A new PBL case-writing course.
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The teaching of the psychological aspects of medical practice are confronted with three great difficulties: 1) Not to turn into an introduction of the teaching of psychiatry, without leaving aside the importance of psychiatric pathology in the general medical practice. 2) To provide medical-psychological scientific knowledge to be applied to everyday medical practice. 3) To base the teaching on scientific foundations of neuroscience and of psychological and social sciences. These aspects are considered in several consensus documents (World Psychiatric Association, International Federation of Societies for Medical Education, Spanish Society for Psychiatry, etc.) which have served as guide for the writing of this new text on medical psychology.
BACKGROUND: Medical education research is a maturing field of inquiry that derives theoretical perspectives from many domains. Yet while such theoretical diversity holds the promise of rich paradigmatic writing and debate, too often medical education researchers do not place their work in a historical or cultural context, giving the impression that they have somehow unearthed universal 'truths' about medical education. METHODS: This paper introduces some of the key 'histories' of medical education from the contexts of Anglophone Canada and the USA following a review of major works in the history of medical education. RESULTS: There are many and conflicting histories of medical education in North America that can be classified according to different socio-historical paradigms. CONCLUSIONS: To avoid the error of over-generalisation, a much greater effort must be made to include historical, sociological, economic and other social science perspectives in the design, interpretation and application of medical education research.
Interdisciplinary care plans, if done properly, become not only a cost-effective form of planning patient care but can also be the most efficient and holistic form of care giving. The key person in the team is the coordinator. The coordinator must ensure timely care plan reviews, notify members of upcoming conferences, enforce conference rules, and ensure proper documentation and efficient utilization of time at the conference. The administrator is ultimately responsible for seeing that each discipline is held accountable for its part of the care plan process. The administrator must encourage the provision of high-quality care through the care planning process, as well as motivate and reinforce to all team members the importance of this holistic concept of patient care. The person actually writing the care plans during the conference can be chosen by the coordinator but should be someone who has a good concept of proper care plan form and medical terminology and who can write quickly. A productive care conference is only part of the answer to an effective interdisciplinary approach. Care plans must be specific, individualized and realistic, with measurable and obtainable goals. They must be made available to all personnel in such a manner that they become a precise menu of the care giving process. All care givers must be keenly aware of the value and usefulness of this patient care tool to ensure high quality in a coordinated, holistic approach.
Addressing health inequity is now recognized as a clinical competency in medical education. We examined the career and writings of Robert Wilson Jr. (1867-1946), longtime dean of the Medical College of the State of South Carolina during the Jim Crow Era, using primary and secondary sources within the context of systemic and structural racism, particularly in South Carolina. Wilson used public health data to refute the "Black Extinction Hypothesis" rooted in social Darwinism. He challenged assumptions of inherent Black susceptibility to tuberculosis, linking disease instead to social determinants of health. He also identified disproportionate mortality from kidney and cardiovascular disease among Black populations, anticipating modern health disparities research. Wilson further acknowledged systemic injustice and implicated structural conditions, including housing, in shaping outcomes. In an era of continuing health inequity and racial health disparities, Wilson applied empirical evidence to reject biological determinism, identify outcomes disparities, and advocate for racial justice.
Electronic prescribing has been gaining momentum with the passage of recent federal legislation. This article attempts to present the current status of e-prescribing. "Electronic communications between physicians and pharmacists is being recognized as the new standard of practice in the health care industry," said Kevin Hutchinson, SureScripts president and CEO. I am not sure I would go that far yet, but electronic prescribing has come a long way since 1998 when Drs. Schiff and Rucker wrote in the American Medical News: "Physicians should never again write a prescription. Given the explosion of scientific information and advances in computer technology, prescribing medications on a blank piece of paper will soon seem as antiquated as ordering tinctures of botanicals in Latin." The benefits of electronic prescribing have been, and continue to be, touted in many articles written, even in lay literature.
Training pharmacists to appropriately document patient-specific problems and recommendations in patients' medical records and subsequent monitoring of pharmacist-written documentation are described. The medical staff of a tertiary care teaching hospital recommended that pharmacists be allowed to write in the permanent portion of patients' medical records. A six-month pilot program was approved to train pharmacists in writing chart notes. Notes would be assessed according to the following criteria: necessity (i.e., a chart note was the appropriate means of communication), clarity, legibility, completeness, correct format, and lack of judgmental language. Initial training was by physicians from the pharmacy and therapeutics committee, with more extensive training by a committee composed of clinical and administrative pharmacists. After training ended, each pharmacist's first few notes were reviewed by a member of the pharmacy committee. The quality of pharmacist-written notes is reviewed quarterly. The first quarterly evaluation and another review 1 1/2 years later showed that all pharmacist notes met all of the established criteria. A multidisciplinary approach was effective in training pharmacists to document interventions appropriately in patients' permanent records. Ongoing monitoring ensures the continuing quality of such documentation.
Patients could post their questions about their disease, the work at the ward and the hospital in separate letter-boxes on central places at the ward. The letter-boxes were still blank 4 weeks later. Talks with patients showed, that they prefer to ask the physicians personally and they don't like to put down their questions in writing. It follows demands for medical activity.
"Abraham Flexner and the Black Medical Schools" first appeared in Beyond Flexner: Medical Education in the Twentieth Century, Barbara Barzansky and Norman Gevitz, eds. Reproduced with permission of Greenwood Publishing Group Inc., Westport, CT. The article will be reprinted in a collection of the author's writings on African-American medical history called Race and Medicine in Nineteenth- and Early-Twentieth-Century America, to be published in December 2006 by Kent State University Press and published here with permission of the Kent State University Press.
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Drug prescription errors are a common cause of adverse incidents and may be largely preventable. The incidence of prescription errors in UK critical care units is unknown. The aim of this study was to collect data about prescription errors and so calculate the incidence and variation of errors nationally. Twenty-four critical care units took part in the study for a 4-week period. The total numbers of new and re-written prescriptions were recorded daily. Errors were classified according to the nature of the error. Over the 4-week period, 21,589 new prescriptions (or 15.3 new prescriptions per patient) were written. Eighty-five per cent (18,448 prescriptions) were error free, but 3141 (15%) prescriptions had one or more errors (2.2 erroneous prescriptions per patient, or 145.5 erroneous prescriptions per 1000 new prescriptions). The five most common incorrect prescriptions were for potassium chloride (10.2% errors), heparin (5.3%), magnesium sulphate (5.2%), paracetamol (3.2%) and propofol (3.1%). Most of the errors were minor or would have had no adverse effects but 618 (19.6%) errors were considered significant, serious or potentially life threatening. Four categories (not writing the order according to the British National Formulary recommendations, an ambiguous medication order, non-standard nomenclature and writing illegibly) accounted for 47.9% of all errors. Although prescription rates (and error rates) in critical care appear higher than elsewhere in hospital, the number of potentially serious errors is similar to other areas of high-risk practice.
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The writer physicians of Islamic medicine have given top priority to the Islamic Medical Ethics in their valuable writings and left the ineffaceable footsteps in the field. Such as, Abul Hasan Ahmed bin Mohammad At-Tabari has devoted the 35th chapter of Maqala l of his precious book entitled 'Moalejat-e-Buqratiya' to medical ethics. The entire chapter reflects the Islamic approach of the scholar. In the following pages, an attempt has been made to highlight some salient features of Islamic Medical Ethics in ancient literature of Islamic Medical with special reference to Moalejat-e-Buqratiya.
Second and third year medical students were invited to write down their comments about necropsies during a pilot study of a postal questionnaire on the subject. Their comments were analysed in detail on the following aspects: about how useful and necessary a procedure the necropsy is in medical practice and in education; their personal distaste for the procedure; whether attendance at a necropsy should remain a compulsory part of a medical education; staff attitudes; observance of relatives' wishes; and feelings about necropsies carried out on self or relatives. The data collated from the questionnaire showed that, although students regard the necropsy as useful in clinical practice, a single demonstration does not clarify what its uses are. For some, the necropsy represents disrespect to its subject, and few students seemed aware of the use of the necropsy as an instrument of quality control. It is concluded that the unpleasant aspects of a necropsy demonstration should be kept to a minimum to encourage attendance and promote a sense of its value, and that it might be useful to influence and modify students' opinions before they become entrenched, perhaps by giving a higher priority to training in discussing dying and death in the medical curricula.
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OBJECTIVE: On the basis of a review of the requirements by some famous medical journals, along with personal experiences, the authors summarize the general guidelines for writing Materials and Methods section in English medical papers, which could be of value for potential contributors of English research papers.