Fellowships in medical education.
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Although a variety of new teaching strategies and materials are available in education today, medical education has been slow to move away from the traditional lecture format. An individualized course in clinical psychiatry is described, both from a philosophical and operational frame of reference. Features of the course of include programmed instruction, behavioral objectives, criterion-referenced mastery level evaluations, contracting for grades, and utilization of small-group discussions. Attention is directed to the advantages of the new methods as well as to new problems which surfaced.
Pressures of time, changing curricula, and increased enrollment in medical schools require the development of more efficient teaching methods to replace or supplement the traditional lecture format. The faculty of the Department of Psychiatry and Behavioral Sciences at the Medical University of South Carolina has developed an individualized course in basic psychiatry which can replace approximately 50 hours of lectures ordinarily delivered to students during the rotation on clinical psychiatry. The individualized course, referred to as the Psychiatry Learning System (PLS), was received by half the class during the year 1973-74, and the lecture course was delivered to the other half. These two groups were compared on several learning outcomes, including attainment of theoretical knowledge about psychiatry, observational skills, interviewing ability, and problem-solving ability. Overall performance ratings by clinical supervisors were also obtained. The PLS group scored no worse on any of the measures but statistically better on half of them than did the lecture group.
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The purpose of the project reported here was to develop and evaluate an educational intervention to improve the interviewing skills learned in medical school. Sixty fourth-year medical students in a required ambulatory care rotation were randomly selected and randomly assigned to one of four conditions. All students interviewed a simulated patient who presented with one of five main complaints, and the interview was videotaped. Students were assigned to a control group or to one of three intervention groups: viewing a self-instruction videotape, viewing and critiquing a videotape of their interview, or both of these activities. The students assigned to the control group did not participate in any educational interventions. At the end of the intervention period, the students again interviewed a simulated patient and were videotaped. The 120 videotaped interviews were reliably rated by a scoring system developed by the project team. The postintervention interviews conducted by students in the two groups that used the self-instruction videotape received significantly higher ratings than those in the control group. These results suggest that this self-instruction intervention can improve the interviewing skills of senior medical students.
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