General practice in the nineties: cottage industry or academic specialty?
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Biomedical subjects
Publications and source records attributed to F Mansfield.
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Supervised role-play is presented as a method for teaching the process of the medical consultation. The process of the consultation is reviewed and a brief description of supervised role-play is given with some of its advantages and disadvantages. Some simple devices used in the method are explained with examples. The 'living' nature of the consultation is emphasized and an active method of teaching is advocated.
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A 10- to 14-year follow-up questionnaire of 146 patients treated for sciatica from a herniated nucleus pulposus by chymopapain (Discase) injection revealed a durable, satisfactory result in 66%. In the 102 patients rated as excellent or good, 5% required surgical discectomy 50-82 months after injection. One-, two-, and three-level injections were performed and the number of levels injected did not influence the success of the procedure or the subsequent need for open surgical intervention. There was no correlation shown between the incidence of job change or unemployment and the number of levels injected.
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