Journal of Medical Education最新文献

The problem-solving process used by scientists and by clinicians is compared and contrasted. The most creative step for both groups is the ability to make an association between some external stimulus or situation and concepts stored in memory. Medical education must put more emphasis on teaching that improves students' abilities to make these associations. Two teaching methods that can promote development of the necessary association skills in clinical contexts--"wait time" and "concept mapping"--are briefly reviewed. Concept mapping consists of connecting words that represent concepts with lines that represent relationships and then labeling the lines. Wait time is waiting three to five seconds between asking a group of students a question and calling on a student to answer or waiting three to five seconds before responding to the student's answer.

The Internal Medicine Residency Program of the Raritan Bay Medical Center's Perth Amboy Division was changed in July 1987 from a full continuity-of-care system to a unit-isolation one. The authors compared patients' data from the first two months of the academic years 1986-87 and 1987-88 and were unable to observe any impact of the change on length of stay in intensive care. However, informal interviews with the house staff members indicated that the change had a positive impact on their education, because of their closer observation of the pathophysiology of individual disease states and greater enjoyment of the time spent in critical care.

A random sample of 120 physicians in Ontario was studied to assess quality of care in primary care and test an hypothesis that quality of care was related to continuing medical education (CME) activities. The quality-of-care scores were obtained by an in-office audit of a random selection of charts. The scores were global scores for charting, prevention, the use of 13 classes of drugs, and care of a two-year period for 182 different diagnoses. There were no relationships between global quality-of-care scores based on these randomly chosen charts and either the type or quantity of the physicians' CME activities. These activities were reading journals, attending rounds, attending scientific conferences, having informal consultations, using audio and video cassettes, and engaging in self-assessment. The implications of these findings are significant for future research in CME and for planners of present CME programs.

Despite the recent dramatic increase in the use of video for patient education, there has been no critical assessment of this medium. In this paper, the author reviews 25 methodologically-sound studies in order to define the efficacy and limitations of video. Video is as good as and often more effective than traditional methods of patient education in increasing short-term knowledge. It offers no advantage, however, in improving long-term retention of knowledge or in promoting compliance with medical regimens. A strength of video is role-modeling. When applied to well-defined, self-limited stressful situations, role-modeling in video decreases patients' anxiety, pain, and sympathetic arousal while increasing knowledge, cooperation, and coping ability. These effects may carry over for patients to less structured but similarly stressful situations.

A 27-item questionnaire was sent to 144 U.S. and Canadian medical schools to identify prevailing patterns in the organization, philosophy, and function of curriculum committees. Overall, 76 percent responded, with 67 percent of the respondents being school administrators and 33 percent being faculty members. Fifty-one percent rated their school's committee as exerting a significant impact on the educational program over the previous five years. Fifty-six percent of the committees had a routine procedure for course review and used data from multiple sources when conducting curriculum evaluations. The committees that annually received a specific assignment from the dean were the most likely (91 percent) to be rated as having a significant impact, followed by committees that conducted frequent course reviews (66 percent). Thirty-eight percent of the committees were primarily faculty oriented, 29 percent were decidedly administrative in composition, and the remaining committees exhibited a mixture of membership.