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PubMed1994

Development, implementation, and evaluation of an advanced physical diagnosis course for senior medical students.

PURPOSE: To develop, implement, and evaluate a new course curriculum designed to increase senior medical students' knowledge, psychomotor skills, interpretative abilities, and clinical utility regarding physical examination techniques. METHOD: From February 1991 through February 1993, 53 fourth-year students at the Medical College of Wisconsin participated in a one-month elective, Advanced Physical Diagnosis (APD), which was taught by faculty members of the Division of General Internal Medicine. The APD course included the following modules: (1) organ-specific didactic and interactive practice sessions; (2) physical-examination-based case conferences; and (3) professorial rounds, consisting of rounds on inpatient medical services and the use of professional patients, i.e., outpatients with specific, incontrovertible physical findings. An objective structured clinical examination (OSCE) was developed to evaluate the examination skills of the APD students. A pre- and post-course OSCE format was used with both the APD students and a control group of students rotating on the general medicine ward service. In addition, the APD students evaluated their own skills in physical examination and evaluated the course and each of its components by anonymously completing an extensive end-of-course survey. RESULTS: The pre-course OSCE detection rate of incontrovertible physical findings was similar between the control and APD students (Mantel-Haenszel chi 2 = 2.4, p > .1); the post-course OSCE showed significant improvement in the detection rates for the APD students compared with the control students (Mantel-Haenszel chi 2 = 45.8, p < .0001). The APD students felt strongly that the course had improved their physical examination skills and highly recommended the elective to their colleagues. CONCLUSION: Both the OSCE results and the students' self-assessments indicate that the pilot curriculum for the APD course improved the students' physical examination skills. The curriculum can be expanded and also exported to other institutions. Such a course may help promote and refine the use of physical diagnosis in the delivery of quality, timely, and cost-efficient health care.

Clinical Competence↗
PubMed1997

The performance of students selected through a special program at St. Louis University School of Medicine.

PURPOSE: To compare the performances of students selected through a special program, the Medical Anatomy Preparatory Program (MAPP), at St. Louis University School of Medicine with those of students admitted at the traditional way. METHOD: The students were members of the classes of 1993-1996 at the St. Louis University School of Medicine (N = 654). Of these, 52 (8%) were MAPP students. The MAPP students and the non-MAPP students were compared on the basis of various test scores and grades obtained from the admission office, the registrar's office, and the office of curricular affairs. Means and standard deviations were computed for each group, and the MAPP students and the non-MAPP students were compared using analysis of variance to assess the statistical significance of any differences. RESULTS: The non-MAPP students were significantly better than were the MAPP students in terms of Medical College Admission Test scores, undergraduate gradepoint averages, grades for three major second-year courses, and performances on Steps 1 and 2 of the U.S. Medical Licensing Examination (all p < .001). There was no significant difference between the groups in grades for three major first-year courses or five major third-year courses. None of the MAPP students has been dropped for academic reasons. CONCLUSION: The MAPP program takes medical school applicants who have been rejected because of their preadmission performances, given them the opportunity to show that they can perform at the medical school level by taking the anatomy courses with the regular medical students, and accepts those who are successful. The results suggest that those chosen can satisfactorily complete the requirements for the MD degree.

Anatomy↗
PubMed2002

Implementation of the mini-CEX to evaluate medical students' clinical skills.

OBJECTIVE: The majority of medicine clerkships use faculty and resident summative ratings to assess medical students' clinical skills. Still, many medical students complete training without ever being observed performing a clinical skill. The mini-CEX is method of clinical skills assessment developed by the American Board of Internal Medicine for graduate medical education. The brief, focused encounters are feasible and produce scores with adequate reproducibility if enough observations are made.(1) The mini-CEX has been used in the medicine core clerkship, being performed once to augment feedback by faculty evaluators in the inpatient setting.(2) However, additional study is needed to address at least two feasibility issues if the mini-CEX is to be used as a measurement tool: (1) multiple settings (inpatient and outpatient) and (2) resident-completed evaluations. Our objective was to determine the feasibility of having students receive multiple mini-CEX's in both the inpatient and outpatient settings from resident and faculty evaluators. DESCRIPTION: We introduced the mini-CEX into our nine-week medicine clerkship (six weeks inpatient and three weeks outpatient) in July 2001. The clerkship uses four inpatient clinical sites and 16 outpatient practices. Inpatient faculty rotate on two-week blocks and residents on four-week blocks. At our clerkship orientation, each student (n = 39) received a booklet of ten adapted mini-CEX forms. In the mini-CEX, students are observed conducting a focused history and physical examination and then receive immediate feedback. Students are rated in seven competencies (interviewing, physical examination, professionalism, clinical judgment, counseling, organization, and overall clinical competence) using a nine-point rating scale (1 = unsatisfactory and 9 = superior). Our students were instructed to collect nine evaluations: three from faculty (one every two weeks), three from residents (one every two weeks), and three from their out-patient attendings (one per week). Students and evaluators were asked to rate their satisfaction with the exercise using a nine-point scale (1 = low and 9 = high). Students were asked to turn in their booklets the day of the exam. Prior to implementation, we reviewed the mini-CEX forms and rationale for use with residents and inpatient faculty. Similar information was mailed to outpatient faculty preceptors. DISCUSSION: Booklets were received from 32 students. The mean number of evaluations completed per student was 7.3 (range 2-9), for a total of 232 evaluations. Faculty completed 58% of the evaluations; 68% were from the inpatient setting. The observation and feedback took an average of 21 minutes and 8 minutes, respectively. Satisfaction with the exercise was rated by faculty/residents as 7.2 and by students as 6.8. We believe these findings support the feasibility of collecting multiple mini-CEX assessments from both inpatient and outpatient sites using faculty and resident evaluators. The feasibility of collecting multiple assessments is important if the mini-CEX is to be a reproducible assessment of clinical skills. Having established feasibility, we plan to look at the reproducibility and validity of mini-CEX scores in order to determine if it can be used as a formal means of clinical skills assessment. We also plan to evaluate the impact on the quality and specificity of end-of-clerkship summative ratings.

Clinical Competence↗
PubMed2004

Student attitudes towards anatomy teaching and learning in a multiprofessional context.

CONTEXT: We carried out a survey of attitudes to learning anatomy amongst students from a range of health care disciplines in a multiprofessional context. SETTING: A joint course called the Common Foundation Programme (CFP) presented by a hospital medical school and a joint university faculty of health and social care sciences in the UK in the first term of the students' courses. PARTICIPANTS: Students following degree courses in biomedical science, medicine, nursing, physiotherapy, diagnostic radiography and therapeutic radiography. OBJECTIVES: To assess student attitudes to cadaveric work, learning anatomy and multiprofessional learning, and to compare student performance between degree courses in an anatomy assessment. DESIGN: A questionnaire was designed that requested demographic information and the students' attitudes to cadaveric work, anatomy learning and multiprofessional learning on a Likert scale. All students sat the same anatomy assessment at the end of the first term. RESULTS: The biomedical science and medical students were the most apprehensive about entering the dissecting room. The biomedical science students enjoyed working in a multidisciplinary group the most. Assessment results varied widely and the physiotherapy and medical students scored more highly than students in other disciplines, although all students had participated in the same course. CONCLUSIONS: It was possible to teach anatomy in the context of the shared learning experience of the CFP, although performance varied widely. Reasons for the differences are discussed and suggestions for the design of multiprofessional courses involving anatomy are made.

Adolescent↗
PubMed2006

Clinical clerkships: students can structure their own learning.

In clinical clerkships, student learning is often unstructured and diverse. Even when curriculum objectives are explicit, they are seldom used by students to guide their learning. Student-determined learning objectives may help students to structure their learning. This study aimed to assess whether students can use this method to meet widely differing learning needs within the general practice clerkship and considered the relationship of student objectives to overall curriculum objectives. Students allocated a 5-week clerkship in general practice from April 2000 to April 2001 were required to set and meet personal learning objectives within a supportive learning environment. They recorded the strategies they used, how well objectives were met and which curriculum objectives they met. Objectives were categorised using a hierarchical system. A total of 143 (85%) students recorded 1549 objectives. Four categories accounted for 1092 (70%) of objectives: Consultation Skills; Study of Diseases; Practical Procedures, and Therapeutics. Otherwise the range of objectives set was wide, encompassing all curriculum objectives. A total of 1043 objectives were rated as satisfactorily or highly satisfactorily met and 185 (12%) were not met at all. Strategies that students used to meet objectives included clinical experience with doctors but also with practice-based nurses. Students were able to use student-determined learning objectives to meet a diverse range of learning needs within the general practice clerkship. The objectives set reflected the breadth of curriculum objectives. This method allows students to address gaps in their knowledge in a clerkship where teaching is largely based on opportunistic contact.

Clinical Clerkship↗
PubMed2006

Understanding of and attitude to xenotransplantation among Italian university students: impact of a 3-yr university course.

BACKGROUND: Young people, and students in particular, generally have a positive attitude to xenotransplantation. We reported previously that university students attending their first year approved of the idea of transplanting animal organs into humans. The aim of this study was to evaluate the impact of a 3-yr course at various faculties on the university students' understanding of and attitude to xenotransplantation. METHODS: University students in their fourth year at five different faculties of Padua University (Italy), who had previously been surveyed in exactly the same way 3 yr earlier, were re-administered an anonymous 19-item questionnaire on their attitude to xenotransplantation. RESULTS: A total of 453 students completed the fourth year questionnaire (84 males, 369 females; mean age 24.6 yr, range 21-36 yr). Students were attending courses in Medicine (22.1%), Veterinary Science (16.5%), Agriculture (10.4%), Educational Sciences (22.1%) and Psychology (28.9%). In their fourth year, 85% of the students knew that animal organs could, at some stage, be transplanted into humans, 81.5% approved of this idea and 84% would accept an animal organ to save their life if necessary (these percentages were 88%, 78% and 76%, respectively 3 yr earlier). A significantly larger proportion of the students who approved of xenotransplantation were attending science courses rather than art courses, while no differences emerged as regards gender. Those who refused xenotransplantation justified their position mainly on ethical-moral (41.7%) and immunological (35.7%) grounds. CONCLUSION: As in their first year, so too in their fourth, University students were well informed about the feasibility of transplanting animal organs into human beings and those attending science courses were more likely to accept this idea than art students. Approval of xenotransplantation was much the same among fourth year males and females, whereas in the first year, male students had approved more than female students.

Adult↗
PubMed2006

Comparison of self-reported and measured height and weight in eighth-grade students.

The goal of this study was to evaluate the relationships between self-reported and measured height, weight, and body mass index (BMI) in a sample of eighth-grade students. The study population consisted of eighth-grade students in eastern North Carolina who completed a cross-sectional survey, self-reported their height and weight, and had their height and weight measured (N = 416). Fifty-nine percent of the sample was male; 42% African American, 46% white, and 12% other races. Mean self-reported weight (62.9 kg) was significantly lower than mean measured weight (64.4 kg). Mean self-reported BMI (22.8 kg/m2) was significantly lower than mean measured BMI (23.3 kg/m2). Race and BMI category were significantly associated with reporting errors. Specifically, African American and white students were significantly less likely to under-report their height compared to other race students. African American students were more likely to underestimate their weight compared to other race students. BMI was more likely to be underestimated in African American and white students compared to other race students. Students who were at risk for overweight and those that were overweight were more likely to underestimate their weight and BMI than students who were normal weight. Approximately 17% of students were misclassified in BMI categories when self-reported data were used. The results indicate that eighth-grade students significantly underestimate their weight, but on average provide valid estimates of their height. Race and measured BMI category influence this discrepancy. School-based research that addresses the prevalence of obesity in adolescents should utilize measured height and weight when feasible.

Adolescent↗
PubMed1998

A longitudinal study of smoking in year 7 and 8 students speaking English or a language other than English at home in Sydney, Australia.

OBJECTIVE: To compare the rates and predictors of smoking uptake between adolescents speaking English and those speaking a language other than English (LOTE) at home. DESIGN: A cross-sectional survey of year 7 and 8 students (aged 12 and 13 years) was conducted in 1994 and repeated 12 months later. A cohort of students was identified with respondents at baseline matched at follow up. chi 2 and logistic regression were used for analysis. SETTING: 38 schools in southern, east, and northern Sydney, Australia. SUBJECTS: Year 7 and 8 students in the schools were included and examined on two occasions, with complete data for 5947 (80%) students at baseline and 6177 (98%) students at a 12-month follow up. Records were able to be matched perfectly for 3513 respondents (59%). MAIN OUTCOME MEASURES: Smoking rates and predictors of smoking uptake among students speaking English or a LOTE at home. RESULTS: At baseline, 6.1% of students surveyed were smokers. Twelve months later, 15.8% of student surveyed were smokers. There were significantly lower smoking rates among students speaking a LOTE at home compared with those speaking English at home at baseline and at 12 months. Using matched data, for students speaking English at home, five variables were significant predictors of smoking uptake: thinking it acceptable to smoke, perceived benefits of smoking, and having a brother, sister, or close friend who smokes. For students speaking a LOTE, the only predictor was the smoking status of close friends. CONCLUSIONS: Despite the higher smoking prevalence among men with a non-English-speaking background, and the reported strong association between fathers' smoking status and smoking onset of their children, adolescents speaking a LOTE at home were significantly less likely to be smokers than their English-speaking counterparts. Thus, there would seem to be a delay of smoking onset among students speaking a LOTE at home. The smoking rates among respondents speaking a LOTE at home in this study are lower than those obtained from the studies conducted in Europe and the United States. Effective smoking prevention interventions need to be implemented at an early stage of adolescence.

Adolescent↗
PubMedDate not supplied

Using a CompuCyte Pathfinder to evaluate cytotechnology student diagnostic performance.

OBJECTIVE: To determine whether the Pathfinder Cytology System facilitates comparison of initial student diagnoses to rescreener diagnoses; provides a platform for collection, storage and retrieval of data on student screening performance; and generates a student screening "score." STUDY DESIGN: Using two CompuCyte Pathfinder units networked to a PC server and printer, eight cytotechnology students prescreened 1,224 gynecologic cases and entered their results into the Pathfinder database. Five staff cytotechnologists rescreened the cases and entered their diagnoses. The database containing the initial and rescreen diagnoses were transferred to a modified scoring grid that computed a screening "score" for each of the students. RESULTS: Student diagnoses matched cytotechnologist target diagnoses in 1,107 to 1,224 total cases (90.4%). Of these 1,107 cases, 996 (81.3%) were reported as "within normal limits" (negative) by both student and cytotechnologist, and 111 (9.1%) were target diagnosed as abnormal (atypical squamous cells of undetermined significance [ASCUS] or above) by both student and cytotechnologist. Of 117 remaining cases, 112 (9.2%) were considered minor discrepancies (one-step discrepancy--e.g., benign cell change-reactive vs. ASCUS--favor reactive), and 5 (0.4%) were considered significant discrepancies (two or more diagnostic categories of difference between student and cytotechnologist-within normal limits vs. low grade squamous intraepithelial lesion). The modified scoring grid developed by CompuCyte for this study was able to compute a numerical score for each student. CONCLUSION: Our preliminary assessment indicated that Pathfinder will facilitate evaluation of student performance. The system shows potential for eliminating the "paper trail" and manual dotting required for traditional student evaluation and, with the addition of a scoring program, may be standardized for use in both educational and clinical settings.

Automation↗
PubMed2005

The effect of computerized provider order entry on medical student clerkship experiences.

OBJECTIVE: To describe medical students' attitudes toward placing orders during training, and the effect of computerized provider order entry (CPOE) on their learning experiences. DESIGN: Prospective, controlled study of all 143 Johns Hopkins University School of Medicine students who began the Basic Medicine clerkship between March 2003 and April 2004 at one of three teaching hospitals: one using CPOE, one paper orders, and one that began using CPOE midway through this study. MEASUREMENTS: Survey of students at the start and after the first month of the clerkship. RESULTS: Ninety-six percent of students responded. Students expressed a desire to place 100% of orders for their patients. Ninety-five percent of students believed that placing orders helps students learn what tests and treatments patients need. Eighty-four percent reported that being unavailable due to conferences and teaching sessions was a significant barrier to participating in the ordering process. Students at hospitals using CPOE reported placing significantly fewer of their patients' follow-up orders compared to students at hospitals using paper orders (25% vs. 50%, p < 0.01) and were more likely to report that their resident or intern did not want them to enter orders (40% vs. 16%, p < 0.01). Comparisons of students at hospitals using CPOE to each other showed that these differences were attributable to one of the hospitals. Thirty-two percent of students at both hospitals using CPOE reported that the extra length of time required for housestaff to review their orders in the computer was a significant barrier. CONCLUSION: Hospitals need to ensure that the educational potential of medical students' clinical experiences is maximized when implementing CPOE.

Attitude to Computers↗
PubMed2004

Development and evaluation of an integrated musculoskeletal disease course for medical students.

BACKGROUND: A recent survey of medical and surgical residents in the United States suggested that our current training of physicians may be inadequate to meet the increasing demand for diagnosis and treatment of musculoskeletal disorders. In response, we developed an integrated, multidisciplinary course to teach knowledge and skills related to musculoskeletal disease to second-year medical students. A three-year prospective outcomes study was conducted to evaluate the new course. METHODS: The primary outcomes that were studied during the first year of the new course were the gains in knowledge, changes in levels of confidence, and long-term retention of skills. Secondary outcomes consisted of student and faculty satisfaction. Ten-item pre-tests and post-tests covering core course concepts were administered to students. A matched-pairs t test was used to evaluate the difference between pre-test and post-test scores. Students were also asked to rate, on a 10-point scale, how much confidence they had in their ability to perform the musculoskeletal physical examination before and after the institution of the new curriculum. A general linear model analysis with post hoc pairwise comparisons (F test) was used to evaluate the changes in the confidence levels of the students. Also, a knee examination station was organized to compare students' scores before and after revision of the course. At the conclusion of the course, students rated each aspect of it on a scale of 1 to 5. Instructors were asked to rate the effectiveness of all elements of the course on the same scale. RESULTS: On the basis of student satisfaction and confidence and faculty satisfaction, the most effective changes in the curriculum were the introduction of a physical examination workshop and simulated clinical situations. Students' knowledge increased significantly (p < 0.001), and their level of confidence increased significantly in thirteen specifically targeted areas (p < 0.0001). On the end-of-the-year examination assessing retention of physical examination skills, the scores for the skills emphasized in the revised course increased significantly whereas the scores for a skill not emphasized in the course remained the same. Revisions made in the second and third years after implementation of the course expanded the more successful elements and further improved student ratings. CONCLUSIONS: Integration of the three clinical disciplines related to musculoskeletal disease--orthopaedics, rheumatology, and physical medicine and rehabilitation--resulted in a highly effective introductory course for second-year medical students. The heuristic strategy of introducing core content through lectures and workshops followed by small-group teaching sessions for practice with the new knowledge effectively increased students' knowledge, confidence, and satisfaction.

Curriculum↗
PubMed2002

Using the human patient simulator to educate students of veterinary medicine.

INTRODUCTION: The human patient simulator has proved to be an effective educational device for teaching physicians and paramedical personnel. METHODOLOGY: To determine whether veterinary medicine students would benefit from similar educational sessions, 90 students each took a turn being the patient's clinician as real-life scenarios were played out on the simulator. The students induced and maintained anesthesia on their patient and monitored vital signs. Several critical events were presented for the students to diagnose and treat as they occurred. All students submitted a written evaluation of the course upon completion. The last 40 students were randomly divided into two groups of 20 students each. The students in Group I experienced the simulator before their clerkship examination, and those in Group II took the examination before their simulator experience. RESULTS: The students rapidly gained confidence in treating their simulated patient. This carried over to the clinical setting, where they appeared to be more confident when anesthetizing live patients. The simulator experience brought together much of the previous didactic material that they had been exposed to so they could appreciate its clinical relevance. The overwhelming response to the simulator experience was positive. The students in Group I had a significantly higher score on the clerkship examination dealing with concepts reviewed by simulation than those in Group II, who engaged in self-study instead of the simulation exercise (p < 0.001). CONCLUSION: We conclude that the human patient simulator was a valuable learning tool for students of veterinary medicine. It was exciting for the students to work with, made them deal with "real-life" scenarios, permitted them to learn without subjecting live patients to complications, enabled them to retrace their steps when their therapy did not correct the simulated patient's problems, and facilitated correlation of their basic science knowledge with clinical data, thus accelerating their ability to handle complex clinical problems in healthy and diseased patients.

Humans↗
PubMedDate not supplied

A strategy for involving on-campus and distance students in a nursing research course.

BACKGROUND: Teaching research at the undergraduate level can be a challenge. This is particularly true for distance education courses, in which students often feel isolated from each other and from faculty. Faculty teaching on-campus and distance education research courses designed a student research project and a method for bringing distance and on-campus students together to present their research findings. METHOD: By actively engaging students in the research process and providing an on-campus research day for the presentation of student posters (Year 1) and research papers (Year 2), course faculty were able to achieve their two goals of directly involving students in the nursing research process and creating a greater student sense of belonging within the college learning community. RESULTS: Statistical analysis of an evaluation survey among on-site and off-site registered nurse to bachelor of science in nursing students indicated both groups ranked the Year 1 poster research day as good to very good. Students attending the Year 2 research day, where they presented papers, ranked the day as good. Statistical analysis indicated a significant difference between the two research days, with a clear student preference for posters. CONCLUSION: Students valued their active participation in the research process and the opportunity to get together and present their work. However, students clearly preferred a poster presentation format to presenting their findings as a research paper.

Education, Distance↗
PubMedDate not supplied

Respiratory allergies and skin test reactivity in high school students in Tenerife, Canary Islands, Spain.

The prevalence of skin test reactivity to 22 aeroallergens and of allergic respiratory diseases was determined in 501 high school students on the island of Tenerife, Spain. Two hundred seventy-seven students (55.2%) had at least one positive prick skin test (wheal > or = 2 mm). Two hundred sixteen students (43.1%) had symptoms of upper or lower respiratory tract allergies [24 (4.7%) had asthma with or without rhinitis and 192 (38.3%) seasonal or perennial rhinitis alone]. Two hundred eighty-five students (56.8%) were asymptomatic. One hundred per cent of the students with asthma, 87.5% of the students with rhinitis and 27.7% of the asymptomatic students had at least one positive skin test. The prevalence of positive skin tests was significantly higher in symptomatic than in asymptomatic students (p = 0.0001). One hundred seventy students (33.9%) had a family history of respiratory allergic diseases. The prevalence of positive skin tests among these students was significantly higher than in students without such history (p = 0.0001). Thus, there is a high prevalence of allergic respiratory diseases and skin test reactivity to aeroallergens among high school students in Tenerife. Significant correlations were found between family history, positive skin tests and respiratory allergic symptoms.

Adolescent↗
PubMedDate not supplied

Survey of knowledge of HIV infection among senior secondary school 3 (SSS3) students in Port Harcourt.

BACKGROUND: The objective of this paper is to study the knowledge of the students on Human Immunodeficiency Virus and Acquired Immunodeficiency Deficiency Disease (HIV/AIDS) among third year senior secondary school (SSS3) students in Port Harcourt metropolis. METHOD: This was a cross-sectional survey involving 1800 SSS3 students from thirteen secondary schools in Port Harcourt metropolis, selected by a two-stage stratified sampling technique, using a self administered structured questionnaire. RESULTS: Thirty one percent, 14.4%, 9.1% and 8% of the students studied identified sexual intercourse, blood transfusion, mother to child (vertical) transmission and intravenous drug use, respectively, as modes of transmission of HIV infection. Only 7.1% identified all the listed four modes of transmission of HIV whilst 0.7% of the students identified all the listed preventive methods. The level of knowledge of the students on HIV did not significantly increase with age (p = 0.745). Students from Federal school demonstrated more knowledge than students from state and private schools. Similarly, students from all-male school had more knowledge than students from all-female and co-educational schools. Students from high social class demonstrated more knowledge than those from middle and low social class. CONCLUSION: It is concluded that the knowledge of the students on the transmission and prevention of HIV/AIDS is poor. There is need to intensify HIV/AIDS education programmes among adolescents.

Adolescent↗
PubMed2004

Internet-based virtual classroom and educational management software enhance students' didactic and clinical experiences in perfusion education programs.

A challenge faced by many university-based perfusion education (PE) programs is the need for student clinical rotations at hospital locations that are geographically disparate from the main educational campus. The problem has been addressed through the employment of distance-learning environments. The purpose of this educational study is to evaluate the effectiveness of this teaching model as it is applied to PE. Web-based virtual classroom (VC) environments and educational management system (EMS) software were implemented independently and as adjuncts to live, interactive Internet-based audio/video transmission from classroom to classroom in multiple university-based PE programs. These Internet environments have been used in a variety of ways including: 1) forum for communication between the university faculty, students, and preceptors at clinical sites, 2) didactic lectures from expert clinicians to students assigned to distant clinical sites, 3) small group problem-based-learning modules designed to enhance students analytical skills, and 4) conversion of traditional face-to-face lectures to asynchronous learning modules. Hypotheses and measures of student and faculty satisfaction, clinical experience, and learning outcomes are proposed, and some early student feedback was collected. For curricula that emphasize both didactic and clinical education, the use of Internet-based VC and EMS software provides significant advancements over traditional models. Recognized advantages include: 1) improved communications between the college faculty and the students and clinical preceptors, 2) enhanced access to a national network of clinical experts in specialized techniques, 3) expanded opportunity for student distant clinical rotations with continued didactic course work, and 4) improved continuity and consistency of clinical experiences between students through implementation of asynchronous learning modules. Students recognize the learning efficiency of on-line information presentation but still prefer the traditional face-to-face classroom environment. Traditional paradigms impose limitations that are rooted in dependence upon the students and instructors being physically located in the same place at the same time. These represents significant impediments for PE programs that use geographically separate clinical sites to provide clinical experience. Historically this has led to a disintegration of the presentation of theory, and a reduction in the quantity or quality of clinical experience opportunities. New PE models help to eliminate limitations and improve the quality of education especially in the face of economic challenges. Perfusion education students and faculty will have to work together to find computer-based offerings that are equivalent to traditional classroom methods.

Allied Health Personnel↗
PubMed1990

Knowledge, attitudes and beliefs about AIDS in township school students in Cape Town.

Students (N = 377) from four Cape Town township high schools were surveyed to obtain information on their knowledge of and attitudes towards the acquired immunodeficiency syndrome (AIDS), and on their sexual behaviour. The study was undertaken to provide information for planning an AIDS education intervention. Three-quarters of students reported that they had had sexual intercourse. Most students had heard of AIDS, and the majority of these knew that it was infectious. More than half of the students were confused or lacked knowledge about the modes of transmission. Two-thirds of the students believed AIDS could be prevented, but knowledge of prevention strategies was superficial. Of the sexually active students only 11.4% had ever used a condom, and of all students 39.6% stated that they would use a condom in the future. Two-thirds of the students were not aware that there is no cure for AIDS. Students did not acknowledge that AIDS could affect them directly, and attributed the problem to prostitutes and 'promiscuous' people in 36.4% of responses, and to 'white' people in 23.8% of responses. Students expressed intolerance, fear and rejection of people with AIDS, and only 6.4% would accept an affected person into their class. Almost all the students wanted AIDS education at school, and most of these requested that the school nurse facilitate this education. It is concluded that appropriate AIDS prevention education is urgently required for both high school and junior school students.

Acquired Immunodeficiency Syndrome↗
PubMed1996

Prevalence and impact of exposure to interpersonal violence among suburban and urban middle school students.

OBJECTIVE: The purpose of this study was to determine the prevalence of exposure to violence in preadolescent children in communities that vary by family income and to determine patterns of physical symptomatology and communication after exposure to a traumatic event. METHODS: Two hundred twenty-eight sixth-grade students from a suburban middle school (school A) and 209 sixth-grade students from an urban middle school (school B) in the Philadelphia metropolitan area were surveyed by a group-administered anonymous questionnaire. RESULTS: Two hundred two students (89%) from school A and 200 students (96%) from school B reported knowing someone who had been robbed, beaten, stabbed, shot, or murdered. One hundred twenty-nine students (57%) and 183 students (88%), respectively, witnessed a robbing, beating, stabbing, shooting, or murder. Ninety-one students (40%) and 141 students (67%) had been personally robbed, beaten up, stabbed, shot, or caught in gun cross fire. One hundred thirty-four (59%) and 152 (73%) reported hearing gunfire in their neighborhood. One hundred eighty-eight (82%) and 202 (97%) had at least one positive response in all three categories: knowing a victim, witnessing an event, and being a victim of violence. The proportion of positive responses from school B was significantly greater than the proportion from school A for all of these results. Many students reported symptoms associated with somatization syndromes, depression, and posttraumatic stress disorder; the school B group had significantly more symptoms than the school A group. Both student groups had discussed episodes of witnessing an event or victimization with others, mostly family members and friends, and expressed feelings of fear, anger, sadness, and frustration about these episodes. A very low percentage of the students (from 1% to 8% in the different analyses) consulted a medical or mental health professional. CONCLUSIONS: These data support a substantial prevalence or exposure to violence for suburban and, even more dramatically, for urban middle school-aged children. The higher-prevalence group reported a higher incidence of symptoms sometimes seen after traumatic stress. Many students in both groups expressed multiple feelings about their exposure to violence, and most talked to someone about their exposure; rarely was this person a health professional.

Chi-Square Distribution↗