[Experiences with simulated handicaps].
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Efficient and effective use of simulations for teaching or review requires that they be matched carefully to a target nursing competency. Guidelines are provided to assist nursing staff development educators in selecting and using simulations for psychomotor assessment and interpersonal skills as well as problem solving.
Actors were trained to simulate a young asthmatic woman in the high risk category. Sixty-four of the 195 general practitioners and family medicine registrars in Christchurch city agreed to take part in the study in which they would be consulted by a simulated patient remaining blind to identification of the patient, the time and the medical problem. The simulators were trained to record information from the consultation and rate doctor behaviour when presenting, as a new patient on transfer, for a repeat prescription of asthma medication. Forty-nine doctors had one consultation and of these 25 had a second. Consultation time averaged 15.6 minutes and waiting time 17.4 minutes. Practice nurses and physiotherapists were rarely utilised. There were no specialist referrals. Serum theophylline levels were estimated in 4%. The chest was examined in 39% of consultations, the peak flow in 59%, both in 30% and neither in 32%. Drug prophylaxis was encouraged in 62%, home peak flow meter monitoring was encouraged in 49%, smoking was discouraged in 41%, aerosol technique was checked in 1%, a crisis plan was provided in 57% and asthma education in 42%. Doctor behaviour and communication skills were rated highly except that clear instruction on follow up appointments was given in only 24%. The second consultation appeared to be a briefer rerun of the first, indicating episodic care rather than planned long term management. A number of issues were identified for further study and education.
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The array of instructional methods utilized in teaching behavioral sciences to dental students has included both teacher-centered and student-centered approaches. The purpose of this study was to evaluate the effectiveness of two small-group treatments, mini-lecture and role-playing, in teaching dental psychology. Freshman dental students were randomly assigned to 12 groups. Groups were then assigned to one of six dentist-pyschologist teaching teams so that each team taught one mini-lecture and one role-playing group. Teaching teams taught seven sessions in which each mini-lecture/role-playing pair of groups received parallel subject matter. Following instruction, two outcome measures were administered: (1) an achievement post-test measuring factual recall, and (2) a measure of facilitative communication. Results indicated that mini-lectures were more effective than role-playing in effecting student mastery of factual information. There were no significant differences between the instructional treatments in teaching facilitative communication skills.
The method of business games developed and used for 5 years may be used successfully in practical training of late-year students of medical institutes in surgery. It expands the possibility of the traditional training methods essentially, promotes better learning of the material, the formation of skill in diagnosis and reaching practical decisions, and acquiring experience in contact with the patients and their relatives.
Responsibilities of the dental practitioner impose stress situations similar to those of any manager. These deal with elements of interpersonal behavior and skills not customarily taught to the dental practitioner. In an effort to train dentists so that they may better cope with these managerial situations a method was devised using as the primary instrument the Dental Managerial Situation Study (DMSS). The DMSS employs a variety of problem situations that the dentist is likely to encounter as a means of eliciting his or her managerial tendency (Managerial Profile). A managerial profile is then applied for diagnostic and training purposes. In group discussions, most appropriate behavior (i.e. normative responses) is determined and new ways to behave are learned as each student witnesses advantages and disadvantages of certain responses. The method described in this paper imparts a lexicon (knowledge) of alternative coping or non-coping behaviors to managerial situations. The dental practitioner is able to apply this knowledge in future situations in a way that is more coping and thus he or she may alleviate some managerial stress.