupational diseases and of the tangled web of governmental-industrial-academic collusion (largely based on industrial funding of research and experts) which delayed this recognition. It shows how these industrial-academic arrangements led to the establishment of the major academic training programs in occupational medical and industrial hygiene still in existence. Using historical sources, this study provides evidence of moral lapses by medical researchers, including directly lying to the victims, withholding data on the true extent of illness and radiation contamination and of distorting evidence. The pivotal role of the Consumers League and of Dr. Alice Hamilton in establishing the truth of the radium dial painting poisonings is discussed.

Adolescent↗
PubMed1994

Therapist/patient matching and early treatment dropout.

This study of intake procedures was initiated with a view towards reducing the early dropout rate of substance abusers. Eight different therapists conducted intake interviews of 634 cocaine dependent, first admissions to an outpatient cocaine treatment program. No significant differences in return rate were found across either the eight therapists or their level of academic training. We found that matching therapists and patients with respect to gender and race for the intake interview did not increase the proportion of patients returning for a second visit. In addition, the hypothesis that providing a sense of continuity by having the therapist who conducted the intake interview become the treatment therapist did not result in a higher return rate than if the patient was assigned to a different treatment therapist. Although the results do not indicate methods of further reducing early treatment dropouts they are helpful in reducing concerns about who conducts intake interviews and how patients are assigned.

Adult↗
PubMed2006

The Boston Marathon Study: a novel approach to research during residency.

Resident physicians from a pediatric academic training program developed a hospital-wide research project in an effort to enhance their residency research experience. In this model, residents themselves assumed primary responsibility for each stage of a large prospective clinical research study. The project, which was integrated successfully into the residency program, enabled a large group of residents, with mentorship from a dedicated faculty member, to benefit from a structured clinical research experience while providing the flexibility necessary to meet the demands of a busy residency curriculum. Careful topic selection with a well-defined end point, faculty involvement, resident collegiality, and institutional support were factors identified by study leaders as central to the success of this model.

Biomedical Research↗
PubMed2000

[Learning leadership: nurses opinion about their academic education].

The purpose of the present study was to identify nurses opinion about aspects of their academic undergraduate education directed to form leaders of the nursing team. Therefore, authors interviewed 17 nurses from a public federal hospital who experience the condition of being staff leaders. The collected material was analyzed through the technique of content analysis. Results evidenced a dissatisfaction concerning their academic training on leadership. The approached aspects showed the importance of a reflection about the need of teaching-learning strategies that allow students to develop leadership skills.

Attitude of Health Personnel↗