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[Challenges in the educational objectives of preventive medicine and community health curriculum in undergraduate medical education].

In the world-wide context of the current innovative movements in medical education it is of importance of set up the appropriate educational objectives--general instructional objectives (GIO) and specific behavioral objectives (SBO) for the undergraduate medical curriculum for preventive medicine and community health. These educational objectives should be constantly evaluated and modified according to the curricular changes which regularly occur so as to maintain relevance. An example is the recent modification of GIOs and SBOs in the curriculum of the University of Occupational and Environmental Health. Each sentence of 7 GIOs and 35 SBOs was simplified, keeping the original meaning (former texts in JJPH 37: 241-246, 1990, initially adopted in 1988) as much as possible. Further analysis of the example was performed including the rationale of the 7 GIOs, the setting up and continued evaluation of the SBOs to meet the relevance. Based on this analysis, future challenges include elaborating the minimal expected competencies (described as GIOs and SBOs in full sentence) in the course of preventive medicine and community health such as seen in the "Objectives of the Qualifying Examinations" of the Medical Council of Canada.

Curriculum↗

Education and training module for a specialist registrar: a move forward in specialist registrar education.

A new post was created in Portsmouth. This produced the opportunity, for a new and innovative approach to the education and training module for the specialist registrar (SpR) training programme. The GP tutor with supervision from the university, designed, implemented and evaluated the module. It took place during the first five months of the SpR contract. The method used was a case study in which the SpR was encouraged to reflect on practice. The learning outcomes were documented initially by the GP tutor and,finally, by the SpR using a logbook based on the dental professional development log. Reflecting on practice enabled the SpR to produce the evidence of her own learning and plan her future learning needs. The project highlights the advantages and problems of reflecting on practice. These issues must be addressed if the conflict between the need to produce the competent doctor and the demands of an educationally sound programme are to be resolved, to create critical thinking and autonomous lifelong, self-directed learners.

Education, Medical↗

Comparative evaluation of educational methods in surgical resident education.

OBJECTIVE: To determine the influence of study methods on American Board of Surgery (ABS) examination performance. DESIGN: Performance on ABS examinations by and faculty evaluations of 54 categorical surgical residents from 1976 to 1992 were correlated with the residents' use of commonly available educational methods (textbooks, Selected Readings in General Surgery, grand rounds, preceptor guidance, clinical surgery review courses, surgical science review courses, Surgical Education and Self-Assessment Program [SESAP], and continuing medical education lectures) in early, late, and after residency. SETTING: An average-sized midwestern US university surgical residency. RESULTS: Residents who consistently scored above the 33rd percentile on ABS examinations had used texts early, Selected Readings later, and SESAP after residency more frequently than those with ABS In-Training Examination scores in the lower one third. Selected Readings and clinical review courses were associated with significant increases in ABS percentile scores when used in late or after residency and, along with SESAP, were used when residents improved their low ABS In-Training Examination scores. CONCLUSIONS: Independent study methods are the most effective pathway to successful ABS examination performance. Formal surgical review courses may help improve the ABS examination scores of residents at a higher risk of failure.

Clinical Competence↗

Identifying educational influentials for formal and informal continuing medical education in the province of British Columbia.

BACKGROUND: The objective of this study was to identify physicians in the province of British Columbia (BC) who are perceived by their colleagues to be the most educationally influential. METHODS: A cross-sectional study using a previously validated survey tool was mailed to a randomly selected sample of 2300 BC registered primary care physicians. Follow-up mailings were sent to nonresponders. RESULTS: The survey response rate was 53%. A list of 375 educationally influential physicians (EIs) was proportionately determined and tabulated by region. IMPLICATIONS: The top 5% of provincial EIs were identified to serve as a resource for formal and informal continuing medical education (CME). Their names will be brought forward in response to selected requests for CME speakers.

Attitude of Health Personnel↗

Educational skills and knowledge needed and problems encountered by continuing medical education providers.

BACKGROUND: The objective of this study was to identify the training needs and difficulties encountered by continuing medical education (CME) providers in Quebec. METHODS: A questionnaire comprised of open-ended and closed questions was sent to 224 general practitioners across Quebec who organize CME meetings. To complement and validate the data, interviews were conducted with 18 physicians selected from this group, based on their years of experience with CME, and with the managers of two organizations involved in CME. RESULTS: The questionnaire response rate was 54%. Quantitative analysis was used to identify the main training needs expressed by CME providers affiliated with the Quebec Federation of General Practitioners, namely, methods for identifying needs (74%), group leadership techniques (69%), basic principles in adult education (69%), and organization of CME activities (66%). The main problems encountered by respondents in their duties are stimulating and maintaining the interest and participation of physicians in formal CME activities (52%), identifying and meeting physicians' educational needs (32%), and motivating physicians to get involved in any kind of CME initiative (18%). The interviews highlighted the wide disparity in the approaches used by CME providers when planning activities and the failure of providers to pass on relevant information to their successors. IMPLICATIONS: Based on the difficulties and the training needs identified, we were able to develop tools (structured training program, biannual newsletter, reference books, and resources) suited to the needs of general practitioners who organize CME activities.

Education, Medical, Continuing↗

Cardiovascular continuing medical education: what education do you want?

In summary, continuing medical education is not generic--it is highly specific. In my view, it does not matter how physicians obtain knowledge in their areas of expertise, only that they obtain the knowledge. Cardiovascular medicine textbooks and scientific journals form the core of our knowledge, but many other modes of education are available, including audio CDs and tapes and CD ROMs. Now, extensive information is available on the internet almost as soon as it is discussed at national meetings. One must be careful with these so-called "up to date" sources of education, since much of this early information has not been peer reviewed. Nonetheless, most of that information turns out to be useful.

Cardiology↗

Superiority of a cognitive education with photographs over ABCD criteria in the education of the general population to the early detection of melanoma: a randomized study.

Most education campaigns for melanoma (MM) detection in the general population have used the "ABCD" algorithm, although recognition of objects in the real life is based on a holistic image recognition rather than on analytic criteria. The objective was to compare analytic (ABCD) and cognitive (photographs) strategies for teaching self-recognition of MM. A prospective 4-arm stratified randomized trial in 255 individuals compared 3 realistic educative interventions by leaflets: 1) ABCD algorithm ("ABCD"), 2) a set of photographs chosen to stimulate recognition of MM among benign pigmented lesions ("Cog"), 3) photographs + explanations ("Cog-Ex" arm) and 4) no intervention ("NI"). A 40-slides test was performed before intervention (T0), 1 week after (T1) and after induction of anxiety (T2). In the "ABCD" arm, sensitivity slightly improved (80 to 83.8%, p = 0.04), but specificity dropped from 65.1 to 56.3% (p < 0.001), with no benefit in accuracy as compared to "NI". In "Cog" arm, there was no change in sensitivity, but a strong increase in specificity (65.9 to 81.1%, p < 0.001) and accuracy (42.1 to 53.1%, p < 0.001). "Cog-ex" resulted in similar although lower benefit. Under stress (T2), there was a dramatic loss of specificity and accuracy in "ABCD" arm (65.1 to 44.1%, p < 0.001 and 40.8% to 35.8%, p < or = 0.001) without higher gain in sensitivity, while sensitivity and accuracy increased (p < 0.005) after "Cog" leaflet, without decreasing specificity. Finally, the "ABCD" message alone does not seem efficacious and is even worse in the context of anxiety, whereas a quick look at a few photographs is sufficient to improve the ability of the laymen to recognize a MM just by optimizing their spontaneous image recognition capacities. Education by photographs is a realistic strategy which should replace or complete "ABCD" message in the campaigns for self-detection of MM.

Adolescent↗

Report. Proteomics education, an important challenge for the scientific community: report on the activities of the EuPA Education Committee.

The main missions of the EuPA Education Committee (EuPA-EC) are to promote and enhance the quality of proteomics knowledge by creating educational programs and to initiate European-wide scientific exchange programs for young proteomics researchers. In this first report we present the initial actions we have undertaken in relation to the missions of the EuPA-EC, and the educational activities that have been planned for 2007-2008. These activities include courses (basic and advanced courses and a summer school), workshops, laboratory networking and tutorials.

Curriculum↗

The educational philosophies behind the medical humanities programs in the United States: an empirical assessment of three different approaches to humanistic medical education.

This study investigates the three major educational philosophies behind the medical humanities programs in the United States. It summarizes the characteristics of the Cultural Transmission Approach, the Affective Developmental Approach, and the Cognitive Developmental Approach. A questionnaire was sent to 415 teachers of medical humanities asking for their perceptions of the amount of time and effort devoted by their programs to these three philosophical approaches. The 234 responses constituted a 54.6% return. The approximately 80:20 gender ratio of males to females and other demographic data on age and educational background were consistent with other studies of the field of medical humanities. Reflections on the results in Table II indicate that some changes need to take place in the teaching of the medical humanities if the perceived ideal is to be achieved. In order for the current teachers of the medical humanities to think that the appropriate philosophies behind the teaching of the medical humanities are being implemented as they should be, much less time and effort need to be devoted to the Cultural Transmission Approach. With no other published reports on the educational philosophies behind the medical humanities programs, this study created a new knowledge base about this relatively young and rapidly emerging field.

Education, Medical↗

Community-based nurse-midwifery education program. Distance learning in nurse-midwifery education.

Distance-learning has greatly expanded the number of students admitted to a nurse-midwifery education program. This article describes the Community-Based Nurse-Midwifery Education Program (CNEP) of the Frontier School of Midwifery and Family Nursing. The organizational structure and curriculum of the CNEP combines apprenticeship learning with academic rigor, permitting students who cannot relocate to the university to pursue graduate education. New technology, such as an interactive electronic bulletin board, networks students and faculty. The program emphasizes theories of independent, adult learning. There is a master's completion option available through the affiliation with Case Western Reserve University.

Community Health Nursing↗

Cooperation project in basic nursing education--the introduction of a new nursing education program in Tianjin, China.

Over the last few decades, traditional basic nursing education has taken place in nursing schools in China. In 1988, a new cooperation project for basic nursing education was tried between a Tianjin nursing school and several hospitals (Tianjin is one of the industrial cities in China). In this paper, an experiment in nursing education in Tianjin is described. In order to help readers to understand the Cooperation Project, the preparation courses are also described. Several advantages and disadvantages are discussed; some new proposals are also put forward at the end of the paper.

China↗

The evolution of social work education in England: a critical review of its connections and commonalities with nurse education.

Social work education in England underwent significant change in its move to degree status in 2003. It is hoped that the result will be increased professional standing for social workers, an improvement in the current widespread problems with recruitment, and assurance that all newly qualified social workers meet the National Occupational Standards for Social Work (Available from: http://www.topssengland.net/files/cd/). This change has pre-occupied social work educators and debate within the profession has concentrated on the practicalities and expectations of reform. This paper suggests that those working in nurse education may observe a number of similarities with its own earlier reforms and with current debates on whether nursing should move to an all-graduate profession. It then highlights three aspects of the new requirements for social work training: service user involvement, the place of research-minded practice, and the primacy of practice--that may be of interest and relevance to nursing colleagues.

Credentialing↗

[Continuing education in primary care: the educational needs of its professionals].

OBJECTIVES: To find professionals' suggestions for training contents, the value they place on various options, the difficulties they detect for attending activities and their preferences for time-table and format of courses. DESIGN: Cross-sectional, descriptive study. SETTING: Primary Care Area 7 in Madrid. PARTICIPANTS: Medical and office workers from the area (n=1,053). MAIN MEASUREMENTS: An anonymous self-filled questionnaire. RESULTS: 39% replied (46% nurses; 42% administrative assistants, and 40% doctors). The subjects for courses most often requested by doctors were dermatology, minor surgery and radiology; by nurses, emergency, functional bandages and computer skills; and by administrative assistants, computers, management of health service delivery and Internet. The continuing education options valued most highly were courses/workshops in the area's continuing education programme, self-training sessions and rotations. The main difficulties for attending courses were the lack of budget for cover and time-tables outside working hours. 42% preferred mornings; and 35%, courses lasting more than 20 hours. CONCLUSIONS: The training needs expressed by doctors and nurses are mainly clinical in content, whereas those of office staff are mainly computer-related. The most highly valued training options are the courses/workshops in the area's continuing education programme. The main difficulty for attending courses is the lack of cover for their job.

Cross-Sectional Studies↗

Political principles in action: a critical analysis of Education and Training: Working Paper 10 and its implications for nurse education.

Education and Training: Working Paper Ten (WP10) (Department of Health 1989a) was published in October 1989. It was an integral part of Working for Patients (Department of Health 1989b) and as such was alleged to embrace the same fundamental principles. WP10 may result in the most significant change to nurse education in the UK since the 1949 Nurses Act, with variations in its funding, structure and organisation. Surprisingly, there has been relatively little discussion about this important development within the nursing press. The aim, therefore, of this paper is to evaluate WP10 within the context of the ideology which has underpinned social policy in the last 14 years. Firstly, Conservative Party policy will be explored, the WP10 itself will then be examined in order to assess how far such principles have been applied to nurse education through its implementation. It is intended that by this process of analysis further understanding will be gained about this policy and its potential consequences for the future of nursing.

Education, Nursing↗

The integration of nursing and midwifery education within higher education: implications for teachers--a qualitative research study.

This study was a qualitative narrative that reviewed the historical developments that led to the integration of nursing and midwifery education with higher education in the United Kingdom (UK). A sample of teachers was investigated with particular reference to role conflicts they may have experienced as a result of integration. In addition to this the views of established academic university staff were assessed. The methodology adopted for the research was an eclectic qualitative one, drawing on several approaches, and sought to inquire into individuals personal perception of these events. In this paper the progression of events, nationally and locally, that led to the educational reforms in nursing and midwifery in the 1990s are examined. This narration includes a brief history of the creation of a new university department. Following this there is detail of how data were collected and analysed from a teacher population within this new department. The findings, whilst difficult to generalize to the wider population of nurse and midwife teachers, demonstrate that the sample of teachers examined, all of whom have been involved in the process of integration, have been exposed to stress that has resulted in role conflict. Established university staff, however, were more objective, expressing some broad anxieties regarding the resource demands and research capability of the new department.

Adult↗

A national medical education needs' assessment of interns and the development of an intern education and training programme.

A needs' assessment of interns was undertaken using a self-completion questionnaire and a semistructured interview. The questionnaire explored to what degree graduates had been helped to acquire a range of competencies and professional characteristics. In the interviews graduates discussed their self-perceived learning needs, their educational and training experiences and made suggestions. A 25% random sample of 1996 graduate doctors was selected from the five medical schools in Ireland (n=95). The overall response rate was 88% (n=84). The software package SPSS was utilized to carry out descriptive statistics on the questionnaire data while the interview data were analysed qualitatively. Of the responders, 91% reported that they were not prepared for all the skills needed as an intern. History taking and clinical examination were considered well covered at the undergraduate level but little training was received in a range of professional competencies and personal characteristics. Formal education and training during the intern year was found to be poor. However, some skills and characteristics improved during the year as a result of work experience. In the interviews the graduates explored educational issues. They considered an improved clinical experience throughout the undergraduate years to be at the heart of curriculum development but stressed that, in order to succeed, it would have to be accompanied by leadership within the healthcare system and efforts to improve the learning environment.

Clinical Competence↗

Incorporating palliative care into primary care education. National Consensus Conference on Medical Education for Care Near the End of Life.

The confluence of enhanced attention to primary care and palliative care education presents educators with an opportunity to improve both (as well as patient care) through integrated teaching. Improvements in palliative care education will have benefits for dying patients and their families, but will also extend to the care of many other primary care patients, including geriatric patients and those with chronic illnesses, who make up a large proportion of the adult primary care population. In addition, caring for the dying, and teaching others to carry out this task, can be an important vehicle for personal and professional growth and development for both students and their teachers.

Curriculum↗