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Biomedical subjects

R E Wakeford

Publications and source records attributed to R E Wakeford.

At least 19 recordsLinked to original sources
PubMed1989

Obstacles to organ donation.

Attitudes towards transplantation were investigated in national surveys of the general public (n = 1471), the medical profession (n = 590) and key clinical staff in units referring potential organ donors (n = 380). A clear majority of doctors would like to see more transplants. Only 16 per cent of doctors opposed them on cost grounds, and a 50 per cent 5-year survival rate is seen as more than adequate clinical justification. However, doctors are less supportive of liver and heart grafts than of kidney and cornea grafts. Few lay people would refuse donation of specific organs, but 30 per cent worry that doctors might be pressured into removal of organs when they are not sure the patient is dead. Religious or moral objection is rare. Intensive care unit staff felt the most important factor restricting organ harvest in their own units was dislike of adding to relatives' distress, followed by lack of training in approaching relatives and adverse media publicity. Only 11 per cent thought reservations on brain stem death a likely or possible influence. Enhanced public awareness of the need for transplants was seen as the most important means of increasing organ harvest. Required request would be controversial and perhaps impossible to implement. We conclude that the time, effort and expense involved in potential organ donation do not play a substantial part in limiting referral. Neither do reservations about brain stem death. Increased training of staff (both in communication skills and in the professional responsibility to encourage donation) and greater public awareness are seen as the twin foundations of a realistic approach to enhancing referral.

Adult↗
PubMed1989

'We'd like to have a family'--young women doctors' opinions of maternity leave and part-time training.

Maternity leave and part-time training should facilitate the integration of the family and professional lives of young women doctors - whom the NHS cannot afford to lose as their numbers rise to half the number of the graduates of UK medical schools. Women doctors' planned professional activity is high, but to what extent do the maternity leave and part-time training arrangements assist them in fulfilling their plans? One hundred and forty-five young women doctors reported their experiences of and views on maternity leave and part-time training. Most had children between 6 and 10 years after qualification, to fit with career development. Seventy-one per cent of the confinements had qualified for maternity leave and pay, but there were complaints about the working of the regulations, particularly in relation to junior hospital doctors' short contracts. When asked to comment about part-time training, most (77%) expressed themselves as broadly in favour - only three actively opposing it. It was perceived as difficult to organize by 20% of respondents, as difficult to undertake by 29%, and as being of low status by 15%. This study concludes that the arrangements for maternity leave need to be improved and that the availability and status of part-time training need enhancing - especially to encourage women doctors to enter careers in hospital medicine.

Attitude of Health Personnel↗
PubMed1989

Women doctors' career choice and commitment to medicine: implications for general practice.

This study examined the work experiences and plans of a national sample of 150 female medical graduates of 1976, 1980 and 1984. The sample was exhaustively traced and information obtained about 97% of the doctors, including 100% of the doctors ever likely to practise in the UK. The findings show a high recent and planned participation rate in medical practice, especially general practice, among these women graduates and no involuntary unemployment. Increased numbers of women at medical school will result in manpower changes, particularly in general practice, but these increases will not counter possible overproduction of medical graduates. The study also demonstrates that it is possible to achieve a high response rate among medical graduates by using a telephone interview.

Adult↗
PubMed1984

Short answer questions in an undergraduate qualifying examination: a study of examiner variability.

Scripts of a short answer Final MB examination paper were re-marked by the original examiner and three colleagues. While individual question marks varied considerably, most examiners agreed quite well as to the overall rank order of candidates--although not about absolute total marks--but a few disagreed considerably. Examiners exhibited remarkably consistent idiosyncratic behaviour in terms of the distribution of marks awarded. These factors led to haphazard pass/fail and pass/distinction decisions on this particular component of the examination. Recommendations are put forward to improve the marking consistency and use of short answer question papers.

Education, Medical, Undergraduate↗
PubMed1984

Graduate and mature entrants to medicine: changes in career intentions.

Fifty-nine students who had previously taken degrees or commenced careers in subjects other than medicine entered the Cambridge Clinical Course in its first 5 years of operation, commencing in 1976. A questionnaire was used to ascertain their original career plans when entering medical education, their career plans in 1981, and the reasons for any changes. Graduates originally planning careers in general practice and teaching or research maintained their intentions, but some of those who had favoured hospital clinical work changed their minds in favour of general practice. General practice was also the most common choice amongst those students who were earlier unsure as to what branch of medicine they would enter. Of students changing their career intentions, half indicated that disenchantment with hospital medicine was a prime reason for the change.

Age Factors↗
PubMed1983

Undergraduate students' experience in 'peripheral' and 'teaching' hospitals compared.

Increasingly, British medical schools are using hospitals other than designated teaching hospitals for the provision of undergraduate clinical experience. This paper reports upon a study which compared students' experience in 'peripheral' and 'teaching' hospitals. Students report greater involvement in peripheral hospital firms and a more encouraging atmosphere. They gain more experience of practical procedures in these hospitals, and devote more time to ward and operating theatre work. More informal teaching is received in peripheral hospitals as compared with the teaching hospital. Less planned, formal teaching occurs, however: this is a focus of student concern, particularly towards the end of their course. There is little support for the view that students receive more experience of common conditions in peripheral hospitals.

Attitude↗
PubMed1981

Teaching anaesthetics to medical students. The design and evaluation of a course in a new clinical school.

The paper describes the rationale and implementation of anaesthetics teaching in the new 2 1/4-year clinical medical course at Cambridge University. A programme designed to monitor and evaluate the teaching established, and the results are reported. Significant improvements in students' knowledge of anaesthetics and their experience of practical procedures were noted, as compared to a control group. It is concluded tha the course achieves the dual aims of providing an introduction to the scope and vocabulary of modern anaesthesia and giving students the opportunity to practise a variety of specified practical skills.

Anesthesiology↗
PubMed1979

A pilot experiment on the inter-examiner reliability of short essay questions.

Although long essay questions have been shown generally to have a low inter-examiner reliability, they are still much used in undergraduate medical examinations, evidently because examiners feel that essays have greater inherent validity than some of the modern 'objective' techniques such as multiple choice questions (MCQs). Evidence exists in the literature to suggest that the reliability of short (c. 10 minutes) essay questions may be higher. A pilot experiment is reported in which students answered six questions requiring a short essay or extended notes (10 minutes per question): these 'SEQs' were each marked by two examiners. With the exception of one question, agreement between examiners was good. The implications of the experiment are considered to be: (a) that SEQs may well have a useful role in a broadly-based examination system; (b) there is a need for more experimentation with this type of question, which can arguably have greater validity than the (highly reliable) MCQ; and (c) that dual marking of all essay scripts is most desirable.

Education, Medical, Undergraduate↗
PubMed1976

Multiple choice questions: to guess or not to guess.

Multiple choice question papers in which the student has a 'don't know' option are widely used in undergraduate and postgraduate examinations in Medicine. In the present study students' performance in papers with a 'don't know' option has been compared with their performance when they are instructed to answer all the questions. By completing questions left unanswered (i.e. 'don't know' options) students were able to increase their score significantly and the rank order of the students in class is changed. Answers omitted may indicate complete ignorance or various degrees of knowledge. It is concluded that the 'don't know' option in multiple choice question papers favours the bold and test-wise student and in consequence their validity as a measure of achievement may suffer. Papers in which the student is instructed to answer all the questions are to be preferred to those in common use where there is a 'don't know' option.

Choice Behavior↗