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The nurse lecturer role in clinical practice conceptualized: helping clinical teachers provide optimal student learning.

Despite the fairly wide reporting in the literature of the many roles of clinical supervision by the nursing teacher, little attention has been given to conceptualizing the relative priorities these roles take during the process of supervising nursing students in clinical practice. The purpose of this paper is to consider the manifestations and implications of conflicting roles when nurse lecturers undertake clinical supervision. Previously published research will provide working examples of issues in a conceptual framework for clinical teaching.

Clinical Competence↗

Reassessing the concept of emotional labour in student nurse education: role of link lecturers and mentors in a time of change.

This article describes part of a follow-up study to Smith's (1992) original work on emotional labour, at a time when questions of the role, scope and crisis in nursing are a matter of local and national debate (Bradshaw 1999, Gillan 1999, Fabricius 1999, Feldman et al. 1999). The article addresses recent changes in nursing and nurse education (UKCC 1986, UKCC 1999a, DoH 1999, UKCC 1999b) as a means of exploring new patterns of learning to care in nursing. Less than a decade ago, emotional labour and helping students learn to care was part of the role of the sister/charge nurse (Ogier 1982, Fretwell 1982, Smith 1992). In this study, the role of the link lecturer, and mentor who currently shape the student nurse's learning experience, is the focus for evaluation.

Education, Nursing↗

[Lecture disasters - and how to prevent them].

Presentations at medical conferences can sometimes confuse or compromise understanding of current topics. Although considerable time and financial costs may be taken to be present at such events, all too often one must go through inferior presentations that are poorly structured and do not contribute to one's understanding of the topic at hand. A good presentation is distinguishable by the clear intentions of the speaker to give a good lecture. The presenter has worked extensively with his topic and is familiar with the audience. The presentation has a clear structure and finishes with a take-home message. The speaker takes the listener from his previous level of knowledge to a new understanding. To do so, both voice and body language are used. The supporting slides are simple and direct, and not overloaded with information. The speech conforms exactly with the pre-determined time limit.

Audiovisual Aids↗

The Nutrition Society Medical Lecture. Obesity: from molecules to man.

Obesity is now a major public health problem in both developed and developing countries. In the UK over 16% men and 17.5% women are obese, an increase of more than 100% since 1980. However, interventions to prevent and treat obesity are hampered by an inadequate understanding of the aetiology of this condition. The present paper considers the current state of knowledge regarding the causes of obesity, including some of the genetic, metabolic, behavioural and environmental factors which influence energy balance. The present paper comprises The Nutrition Society Medal Lecture and focuses in particular on the research carried out at the MRC Dunn Nutrition Centre in Cambridge. It argues that despite decades of intensive research there is relatively little evidence of genetic or metabolic defects to explain the majority of cases of human obesity. Instead we must look to behavioural and/or environmental factors which may be underpinning the current epidemic of obesity.

Diet↗

1975 Yant Memorial Lecture New aspects on dust and pneumoconiosis research.

This lecture deals with pneumoconiosis, in particular with fibrotic tissue reactions caused by SiO2 and asbestos dusts in the lungs. The term "fine dusts" is defined in connection with the setting up of MAC-values. The aerodynamical diameter of particle shaped and fibrifom dust is set forth. Results of the fundamental research with SiO2, Coal mine and asbestos dusts in animal and cell experiments are explained.

Animals↗

The C. J. Shanaberger lecture: the evolution of prehospital cardiac care: 1966-2006 and beyond.

Prehospital cardiac care began 40 year ago. This lecture reviews the origins and evolution of prehospital emergency care for cardiac arrest. Several national and international guidelines have defined an evolving standard of care. The most recent guidelines, published in 2005, argue for a return to the basics and emphasize the importance of CPR and defibrillation. In 40 years we have learned much about the epidemiology of cardiac arrest and the factors associated with successful resuscitation. Timely CPR and defibrillation remain the cornerstones of successful therapy. A new role for EMS personnel may help identify at-risk patients and thus prevent future cardiac arrest. A pilot program, know as SPHERE (Supporting Public Health with Emergency Responders) is underway in King County, Washington. The goal is to identify patients with risk factors of high blood pressure or high blood glucose and motivate the patient to seek follow-up care. Several intervention strategies are being tested. Since EMS providers see up to 10% of the population in any given year the chance to identify at-risk patients provides a public health opportunity.

Emergency Medical Services↗

The pathos of pathology and a possible cure: H.P. Smith Memorial Lecture.

This H.P. Smith Memorial Lecture attempts to define and prescribe treatments for a malady afflicting clinical pathology today--its difficulty in communicating the vital role of the pathologist in patient care to the public, politicians--and, in many instances, our own colleagues in other medical specialties. In paying tribute to a pioneering clinical pathologist, Dr. H. P. Smith, attention is drawn to his diagnosis of these problems--a diagnosis he perceived decades ago. The ancient meaning of pathos, the Greek stem for which the word pathology comes, is used to pinpoint the problems that have led to clinical pathology's own pathos--the lack of recognition afforded those physicians who practice it. A review of the conditions that led to this state is presented, and these conditions are compared with others present in our specialty, e.g., the "behind the scenes" situation of surgical pathology and the decline of the utilization of the autopsy. Factors that tend to frustrate the normal relationship between the clinical pathologist and the patient, as well as his or her role as a consultant to the attending physicians, are summarized. Suggestions are put forward for changing the image of the clinical pathologist from one of near invisibility to one of dynamic interaction with patients and with other physicians of the medical care group, for the good of all concerned.

Autopsy↗

Teaching advanced genetics without lectures.

In an effort to increase student engagement and therefore student learning, an advanced genetics course was developed in which traditional lectures were eliminated. Instead, students were required to complete reading assignments before each class meeting, and those readings were then the topic of group discussion. Assigned readings alternated between text assignments and articles from the primary literature. Students were made accountable for their own preparation by the administration of a quiz at the start of each class. Group discussion of the topics engaged students in the learning process and readministration of the quiz at the end of class allowed them to benefit from the group interaction and understanding. Interspersing text readings and primary literature led to student understanding of how genetic knowledge is acquired and interpreted and how experimental detail leads to the construction of general models.

Curriculum↗

Hunting for electrophiles that harm human DNA: Frits Sobels Award Lecture.

This lecture is dedicated to Frits Sobels and his farsighted vision on research directions in genetic toxicology. Some accomplishments by the author's research group in the area of cancer etiology research and pre-clinical drug safety evaluation are presented. Praziquantel, an antischistosomal drug, was found to be devoid of any genetic effects which determined the drug companies to proceed with further safety evaluation and marketing. This highly efficient life-saving drug is now in use world wide. Biomonitoring methods have been developed to quantitate carcinogens, their metabolites or DNA adducts in humans exposed environmentally and endogenously to genotoxic agents. The methods were applied in ecological and case-control studies aimed at establishing causal relationships between exposure and disease. Results from both field studies in Iran and laboratory investigations supported the hypothesis that opium use, in particular ingestion of its pyrolysates, may be a risk factor for esophageal cancer in this region, probably acting together with nutritional deficiencies and thermal injury. By applying the nitrosoproline (NPRO) test in ecological studies on esophageal cancer causation in China some support was obtained for the involvement of N-nitroso compounds. In inhabitants of high risk areas endogenous nitrosamine synthesis could be markedly reduced by ingestion of vitamin C. Ultrasensitive detection methods for etheno-DNA adducts, which are formed by lipid peroxidation products resulting from increased oxidative stress, have been developed. Known cancer risk factors such as metal storage, chronic inflammatory processes and a high omega-6 PUFA fat diet increased the background level of these miscoding DNA adducts many times. They were found to increase progressively in premalignant lesions of cancer-prone tissues of humans and rodents, probably contributing to the genetic instability that drives cells to malignancy. Etheno-DNA adducts are thus promising markers to verify the efficiency of chemopreventive measures in humans.

Animals↗

Slide-tape versus lecture demonstration presentation of thermal agents in a physical therapist assistant program.

A slide-tape individualized method and a conventional lecture-demonstration method of teaching thermal agents to physical therapist assistant students were compared. Performance measures included clinical procedures, written tests, attitudes toward the method used, and time spent in the learning center and in the classroom laboratory. No significant differences were found between the groups on performance of clinical procedures, written tests, or attitudes. The group using the slide-tape individualized method, however, spent significantly less time in achieving satisfactory performance on written tests and in clinical procedures.

Audiovisual Aids↗

Signs of death as considered by Dr. B.M. Vance in a lecture fifty years ago.

This work is based on the lecture given by Dr. Bernard M. Vance, then Assistant Chief Medical Examiner of New York, to the Homicide Squad Detectives of New York City on November 2, 1933, at the New York Police Academy. He entitled his presentation "Death, simulation of death and suspicion of death." Dr. Vance was an outstanding member of the New York Office's Forensic Pathology Group and was known for his colorful renditions of the scene and autopsy findings in medicolegal cases.

Death↗

The rebirth and blooming of forensic medicine, Milton Helpern Lecture.

This features a presentation by Dr. Sidney Kaye on the occasion of the Milton Helpern Lecture at the annual meeting of the National Association of Medical Examiners near Fort Myers in Florida in 1989. The author experienced the "golden age" of forensic medicine as a student and associate of Dr. Alexander Gettler in the New York Medical Examiner's Office. He also worked with Dr. Rutherford Gradwohl in the St. Louis Police Department and was one of the founders of the American Academy of Forensic Sciences. He was the toxicologist in the Virginia medical examiners' system before moving to Puerto Rico. His discussion is a historical review of his experiences in developing forensic sciences.

Awards and Prizes↗

Making slides for lecture or teaching.

Technical details are provided for making slides of several types for lecture or teaching. Advantages are simplicity, versatility, speed, high quality, and low cost.

Color↗

Ratings of students' performances in a third-year internal medicine clerkship: a comparison between problem-based and lecture-based curricula.

PURPOSE: To compare clinical performances in a third-year medicine clerkship between studies from a problem-based learning (PBL) curriculum and students from a traditional, lecture-based learning (LBL) curriculum. METHOD: The study participants were 88 PBL students and 364 LBL students rotating through a common third-year internal medicine clerkship at the Bowman Gray School of Medicine at Wake Forest University, classes of 1991-1995. Faculty and housestaff assessed the students' performances using four clinical rating scales. The student also completed the medicine student ("shelf") test of the National Board of Medical Examiners (NBME). RESULTS: On average, the PBL students received significantly higher ratings from housestaff and faculty on all four rating scales. No difference in scores on the NBME medicine shelf test was observed. CONCLUSION: The results support the hypothesis that preclinical PBL curricula as found at the Bowman Gray School of Medicine may enhance third-year students' clinical performances.

Achievement↗

The biology of wound healing in the corneal stroma. Castroviejo lecture.

The healing and remodeling of a stromal incision in described at the gross, fibrillar, and cellular levels. The possibility that the healing of the wound and the clearing of the scar can be accelerated by biological interventions is discussed. Castroviejo Lecture was given on November 9, 1986.

Cicatrix↗

The 2000 NCRP Lauriston S. Taylor lecture--administered radioactivity: unde venimus quoque imus. National Council on Radiation Protection and Measurements.

In this lecture, which celebrates Lauriston S. Taylor, a pioneer in radiation protection and founding president of the NCRP, I review some features of medically administered radioactivity through the past century and attempt to forecast some aspects of its future. I have used as my guide NCRP Report No. 70, Nuclear Medicine--Factors Influencing the Choice and Use of Radionuclides in Diagnosis and Therapy. The following topics are addressed: (1) decision-making considerations in the choice of radiopharmaceutical drug products, (2) factors in choosing an instrument for nuclear medicine procedures, (3) radiation dose, (4) evaluation of radionuclide procedures and their clinical utility, and (5) guidelines for performing nuclear medicine procedures.

Decision Making↗

Lauriston S. Taylor Lecture: Radiation protection in the aftermath of a terrorist attack involving exposure to ionizing radiation.

I would like to start this Twenty-Eighth Lauriston S. Taylor Lecture by expressing my gratitude to the National Council on Radiation Protection and Measurements (NCRP) for this unique occasion. I feel particularly honored for this opportunity to address a highly specialized and qualified audience of professionals who are specifically interested in what appears to be a forthcoming worldwide challenge, namely radiological terrorism and managing its potential radiological consequences.

Benchmarking↗

Computer aided learning versus standard lecture for undergraduate education in urology.

PURPOSE: The current model of undergraduate medical education is under debate since knowledge retention and student interest seem to be decreasing. To clarify this situation we developed and evaluated a computer aided learning program using a multimedia presentation about prostate cancer for undergraduate teaching in urology. MATERIALS AND METHODS: A total of 60 medical students from years 2 and 3 were divided into group 1-31 who used the multimedia program and group 2-29 who attended a standard lecture on the same subject. At the end the level of knowledge acquisition for the 2 groups was evaluated by a multiple choice test. Group 1 students also answered a questionnaire about subjective feelings on computer based teaching. RESULTS: Test performance in groups 1 and 2 was similar (60% vs 62% correct answers, p >0.05). On the other hand, 23 of 31 students using the multimedia program believed that it did not adequately replace the instructor and interaction with a mentor still seems to be relevant. CONCLUSIONS: According to this study computers and multimedia programs can be used for undergraduate education in urology, providing that direct contact with an instructor is concomitantly offered to students.

Computer-Assisted Instruction↗