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PubMed1994

Educational audit of postgraduate medical education.

This project examined the academic audit of postgraduate medical education, and went on to research, design and implement an educational audit system for use in Mersey Region, UK. Issues found to be significant included ownership of both standards and results, norming, and the levels of aggregation of data. The project has demonstrated that designing and implementing a system of feedback which is effective and sustainable is feasible, but requires the agreement and support of tutors as to its objectives and use. The resulting system has now been tested across a range of courses and programmes of meetings in Mersey Region, and has been accepted by the Postgraduate Office as the basis for future development.

Education, Medical, Graduate↗
PubMedDate not supplied

Epilepsy education in medical schools: report of the American Epilepsy Society Committee on Medical Student Education.

The education of medical students about epilepsy is often fragmentary and incomplete. Basic information regarding the classification of epileptic seizures, epilepsy syndromes, first aid for seizures, and practical use of antiepileptic drugs (AEDs) may not be covered in medical school curricula. In this report we describe reasons why the study of epilepsy provides a relatively unique opportunity to integrate concepts related to basic neuroscience and clinical neurology. Furthermore, we present a curricular framework that may prove useful for the education of medical students about epilepsy.

Anticonvulsants↗
PubMed1995

Values education: a new direction for medical education.

This paper suggests that medical education should redirect resources to values education, specifically developing new strategies to improve the process of clarification of values. The author suggests using the values journal method which is based on a systematic record of students' personal value systems reflected in their stories and life experience; and on their responses to case presentation. Generating a personal values journal helps students define who they are, what their social and professional roles are, what their expectations are and where they are going. Keeping values journals promotes students' decision-making capacity, and equips them with the necessary skills to teach their future patients how to generate their own value systems. The development of a well defined values journal is a preparatory stage for active participation in clinical conferences or group discussion, and for effective communal dialogue among the group's members.

Autobiographies as Topic↗
PubMedDate not supplied

Can access to spirometry in asthma education centres influence the referral rate by primary physicians for education?

BACKGROUND AND OBJECTIVES: Asthma remains uncontrolled in a large number of asthmatic patients. Recent surveys have shown that a minority of asthmatic patients are referred to asthma educators. The objective of the present study was to assess the influence of increased access to spirometry in asthma education centres (AECs) on the rate of patient referrals to these centres by general practitioners. METHODS: A one-year, prospective, randomized, multicentric, parallel group study was conducted over two consecutive periods of six months each, with added spirometry being offered in the second six-month period to the experimental group. Ten AECs were enrolled in the project. An advertisement describing the AECs' services was sent by mail to a total of 303 general practitioners at the start of each period, inviting them to refer their patients. Measures of the frequency of medical referrals to the AECs were assessed for each period. RESULTS: The group of AECs randomly selected for spirometry in the second six-month period received 48 medical referrals during the first period and 32 during the second one, following proposed spirometry. AECs that had not offered spirometry received five referrals during the first period and seven during the second period. One AEC withdrew a few weeks after the study began and others encountered administrative problems, reducing their ability to provide interventions. CONCLUSIONS: Referral to AECs is not yet integrated into the primary care of asthma and offering more rapid access to spirometry in the AECs does not seem to be a significant incentive for such referrals.

Asthma↗
PubMed1995

Bilingual special education teachers' shifting paradigms: complex responses to educational reform.

This study examined the nature and process of change among five bilingual special education teachers as they attempted to modify existing instructional practices. Three factors affected the change process: (a) The more special education training in the teachers' background, the stronger their reductionist orientation; (b) change involves shifts in instructional practices and shifts in beliefs, and they do not automatically go hand in hand; and (c) change is most facilitated at the beginning stages of collaboration by including practicing members of the teachers' occupational community as agents of change.

Attitude↗
PubMed2000

Utilizing a JCAHO review in the education of clinical pastoral education CPE residents.

Reflects on how a pastoral care department utilized a Joint Commission review in the education of five pastoral care residents enrolled in their third unit of Clinical Pastoral Education in a medical center. Outlines how residents prepared for the review, the learning opportunities for residents and medical staff, the outcomes, and the recommendations.

Accreditation↗
PubMedDate not supplied

Process evaluation of an educational intervention to improve end-of-life care: the Education for Physicians on End-of-Life Care (EPEC) program.

Despite the growing importance of end-of-life care and the need to improve it, physicians receive little formal training in palliative care. The Education for Physicians on End-of-life Care (EPEC) project, developed by the American Medical Association and the Robert Wood Johnson Foundation, tested a train-the-trainer educational intervention to address this deficiency. This paper presents data from a process evaluation of the initial rollout of EPEC. By all accounts, EPEC provided a state-of-the-art curriculum covering important and clinically relevant topics to the care of the dying patient. It was less clear, however, if EPEC adequately prepared trainees to teach these new skills to other practicing physicians. Factors that may advance efforts to generalize EPEC to other settings and improve future applications of the program are discussed.

American Medical Association↗
PubMed1991

Health education in England: a five-year strategy for the Health Education Authority.

The Health Education Authority in England has published its first Strategic Plan, covering the years 1990-1995. The origins and functions of the Authority are described, as are the various factors contributing to the Plan. The strategic objective is defined as being "to ensure that by the year 2,000 the people of England are more knowledgeable, better motivated, and more able to acquire and maintain good health," as suggested by six criteria for program effectiveness. Selected programs include HIV/AIDS, coronary heart disease, cancer, smoking, alcohol, nutrition, and family and child health. Complementary delivery methods are examined, such as use of the mass media, the National Health Service, schools and colleges, and the workplace, utilizing partnerships with health, education, and other agencies, promoting professional development, and dissemination of research and local initiative results.

Aged↗
PubMed1995

Technical report: service provision under the Individuals with Disabilities Education Act-Part H, as Amended (IDEA-Part H) to children who are deaf and hard of hearing ages birth to 36 months. Joint Committee of American Speech-Language-Hearing Association and the Council on Education of the Deaf.

At the request of the Council on Education of the Deaf (CED) and the American Speech-Language-Hearing Association (ASHA), the Annals is publishing in its entirety and verbatim the report of a joint CED/ASHA committee designed to provide information to professionals about the services to deaf and hard of hearing children below three years of age and their families mandated by the Individuals with Disabilities Education Act-Part H, as Amended. This information should be of benefit to all professionals providing services through an individual family service plan. The report has also been published in the August, 1994 issue of the ASHA Journal.

American Speech-Language-Hearing Association↗
PubMed1991

The Tuskegee Syphilis Study, 1932 to 1972: implications for HIV education and AIDS risk education programs in the black community.

The Tuskegee study of untreated syphilis in the Negro male is the longest nontherapeutic experiment on human beings in medical history. The strategies used to recruit and retain participants were quite similar to those being advocated for HIV/AIDS prevention programs today. Almost 60 years after the study began, there remains a trail of distrust and suspicion that hampers HIV education efforts in Black communities. The AIDS epidemic has exposed the Tuskegee study as a historical marker for the legitimate discontent of Blacks with the public health system. The belief that AIDS is a form of genocide is rooted in a social context in which Black Americans, faced with persistent inequality, believe in conspiracy theories about Whites against Blacks. These theories range from the belief that the government promotes drug abuse in Black communities to the belief that HIV is a manmade weapon of racial warfare. An open and honest discussion of the Tuskegee Syphilis Study can facilitate the process of rebuilding trust between the Black community and public health authorities. This dialogue can contribute to the development of HIV education programs that are scientifically sound, culturally sensitive, and ethnically acceptable.

Acquired Immunodeficiency Syndrome↗
PubMed2006

Perspectives in medical education. 3. Reforming medical education to change healthcare practice in Japan.

The enviable health status of Japanese citizens is one of the reasons for obdurate opposition to reform of Japanese healthcare practice. Change is widely believed to be unnecessary for a system that is both successful and profitably exploited to universal benefit. However, societal trends are conspiring to make current healthcare practice patterns and expenditures unsustainable in the future. In particular, Japan has undergone an unprecedented demographic shift from a society of young (and healthy) workers to one of older retirees with a higher prevalence of obesity. As a result, an equally dramatic future increase can be anticipated in the prevalence of age- and obesity-related disorders. The traditional paradigm of Japanese healthcare is not conducive to the restraint necessary for preserving its future viability, given these trends. Japanese healthcare does not reward clinical problem-solving skills, values specialists over generalists, places a heavy reliance on expensive technology, does not require interventions to be evidence-based, and provides no incentives to improve quality or efficiency. If this paradigm endures, Japanese healthcare faces the real prospect of bankruptcy. The failure of Japanese medical education to inculcate clinical skills and stress evidence-based medical practice lies at the heart of the impending crisis in healthcare. To solve the crisis, medical education in Japan must change its focus to training and developing a cadre of physicians with the broad-based expertise and clinical skills to make evidence-based decisions in a medically and fiscally responsible manner. The future health of the system and of the Japanese people depends on it.

Clinical Competence↗
PubMed2006

Perspectives in medical education--1. Reflections on the state of medical education in Japan.

The current shortcomings in Japanese medical education are highlighted by identifying four major areas of concern, based on the author's personal observations at Keio University Hospital. The first of these is a woeful lack of clinical skills among Japanese medical students and residents. This lack springs directly from the complete absence of any bedside clinical instruction, which constitutes the second area of concern. The third is the attitude of faculty towards teaching as a burden that detracts and diverts them from their primary goal of academic advancement through research. Finally, there is no recognition of the value of a problem-based approach to teaching clinical medicine, so that clinical problem-solving skills have atrophied to the point of near-extinction in the current generation of Japanese physicians. The promise of problem-based learning (PBL) provides a crucial starting point for efforts to change the system. PBL emphasizes the importance of an integrated approach to clinical problems, and a reliance on critical thinking--the basis of primary care. This contrasts with the selective and highly specialized approach to disease, and reliance on sophisticated technology, which are hallmarks of specialty care. The effort to reform medical education will fail without visionary leadership and without the willingness to confront the truth, as unpleasant as it may seem to be. Both these crucial elements exist at Keio University at this critical juncture. It is this happy confluence that emboldens the author to hope that the future of reform is in good hands at this august institution.

Communication Barriers↗
PubMed2006

Perspectives in medical education-2. A blueprint for reform of medical education in Japan.

A blueprint for reform of medical education in Japan is presented, with the goal of training well rounded physicians who possess the ability to think critically and the clinical skill to function as generalists before they enter specialty training. Practical solutions are offered in three problem areas that lie at the heart of the shortcomings in Japanese medical education. They have to do with (i) the way Japanese students learn, (ii) the way Japanese teachers teach, and (iii) the material that students are taught. The inherently passive nature of Japanese students can be changed by emphasizing "active learning" and "critical thinking at the bedside" through a problem-oriented approach, both in the classroom and in the wards. Changing student learning, however, requires a commitment to teaching. At the present time, there is no incentive to teach at all, let alone teach in a constructive or interactive way. Teaching is widely perceived as a burden that takes time away from research, rather than as a credible and rewarding academic pursuit. Thus, promotion policies must be altered to reward teachers and accord teaching its rightful place as a primary function of the faculty. Finally, the introduction of active learning and interactive teaching depends on reducing the current emphasis on didactic instruction, which is passive and unidirectional. Thus, medical school curricula must be restructured to emphasize a problem-oriented, organ system-based approach throughout medical school, starting from the preclinical years. Reforms in all three areas must be implemented in concert for them to succeed.

Education, Medical↗
PubMed1989

Attitude toward physical education and self-concepts of asthmatic and nonasthmatic children taught by physical education specialists.

50 asthmatic and 741 nonasthmatic children in Grades 4 to 6 were compared on attitudes toward physical education and self-concept. Data were collected using the Children's Attitude Inventory Toward Physical Education, a paired-comparison inventory for indicating preferences among 10 school subjects, and the Children's Self-concept Scale. Analysis of variance and X2 indicated no significant differences between asthmatic and nonasthmatic children on the three measures.

Adolescent↗
PubMed1996

[University education in geriatrics--present status and future prospects of gerontology and geriatrics education in pathology].

The increase in the number and proportion of the elderly in Japan over the last 30 years has been faster than that in any other country. One of the measures we are compelled to take to deal with this drastic change in medicosocial circumstances is reform of the medical school curriculum. However, the necessary reforms are being implemented slowly and are still insufficient. We surveyed the present status of gerontology and geriatrics education in pathology, and the understanding, interest, and opinions on this matter among professors of pathology. Questionnaires were sent to 148 professors of pathology in 80 medical schools. Responses were received from 84 professors (57%) at 64 medical schools (80%). Of the 11 medical schools with a department of geriatrics 10(90%) included gerontology in the curriculum. In contrast, 43(80%) of the 53 remaining schools did not include gerontology in the curriculum, although education in geriatrics and gerontology has been given as part of pathology lectures in almost all medical schools. Many professors want to establish a department of geriatrics in their school, but feel it will be difficult because of lack of money and higher priority given to other fields. As other hindrances, most of the respondents noted the lack of money and higher priority given to other fields. As other hindrances, most of the respondents noted the lack of a good textbook of gerontology, ambiguity in the concept of the field, and the immaturity of gerontology as a science. Another major problem noted was uncertainty regarding the status of geriatrics as a clinical specialty. One professor mentioned that promotion of aging research would be the best way to solve these problems.

Education, Medical, Undergraduate↗
PubMed1998

The changing environment of community health practice and education: perceptions of staff nurses, administrators, and educators.

Historically, baccalaureate nursing programs in Canada have prepared graduates to practice in the community. Two recent trends-the move to prepare all registered nurses in degree programs and the changing climate in which community nursing is practiced-made it timely to explore the educational preparation required for community health practice. This article reports on one part of the study, i.e., on findings that explicate the nature of community health nursing practice in a western Canadian province, as it has changed during the past decade, as it is currently practiced, and as it is expected to develop in the future. What, in other words, is the nature of the community practice for which nursing students should be prepared? An action research design guided the study. Participants were recruited from all major urban, rural, and northern settings in which baccalaureate nurses practice throughout the province. The perspective of relevant people was considered important, i.e., nurses practicing in the community, administrators, and educators of future community nurses. One hundred eighteen (118) participants were interviewed in 27 focus groups. Data were tape recorded, transcribed, and analyzed for content. Among the themes identified were those that captured changes community health nurses experienced in their nursing practice. Nurses also described how they thought practice would evolve in the years to come. These themes are discussed within a primary health care framework in which nurses can be expected to play a more active role in shaping community health nursing practice.

Canada↗
PubMed2004

Educating nursing students with disabilities: one nurse educator's journey from questions to clarity.

Nurse educators are increasingly facing accommodation of students with disabilities in their nursing curricula, and questions regarding issues of fairness to all students and patient safety often rise. Several schools and state boards of nursing have turned to writing lists of essential functions of nursing to provide a framework. Before the list is written, educators need to examine their own thoughts on the definition of nursing and the abilities essential to functioning as a nurse.

Persons with Disabilities↗