PubMed · 15656389
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Lindsey Dyer. Diatribe.. https://pubmed.ncbi.nlm.nih.gov/15656389/
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OBJECTIVE: To assess the potential effect of educational intervention on episiotomy practice. STUDY DESIGN: A survey of the attitude of obstetrical caregivers toward episiotomy was conducted among obstetricians and midwives in the three public hospitals in Haifa. Data regarding episiotomy rates was collected for the years 2001-2003. At the beginning of 2002, lectures on the risks and benefits of episiotomy were given in two hospitals. Episiotomy rates before and after the lecture were compared. RESULTS: A significant and lasting reduction in episiotomy rates was observed in the two hospitals where lectures were given. There were no clinically significant and consistent changes in the episiotomy practices in the third hospital. CONCLUSION: Education may play an important role in changing common medical practices, as in episiotomy. It was clearly shown that our beliefs are not always up to date. We call for periodic reassessment of all medical procedures, as common and accepted as they are.
RATIONALE: The goal of this study was to examine oncologists' attitudes towards recommending exercise to patients with cancer during treatment. PATIENTS AND METHODS: Using a national survey, all 659 practicing medical and radiation oncologists in Canada were sent a brief questionnaire. RESULTS: The response rate was 46% (281/610). The majority of oncologists agreed that exercise was beneficial (62.0%), important (55.8%) and safe (63.1%) for patients with cancer during treatment. Forty-three percent of oncologists reported that they tried to recommend exercise to their patients when appropriate. Moreover, oncologists actually reported recommending exercise to 28% of their patients during the past month. Analyses also indicated significant differences between oncologists, with younger, female, and medical oncologists generally having more favorable attitudes towards exercise for patients with cancer than their older, male, and radiation oncology counterparts. CONCLUSIONS: Oncologists have a favorable attitude toward recommending exercise to patients with cancer although several important barriers may prevent oncologists from providing exercise advice to their patients. Further research is required evaluating the effectiveness of interventions and strategies designed to improve oncologists' confidence and ability to advise their patients on exercise during oncology consultations.
INTRODUCTION: The Rural Undergraduate Support and Coordination program funds medical schools to provide all medical students some time in rural Australia throughout their course. The University of Adelaide has developed a rural week program for both first and second year students to fulfill part of this objective. METHODS: First year students' rural week is an introduction to a range of rural health issues, Indigenous culture and rural lifestyle issues. Second year students choose either a clinical rural week with a general practitioner or a week of Indigenous cultural learning with the Adnyamathanha people in the Flinders ranges, South Australia. Evaluation data were collected from students, practitioners and university staff during rural weeks in 2003 and 2004 using quantitative and qualitative methods. RESULTS: First year students increased their knowledge of and interest in rural medicine and enjoyed their (limited) clinical interaction with patients. Second year students appreciated the clinical experience and valued the welcome they received from doctors and practice staff. Those who chose Indigenous cultural programs appreciated the opportunity to interact with and learn from Indigenous people. General practitioners valued contributing to student knowledge and skills and the opportunity to promote rural practice. Volunteer community members were very enthusiastic about meeting the students and their generosity had a significant impact on the students' ideas about rural lifestyle. University academic and administrative staff found rural week very intensive work but experience and thorough preparation now ensures that few problems occur. CONCLUSION: Rural weeks are now an established part of the first year and second year curriculum at the University of Adelaide Medical School. The ability to provide small groups of students with an intense introduction to rural practice and/or Indigenous culture results in a positive change in opinion about this aspect of medical education. Students now have first-hand experience to positively influence their choice of rural education or Indigenous health options in the medical course. Problems do occur with students being away from the traditional classroom, and protocols have been put in place for behaviour of all parties. Despite the rural weeks program being very demanding on staff energy, financial resources, general practices and rural communities, we feel that this program is valuable and sustainable. Further experience will determine if rural weeks function effectively as a recruitment strategy for the long rural placements offered by the Rural Clinical School.