Journal of Medical Education最新文献

A program in personal and professional development for interns was developed six years ago for the residency program in internal medicine of the University of Connecticut Affiliated Hospitals to reduce maladaptive responses to the stresses of medical training. The principal goals of the program are to provide a supportive atmosphere in which interns can discuss common concerns, build mutual trust among themselves, promote deeper self-understanding and sensitivity, develop coping strategies, and examine difficult situations in training. Sessions are scheduled regularly throughout the year and take place outside the hospital; interns are excused from their service responsibilities for the duration of the meeting. Participants focus equally on issues of professional concern (for example, relationships with staff members, peers, and attending physicians or bureaucratic problems such as lack of ancillary help) and personal concern (for example, making necessary life-style adjustments and handling family crises). A variety of techniques are used in the program, but small-group discussions and individual tasks are particularly emphasized. Participants have generally reported satisfaction with the program and positive effects upon their behavior at work and at home.

A quasiexperimental research design involving a nonequivalent control group was used to examine the efficacy of a brief educational intervention in teaching medical students to select optimal diagnostic data consistent with the competing-hypotheses heuristic and Bayes' theorem when solving clinical problems. There was no significant difference between intervention (n = 119) and control (n = 89) groups in performance at baseline, but the intervention group performed significantly better (p less than .001) than the control group after training. The results suggest that some problem-solving skills, such as learning to use the competing-hypotheses heuristic, can be enhanced or learned independent of the acquisition of content knowledge.

A program for teaching the social sciences in the clinical years in medical school is described. This program focuses on psychosocial conferences (PSC) held during the clerkships in internal medicine, pediatrics, and surgery. The aim of the PSC is the integration of the knowledge and skills imparted in the preclinical social sciences curriculum with the students' clinical experiences. PSC teaching includes tutorial guidance throughout the student's preparation of a case presentation in which psychological, sociological, and anthropological aspects of the patients' coping with illness and the patient-physician interrelationship are emphasized.

Many women in medical training want to combine a family life and a career. Of major interest to these women is determining the most desirable time for pregnancy during their medical education and career. The results of a study on women physicians' timing of pregnancy are reported. A 53 percent response rate was obtained in a randomized national survey of women physicians who had completed residency training and were less than 50 years of age. Their first pregnancies (of which 77 percent were planned) occurred as follows: prior to medical school, 4 percent; during medical school, 7 percent; in first year as house officer, 11 percent; in other residency year, 32 percent; in fellowship year(s), 13 percent; in practice, 28 percent, on leave or other, 5 percent. Seventy percent of the respondents considered "after completion of residency" to be the best time to become pregnant. Sixty percent of the respondents' maternity leaves were six weeks or less in duration. Seventeen percent required some medical leave before delivery, although only 5 percent required more than eight weeks of medical leave. Only a third reported that their training or work sites had maternity leave policies. Ninety-one percent of the respondents reported satisfaction in their careers.