The relevance of academic input into surgical training.
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Psychiatric residency training programs in rural communities face many well-known obstacles, including lack of structure, professional isolation, and excessive demands on residents to provide clinical services. The author describes a psychiatric residency training program in rural North Carolina developed through the collaboration between a rural four-county area mental health program, a medical school department of psychiatry, and a state agency. Rather than focusing on the problems of rural practice, the residency program emphasizes clinical and administrative issues common to all practice settings, fosters an atmosphere in which all staff at the training site support the program's educational mission, and encourages residents to identify with professionals who perform successfully in rural settings.
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This study proposes a series of guidelines for designing multimedia educational interfaces that combine educational strategies with cognitive load theory. There is a large body of research that confirms multimedia education is at least as effective as the traditional approach, but there is no discussion regarding the effectiveness of the interface design. This trial compares two interfaces to determine which design techniques are most cognitively efficient for the learner.
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OBJECTIVE: The authors document the development and growth of geriatric psychiatry fellowship training in the United States (U.S.) through 2002. METHODS: A cross-sectional survey of the 62 U.S. geriatric psychiatry fellowship programs was conducted in Fall 2001. They also analyzed longitudinal data from the American Medical Association (AMA) and the Association of American Medical Colleges' (AAMC) National Graduate Medical Education (GME) Census, along with data from the Accreditation Council for Graduate Medical Education (ACGME). RESULTS: Forty-six (74%) of 62 training directors (TDs) responded. The number of fellowship programs has slowly increased over the past 7 years. During 2001-2002, a total of 94 fellows were in training (all years of training). Seventy-eight percent (N=36) of responding programs offered only 1-year fellowship training experiences. TDs reported that application rates for fellowship positions were stable during the academic years 1999-2002, with a median number of eight applications per program for first-year positions in 2001-2002. The fill-rate for first-year geriatric psychiatry fellowship positions dropped from 84% in 1999-2000 to 61% in 2001-2002. During 2001-2002, 73% of programs reported having two or fewer first-year fellows, and 16% had no first-year fellows. Seventeen programs reported having no U.S. medical school graduates (USMGs) as first-year fellows. CONCLUSION: Recruiting high-quality USMGs into geriatric psychiatry fellowship programs remains a challenge. Furthermore, retaining first-year fellows for additional years of academic training has been difficult. Findings indicate that specific strategies need to be developed to stimulate undergraduate and graduate interest in careers in clinical and academic geriatric psychiatry.
The responsibility for those of us involved in residency training programs is to foster the development of future leaders in thoracic surgery. Although the actual training of female surgeons is no different than training male surgeons, academic advancement after training can be more difficult for women due to a variety of reasons. The education and training of female surgeons has its origin in admission to medical school followed by recruitment into a residency program. Following completion of a residency program, the retainment of women and men faculty should be the goal of departments and divisions of thoracic surgery. Specific recommendations are made for retainment of faculty. In addition to academic promotion and financial reward, creating the proper environment is an important consideration to allow women the chance to succeed in medicine. This report addresses the training aspects involved in the thoracic residency program and the state of professional academic advancement at the Johns Hopkins University School of Medicine.
The training experiences of 35 academic psychiatrists first appointed in the years 1966-72, obtained by a postal questionnaire, are reported and compared with those of N.H.S. consultant psychiatrists appointed in the same period. The academic group reported less satisfactory training in a number of important areas, including psychogeriatrics and work in the community. Academics also differ from consultants in their fathers' socio-economic status and educational background.
Although the total number of social workers within the academic medical center will probably decrease because of decreasing hospital bed usage, the role for those who remain will be that of a clinical specialist, a sophisticated and adaptable practitioner who can work flexibly under minimal supervision. The valued social work practitioner will be an independent player on the health care team who assumes a significant role which no other member of that team is equipped to take. Advanced training is more important today than ever before in the evolution of social work practice in academic health care. However, this training is not now available within the parameters of the two year master's program.
The main objective of the present study was to empirically verify the effect of hypnotic training programs on the academic performance of students. A pre and posttest design was used. Two experimental and two control groups (total sample N=119) of volunteer second year psychology students at the University of Stellenbosch in South Africa comprised the sample. One of the experimental groups was exposed to active alert hypnosis and the other to relaxation hypnosis. One control group was exposed to progressive relaxation, while the other did not receive any intervention. The participants' April grades were used as a pretest, while their June grades served as a posttest. The two hypnotic training programs had a significant effect on the academic achievement of the participants, which was not found in the control groups. Regarding the efficacy of the two programs, however, no significant difference was found.
The academic leadership of internal medicine is considering fundamental changes in the curriculum for internal medicine residency training. The impetus to change the curriculum is derived from various socioeconomic changes during the past 10 years. These changes have resulted in a drastically shortened length of stay of patients in hospitals, an emphasis on outpatient care by reimbursement agencies, and a sharp decline in the numbers of U.S. medical graduates selecting careers in internal medicine. Curriculum change will mandate that we define the roles of general internists and subspecialists in the delivery of primary care and that we re-define how we train these two groups of internists. We must focus attention on the issue of service compared with education and must confront the issue of how best to train foreign medical graduates. Any curriculum change will also have to accommodate residents selecting careers in research in order to ensure an adequate supply of physician-scientists. Before implementing any change in curriculum, we must put into place a rigorous, prospective evaluation system. We must be able to accurately assess both positive and negative outcomes of these changes and make necessary midcourse corrections. The impetus for curriculum change in internal medicine will, it is hoped, ultimately benefit the public, the trainees, and the practice of internal medicine.
Many public-academic liaisions for training in psychiatry have developed in New York State over the past 40 years. Their goals have ranged from broadening residents' exposure to community patients to recruiting for state service. The state has developed explicit guidelines for these liaisons to promote fairness among university participants and promulgate standards for their involvement. Currently, all 12 medical schools in the state participate in such liaisions, which provide residencies in general psychiatry and fellowships in child and adolescent, forensic, geriatric, public, rehabilitation, and research psychiatry. The total cost to the state is about $10.5 million per year.
"Sect of Integration of Chinese and Western Medicine" came into the world four hundred years ago when Traditional Chinese Medicine (TCM) contacted Western Medicine (WM) at the beginning of the 17th century. It collected historical experiences showing that the cooperation of TCM and WM is more efficient for the cure and prevention of disease than each of them separately. Now the recognition that the cooperation of eastern and western medicine is more efficient to cure disease is spreading widely. This study will help Korean eastern and western medicine to find their directions. First, the concept of "sect of Integration of Chinese and Western Medicine" which was established between the beginning of the 17th century and the middle of the 20th century, and Integration of Traditional Chinese and Western Medicine (ITCWM) which was formed after the middle of the 20th century will be discussed. The relationship of "sect of Integration of Chinese and Western Medicine" and ITCWM and political consideration for the establishment of ITCWM will also be discussed. Finally, the current status of ITCWM in China will be discussed. New trends of thought appeared in Chinese medicine, owing to the cultural background of modern China, the development of WM, and the academic background of the intellectual class. "Sect of Integration of Chinese and Western Medicine" and ITCWM are different in historical and social background. However, purpose, foundation of thoughts and logical idea are fundamentally the same. It can be said that "sect of Integration of Chinese and Western Medicine" provided academic mood to open the way for ITCWM and ITCWM is a succession of "sect of Integration of Chinese and Western Medicine". The concept of ITCWM has many ways of explanation. However, it can be said to build up the foundation of new medical area including Chinese special way of medical treatment and new methods of modern medicine, succeeding a legacy of TCM. ITCWM began before the establishment of People's Republic of China. Mao Ze-dong (1893-1976), a powerful politician, and Li Ding-ming (1881-1947) who had many experiences and insight for TCM and WM played important roles at this stage. The period from the New China to the Great Proletarian Cultural Revolution (1966-1975) is the term for the establishment of the shape of ITCWM. "The effort of research and development on TCM-WM integration" was adapted as one of hygienic policies for curing of epidemic disease and succession and development of the heritage of TCM to establish new medical area. TCM class for western medical doctors was opened and mass media was used to spread out ITCWM throughout China. During the period of the Great Proletarian Cultural Revolution, ITCWM had to be stepped back and stagnant. Only the TCM class of western medical doctors and some clinical applications were barely kept moving on and alive. From the period of the Great Proletarian Cultural Revolution to the end of the 1980s, there are the movement of re-preparation of ITCWM, education of successors, and the establishment of the Institute of ITCWM. Hospitals began to establish department of ITCWM. Furthermore, it was clearly indicated in the constitutional law that "We not only have to develop modern medicine but also traditional medicine". The equality of TCM and WM was legally established in this time. From the 1990s, "equality of TCM and WM" was adapted as one of the hygienic policies, and department of ITCWM was opened in traditional Chinese medical school and western medical school. ITCWM has been settled down as a new academic field through education, training, research, academic activity, and publishing text books. In conclusion, the motive of the development of ITCWM was the policy such as "the effort of research and development on TCM-WM integration" abd "equality of TCM and WM" aimed at the development of Chinese medical area. It is no doubt helpful to organize systems and policy-making for the cooperation of eastern and western medicine in Korea.
This report documents the development and growth of geriatric medicine fellowship training in the United States through 2002. A cross-sectional survey of geriatric medicine fellowship programs was conducted in the fall 2001. All allopathic (119) and osteopathic (7) accredited geriatric medicine fellowship-training programs in the United States were involved. Data were collected using self-administered mailed and Web-based survey instruments. Longitudinal data from the American Medical Association (AMA) and the Association of American Medical Colleges' (AAMC) National Graduate Medical Education (GME) Census, the Accreditation Council for Graduate Medical Education (ACGME), and the American Osteopathic Association (AOA) were also analyzed. The survey instrument was designed to gather data about faculty, fellows, program curricula, and program directors (PDs). In addition, annual AMA/AAMC data from 1991 to the present was compiled to examine trends in the number of fellowship programs and the number of fellows. The overall survey response rate was 76% (96 of 126 PDs). Most (54%) of the PDs had been in their current position 4 or more years (range: <1-20 years), and 59% of PDs reported that they had completed formal geriatric medicine fellowship training. The number of fellowship programs and the number of fellows entering programs has slowly increased over the past decade. During 2001-02, 338 fellows were training in allopathic programs and seven in osteopathic programs (all years of training). Forty-six percent (n = 44) of responding programs offered only 1-year fellowship-training experiences. PDs reported that application rates for fellowship positions were stable during the academic years (AYs) 1999-2002, with the median number of applications per first year position available in AY 2000-01 being 10 (range: 1-77). In 2001-02, data from the AMA/AAMC National GME Census indicated a fill rate for first-year geriatric medicine fellowship positions of 69% (259 first-year fellows for 373 positions). During 2001-02, more than half of programs (53%) reported having two or fewer first-year fellows, whereas 31% had three or four first-year fellows. Thirty-three programs (36%) reported having no U.S. medical school graduate first-year fellows, and another 25 (28%) reported having only one. Of the 51 programs offering second-year fellowship training, PDs reported 61 post-first-year fellows (median 1, range: 0-7). During the past 10 years, 27 new allopathic geriatric medicine fellowship programs opened; there are now 119 programs. There are also seven osteopathic programs. The recruitment of high-quality U.S. medical school graduates into these programs remains a challenge for the discipline. Furthermore, the retention of first-year fellows for additional years of academic training has been difficult. Incentives will be needed to attract the best graduates of U.S. family practice and internal medicine training programs into academic careers in geriatric medicine.
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We evaluated whether, among hyperactive children who required maintenance stimulant treatment, cognitive training enhanced academic performance; improved the functioning of youngsters who had only a partial behavioral response to medication; facilitated withdrawal of stimulant treatment; and enhanced maintenance effects of academic gains following termination of stimulants. A 16-week cognitive training program that emphasized reflective problem-solving strategies and social problem-solving skills was compared with an attention control treatment and with no training. There was virtually no evidence of efficacy of cognitive training. No significant treatment effects were obtained on academic, behavioral, and cognitive measures. Cognitive training did not improve behavior among children with residual problems, nor did it facilitate the withdrawal of medication. With placebo substitution, the overwhelming majority of children required remedication, regardless of previous exposure to cognitive training.