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Family medicine research. Status at the end of the first decade.

In a national survey of family medicine university units and residencies, 549 MD and 135 PhD faculty pursuing family medicine research were identified. Resources available for research were assessed, as were practice data system characteristics. The practice base nationally of programs pursuing research included 2.6 million patients from 1 million families, making 5.1 million visits per year. Common major impediments to research reported by programs included lack of faculty time (78%), lack of funding for faculty (61%) or staff, equipment and supplies (48%), and lack of research skill (45%) and role models (43%). The annual amount of all research grants received for calendar year 1979 was $3.4 million, of which $2.6 million was from federal government sources. This represented 0.06% of the federal health research effort. Continued development of family medicine research will require increased funding support both for research and research training.

Academic Medical Centers↗

[History and personalities at the Department of Urology, University of Magdeburg. From medical academy to university].

The Medical Academy of Magdeburg was founded in 1954, but at that time the university did not have its own urological department. It was founded in 1957. Chiefs of the department were Hartwig Eggers (through 1958), Gerhard Wilhelm Heise (1958-1976), Gerd-Wolfgang Mueller (1976-1994), and Ernst Peter Allhoff (since 1994). The department has an interesting history. Numerous famous urologists were trained here.

Academic Medical Centers↗

Cross-training for obstetrics using an internship program.

During these changing times in the healthcare environment, staff development and management must work together to provide competent staffing models. This article focuses on an innovative pilot internship program that was developed and implemented collaboratively by the management/staff development team. The article describes a cross-training program for new graduates in obstetrics at a major southeastern university hospital. The article focuses on a present and future opportunity for staff development--"cross-training."

Academic Medical Centers↗

Peer-assisted learning in the athletic training clinical setting.

CONTEXT: Athletic training educators often anecdotally suggest that athletic training students enhance their learning by teaching their peers. However, peer-assisted learning (PAL) has not been examined within athletic training education in order to provide evidence for its current use or as a pedagogic tool. OBJECTIVE: To describe the prevalence of PAL in athletic training clinical education and to identify students' perceptions of PAL. DESIGN: Descriptive. SETTING: "The Athletic Training Student Seminar" at the National Athletic Trainers' Association 2002 Annual Meeting and Clinical Symposia. PATIENTS OR OTHER PARTICIPANTS: A convenience sample of 138 entry-level male and female athletic training students. MAIN OUTCOME MEASURE(S): Students' perceptions regarding the prevalence and benefits of and preferences for PAL were measured using the Athletic Training Peer-Assisted Learning Assessment Survey. The Survey is a self-report tool with 4 items regarding the prevalence of PAL and 7 items regarding perceived benefits and preferences. RESULTS: A total of 66% of participants practiced a moderate to large amount of their clinical skills with other athletic training students. Sixty percent of students reported feeling less anxious when performing clinical skills on patients in front of other athletic training students than in front of their clinical instructors. Chi-square analysis revealed that 91% of students enrolled in Commission on Accreditation of Allied Health Education Programs-accredited athletic training education programs learned a minimal to small amount of clinical skills from their peers compared with 65% of students in Joint Review Committee on Educational Programs in Athletic Training-candidacy schools (chi2(3) = 14.57, P < .01). Multiple analysis of variance revealed significant interactions between sex and academic level on several items regarding benefits and preferences. CONCLUSIONS: According to athletic training students, PAL is occurring in the athletic training clinical setting. Entry-level students are utilizing their peers as resources for practicing clinical skills and report benefiting from the collaboration. Educators should consider deliberately integrating PAL into athletic training education programs to enhance student learning and collaboration.

Journal Article↗

Hospital pharmacology: An alternative model for practice and training in clinical pharmacology.

External pressures continue to be exerted on hospitals to prioritize programs that minimize costs and improve the safety of medication use. Clinical pharmacologists are in an ideal position to provide leadership for such programs. At academic health centers, an added dimension is the exposure of physicians-in-training to the practical application of clinical pharmacology principles. At SUNY Upstate Medical University, the approach is led by a physician with clinical pharmacists and pharmacy practice residents. To align the clinical pharmacists with the overall goals of the program, a faculty promotions track system designed specifically for them has been enacted within the college of medicine. This report summarizes the "hospital pharmacology" program that provides funding for an academic physician-clinical pharmacologist. With this report, the authors hope to outline an alternative practice and training paradigm to potentially address the decline in physicians being trained in and practicing clinical pharmacology since the late 1970s.

Education, Medical, Graduate↗

Results of the 1993 survey of the American Association of Academic Chief Residents in Radiology.

RATIONALE AND OBJECTIVES: A survey of chief residents of academic radiology programs is conducted annually on behalf of the American Association of Academic Chief Residents in Radiology (A3CR2). Data are obtained to improve the training of diagnostic radiology residents and to increase the understanding of radiologists and their associates about issues of interest to radiologists in training. METHODS: Questionnaires were mailed to 133 accredited programs in the United States and Canada. A wide variety of demographic and common interest questions were asked. The analysis took into account geographic location of the responders and the size of the residency program. Comparisons were made to the data from prior years. RESULTS: Completed surveys from 93 programs (70%) were returned. The percentage of women residents is increasing. Important regional and size variations exist in several areas including salary, workload, prior clinical training, resident/fellow ratios, post residency plans, and call schedules. Although many chief residents feel knowledgeable about the health care system, opinions about the future of radiology and medical care are tentative. CONCLUSIONS: This survey provides important demographic information about academic radiology residency programs. The summary information regarding plans for fellowship training, resident call schedules, and opinions about socioeconomic issues may be useful for chief residents, program directors, and departmental chairmen.

Canada↗

End-of-life care at academic medical centers: implications for future workforce requirements.

The expansion of U.S. physician workforce training has been justified on the basis of population growth, technological innovation, and economic expansion. Our analyses found threefold differences in physician full-time-equivalent (FTE) inputs for Medicare cohorts cared for at academic medical centers (AMCs); AMC inputs were highly correlated with the number of physician FTEs per Medicare beneficiary in AMC regions. Given the apparent inefficiency of current physician practices, the supply pipeline is sufficient to meet future needs through 2020, with adoption of the workforce deployment patterns now seen among AMCs and regions dominated by large group practices.

Academic Medical Centers↗

A survey of training in child and adolescent psychiatry.

In a survey of training in child psychiatry in Great Britain, all senior registrars were sent questionnaires; the response rate was 69 per cent. We describe background factors of the trainees, details of the clinical and academic experience available to them, and their attitudes towards their training. Most trainees had had extensive previous experience in adult psychiatry and the predominant orientation was psychoanalytic. In general, they approved of the guidelines for training issued by the Joint Committee for Higher Psychiatric Training. Family therapy was the most popular treatment method. We comment on their training experience where the interest expressed was not matched by adequate availability of the training facilities.

Adolescent Psychiatry↗

Mood states and health behaviours in paramedical first-year students.

The aim of this study was to compare first-year students enrolled in an Integrated Course at a Nursing College (n = 103) with first-year paramedical students from the following disciplines: Logopaedics (n = 12); Physiotherapy (n = 24); Occupational Therapy (n = 18); BSc Nursing (n = 12); Radiography (n = 27), on the Profile of Mood States (POMS), Health Behaviour Assessment Scale (HBAS) and Matric scores. The Integrated Nursing students revealed significantly lower Matric scores than the other students (p less than 0.0001), and showed significant differences on other variables, indicating higher negative mood states and less healthy life-styles. Recommendations are made regarding a possible alternative nurse training programme with emphasis on clinical skills in addition to the heavily academic 4-year Diploma course. A prophylactic stress management programme emphasising healthy life-styles commencing at the start of the training, is proposed.

Education, Nursing, Baccalaureate↗

Behavioral science and family practice: a status report.

The purpose of this study was to assess the current status of behavioral science instruction in family practice residency training programs. The primary areas of interest were: (1) characteristics of those who teach behavioral science (number of persons teaching behavioral science by discipline and academic degree, number and percent of time behavioral science personnel employed, work responsibilities, academic unit responsible for instruction, description of those who provide inservice training in behavioral science ), (2) the relative importance of various behavioral science topics as perceived by faculty/staff (21 topics), and (3) preferred methods of instruction. The data revealed a wide variety of persons involved in behavioral science instruction, a strong emphasis placed on communication and counseling skills, and similar, but not innovative, teaching methods used for behavioral science instruction.

Behavioral Sciences↗

Family practice residents' attitudes toward their academic projects.

BACKGROUND AND OBJECTIVES: As research has become an increasingly important activity in family medicine, so the teaching of research skills has become an important part of family practice residents' training. The purpose of the study was to determine the attitudes toward research and related topics of a family practice program's graduates who had participated in a required academic project during their residency training. METHODS: A questionnaire using Dillman methodology was mailed to graduates of the University of Toronto family practice program. Graduating years surveyed were 1987-1992. RESULTS: There were 321 (78%) responses from the 427 graduates. Most projects completed during residency had been literature reviews. Ninety percent of respondents felt that critical appraisal skills were important to them as practicing physicians, but only 39% felt they had been sufficiently educated about these skills. Other research-related skills (writing, presenting, data analysis) were learned more thoroughly. The majority (58%) felt neutral or negative about their projects, and 79% would not have done a project if it had been optional. CONCLUSIONS: This cohort of family practice graduates felt negatively about the teaching of research skills during residency. Providing more support and developing a curriculum may improve resident satisfaction.

Adult↗

[Systematization of otorhinolaryngology training].

Resident training in otorhinolaryngology is a continuous learning process which includes academic, clinical, and research activities, the purpose of which is to develop skilled specialists. To achieve this goal, systematic planning of the educational process is needed. Planning should contemplate establishing the aims of training, defining the instruments to be used to achieve these aims, and determining how results will be evaluated. We described our philosophy as regards planning the educational process in otorhinolaryngology training, and define and develop the content of the stages involved. In our opinion, systematic application of these principles would facilitate educational efforts, improve specialist training, and enhance the performance of future specialists.

Humans↗

Anatomy of a successful K-12 educational outreach program in the health sciences: eleven years experience at one medical sciences campus.

The Department of Anatomy and Neurobiology, College of Medicine, University of Arkansas for Medical Sciences (UAMS) is the administrative home of a nationally recognized educational outreach program in the health sciences for K-12 teachers (includes school nurses, counselors, etc.) and students. This program is called the Partners in Health Sciences (PIHS) program. It began in the summer of 1991 and is based on an annual needs assessment of the state's teachers. PIHS is a program available to all teachers and students in the state. It has several different components: (1) a cafeteria of 21 days of mini-courses offered in the summer to meet the professional development needs of K-12 biology/health teachers and other school personnel; (2) weekly, interactive telecommunication broadcasts for students during the academic year; (3) intensive, 5-day workshops that train five selected teachers at a time (10 per year) to use an authoring software program to develop grade-appropriate interactive, computer-assisted, instructional (CAI) modules for Internet (http://k14education.uams.edu) use by teachers and students; (4) a monthly science night for students and their parents at a local science magnet high school; (5) field trips to the UAMS campus for teachers and their students; (6) community-requested presentations by program faculty; and (7) availability of earning undergraduate and graduate credit for science education majors in the College of Education, University of Arkansas at Little Rock. The data presented in this report span the period from 1991 through 2001. For all program activities, 14,084 different participants have consumed a total of 50,029 hours of education.

Academic Medical Centers↗

Clinical pharmacology and therapeutics--past, present and future.

AIMS: To obtain information about the speciality of clinical pharmacology and therapeutics in the United Kingdom. METHODS: A survey of the views of 26 individuals in academic posts in clinical pharmacology and therapeutics was carried out by postal questionnaire. Response rate was 100%. RESULTS: Of 25 assessable responses of 25 centres, there were 35 academic staff of professorial status (median 2, range 0-5) and 61 staff of reader/senior lecturer status (median 2, range 0-5) but only 20 clinical staff in training grades in 19 institutions. All had extensive clinical commitments. Two-thirds of respondents considered that the speciality was stable locally and nationally. However, recruitment of trainees was poor with only 8% of responders having several good applicants for each post and 90% reported that recruitment had deteriorated in the last 5-10 years. Likely good future careers for clinical pharmacologists in training were considered by 75-80% of respondents to likely lie in the pharmaceutical industry or regulatory authorities. Greater flexibility is required to facilitate training in clinical pharmacology and therapeutics. CONCLUSIONS: Clinical pharmacology and therapeutics in the United Kingdom has a strong academic base but a sub-optimal age structure. Recent experience in recruitment into training posts was disappointing. This may reflect wider problems of recruitment into academic medicine in this country.

Forecasting↗

Multiple mentoring strategy in the academic preparation of quality assurance directors.

Availability of adequately educated and trained nursing quality assurance directors is a must for the survival of health care institutions. Educators meet many challenges in preparing masters students for this role. Issues pertaining to definition of a relevant course of study in theoretical and practical content areas, and faculty's lack of personal experience with the role are situations that must be resolved. This article describes a model of multiple mentoring through collaboration that was implemented at a large urban nursing department with satisfactory solutions.

Education, Nursing, Graduate↗

Instituto Nacional de Enfermedades Neoplásicas: past and present.

The Instituto Nacional de Enfermedades Neoplásicas was established by the government of Peru as an institution for the treatment of cancer patients in 1939; it has existed under different names until the current title was adopted in 1952. Between 1980 and 1987, attendance increased by 70% and a new and larger facility came into use at the beginning of 1988. This institution has national responsibility for cancer prevention, detection, treatment, education, and research and is currently organizing satellite treatment centers in other parts of the country. More than 80% of the medical staff has been trained in the institute's residency program, the majority of whom received additional postgraduate training in the United States and Europe; 90% of the medical staff hold academic appointments in medical schools. In 1952 the Institute became the first hospital in Peru with a formal postgraduate training system for various medical disciplines, including surgical oncology and medical oncology. So far we have trained about 500 surgical oncologists who are working in all parts of Peru. The Maes-Heller Institute for Cancer Research forms part of the National Cancer Institute complex. Research will be directed mainly toward new diagnostic and therapeutic approaches, multidisciplinary tumor therapy, and large-scale cancer screening. The Institute focuses on early detection and prevention of cancer and is active in breast self-examination education and antismoking campaigns. It enjoys community support evidenced in the women's organization, Adainen, involved in fundraising; 460 women volunteers give at least 4 hr service per week to the Institute. The Institute has grown from 9,000 patients seen per year in its early days to 215,000 attendances in 1986.

Adult↗

Opinions of South Carolina dental students toward tobacco use interventions.

OBJECTIVES: Tobacco use accounts for 75 percent of oral cancer deaths in the United States. One objective of Healthy People 2010 is to increase the percentage of dentists who provide smoking cessation counseling. However, studies of dentists have shown that the majority feel inadequately prepared to do so. The objective of this study was to determine the opinions of dental students at the Medical University of South Carolina (MUSC) regarding the provision of tobacco use interventions for patients. METHODS: In 2002, 163 students were administered a written questionnaire which included questions about tobacco use interventions (response rate=80 percent). Opinion items were analyzed using factor analysis, Fisher's Exact Test, and ANOVA (a < or = 0.025). RESULTS: While 89 percent of students agreed that dentists should be trained to provide tobacco cessation education, only 39 percent thought that they themselves were adequately trained. Students' opinions toward the role and training of dentists in providing tobacco use interventions differed by academic year. Only 14.1 percent of dental students were quite or very confident in their ability to help patients to stop smoking. CONCLUSIONS: This study indicates that although MUSC dental students support tobacco cessation training for dentists, the majority responded that they are not adequately trained and are not comfortable providing tobacco cessation education to patients. A comprehensive tobacco prevention and cessation program is indicated for the objective of Healthy People 2010 to be met.

Attitude of Health Personnel↗

Results of the 1994 survey of the American Association of Academic Chief Residents in Radiology.

RATIONALE AND OBJECTIVES: Radiology chief residents are surveyed annually and the data are used to improve the training of diagnostic radiology residents. METHODS: Questionnaires were mailed to accredited programs in the United States and Canada. A variety of demographic and common-interest questions were asked. For the first time, an individual resident questionnaire also was included. RESULTS: Completed surveys from 53 programs (42%) were returned. The percentage of female residents was similar to that reported in other recent surveys. Resident salaries continued to increase. Residency selection remained highly competitive. Residents indicated that the utility of a fellowship in radiology exceeded the utility of clinical training in other fields prior to the radiology residency. Residents agreed with recommendations by the American Association of Academic Chief Residents in Radiology concerning proposed changes in the American Board of Radiology (ABR) examinations. CONCLUSION: The information derived from the surveys on resident selection, the utility of preradiology clinical training, and the ABR examination may be useful for residents, program directors, and departmental chairs.

Female↗