[Use of the Ekran-3 slide projector for self-instruction of students in a course of radiodiagnosis].
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PURPOSE: To determine the amount and type of training U.S. internal medicine residents receive in providing home care to patients. METHOD: A four-item questionnaire was developed and sent to the program directors of all accredited internal medicine residencies in the United States (n = 397) to assess the amounts and types of training (didactic sessions or lectures, house calls, or both) internal medicine residents receive in providing home care. Demographic information about the residency programs was also collected and analyzed. RESULTS: A total of 312 (78.6%) of the program directors responded. Sixty-eight percent of their programs included instruction in home care consisting of house calls, lectures, or both. Fewer than half of the responding programs offered any lecture in home care in their curricula, and only 25% of them included a mandatory house-call experience for trainees. Residency programs that had primary care tracks were more likely than were other programs to include either of these experiences in their curricula. CONCLUSIONS: Most internal medicine residents receive limited training in home care. As a consequence, future internists may be inadequately prepared to meet the needs of their patients, particularly as the population ages.
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Presses on left and right buttons by undergraduate students occasionally produced points exchangeable for money, according to a multiple random-ratio random-interval schedule. During interruptions in the schedule, the subjects were required to fill out sentence-completion guess sheets about how they should press the buttons to gain the points available. Three of six subjects were instructed about the rules of button pressing (the instructed group), whereas the others received no instructions but their guesses were shaped with differential points also worth money (the shaped group). The schedule was changed so that button pressing relying on the instructed or shaped rules substantially decreased the available points in the contact condition but not in the no-contact condition. A schedule change in the no-contact condition produced no performance change in either groups. In the contact condition, shaped group subjects showed a performance change, whereas instructed group subjects did not until they temporarily encountered an extinction schedule. When the no-contact condition was reintroduced, sensitive responding occurred in the shaped group but not in the instructed group suggesting that prior experience in the contact condition increased the schedule sensitivity of the shaped group. The findings clearly demonstrated that responding was more sensitive to schedule changes when the rules were shaped than when they were instructed.
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This study investigated the way new information is presented to students. Subjects were 60 elementary and middle school students, most with learning disabilities. Students used two versions of a specially designed computer-assisted instruction (CAI) program. One version rapidly presented students with seven pieces of information (rapid-introduction group); the other cumulatively presented smaller "chunks" of information (cumulative-introduction group). Both groups worked to mastery level successfully but students in the cumulative group spent one-third the time, required fewer responses, showed less frustration, and made fewer errors in the process. Results suggest that students with learning disabilities need much more practice than most commercial CAI programs supply.
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BACKGROUND: Volunteer ophthalmologists can achieve success with teaching and service programs working with high intensity over a short term. Continuation of initially successful programs may be limited by lack of timely, effective communication and follow-up. In an attempt to overcome these limitations, a total of 6 telemedicine programs were established after a successful trial program at the Ramon Pando Ferrer Hospital in Havana, Cuba. METHODS: Two pediatric ophthalmology-strabismus clinics, one in Cuba and one in Romania, were provided a digital camera and a computer in order to obtain and then transmit by e-mail patient images obtained according to a prescribed format. Ophthalmologists in both of these programs were instructed personally during an orientation period in their clinics. Training included use of a digital camera and computer, patient examination, and surgical technique in the operating room. Four additional programs referred patients via digital images after receiving only written and oral instruction. RESULTS: The diagnosis and treatment plan determined by one of us (E.M.H.) for each of the first 15 Cuban patients after study of digital images sent by e-mail was the same as the diagnosis and treatment plan determined by the same observer after in-person examination of the patients. On the basis of the level of confidence attained in these patients, 35 additional patients from a total of 6 clinics were seen by digital consultation only. CONCLUSION: A store-and-forward telemedicine consultation technique that uses digital images and e-mail holds promise to be an effective means for carrying out consultation for patients with strabismus.