PubMed Health⌕ Search

Biomedical subjects

K V Mann

Publications and source records attributed to K V Mann.

At least 19 recordsLinked to original sources
PubMed2001

Community family medicine teachers' perceptions of their teaching role.

OBJECTIVES: Our study explored community preceptors' perceptions of their teaching role, to better understand effective ambulatory and community-based teaching. METHODS: Bandura's social cognitive theory and Schön's notion of reflective practice guided conceptual development of an interview exploring preceptors' views of their role, teaching goals, teaching techniques, student assessment practices, factors affecting teaching and learning, and balance of patient and student needs. Preceptors reflected also on a significant personal teaching experience. A total of 17 highly student-rated preceptors participated. A trained interviewer conducted each interview; all were transcribed and subjected to content analysis. RESULTS: Preceptors (male, 14; female, 3) described learner-centred approaches, setting goals jointly with the student. Demonstration, guided practice, observation and feedback were integral to the experience. Preceptors saw student comfort in the environment as key to effective learning; they attempted to maximize students' learning and breadth of experience. They wanted students to understand content, "know-how" and "being a family physician". Patients remained the primary responsibility, but learners' needs were viewed as compatible with that responsibility. Many preceptors perceived a professional responsibility as "role models". CONCLUSIONS: Preceptors recognized the dynamic environment in which they taught students, and they described strategies which demonstrated how they adapted their teaching to meet the needs of the learner in that environment. These teachers combined learner-centred approaches with sound educational practices, broad learning experiences, attention to student learning and concern for development of professional expertise and judgement. These findings may assist faculty development in family medicine, and other disciplines, in providing effective ambulatory care teaching.

Canada↗
PubMed2000

A comparison of standard-setting procedures for an OSCE in undergraduate medical education.

PURPOSE: To compare four standard-setting procedures for an objective structure clinical examination (OSCE). METHODS: A 12-station OSCE was administered to 84 students in each of the final (fourth-) year medical classes of 1996 and 1997 at Dalhousie University Faculty of Medicine. Four standard-setting procedures (Angoff, borderline, relative, and holistic) were applied to the data to establish a cutoff score for a pass/fail decision. RESULTS: The procedures yielded highly inconsistent results. The Angoff and borderline procedures gave similar results; however, the relative and holistic methods gave widely divergent results. The Angoff procedure yielded results reliable enough to use in decision making for a high-stakes examination, but would have required more judges or more stations. CONCLUSIONS: The Angoff and borderline procedures provide reasonable and defensible approaches to standard setting and are practical to apply by non-psychometricians in medical schools. Further investigation of the other procedures is needed.

Education, Medical, Undergraduate↗
PubMed1999

Motivation in medical education: how theory can inform our practice.

Medical educators seek to understand and facilitate learners' motivations to acquire the skills, knowledge, values, and attitudes that will prepare them for life-times of learning and providing care to their patients and communities. Yet faculty are often challenged by experiences with learners who appear unmotivated, or who seem to value goals other than those the faculty espouse. Understanding what motivates learners may help educators appreciate the complex environment in which motivations are formed, and the sometimes-hidden influences upon motivation that may explain learners' attitudes and behaviors. In this brief essay, the author discusses some of the current theories about motivation and describes how they might relate to the education of physicians. She also explores the too-frequent disparities between medical schools' stated goals for learners and what is actually taught or rewarded by faculty. Although motivation is multifaceted, involving learners and the entire learning environment, there are strategies that may be used to strengthen students' motivations to achieve important goals.

Curriculum↗
PubMed1998

Comparing achievement on the Medical Council of Canada Qualifying Examination Part I of students in conventional and problem-based learning curricula.

PURPOSE: To compare the levels of achievement on the Medical Council of Canada (MCC) Qualifying Examination Part I of students in conventional and problem-based learning (PBL) curricula. METHOD: Students in three classes (1995, 1996, and 1997) took the MCC Qualifying Examination Part I upon completing their MD degrees. This examination tests core knowledge in the major disciplines and clinical reasoning skills. Candidates' scores were masked to protect confidentiality. Total scores, individual discipline scores, and pass/fail proportions were compared among the classes. RESULTS: The PBL classes of 1996 and 1997 performed better on the psychiatry component than did the 1995 conventional class (p = .001); the 1997 class also exceeded the 1995 and 1996 classes in preventive medicine and community health scores (p = .001). No difference emerged in other disciplines, clinical reasoning scores, total multiple-choice question scores, or the proportions of successful candidates. CONCLUSION: PBL and conventional curriculum graduates performed similarly, except in psychiatry and preventive medicine and community health, where PBL graduates scored higher.

Achievement↗
PubMed1997

Basic sciences in problem-based learning and conventional curricula: students' attitudes.

The purpose of this study was to compare the attitudes toward basic sciences of students in a preclinical problem-based curriculum and a conventional lecture-based curriculum at the end of their second year of medical school. The results showed that the PBL class had more positive attitudes toward basic sciences than students in the conventional class. These results may reflect a learning environment where students meet many scientist role models as teachers and where basic science is learnt in the context of clinical problems.

Curriculum↗
PubMed1997

Surveillance of loperamide ingestions: an analysis of 216 poison center reports.

BACKGROUND: Loperamide was approved for nonprescription use in 1988. While efficacy is well documented, there are few data on loperamide overdose and management. METHODS: Eight poison centers participated in a prospective study enrolling 216 patients. RESULTS: Where the amount ingested was known, it ranged from 0.03 to 0.94 mg/kg. One- to 3-year-olds were involved in 57.9% of ingestions. Ingestion was unintentional in 182 cases (84.3%), including 59 patients with therapeutic errors (27.3% of all cases). Dispensing cup errors were implicated in 23 cases; 15 patients assumed the dispensing cup was the unit of measure. No symptoms developed in 63.0%; 27.8% had related symptoms. No related symptoms were life-threatening, and no fatalities occurred. The most frequent symptoms were drowsiness (15.7%), vomiting (4.2%), and abdominal pain or burning (3.7%). The frequency of related symptoms was compared in patients receiving the most frequently utilized decontamination modalities: ipecac alone, activated charcoal alone, lavage and activated charcoal, and ipecac and activated charcoal. Compared to the 112 patients who received no decontamination, only the ipecac-treated group demonstrated a significant reduction in the frequency of related symptoms; 13.9% of patients given ipecac alone (without other gastric decontamination) had related symptoms compared to 33.0% of patients who received no decontamination. Three patients received naloxone for CNS symptoms related to loperamide; two responded and the response of the third was unknown. CONCLUSION: Within the range of doses implicated in this study (up to 0.94 mg/kg), there were no life threatening clinical effects and no fatalities. Development of a management protocol is complicated by the absence of a predictable clinical response in each dose range. The data suggest that children over six months with single acute ingestions up to 0.4 mg/kg, and possibly higher, can be safely managed at home, without gastric decontamination.

Adolescent↗
PubMed1996

Comparing students' attitudes in problem-based and conventional curricula.

PURPOSE: To compare the attitudes of students in a new problem-based learning (PBL) medical curriculum and in the previous conventional curriculum after the second curriculum year, prior to the clinical clerkships. The authors hypothesized that the PBL students would have more favorable attitudes toward their learning environment, social issues in medicine, and their curriculum. METHOD: The students in the classes of 1995 (conventional curriculum) and 1996 (PBL curriculum) at the Dalhousie University Faculty of Medicine were asked to complete two main questionnaires and a few additional items that measure attitudes. The admission variables of the two classes were equivalent. Their attitude ratings were compared using t-tests. RESULTS: Response rates averaged 87% (73 of 84 students) and 68% (57 of 84) for the PBL and conventional classes, respectively. The students in the PBL class had more positive attitudes toward their learning environment on the subscales for enthusiasm and authoritarianism (i.e., they rated their curriculum more favorably for democratic decision making); they were less positive on the student-interaction subscale. No significant difference emerged between the two classes on any subscale for attitudes about social issues in medicine. The PBL students reported more positive attitudes toward their curriculum. CONCLUSION: The study results support the superiority of the PBL curriculum regarding the students' attitudes toward their medical education.

Attitude of Health Personnel↗
PubMed1995

Living with haemophilia and HIV/AIDS: support and coping.

This paper describes sources and types of support, appraisal of support, and use of social support as a strategy for coping with Acquired Immune Deficiency Syndrome (AIDS)-related stresses. Thirty people with haemophilia, 23 family caregivers and 17 bereaved relatives participated. The study was conducted in two stages: individual interviews and mailed questionnaires. The key coping strategies used were 'normalizing personal relationships' and 'seeking informational support'. Informational support was provided by health professionals and practical aid by relatives. Respondents reported insensitivity, prejudice and avoidance from others. Participants needed peers for emotional and affirmational support, and professionals for informational support. The preferred intervention was support groups, co-led by professionals and peers.

Adaptation, Psychological↗
PubMed1995

A response to the ACME-TRI report: the Dalhousie problem-based learning curriculum.

With the class of 1996, Dalhousie University Faculty of Medicine instituted a totally revised curriculum. The revisions transformed an entirely traditional curriculum to a student-centred curriculum, which is based on learning in context, and incorporates a problem-based approach to the entire curriculum. This paper describes our experience in the actual implementation of our revised curriculum, in the context of the Association of American Medical Colleges Assessing Change in Medical Education--The Road to Implementation (ACME-TRI) Report.

Canada↗
PubMed1994

Educating medical students: lessons from research in continuing education.

Creating a true continuum of medical education from admission to medical school throughout a lifetime of professional learning is easier said than done. To do so, the various components on the continuum must be explored to determine where appropriate links might be made. The author considers selected concepts and evidence from the theory and practice underlying continuing medical education (CME) and continuing professional education (CPE) insofar as CME and CPE can inform undergraduate medical curricula, including its current innovations. Five conceptual and empirical approaches from CME and CPE are discussed in detail: social learning theory, how physicians learn and change, competence in business and the professions, how professionals learn in practice, and lifelong self-directed learning. Then the author describes the implications of these approaches for the ongoing development of undergraduate medical education. (1) The entire learning environment, and not merely discrete aspects such as curriculum content, must be examined and fully utilized to benefit learning. (2) The importance of the contexts in which learning occurs must be emphasized in several ways. (3) Learning should be centered around clinical problems. (4) The many benefits of small-group learning and other ways of learning from colleagues should be emphasized. (5) The undergraduate curriculum should emphasize the development of students' feelings of self-efficacy to ensure that students become physicians who are confident about their abilities. (6) CME research and CPE research reinforce the efforts in undergraduate medical education to emphasize the early development of students' process skills as well as content mastery.

Education, Medical, Continuing↗
PubMed1992

Help! Is anyone listening? An assessment of learning needs of practicing physicians.

We used a theoretical framework of adult learning, physician learning and change, and educational evaluation to assess physician--learner needs. The study emphasized the physician's perspective and the context of expressed needs. The respondents acknowledged ineffective learning patterns and lack of ongoing self-assessment, and identified changing and specific, emerging, learning needs. New roles are suggested for CME providers. We believe our findings support the usefulness of an integrated theoretical perspective to guide needs assessment that will be cognizant of the complexity of ongoing professional learning.

Education, Medical, Continuing↗
PubMed1991

Succimer, an oral lead chelator.

The pharmacology, pharmacokinetics, clinical efficacy, adverse effects, and dosage and administration of succimer when used for the treatment of lead poisoning are reviewed. Succimer is an orally active, heavy-metal chelating agent that forms stable, water-soluble complexes with lead; it also chelates other toxic heavy metals, such as arsenic and mercury. It is a designated orphan drug that is indicated for the treatment of lead poisoning, specifically in children with blood lead concentrations higher than 45 micrograms/dL. Succimer reverses the adverse metabolic effects of lead on heme synthesis while increasing urinary lead output without adversely affecting essential mineral excretion at the recommended dosage regimen. The rebound in lead concentrations that can occur after short courses of chelating therapies (caused by redistribution of lead from bone stores) may require frequent and multiple courses of chelation therapy. The most common adverse effects reported in clinical trials of succimer in children and adults were nausea, vomiting, diarrhea, appetite loss, and loose stools; these effects may be related to the drug's unpleasant mercaptan odor. There are no known drug interactions between succimer and other drugs, including iron supplements, although data are limited. The recommended initial dosage in children is 10 mg/kg or 350 mg/sq m every eight hours for five days. The dosage is then reduced to 10 mg/kg or 350 mg/sq m every 12 hours for an additional two weeks. Clinical studies indicate that succimer is relatively selective for lead and effectively lowers blood lead concentrations. Although clinical experience is limited, an oral lead chelator may offer advantages over currently available agents.

Administration, Oral↗
PubMed1990

Priority issues in continuing medical education show sensitivity to change in Canadian health care.

The degree and scope of significant change in health care expectations, roles and delivery patterns in Canada have been widely documented. In 1988 the Sub-Committee on Research of the Standing Committee on CME [continuing medical education], Association of Canadian Medical Colleges, conducted a survey to determine whether those responsible for the CME portion of the medical school curriculum are changing their perceptions to keep pace with the changes in health care. The results were compared with those of a similar survey done in 1983. In both surveys people directly responsible for delivery of formal CME were asked to identify and rank research needs in CME. The response rates were very high. The CME issues identified in the two surveys had changed considerably, with entirely new issues being identified in 1988 and the emphasis placed on issues having changed. The identification of factors that promote or inhibit application of new knowledge by practising physicians was of lowest importance in 1983 and of primary importance in 1988, and comparison of the cost-effectiveness of CME methods was an important issue in 1983 and among the least important in 1988. The noted changes mirror developments in Canada's health care milieu.

Attitude of Health Personnel↗
PubMed1990

Defining fitness and aptitude to practice medicine.

This article describes the use of the critical incident technique to define noncognitive behaviours, referred to as 'fitness and aptitude', that physicians should demonstrate in their practice. A total of 484 behaviours were categorized under four categories: attitude and personal attributes; communication; practice organization; and professional competence. Each category was further subdivided into subcategories. The communication category was by far the largest, representing 46% of all behaviours. The behaviours were written as objectives so that they could be included in a medical school curriculum and evaluated with much less subjectivity.

Aptitude↗