[Integral maintenance program].
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Since 1976 dental students in The University of Western Australia have undertaken a revised course in oral histology and embryology taught within the framework of an oral biology program. The new course includes clinic sessions, which are presented prior to scheduled lecture and laboratory instruction on a particular tissue, and are intended to familiarize students with the clinical appearance of that tissue. Participating staff include members from the divisions of oral biology, oral pathology, periodontics, pedodontics, and preventive dentistry, Examination of histologic slides during laboratory sessions is supplemented by use of dental radiographs in order to achieve a close correlation between histologic structure and radiographic appearance. The use of the dental clinic environment to teach basic and applied microanatomy, and inclusion of clinical data such as radiographs, has strengthened the link between basic biological science and clinical dentistry.
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Prior to recognition of etiologic agents of zoonoses (infections transmitted between animals and man), physicians encountered these illnesses in man and veterinarians observed them in animals. As the agents were identified, interspecies relationships (and spread) became evident and control programs evolved without consideration of cost-effectiveness. Today, the public demands efficient use of financial resources. Human health as well as economic losses are concerns of animal health agencies. Zoonoses affecting livestock, though not major priorities among public health agencies, cannot be ignored. It seems economical, therefore, to combine the efforts of these agencies in zoonoses control. This would benefit human health by reducing the animal reservoirs and the livestock industry will benefit by lowered production costs.
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This article describes an integrating framework to provide guidance for curriculum evaluation and focus. The development of the framework was approached from a theoretical standpoint. A review of the work in allied health related to roles and functions is made. In the framework, society is placed in a central position and is equated with self, others, and institutions. Central to this thesis is the belief that higher education has an obligation to change society rather than to constantly respond to it.
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BACKGROUND: Surgical residents have traditionally been evaluated by ward evaluations and multiple-choice testing; overall resident performance has seldom been objectively evaluated. We developed a comprehensive evaluation program for senior residents. The purpose of this study was to determine whether the several different assessment methods included in this program provide similar information about senior residents' clinical knowledge and performance. METHODS: Sixteen senior general surgery residents were evaluated by subjective faculty ward evaluations, a structured oral examination, the American Board of Surgery In-Training Examination, and an objective structured clinical examination (OSCE). The OSCE was divided into two parts: part A required the resident to obtain a directed history or to perform a physical examination; part B required the resident to answer questions about the patient seen in part A. RESULTS: The various evaluation methods differed in their estimates of clinical competence (ward evaluations rated residents highest; the OSCE, lowest). The American Board of Surgery In-Training Examination correlated with both the structured oral examination and OSCE part B, indicating that all are adequate measures of knowledge. Neither the total OSCE score nor OSCE part A correlated with other measures, but the fact that both are highly reliable suggests that they evaluate different clinical skills. Faculty ward evaluations are inflated and do not correlate with other measures. CONCLUSIONS: We conclude that developing a comprehensive program for evaluating resident competence is desirable and feasible.
We examined the effect of research program size on clinical costs (current dollars/work unit) and productivity (work units/ employee) in Department of Veterans Affairs (DVA) hospitals. Our data demonstrate that research programs have a small, almost negligible effect on clinical costs. The data also show that average acute medical service length-of-stay was inversely related to research program size. The indirect cost of research may have been almost entirely offset by an increased efficiency, as reflected in the shortened length of stay. This unexpected benefit of research may be due to the influence of research opportunities on the recruitment and retention of highly trained clinicians, including medical specialists. In the past, recruitment and retention was part of the justification for the DVA research program. Although this justification no longer appears to be considered politically acceptable, our data strongly support the notion that research programs can and do enhance the efficiency of medical care. Furthermore, research activities help professional staff maintain their critical thinking and analytic skills. We discuss the implications of these observations on cost containment in health care systems.
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Search Institute's integrated program of research on the linkages among community, developmental assets, and health outcomes is discussed. Recommendations are made for building a science that is dedicated to exploring pathways to developmental success.
A computer program, PROBE, has been designed for the prediction of protein structural features from amino acid sequence. This program integrates a variety of computer-simulated neural networks, each predicting an aspect of protein structure, into a single, easy-to-use package. The surface accessibility of each residue, the presence of disulfide bonds, the overall secondary structure composition and the residue secondary structures, including beta-turn type, are predicted. In addition, the overall amino acid composition and relative hydrophobicity are used to determine whether a protein belongs to one of four common folding motifs. PROBE is able to compare and synergistically improve the predictions by allowing communication between the different networks.