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The Department of Humanities at Pennsylvania State University's (Penn State) College of Medicine, created at the founding of the College in 1967, was the first of its kind at any medical school. This article begins by describing how the department has developed over the years, and then discusses its present configuration, including kinds of faculty appointments, information about how it is funded, specific courses that comprise the department's four-year curriculum, and activities it sponsors. That a College of Medicine would make the teaching and practice of humanistic medicine a major and explicit commitment attracted the notice of Drs. Lawrence and Jane Kienle, who made possible the Doctors Kienle Center for Humanistic Medicine. The Humanities Department is closely allied with the Doctors Kienle Center, which integrates the College and the Medical Center by supporting a variety of projects, research, and awards that further the teaching and practice of humanistic medicine. Faculty in the department are encouraged to demonstrate excellence in scholarship and in teaching, but are also expected to become engaged in the life of the Medical Center, especially in furthering humanistic patient care. As such, the Humanities Department plays a major role in furthering the mission of the Pennsylvania State University's College of Medicine.
The authors describe the strategies developed at the Pennsylvania State University College of Medicine, as part of The Robert Wood Johnson Foundation's Generalist Physician Initiative, to increase the proportion of graduating medical students entering generalist disciplines. These strategies included modifying the admission process to involve more primary care faculty so that students with identified potential for primary care would make up at least half of each entering class, and partnering with selected colleges and universities in Pennsylvania to increase the number of applicants with the potential for primary care. They describe partnering and outreach programs--Primary Care Day, off-campus cluster meetings, and the Primary Care Scholars Program for college seniors--and present promising information about the results.
With funding from The Robert Wood Johnson Foundation's Generalist Physician Initiative, the Pennsylvania State University College of Medicine created a community-based primary care clerkship in general pediatrics, general internal medicine, and family and community medicine, in which third-year students spend a month in a small town, rural area, or urban underserved medical community. In addition to linking students with preceptors who would teach the clinical skills essential to primary care practice, the medical school set out to teach and to evaluate knowledge, attitudes, and behaviors unique to primary care. This paper describes the three-part teaching tool/evaluation developed to address (1) a student's recognition of the characteristics of primary care (learning objectives assignment), (2) a student's ability to appreciate the multiple nonmedical factors influencing a patient's health and experience of illness (family project), and (3) a student's ability to solve clinical problems (clinical reasoning examination). The authors describe how these evaluation methods are linked with the clerkship's goals and objectives and how they yield a richer portrait of the student's performance than the traditional preceptor's evaluation alone can provide. They also discuss the relationship between students' performances on the primary care clerkship and their performances in other clinical clerkships. Similar clinical experiences in primary care should focus on features unique to primary care medicine in both teaching and evaluation.
The number of patients who would be candidates for replacement of their failing native heart with an artificial device increases every year. A multidisciplinary group at The Pennsylvania State University is working toward the development of a reliable, totally implantable artificial heart. Initial work resulted in a pneumatic total artificial heart that has performed well in animal implants and has been used clinically in three patients as a temporary bridge to cardiac transplantation. Although pneumatic total artificial hearts have demonstrated utility as temporary mechanical circulatory support devices, attempts at permanent implantation by other groups have been fraught with complications. Because of the suboptimal performance of the pneumatic devices used for permanent implantation, the authors' groups at Penn State is developing n electric motor-driven total artificial heart with encouraging results in calf implants. This artificial heart of the future will use a transcutaneous energy transmission system that will obviate the need for percutaneous lines. Thus, the patient will be provided with as near a normal life-style as possible. At present the technology is at hand to implant an electric blood pump system that should provide a reasonable life-style and function reliably with minimal care. Ongoing cooperative experimental efforts will help to provide the answers necessary to make this system ready for clinical use.
To eliminate the need for a separate parapleural compliance chamber, we are currently investigating the feasibility of an annular compliance chamber. This chamber wraps around the energy converter and fits between the blood pumps of the Pennsylvania State University electric total artificial heart. For the 100 cc total artificial heart, the compliance chamber volume is 76 ml and the tissue contacting surface area is approximately 85 cm2. The chamber is made of Dacron velour covered segmented polyether polyurethane urea. The annular compliance chamber was evaluated in vitro by comparing pump balance control performance against that obtained with an open vent. In the CVP range of 5-12 mmHg, LAP was maintained within 1 mmHg of the values obtained with a vent. Studies continue to determine the range of volumes over which the chamber is effective, differences in rates of diffusion, and performance during changes in barometric pressure.
In a constantly evolving health care landscape shaped by many voices--including those of third party payers and government--physicians must learn to play a more proactive role to become better advocates for their patients and to uphold the basic tenets of their noble profession. As legislation and public health become increasingly intertwined with the practice of medicine, educators must provide future physicians with the tools to meet these new challenges. Accordingly, in 1996 Pennsylvania State University College of Medicine embarked on its Health Policy and Legislative Awareness Initiative, a medical school elective designed to provide theoretical knowledge as well as practical experience in legislative and policy issues for future physicians early in their careers. The Initiative has three key elements: a series of lectures taught by national and local experts covering a basic health policy curriculum, a mini-internship conducted at the office of a Pennsylvania State legislator, and a practical assignment leading to authorship of a resolution to a national medical organization or assisting in drafting a bill intended for introduction to the Pennsylvania State Legislature. Following several years of successful implementation and a moderate growth in enrollment, recent changes in the local and national scene have peaked the interest of most students to learn about the system in which they will practice medicine. Therefore, in addition to describing the Initiative in its current form, the authors discuss future plans for expanded elective opportunities and consider the issue of integrating health policy education into core medical school curricula.
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This paper discusses a new medical library. The physical plant, the development of the collection, and special activities are described. The budget is presented.
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