Journal of Medical Education最新文献

Computerized medical records systems are used in only a small percentage of U.S. health care facilities, despite predictions that they would be widely used. The authors here report on their experience with the Computer Stored Ambulatory Record (COSTAR), a computerized medical records system, installed at a large primary care clinic at a university medical center. Although some equipment and computer resources were provided by the medical center, ongoing operations were financed by clinic revenues. After four months, use of the system was terminated because clinic revenues could not cover operating costs. The operating costs accounted for 17 percent of the average charge for an office visit. The major component of the operating costs was personnel expenses for data entry.

In 1984, 50 percent of the first-year students at the University of Southern California School of Medicine felt unprepared to handle the cultural barriers between themselves and their patients during their clinical rotations. Therefore, in 1985 a group of students developed a four-hour workshop designed to teach fellow students about ethnic and cultural issues in patient care. Since then the workshop, which uses videotaped vignettes, discussions, and role-playing exercises, has become a required part of the Introduction to Clinical Medicine course for all second-year students. Evaluation of the program in 1985 compared pretest and posttest questionnaires. The participants showed improvement in understanding several specific issues discussed during the workshop, but overall no significant differences were found. In 1986 and 1987, evaluations were based upon the students' attitudes about content, format effectiveness, and subject matter. They consistently responded favorably in all these areas.

The authors conducted a study to collect information on the teaching of research-related topics at medical schools. A questionnaire was developed and mailed to appropriate administrators of all accredited United States, Canadian, and Puerto Rican medical schools that asked for information on courses offered in epidemiology, statistics, evaluation of medical literature, and research design. Ninety-seven percent of the medical schools responded to the questionnaire. All but one of the 139 respondents reported offering formal instruction in at least one of the four topics; epidemiology and statistics were offered by 98 percent and 96 percent, respectively, of the responding schools. Training in evaluating medical literature was required by slightly less than half of the responding schools, and research methodology was required by one-third. Future studies should evaluate the effectiveness of such courses.

The authors' objective in the study reported here was to gather data on the stress and coping of medical students in order to design a health promotion and wellness program. A retrospective questionnaire was completed by 71 of 157 graduating seniors. Examinations, classwork, and financial responsibilities were considered the three most stressful aspects of medical education. The most uplifting items (that is, pleasant, happy, or satisfying experiences) were recreation and social interaction, although good examination performance was rated second highest. Planful problem-solving (that is, deliberate problem-focused efforts to alter a situation) was the most frequently used form of coping, although four of the eight forms of coping assessed were used at least moderately often and all eight were used to some extent.

In the spring of 1987, 20 medical students from the Eastern Virginia Medical School of the Medical College of Hampton Roads were involved in a pilot program to teach about the acquired immune deficiency syndrome (AIDS) to high school senior students in Norfolk, Virginia. The medical students received instruction about AIDS from basic science and clinical faculty members at the medical school in preparation for the project. All participating high school seniors completed a 15-item knowledge test about AIDS prior to the intervention and an equivalent posttest one week after the program was completed. T-test analysis revealed a significant increase in knowledge by students at all five high schools. Responses to 10 subjective posttest questions indicated that the high school students were interested in learning about AIDS and having medical students as their teachers. This program provides an example of how medical institutions can develop a collaborative community education project that contributes to the education of medical students.