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PubMed1975

Learning pulmonary function interpretation: deductive versus inductive methods.

Volunteer undergraduate medical students were randomly divided into 2 groups. One group were given pulmonary function data and the correct diagnoses from 18 patients. They were told to try to derive the rules by which the diagnoses were made. The other group were given the data from the same 18 patients, but were required to use a computer-assisted instructional program to arrive at the diagnoses in a deductive fashion. Both groups were pre- and post-tested. The deductive method provided higher post-test results. The inductive method took longer and produced more dropouts from the study.

Analysis of Variance↗
PubMed2004

Relationship of substance use by students with disabilities to long-term educational, employment, and social outcomes.

The study is based on data from the National Education Longitudinal Study of 1988-2000 (NELS: 88). The results indicate that adolescents with disabilities who used either cigarettes or marijuana or who engaged in binge drinking had significantly higher dropout rates, lower high school graduation status, lower college attendance, and lower high school grade point averages, and fewer earned core credit units in English, science, and mathematics than nonusers. In addition, adolescents with disabilities who used either cigarettes, alcohol, or drugs were significantly more likely to engage in sexual activity at a younger age. The findings support the need for improved substance use prevention programming targeting the needs of youth with disabilities.

Adolescent↗
PubMed2005

A program of supported education for adult Israeli students with schizophrenia.

This report describes a supported education program (SEP), a novel community-based program of rehabilitation for psychiatric patients, started in Israel in 1999. Objectives, target population and activities are described. In addition, initial findings of two program-related studies are presented. One study explored the relationship of psychological distress with students' coping strategies and perceived social support. The second study is a survey of mental health literacy and attitudes of heads of schools for adult education where the SEP was implemented. Studies' findings suggested a "case for action" with the following objectives: to develop interventions to prevent distress among SEP users, and to enhance mental health knowledge and foster positive attitudes among school personnel aimed at decreasing dropout rates and encourage the utilization of the opportunities provided by SEP.

Adaptation, Psychological↗
PubMed1984

Evaluating medical school graduates of a reduced course program: a preliminary report.

The performance of 32 medical school graduates who had pursued a reduced course load ("extended program") for one or more years during medical school was examined during the first postgraduate year (PGY-1) of training. Those with academic problems as undergraduates performed at only a slightly lower than average level, while those who had extended their curricula to pursue personal or extracurricular interests tended to perform at a better than average level in the PGY-1 residency. Graduates with significant emotional disorders in medical school who pursued a reduced course load had a high (35 percent) dropout rate during the residency that occurred despite expert psychiatric care and substantial support during medical school and the residency. The authors suggest that extended programs may be useful for students seeking personal enrichment and for some with academic problems but that they do not seem particularly helpful to students with major emotional disturbances.

Affective Symptoms↗
PubMed2006

Knowledge of reproduction in teenagers and young adults in Sweden.

OBJECTIVE: To investigate the knowledge of reproductive physiology and anatomy among adolescents and young adults in Sweden, and to evaluate the education obtained on these issues. METHODS: Two hundred and nine study specific questionnaires were distributed, of which 206 were answered by students in primary school, upper secondary school and at first year of university. A total knowledge score based on 21 out of the 35 questions in the questionnaire was calculated. As only 44 of the 206 respondents answered all the questions a revised score was also calculated, in which partial dropouts were interpreted as wrong answers. RESULTS: The mean of the total knowledge score was 28.7 out of 54 among the 44 respondents answering all questions, and the revised knowledge score was 24.0. The level of knowledge tended to be higher in older age groups, among women, as well as among respondents who had visited a Youth clinic. The time of ovulation was known by 21.4% of men compared to 63.4% of women. Almost 50% of the students knew one mechanism whereby oral contraceptives act to protect against pregnancy. Of the respondents, 77.2% knew of Chlamydia trachomatis but the knowledge of other STIs, like condyloma, was poorer (16.5%). Reasons for infertility were relatively well known among the respondents. Of the respondents, 57.5% stated that they had not received enough information on reproductive issues. CONCLUSIONS: The students have not achieved sufficient knowledge concerning sexual and reproductive matters that they, according to the national curriculum, should have attained by the end of the 9th grade. An improvement of the quality of the education, adapted to the students' age and pre-existing knowledge, and a review of the contents of the education is therefore needed.

Adolescent↗
PubMed2005

Attitude towards computer-based learning: determinants as revealed by a controlled interventional study.

BACKGROUND: Curriculum-wide implementation of computer-based learning (CBL) in undergraduate medical education remains elusive. Unlike many pilot tests of singular learning programmes, dropout rates are high and acceptance seems low in the long run. We studied the effect of a new CBL programme, suitable for curriculum-wide implementation, on Year 3 medical students' attitudes towards CBL. METHODS: Students from 2 universities participating in a mandatory pharmacology course were given access to a CBL programme covering cardiovascular drug therapy in a controlled randomised study (n = 167). Learner properties and attitude towards CBL were measured using psychometric scales, and knowledge by multiple-choice questions (pre- and post-test). RESULTS: Attitude towards CBL worsened in the CBL group (n = 70). Individual learners' properties did not explain this effect. The perceived programme quality was rated only 'average', which may contribute to the lower post-test values of attitude towards CBL. Learning outcomes were similar between the control group (n = 97) and students using CBL (n = 44). Learning efforts were shifted from self-study towards CBL. CONCLUSION: The initial enthusiasm of students was not maintained when using a programme designed to complement or even replace traditional teaching. Curriculum-wide implementation of CBL might be hampered by the discouragement of users.

Attitude of Health Personnel↗
PubMed2001

Reliability and validity of the translated Psychotherapy Expectancy Inventory.

Matching treatment to therapy expectations is important. It increases treatment benefit and prevents dropout. No treatment expectation inventory existed in Hebrew, therefore a translation from English, of the Psychotherapy Expectancy Inventory-Revised, developed by Berzins, was undertaken. The questionnaire was given to 268 students twice, to 21 therapists and 107 parents of children referred to a child and adolescent clinic once. The translated questionnaire has high test-retest reliability, high internal consistency and significant criterion related validity-contrasted groups on advice, audience and relationship. Factor analysis yielded the four original scales, with the exception of two questions, which were moved to different scales.

Adolescent↗
PubMed1998

Dental fear among university employees: implications for dental education.

We surveyed 350 University of Washington permanent employees chosen randomly from among both faculty and staff. The aim was to determine the extent and nature of dental anxiety in the university population potentially available for teaching clinics. In addition, the relationship of fears to self-reported dental health, utilization of dental care, and other general and mental health issues was examined. Dental anxiety was prevalent in this population; 13 percent of subjects reported high dental fear. In contrast to respondents with lower dental fear, subjects with clinically significant fear reported poorer perceived dental health, a longer interval since their last dental appointment, a higher frequency of past fear behaviors, more physical symptoms during last dental injection, and higher percentage of symptoms of anxiety and depression. Dental anxiety was not associated with poorer perceived general health or a longer interval since the last dental injection. University employees are a rich source of potential teaching patients for achieving curricular requirements for managing anxious patients. Student clinicians need guidance to be able to recognize fearful patients; they also need instruction about psychiatric conditions like anxiety and depression in order to be able to better manage and prevent dropouts in their patient roster.

Adult↗
PubMed2000

A comparison of patient satisfaction among current and former dental school patients.

Patient satisfaction is becoming an increasingly important indicator of quality dental care. However, most patient satisfaction surveys target only the current patients of the dental practice or institution, which may give an inflated estimate of satisfaction with care, since dissatisfied patients are likely to have left the practice or institution. The purpose of this study was to compare the satisfaction of three categories of dental school patients with several aspects of care received at the school. Data were collected using a telephone survey of 291 patients, systematically selected from the dental school's computer listings of all current, recall, and former patients. The survey instrument sought information about why respondents came to the school for dental treatment, why respondents who were no longer in treatment had dropped out of care, and respondents' opinions on eleven aspects of quality of care provided at the dental school. Dental students who had completed a training session served as interviewers. Results indicate that, overall, patient satisfaction with the care received was high, with none of the means for any category of patient falling into the dissatisfied range. Respondents who had dropped out of care were less satisfied than active or recall patients in five areas: quality of care, length and number of appointments, treatment explanation, and fees. Results have implications for dental school administrators and educators in their efforts to provide high quality patient care and to retain an adequate patient pool to ensure optimal clinical experiences for students.

Dental Care↗
PubMed1994

The United States Neurological Surgery Residency Matching Program.

After 3 years of deliberations, The Society of Neurological Surgeons approved a national Neurological Surgery Matching Program in 1983 for residency positions beginning July 1, 1985. All directors of United States neurological surgery residency training programs agreed to participate and abide by the rules of the match. A review of 10 years' experience with 11 matches from 1983 to 1994 indicates full acceptance by both applicants and program directors and a highly successful process and outcome, satisfactory for everyone except for qualified applicants who failed to obtain a residency position. Since 1985, 1455 neurosurgical (Postgraduate Year 2) residency positions have been offered for match, and 2708 applicants have submitted a ranking list, filling 1434 positions with the initial computer run each year and leaving 1274 unmatched applicants. Thus, the ratio of applicants to available positions is almost 2:1. Various interesting details about multiple-year applications, International Medical Graduates, and nonstart, transfer, and dropout rates are presented, including the eventual practice activities of residents not completing neurosurgical training. A comparison of all United States medical schools, considering data on applications and matches for neurosurgical residency versus number of senior medical students, reveals wide differences. These differences are probably related to the availability of neurosurgical clerkships, faculty participation in the undergraduate curriculum, and the presence of a neurosurgical residency program.

Career Choice↗
PubMed1995

A pilot program of contraceptive continuation in six school-based clinics.

PURPOSE: Few school-based health centers (SBHC) in the United States dispense contraceptives on-site and little is known about contraceptive continuation in these health centers. METHODS: An 11-month contraceptive continuation pilot project offering monthly reproductive health assessment and counseling to students enrolled in Baltimore school clinics was evaluated. One hundred-forty-three women voluntarily enrolled in the study over a seven month period. A monthly contraceptive calendar was developed to collect data on contraceptive use, pregnancy and STD risk, sexual behavior and parental support for contraceptive use. Physical assessment was provided as needed to assess the presence of STD's or pregnancy. Data were analyzed for the month prior to enrollment in the program and eleven months after entry into the program. RESULTS: Both contraceptive (OCP) use and abstinence increased over the course of the program. Condom use remained at approximately 30% with frequent use of OCP's and condoms, condoms or abstinence. Program drop-out was common. Thirteen students became pregnant while enrolled in the program and 35% of the students were diagnosed with one or more sexually transmitted diseases. Partner-switching was common, although two or more partners within any one month was rare. CONCLUSIONS: Monthly follow-up provided through SBHCs can improve contraceptive use although dropout rate and contraceptive failure remain high.

Adolescent↗
PubMed1991

Quantitative and qualitative changes in cocaine use among American high school seniors, college students, and young adults.

Based on the data presented in this chapter, there is clearly no cause for complacency about the problem of cocaine use among the Nation's youth. Lifetime prevalence is at a disturbingly high 15 percent among high school seniors and over 20 percent among college students. Prevalence is considerably higher, around 30 percent, among young adults in the age range of 19 to 28, and reaches nearly 40 percent for people in their late twenties. The use of cocaine is higher among males than among females; higher in the West and Northeast and lower in the North Central and South; and distinctly lower in rural, compared to more urban, areas. The prevalence figures made clear that cocaine use has by no means become a rare behavior among young people. And the new form, crack, has made substantial inroads among these populations. Among high school seniors, more than 1 in 20 have tried crack cocaine. Although these figures are very high, there is encouraging news in the slight downturn in prevalence that occurred in 1986 and particularly in the sharp decline in 1987. Clearly, these declines were not due to any reduction in perceived availability of cocaine, which actually increased. The declines appear to be due primarily to the increasing recognition that cocaine use is dangerous and caries substantial risk of harm. On the other hand, there is reason to be concerned about the situation with respect to crack cocaine. Some indicators suggest that use of crack cocaine is not declining to the same extent that other cocaine use is. Moreover, this study does not represent well the populations of inner cities, with their extraordinarily high dropout rates; it may well be that the epidemic is continuing to grow there.

Adolescent↗
PubMed2000

Understanding the links among school misbehavior, academic achievement, and cigarette use: a national panel study of adolescents.

Relations among academic achievement, school bonding, school misbehavior, and cigarette use from 8th to 12th grade were examined in two national panel samples of youth (n = 3056). A series of competing conceptual models developed a priori was tested using structural equation modeling (SEM). The findings suggest that during middle adolescence the predominant direction of influence is from school experiences to cigarette use. School misbehavior and low academic achievement contribute to increased cigarette use over time both directly and indirectly. Two-group SEM analyses involving two cohorts-gender and ethnicity- revealed that our findings are robust. In addition, comparisons between high school dropouts and nondropouts and between eighth-grade cigarette use initiators and nonusers revealed few differences in direction or magnitude of effects. Results suggest that prevention programs that attempt to reduce school misbehavior and academic failure, as well as to help students who misbehave and have difficulty in school constructively avoid negative school- and health-related outcomes, are likely to be effective in reducing adolescent cigarette use.

Adolescent↗
PubMed1986

Predicting the success of minority students in a baccalaureate nursing program.

Entering grade point average (ENTGPA), American College Test Assessment (ACT), high school rank (HSRANK), high school GPA (HSGPA), number of college credit hours prior to program admission (HRSPTA), age at admission, and an index of applicant motivation and related experience (MEP) were investigated to determine the best predictive combination of variables for success among minorities in a baccalaureate nursing program. Final GPA, program completion, and State Board Examination (SBTPE) performance were used as indicators of success. Minority students (N = 145) admitted between 1971-1981 were identified by record review. Two minority subgroups, blacks (n = 111) and nonblack minorities (n = 34) were compared using multiple regression and discriminant analysis procedures. ACT was the strongest, most consistent predictor of SBTPE performance and final GPA for all minorities. ENTGPA and ACT provided substantial predictive power for both subgroups, but explained markedly less variance for blacks. HSGPA, HRSPTA, and HSRANK explained some variance differently by subgroup. ENTGPA provided the only discrimination between graduates and dropouts. Cognitive attributes are critical to academic success among minorities, although predictors may vary in explanatory power by minority group. Variables interfering with program completion need to be explored.

Achievement↗
PubMed1999

Epidemiology of tobacco use among US adolescents.

Among persons in the United States under age 18 years, every day more than 6000 try cigarette smoking for the first time and more than 3000 become daily smokers. The overwhelming majority of adults who smoke began by age 18 years. Slightly more than one-third of US high school students were cigarette smokers in 1997. In recent years, males were about as likely as females to smoke. American Indians/Alaska Natives and whites were more likely to smoke than were Hispanics, African-Americans, and Asian-Americans/Pacific Islanders. Overall, cigarette smoking prevalence declined in the late 1970s or early 1980s, leveled off in the 1980s, and increased in the 1990s. The decline in prevalence among African-Americans was especially noteworthy. Among US high school students in 1997, the prevalence of cigar smoking was higher than that of smokeless tobacco use. Indicators of nicotine dependence are prevalent among adolescents who use tobacco products. Efforts to: (1) improve the validity of self-reported behaviors; (2) increase access to school dropouts and infrequent school attendees; and (3) improve school participation rates, data availability, and data linkage systems will benefit the field. Qualitative research can suggest variables to be added to survey questionnaires. Methods research should be conducted to better quantify and explain differences between survey estimates. Tracking relevant environmental variables and new tobacco products will expand the science base and facilitate appropriate public health action.

Adolescent↗
PubMed1995

Effects of self-efficacy and dispositional optimism on adherence to step aerobic exercise classes.

This study investigated the effects of generalized and domain-specific expectancies on participation in 8 weeks of step aerobic-exercise classes. 154 university students and staff who registered for step aerobic classes completed measures of aerobic self-efficacy and dispositional optimism prior to attending their first class. Attendance was taken at each session by the instructors. A split at the median on attendance classified participants as dropouts or adherers. Analysis indicated that adheres scored significantly higher on self-efficacy that did dropouts. Adherers and dropouts did not differ on dispositional optimism.

Adolescent↗
PubMed1984

Epilepsy and the inner city schools: a school-based program that makes a difference.

A program was developed within the Baltimore City School System to comply with U.S. Public Laws 94-142 and 94-484. The program provided assessment, appropriate placement, counseling, work experience, and epilepsy education. Self-identified students were primarily black and poor, more likely to be either 1 year behind in reading or in special education. Seventy percent had psychosocial problems but for less than half were the problems directly related to seizures. The program decreased the nonpromotion rate and the dropout rate to less than half of that for the school system as a whole, and cut in half the percentage of youths who were unemployed or not in school or training 1 and 2 years after graduation. The per pupil cost was 10% greater than current expenditures for the system as a whole.

Adolescent↗