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PubMed1999

A survey of oral implantology teaching in the university dental hospitals and schools of the United Kingdom and Eire.

AIM: To provide an overview of the currently available academic teaching and clinical training in oral implantology at the university dental schools and hospitals of the United Kingdom and Eire. METHOD: A questionnaire was sent to the dean or director of dental studies and forwarded to the respective units involved in the academic teaching and clinical training of oral implantology. The setting was the university dental hospitals, and dental schools of the UK and Eire. Information was collected between July 1997 and March 1999. The main outcome measures were course availability, duration and emphasis for undergraduate and postgraduate study in the clinical discipline of oral implantology. The units or departments responsible for training and teaching were identified and formal degree courses were distinguished from non-degree courses. RESULTS: All institutions replied to the survey. All university dental schools provide undergraduate training in oral implantology in accordance with the guidelines provided by the General Dental Council. However, the courses vary with regard to the departments involved and the level of student participation. Thirteen centres provide informal postgraduate training with the duration ranging from one to eighteen days. Just eight centres provide formal academic graduate training based on oral implantology leading to recognised degrees. CONCLUSION: All university dental schools provide undergraduate teaching in oral implantology. Most centres also provide informal postgraduate training based on oral implantology. However, opportunities for academic graduate training, leading to recognised qualifications in this subject, appear limited at present.

Certification↗
PubMedDate not supplied

Becoming a good doctor: perceived need for ethics training focused on practical and professional development topics.

OBJECTIVE: Ethics training has become a core component of medical student and resident education. Curricula have been developed without the benefit of data regarding the views of physicians-in-training on the need for ethics instruction that focuses on practical issues and professional development topics. METHODS: A written survey was sent to all medical students and PGY1-3 residents at the University of New Mexico School of Medicine. The survey consisted of eight demographic questions and 124 content questions in 10 domains. Responses to a set of 24 items related to ethically important dilemmas, which may occur in the training period and subsequent professional practice, are reported. Items were each rated on a 9-point scale addressing the level of educational attention needed compared to the amount currently provided. RESULTS: Survey respondents included 200 medical students (65% response) and 136 residents (58% response). Trainees, regardless of level of training or clinical discipline, perceived a need for more academic attention directed at practical ethical and professional dilemmas present during training and the practice of medicine. Women expressed a desire for more education directed at both training-based and practice-based ethical dilemmas when compared to men. A simple progression of interest in ethics topics related to level of medical training was not found. Residents in diverse clinical specialties differed in perceived ethics educational needs. Psychiatry residents reported a need for enhanced education directed toward training-stage ethics problems. CONCLUSIONS: This study documents the importance placed on ethics education directed at practical real-world dilemmas and ethically important professional developmental issues by physicians-in-training. Academic medicine may be better able to fulfill its responsibilities in teaching ethics and professionalism and in serving its trainees by paying greater attention to these topics in undergraduate and graduate medical curricula.

Adult↗
PubMed2004

Attrition from ophthalmology residency programs.

PURPOSE: To investigate the incidence of and reasons for voluntary resident attrition from ophthalmology training programs. DESIGN: Retrospective survey. METHODS: A survey was mailed to residency program directors of the 121 Accreditation Council for Graduate Medical Education-accredited ophthalmology residency programs asking them to report the number of residents who withdrew from training during 2001 to 2002 and the reasons for withdrawal. RESULTS: Of 102 responding programs, 13 (12.7%) had one resident withdraw from training in the academic year 2001 to 2002. These 13 residents represented 1.1% of all ophthalmology residents in training at the responding institutions during that academic year. The most frequent reason for withdrawing was to enter another medical specialty. CONCLUSIONS: Voluntary resident attrition from ophthalmology training programs is uncommon. The 1.1% attrition rate in this study is the lowest among published reports of attrition from other specialties.

Career Choice↗
PubMed1989

Assessing university nephrology training as preparation for community consultative practice.

The authors gathered information about the consultative practice of nephrology in a community environment and used this information to speculate about improvements that could be made in the training of nephrologists in academic medical centers, based on their knowledge of such training. Data were gathered on the specialty affiliations of the physicians who requested 211 consecutive consultations, on the clinical problems encountered, and on the most likely diagnosis for each problem. In some instances the referral patterns, patient mixes, and clinical diagnoses observed in the community-based practice differed significantly from those often emphasized in training programs in academic medical centers. Such differences may be unintentionally reinforced, because the clinical literature in which new findings are reported and validated largely arises from university-type clinical practices. Specific examples of the differences observed and some suggestions for change are given. Although additional research is needed to confirm the findings of this study, and although these findings may not be applicable to other settings or other internal medicine subspecialties, these findings raise questions about the appropriateness of completely university-based training in preparing physicians for practice in a community setting. The authors suggest that cooperation between community hospitals and established university programs could bring about the best opportunities for clinical training.

Community Medicine↗
PubMed1992

The pastoral counselor as mental health professional: a comparison of the training of AAPC Fellow Pastoral Counselors and Licensed Clinical Social Workers.

Compares the academic and clinical training requirements for Fellow level members of the American Association of Pastoral Counselors (AAPC) with those of Licensed Clinical Social Workers (LCSWs). Concludes from the empirical findings that AAPC Fellows receive more education, clinical training, and continued supervision than do Licensed Clinical Social Workers. Notes a need for additional and similar types research comparing education and clinical requirements of pastoral counselors with those of other mental health professionals.

Clinical Competence↗
PubMed2005

The evaluation of first aid and basic life support training for the first year university students.

In Turkey, the first aiders are few in quantity and yet they are required in many settings, such as earthquakes. It was thought that training first year university students in first aid and basic life support (FA-BLS) techniques would serve to increase the number of first aiders. It was also thought that another problem, the lack of first aid trainers, might be addressed by training medical students to perform this function. A project aimed at training first year university students in FA-BLS was conducted at Hacettepe University. In the first phase, medical student first aid trainers (MeSFAT) were trained in FA-BLS training techniques by academic trainers and in the second phase, first year university students were trained in FA-BLS techniques by these peer trainers under the academic trainers' supervision. The purpose of this study was to assess the participants' evaluation of this project and to propose a new program to increase the number of first aiders in the country. In total, 31 medical students were certified as MeSFATs and 12 of these trained 40 first year university students in FA-BLS. Various questionnaires were applied to the participants to determine their evaluation of the training program. Most of the participants and the authors considered the program to be successful and effective. This method may be used to increase the number of first aid trainers and first aiders in the community.

Adolescent↗
PubMed1995

The relationship of postdoctoral research training to current research activities of faculty in academic departments of psychiatry.

OBJECTIVE: This report describes the postdoctoral research training of faculty in departments of psychiatry and relates research training characteristics to current involvement in research. METHOD: Data were taken from a survey of 3,107 doctoral-level faculty in departments of psychiatry at 116 U.S. medical schools. The survey instrument gathered information about faculty members' postdoctoral research training and current research activities and elicited recommendations for research training programs. RESULTS: Of the survey respondents, 34.8% had had some form of postdoctoral research training. Most of those had trained in medical schools or intramural programs of the National Institutes of Health and federal institutes on alcoholism, drug abuse, and mental health. Most funding came from the federal government. Postdoctoral research training was significantly related to greater current research involvement across all degree types--M.D., Ph.D., and M.D.-Ph.D. Length of training was related to level of research involvement for M.D.s and Ph.D.s but not M.D.-Ph.D.s. Although most researchers believed their training programs prepared them for independent research, a smaller proportion of M.D.s than M.D.-Ph.D.s or Ph.D.s responded affirmatively to that question. Researchers were more likely than nonresearchers to consider their training adequate. Respondents rated time with mentor, course work in statistics, and length of training as the most important training program features. Both research training and research activities were concentrated in a relatively few institutions. CONCLUSIONS: These data show the critical importance of both federal support of research training and postdoctoral research training for subsequent research involvement of psychiatric faculty.

Attitude of Health Personnel↗
PubMed2002

Carbon dioxide monitoring in emergency medicine training programs.

OBJECTIVES: Although the measurement of carbon dioxide (CO2) in breath is the standard of care for verification of endotracheal tube placement in all anesthesia practice and in the prehospital setting, there is currently no uniform consensus on the status of CO2 monitoring in emergency medicine. We conducted this survey to delineate practice patterns of CO2 monitoring in academic emergency medicine training programs and to describe the preference for type of CO2 monitoring device. METHODS: We surveyed the availability, presence, and types of CO2 monitoring in all general emergency medicine (GEM) residency programs and all pediatric emergency medicine (PEM) fellowship programs. A two-question survey was used, and data were collected from March 1998 to June 1998. The clinicians surveyed were asked whether their emergency department (ED) used CO2 monitoring for detection of endotracheal tube placement and, if so, what type of CO2 monitoring devices was used. Types of CO2 monitoring devices were categorized as colorimetric, capnometric, capnographic, or combinations of these. RESULTS: Of the 168 programs surveyed, all GEM and PEM programs responded, and the survey results showed that 136 of 168 (81%) used some form of CO2 monitoring, and 32 of 168 (19%) did not use CO2 monitoring. The majority of programs (115/168, 68%) used a single device. Colorimetric devices were used most frequently (76/168, 45%), and capnometry was used the least (9/168, 5%). PEM programs had a significant preference for quantitative CO2 monitoring, whereas GEM programs had a significant preference for qualitative CO2 monitoring. CONCLUSIONS: Although the majority of academic emergency medicine training programs used CO2 monitoring, 19% did not. Colorimetric devices were the most frequently used CO2 monitoring technology.

Carbon Dioxide↗
PubMed1997

Physicians in training as quality managers: survival strategy for academic health centers.

Being responsible for medical education places academic health centers at a disadvantage in competing for managed care contracts. Although many suggestions have been made for changing medical education to produce physicians who are better prepared for the managed care environment, few studies have shown how physicians in training can actually contribute to the competitiveness of an academic health center. We present three examples of engaging trainees in projects with a population-based perspective that demonstrate how quality improvement for the academic health center can be operationalized and even led by physicians in training. In addition to gaining experience in a managed care skill that is increasingly important for future employment, physicians in training can simultaneously improve the quality of care delivered through the academic health center.

Academic Medical Centers↗
PubMed2004

Students assigned to community practices for their pediatric clerkship perform as well or better on written examinations as students assigned to academic medical centers.

BACKGROUND: Medical schools are increasingly using community practice sites (CPS) for clerkship training. PURPOSES: We compared the test performance of all students assigned to CPS with all students trained at an academic medical center (AMC) for their pediatric clerkship for the past 5 years. METHODS: Baseline comparability of both groups was established by the group mean scores on 1st and 2nd year medical school grade point average (GPA) and the United States Medical Licensing Examination (USMLE) Step 1 and Step 2. Performance outcome was compared by group mean scores on a written clerkship exam and the National Board of Medical Examiners Pediatric Subject Examination. RESULTS: There was no statistical difference between the two groups with regard to GPA or USMLE scores. Standardized test performance results: [table: see text] CONCLUSION: The CPS-trained students performed as well or better on standardized written tests compared with AMC-trained students. Community pediatric practices can provide a quality clerkship experience for junior medical students.

Academic Medical Centers↗
PubMed1995

Academic health centers and HMOs: a systems perspective on collaboration in training generalists physicians and advancing mutual interests.

Academic health centers (AHCs) and health maintenance organizations (HMOs) often hold each other at arm's length because of fundamental organizational differences. AHCs view HMOs as too intrusive in the clinical management of patients and too concerned with the financial bottom line. HMOs view AHCs as organizationally fragmented and expensive in providing health care services. AHCs must expand their primary care networks and reassess their mission and public accountability in training a more balanced physician workforce. HMOs are growing rapidly and need well-trained generalist physicians to support that growth. This paper uses an organizational systems model in examining AHCs and HMOs to identify common needs, mutual interests, areas for potential collaboration, and bridging strategies. These include health care systems development, professional education, information management systems, and health services research. As the financing and delivery of health care continue to change and to become more integrated, both organizations have much to gain from collaboration.

Academic Medical Centers↗
PubMed1998

Effect of evaluator and resident gender on the American Board of Internal Medicine evaluation scores.

OBJECTIVE: To examine the effects of resident and attending physician gender on the evaluation of residents in an internal medicine training program. DESIGN: Cross-sectional study. SETTING: Large urban academic internal medicine residency program. PARTICIPANTS: During their first 2 years of training, 132 residents (85 men, 47 women) received a total of 974 evaluations from 255 attending physicians (203 men, 52 women) from 1989 to 1995. MEASUREMENTS: The primary measurements were the numerical portions of the American Board of Internal Medicine evaluation form. Separate analyses were performed for each of the nine evaluation dimensions graded on a scale of 1 to 9. The primary outcome was the difference in the average scores received by each resident from male versus female attending physicians. RESULTS: Compared with female trainees, male residents received significantly higher scores from male attending physicians than from female attending physicians in six of the nine dimensions: clinical judgment, history, procedures, relationships, medical care, and overall. Similar trends, not reaching conventional levels of statistical significance, were observed in the other three categories: medical knowledge, physical exam, and attitude. These differences ranged from 0.24 to 0.60 points, and were primarily due to higher grading of male residents by male attending physicians than by female attending physicians. CONCLUSIONS: In one academic training program, we found a significant interaction in the grading process between the gender of internal medicine residents and the gender of their attending evaluators. This study raises the possibility that subtle aspects of gender bias may exist in medical training programs.

Bias↗
PubMed2003

Medical training in community medicine: a comprehensive, academic, service-based curriculum.

The University of Pennsylvania's Family Practice Residency includes a significant community medicine component in order to accomplish the goals of addressing the health-related needs of the university's neighbors; exposing residents to the knowledge, skills and attitudes necessary to address the health needs of a community; and encouraging health careers with a community focus. It is my belief that these goals further the agenda of the National Institute of Medicine and Healthy People 2000 and 2010. Longitudinal and block community medicine experiences were established to accomplish these goals. This article describes and discusses three measurable outcomes of this curriculum: (1) individual resident projects, (2) resident class projects and (3) significant career foci in community medicine among resident graduates. I believe that our community medicine program exemplifies medical training in a community setting and furthers the national health agenda.

Community Health Services↗
PubMed2000

WAAVP/Pfizer award for excellence in teaching veterinary parasitology: teaching of veterinary parasitology--quo vadis?

Some thoughts on training and recruitment of academic teachers and future trends in teaching veterinary parasitology are presented with emphasis on the European situation. It is underlined that research is an indispensable basis for academic teaching. Besides a broad scientific background of the teacher, motivation and teaching methods are also important. Many academic teachers do not receive formal training in teaching methods. In order to improve future education, training of staff members in teaching methods should be promoted. Quality control of teaching and research, already established in many schools, should generally be introduced. Teaching is mostly underestimated in relation to research. Therefore, more weight should be placed on the former both in selecting scientists for the career as academic teachers and in evaluating and ranking departments for their academic activities. In the future veterinary medicine will have to cope with profound changes in the society and the veterinary profession, and the progressing European unification will enhance trends for internationalizing teaching curricula. Therefore, veterinary medicine has to reconsider the teaching subjects and methods and to lay more emphasis on flexibility, skills of problem-solving and self-learning and on training for life-long learning. At present there is an ongoing discussion on the question how to teach veterinary medicine, including veterinary parasitology. There are various options, and some of them are discussed, namely, the disciplinary and the problem-based/organ-focussed approaches. It is concluded that for teaching of veterinary parasitology and related disciplines a combined disciplinary and problem-based approach offers the best chances for fulfilling the requirements of teaching for the future. In the curriculum of undergraduate teaching of veterinary medicine at least 70-90 h should be dedicated to veterinary parasitology using a disciplinary and taxonomic approach. Additional hours are required for instructions on clinical cases in approaches focussed on animal species and/or organ diseases. As there is a need for discussing teaching issues, post-graduate specialization, and continuing education in parasitology and related disciplines on national and international levels, it is recommended to WAAVP to include regular workshops on teaching in the programmes of the biannual conferences, and to establish a permanent committee which should collect information and submit proposals for improvement of teaching veterinary parasitology.

Animals↗
PubMed2001

Hospice volunteer training for health science students: an academic medical center-hospice community partnership.

Within the academic medical center providing interdisciplinary, experiential, longitudinal, and mentored learning experiences for students regarding hospice/end-of-life care is a considerable challenge. This article describes an innovative course for medical, nursing, and social work students taught as a partnership among the departments of family medicine, medical history/ethics and three community hospice programs. The goals of the course are: (1) understanding the hospice philosophy of care; (2) understanding that hospice care is an interdisciplinary team process; and (3) development of the caregiver skills of self-reflection as a form of self-knowledge while participating in the care of terminally ill patients. Achieving these goals is challenging for students (especially medical students) and faculty but highly rewarding. The development, implementation and evolution over the past 3 years of this hospice volunteer training course are discussed.

Curriculum↗
PubMed1998

Neurosurgery at the University of Virginia.

Before 1937, members of the Department of Surgery and Gynecology practiced emergency neurosurgery at the University of Virginia in the same fashion as in other hospitals in the United States. In 1937, Claude C. Coleman, Chairman of the Department of Neurosurgery at the Medical College of Virginia in Richmond, organized a Division of Neurosurgery as part of the Department of Surgery and Gynecology at the University of Virginia. He designated one of his staff members, John M. Meredith, as Neurosurgeon-in-charge. Dr. Coleman served as Clinical Professor of Neurological Surgery at the University of Virginia from 1937 to 1941, while also working in Richmond. This arrangement attracted increasing numbers of patients, leading to the formation of a separate department, under the direction of William Gayle Crutchfield, in 1941. In conjunction with Juan de Dios Martinez-Galindo, who joined the faculty in 1943, Dr. Crutchfield built and directed the neurosurgical training program until his retirement. In 1969, John A. Jane, Sr., became Professor and Chairman of the Department of Neurosurgery. Pursuing the Jeffersonian intent of attracting "... those of due degree of science and of talents for instruction," the Department has been enhanced by the arrival of Neal F. Kassell in 1984, Ladislau Steiner in 1987, Edward R. Laws, Jr., in 1992, Dheerendra Prasad in 1995, Gregory Helm in 1996, and Mark Shaffrey in 1997. Resident training has been a priority of the Department of Neurosurgery; many academic neurosurgeons were trained and practiced their specialty in the Department early in their careers. Sixty years after its foundation, the Department of Neurosurgery continues its commitment to patient care, research, and the "... instruction of those who come after us."

Education, Medical, Graduate↗
PubMed1998

Professional training in the practice of hypnosis--the Australian experience.

Increasingly around the world as clinicians and researchers alike become more sophisticated in their understanding of the hypnotic process, there is developing a conviction that the hypnotic state or process itself poses no inherent dangers for patients but that its inexpert use may. The solution to prevent potential patient harm is to ensure that all clinicians of whatever discipline have adequate and appropriate clinical training prior to being allowed to practice. Since 1985, in all the Australian states, the appropriate disciplines, already licensed to practice their profession, have completed 2 years part-time academic and clinical training in the nature and nuances of hypnosis (30 hours), practical experience of direct and indirect approaches, and supervised clinical case management (50 hours). At the end of the training they complete a 3 part examination of competence (clinical cases reports, written examination, and oral examination) in order to be accepted as members of the Australian Society of Hypnosis. Only by completing this training and peer reviewed assessment are clinicians able to receive the backing of the Society and recommendation to patients of their competence as clinicians using hypnosis. Recently in the states of Victoria and South Australia (and soon in the state of Queensland), the training program of the Australian Society of Hypnosis has been incorporated into a university diploma course, giving formal academic recognition to the approach to training. The University of Melbourne diploma course will be discussed with a view to illustrating these recent developments.

Australia↗