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PubMed1999

Dental students' evaluation of 2 community-oriented PBL modules.

OBJECTIVES: To evaluate dental students' perception of 2 problem-based learning (PBL) modules in Dental Public Health implemented within the context of a traditional formal curriculum. METHODS: 2 dental community modules were implemented with an 8-month interval between them on the same group of dental undergraduates; the first in Term 2 and the second in Term 4 of a 5-year 15-term dental course. At the end of each module, a semi-structured questionnaire was administered to evaluate the introductory lecture, the fieldwork activity and the organisation of the modules. RESULTS: In both modules, students reported gaining insight into the subject matter, skills in teamwork, making presentations and collecting data. Some students in the 1st module needed more time to fulfil their learning objectives and had difficulty in collecting data. In the 2nd module, students reported that they lacked motivation because of the place of the module within their timetable. Opinions differed about groupwork. The content of and interest generated by fieldwork activity was rated more positively in the 2nd module than the 1st. Less positively rated in the 2nd module was the introductory lecture and module organisation. CONCLUSIONS: Implementing PBL within a traditional curriculum does not offer uniform outcomes for students. Optimum group size and adequate time are necessary if students are to benefit from PBL. A consistent and continuous PBL approach should be adopted rather than a sporadic one. Further research should establish the optimum balance between PBL and traditional approaches that would allow students to maximise the benefits of both and to identify those students best equipped to benefit from a 'mixed economy' of learning.

Community Dentistry↗

PubMed1997

An introduction to the framework project.

The framework project of the Advisory Committee on Cancer Control (ACOCC), National Cancer Institute of Canada (NCIC), was based on the NCIC/ACOCC conceptual framework for bridging the gap between research and action. The project was carried out under the auspices of the Sociobehavioural Cancer Research Network (SCRN) of the NCIC. It focused on 3 research areas of cancer control research: smoking control, palliative care and screening for breast cancer. In this introductory paper, the criteria and methodology used for the framework project are described, the main features of the framework are outlined and the definitions of terms used in the framework are summarized. It was expected that the framework project would lead to a better understanding of the strengths and weaknesses of the NCIC/ACOCC conceptual framework. The project was also expected to assist the SCRN in its ongoing efforts to develop and refine an action-oriented research agenda.

Academies and Institutes↗

PubMed1989

Teaching microcomputing to student nurses: an evaluation.

This paper describes an introductory computer course designed for student nurses facing a career in nursing in which computers will play a major part. Questionnaires were given before and after the course. The purpose of the questionnaires were (a) initially to gain information about the students' previous computing experience, motivation and expectations of the course, and (b) to enable an evaluation to be undertaken. The course content, structure and results of the questionnaires are presented; modifications made to the course following the evaluation are mentioned and finally some of the issues which need to be considered when developing a computer course for nurses are raised.

Computer User Training↗

PubMed1991

Distance learning in a local setting: a structured learning course for the introduction of general practice to undergraduate students.

This paper describes the development and evaluation of a structured introductory course in general practice. Following some of the principles developed in distance education, the Department provides everything the student needs for the formal learning requirement as well as detailed assistance in how best to tackle the selected topics. The course was reported to be demanding, relevant and enjoyable. The major areas requiring attention were in reducing the amount of reading required, more help in learning to work in small student-run groups and more one-to-one supervision of physical examination skills. With further refinement the course should be applicable to other medical schools in developed countries.

Curriculum↗

PubMed2001

[The prevalence of undiagnosed type 2 diabetes mellitus in consulting rooms of general practitioners].

UNLABELLED: The aim of study was to estimate the prevalence of newly detected type 2 diabetic patients and compare it with prevalence of registered type 2 diabetic patients in the Slovak republic. The second aim was to improve the cooperation between general practitioners and diabetologists in the detection of unrecognized diabetes. PATIENTS AND METHODS: Seventy-six general practitioners were involved in Slovak Diabetologic Detection Program. Randomly taken capillary glucose (glucometer One-Touch, Lifescan) was measured in 18,942 probands over 40 years of age with one or more risk factors for type 2 diabetes in nine regions of Slovakia during a 6-month period. When capillary glucose was over 6 mmol/l the proband was referred to one of the nine diabetologic outpatient clinics for further evaluation. The history, physical examination and fasting capillary glucose or oGTT were performed in these patients. After exclusion of previously registered diabetic patients, noncompliant patients and insufficient examinations the data were evaluated in 15,387 probands. This data were compared with the Slovak National Registry, which is based on yearly collected and evaluated data from all diabetologic outpatient clinics. RESULTS: Newly detected (undiagnosed) type 2 diabetes was found in 444 (2.9%) and impaired fasting glucose and/or impaired glucose tolerance in 347 (2.3%) out of 15,387 probands. Data from Slovak National Registry show 9.5% type 2 diabetic patients over 40 years of age. In our detection program the number of undiagnosed type 2 diabetic patients over the age of 40 years was 2.9%. Therefore authors estimated the overall prevalence of type 2 diabetes in Slovakia over the age of 40 on 12.3% of general population in this age category (population ca 2.2 million people). When is compared prevalence of undiagnosed and registered type 2 diabetic patients it can be claimed that on three registered diabetic patients, there is one undiagnosed and one other with impaired fasting glucose and/or impaired glucose tolerance. The patients with undiagnosed diabetes and ones with impaired fasting glucose and/or impaired glucose tolerance had significantly higher body mass index and significantly higher occurrence of arterial hypertension and positive family history of diabetes compared to non-diabetic probands. Authors also achieved the second aim by establishing the collaboration between general practitioners and diabetologists in the selected nine regions of Slovakia. This relationship is essential for detection the undiagnosed diabetic patients by general practitioners and confirmation of diagnosis of diabetes as well as initiation of introductory education by diabetes specialists. Authors conclude that it is essential to actively screen for disturbances of glucose metabolism in population over 40 years old in general practice.

Adult↗

PubMed1998

Institutional learning curve of surgeon-performed trauma ultrasound.

BACKGROUND: Sonography has become the primary mode for the initial evaluation of abdominal injury in many trauma centers. However, the rate at which nonradiologists become proficient in this technique remains controversial. OBJECTIVE: To assess the learning curve for this technique in a single institution. DESIGN: Retrospective review of sonographic examinations for trauma performed by senior surgical residents during a 24-month period at an American College of Surgeons-verified level I trauma center. SETTING: University-affiliated private hospital. PATIENTS AND METHODS: Before the initiation of a program of surgeon-performed trauma ultrasound, senior surgical residents (postgraduate years 4 and 5) received 11.5 hours of hands-on and didactic instruction in the focused ultrasound examination for trauma. This examination then became a standard component of the evaluation of injured patients. Subsequent groups of senior residents received 8 hours of instruction at the onset of new academic years, 6 and 18 months, respectively, after the initial course. The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value were then calculated for each 6-month period after the introduction of trauma sonography. RESULTS: During the 24-month study period, 902 sonographic examinations were performed. No statistically significant differences were noted in sensitivity, specificity, accuracy, positive predictive value, or negative predictive value for any 6-month period of study when compared with the other 6-month periods or with the values calculated for the entire study period. CONCLUSIONS: Senior surgical residents are capable of performing the focused ultrasound examination for trauma with a high level of skill after a concise introductory course. A learning curve was not apparent in our series. Criteria for being permitted to perform trauma sonography that include the requirement of a large number of examinations or extensive proctoring should be reassessed.

Abdominal Injuries↗

PubMed2006

Learning while evaluating: the use of an electronic evaluation portfolio in a geriatric medicine clerkship.

BACKGROUND: Electronic evaluation portfolios may play a role in learning and evaluation in clinical settings and may complement other traditional evaluation methods (bedside evaluations, written exams and tutor-led evaluations). METHODS: 133 third-year medical students used the McGill Electronic Evaluation Portfolio (MEEP) during their one-month clerkship rotation in Geriatric Medicine between September 2002 and September 2003. Students were divided into two groups, one who received an introductory hands-on session about the electronic evaluation portfolio and one who did not. Students' marks in their portfolios were compared between both groups. Additionally, students self-evaluated their performance and received feedback using the electronic portfolio during their mandatory clerkship rotation. Students were surveyed immediately after the rotation and at the end of the clerkship year. Tutors' opinions about this method were surveyed once. Finally, the number of evaluations/month was quantified. In all surveys, Likert scales were used and were analyzed using Chi-square tests and t-tests to assess significant differences in the responses from surveyed subjects. RESULTS: The introductory session had a significant effect on students' portfolio marks as well as on their comfort using the system. Both tutors and students reported positive notions about the method. Remarkably, an average (+/- SD) of 520 (+/- 70) evaluations/month was recorded with 30 (+/- 5) evaluations per student/month. CONCLUSION: The MEEP showed a significant and positive effect on both students' self-evaluations and tutors' evaluations involving an important amount of self-reflection and feedback which may complement the more traditional evaluation methods.

Adult↗

PubMedDate not supplied

Preparing and presenting an introductory course on motor vehicle injury.

Health professionals are key to any progress in reducing motor vehicle injury and death, yet they have been slow to recognize their role in this important area. One factor contributing to this problem has been the absence of courses on motor vehicle injury from the curriculums of the health professions schools. A comprehensive course on motor vehicle injury and death was developed, presented, and evaluated at the University of Illinois at Chicago School of Public Health. The major course objectives were for students to (a) comprehend that highway injury is a major public health problem, (b) understand that this problem can be mitigated by proven public health techniques, and (c) understand and be able to implement multidisciplinary solutions. It was hoped that students would champion the prevention of motor vehicle injuries as a high priority for public health agencies and other professional and community organizations. The course has now been presented twice. A teaching guide was prepared and was reviewed by faculty at 13 schools of public health. This guide discusses practical aspects of introducing and implementing this type of course, overall course objectives, specific learning objectives, a model curriculum (with suggested readings) for nine topic areas, materials from which transparencies or slides could be made, and a geographic listing of resource persons. The objectives for the guide were for it to be a practical model for a motor vehicle injury course and to acquaint health professions faculty with the resources available to them for course development, as well as with a network of professionals who are willing to aid them in their efforts. The guide is not a programmed learning text or a collection of canned lectures, but rather it is intended to provide a framework and encouragement to those at other institutions who seek to develop such a course.

Accidents, Traffic↗

PubMed1994

Student-initiated revision in child health.

Most teaching of child health in Cardiff takes place in block attachments of 8 weeks. There is an introductory seminar of 2 days followed by a 6-week clinical attachment in a district general hospital in Wales, and then a revision period of one week designed to help students formalize and structure their basic knowledge and to clarify aspects of child health which they may have had difficulty in understanding. The revision programme has to take into account: the short time available, the small number of teaching staff, the most relevant basic knowledge and active participation by the student. This paper describes how this week has been improved through the use of student-initiated revision (SIR). The students' appraisal of this revision and in particular SIR is presented.

Child↗

PubMed2005

Introducing HIV/AIDS to South African health sciences students.

Given the burden of HIV/AIDS in South Africa, there is a need to introduce students to the issues health professionals face about the disease. We developed an introductory peer-led workshop on HIV/AIDS for first year students covering a range of biomedical and social issues. To evaluate the workshops, volunteer students were randomly allocated to participate in one of the workshops or not. At follow-up, students who participated in the workshops showed positive changes in their attitudes and skills regarding HIV. They were also more likely to feel empathy towards HIV-infected people and be more comfortable with the prospect of working with HIV-infected patients, compared to controls. This programme represents a platform for introducing a 'golden thread' of HIV/AIDS into health sciences curricula in countries profoundly affected by the epidemic.

Attitude of Health Personnel↗

PubMedDate not supplied

The College Alcohol Problems Scale.

A short, reliable two-factor instrument measuring drinking-related negative consequences was developed from a previous measure using two samples of college students. In Study I, data on alcohol use and problems associated with alcohol use were collected on 382 introductory psychology students. The original College Alcohol Problems Scale (CAPS) was tested and found to fit the data poorly. Sequential methods were used to develop a revised instrument. Principal components analyses (PCA) on half of the sample were conducted on 20 items written to measure negative consequences related to college student drinking. Results indicated a two-factor solution measuring social and emotional problems. Confirmatory factor analyses (CFA) on the other half of the sample confirmed the two-factor structure. Further refinement of the instrument resulted in the revised CAPS (CAPS-r), an eight-item two-factor scale. In Study II, the response format was altered to coincide with the Young Adult Problem Screening Test. A total of 726 students completed the instrument as part of a university-wide random sample. CFA showed that the hypothesized model fit well across all measures of model fit and the factor structure was invariant across gender. Additional analyses revealed that the scale was internally consistent and externally valid. A short reliable and valid measure of alcohol-related problems is needed to enable low-cost data collection on college campuses across the nation, as well as to facilitate program evaluation and routine epidemiological surveillance and monitoring.

Adolescent↗

PubMed2005

Lowering stress while teaching research: a creative arts intervention in the classroom.

Undergraduate students often request "hands-on" research experience but seldom have the time and opportunity during a one-semester introductory course to participate in such a project. The purposes of this educational approach, implemented during a beginning research class for baccalaureate nursing students, were to provide an opportunity for students to participate in an experimental research study, and test the effect of a creative arts intervention on students' stress, anxiety, and emotions. Students designed, participated in, and analyzed the results of the project. The intervention significantly reduced stress and anxiety and increased positive emotions in this student population, while providing a creative research experience. For future use, the intervention may be helpful with a variety of vulnerable groups.

Adaptation, Psychological↗

PubMed1997

Pathophysiology of the thalassemias. The Albion Walter Hewlett Award presentation.

The Albion Walter Hewlett Award (named for Professor of Medicine and Chair of the Stanford Department of Medicine 1916-1925) recognizes a role model, accomplished in discovery of the biological sciences and at the same time a consummate and compassionate physician. In introductory remarks, Dr. Stanley L. Schrier, Professor of Medicine (Hematology), the tenth recipient of the Award, indicated that the person so identified is no longer a viable model in academic medicine. The loss of this sort of person is serious because this appropriately trained physician-investigator was uniquely positioned to study pathophysiology, defined as the processes by which disordered biology produces disease. He used his own studies on the clinical manifestations of the thalassemias to clarify what he meant by pathophysiology. Thus he and his colleagues first defined membrane material properties of alpha and beta thalassemic RBC membranes and the states of hydration of alpha and beta thalassemic RBC and found them to be strikingly divergent. The biochemical counterparts of these alterations proved to be the accumulation of the excess unmatched partially oxidized globin chains on the membrane skeleton. In vitro studies with chemical oxidants selectively oxidized alpha and beta globin chains which then attached to the RBC membrane skeleton and reproduced the membrane material properties characteristic of beta and alpha thalassemia respectively. Many of these alterations had occurred prior to the reticulocyte stage so that pursuit of pathophysiology shifted to studies of marrow erythroid precursors, and it was shown that in beta thalassemia major there was accelerated programmed cell death as well as defective assembly of the membrane skeleton.

Awards and Prizes↗

PubMed2005

Starting learning in medical practice: an evaluation of a new Introductory Clerkship.

The transition from undergraduate medical education to learning in clinical clerkships can be difficult for students. Learning in clinical practice requires awareness of learning opportunities and goals, active elaboration and reflection. Staff should provide students with guidance to learn from their experiences. A new Introductory Clerkship was designed to facilitate the start of goal-oriented, active and reflective work-based learning. This four-week clerkship is a result of the cooperation of six major specialties in the university hospital. The innovations included explicitly formulated goals, a description of the student's activities in daily practice and of the staff's role, group meetings, a logbook, a halfway formative interview and a final summative interview. The aim of this study was to investigate to what extent the innovations of the new Introductory Clerkship were implemented and how students and residents valued them. Two questionnaires were constructed: one was administered to students (n = 54) and the other to residents (n = 27). Students considered participation in daily practice very instructive, although more observations of history taking and physical examination are wanted. The interviews and group meetings promote students' learning. Use of the logbook needs improvement. Residents perceived a shortage of time and would appreciate more participation of staff members, as well as a better preparation for supervising tasks. Overall, the study demonstrates that it is possible to introduce innovations in clinical clerkships to improve the learning environment of work-based learning.

Attitude of Health Personnel↗

PubMed1998

Oral cancer education training methods: a comparison of self-study and didactic approaches.

BACKGROUND: Dentists' competence and comfort level in detecting oral cancer may be strongly influenced by their dental school training. The purpose of this study was to compare the demonstrated knowledge of oral cancer topics among students receiving lectures and those learning the material through self-instruction at two dental schools. METHODS: Students at School 1 received 17 hours of lectures on various topics in oral cancer, including epidemiology, etiologic factors, histopathology, clinical appearance, clinical management and treatment, and oral complications. Lecture topics reflected material in the assigned text. Students at School 2 received only an introductory lecture, followed by a ten-week self-paced course using the same text used in School 1. At the end of the courses, the students at the two schools received identical 50-item final examinations. RESULTS: The students who had received the lectures and assigned readings scored significantly higher than did those assigned self-instruction alone (mean score of 91.2% vs 81.3%; p < 0.0001). This difference remained after statistical adjustment for entering grade-point average and Dental Aptitude Test score. CONCLUSIONS: Self-study of assigned readings may result in lower levels of knowledge of oral cancer topics than more traditional lecture-based teaching. The impact of this difference on clinical performance has not yet been demonstrated.

Analysis of Variance↗

PubMed1998

Introduction of cyclofem once-a-month injectable contraceptive in Mexico.

A large introductory study of Cyclofem, a once-a-month injectable contraceptive, was conducted in three Mexican provinces. A total of 3457 healthy women participated: 640 women from rural areas (community-based component) and 2817 women from urban and suburban areas (health center-based component). A total of 20,316 women-months of treatment experience were accumulated during a one year period. Cyclofem proved its use-effectiveness (pregnancy rate of 0.03%) and its safety under routine service conditions of family planning facilities in Mexico. The overall life table continuation rate at 1 year was 26.1%. Higher continuation rates were observed in the community-based component (36.6%) as compared to the health center component (23.7%). The most common reason for method discontinuation was change of address. Only 15% of the discontinuations were attributable to the injectable contraceptive method, with the overall 1 year discontinuation rate for bleeding problems (including amenorrhea) was < 11%. These observations underscore the importance of appropriate counseling and follow-up measures, providing convenient access to repeat injections, and other service delivery issues related to continuation of Cyclofem. The results of this trial have once again demonstrated that Cyclofem is a highly effective method with an acceptable side effect profile. In addition, the study provided the elements for its approval by local health authorities and its inclusion into the Ministry of Health Family Planning Program.

Adolescent↗

PubMed2001

Introducing quality improvement to pre-qualification nursing students: evaluation of an experiential programme.

OBJECTIVE: To evaluate a programme introducing quality improvement (QI) in nursing education. SETTINGS: Betanien College of Nursing and clinical practices at hospitals in Bergen. SUBJECTS: 52 nursing students from a second year class working in 16 groups undertaking hospital based practical studies. INTERVENTION: Second year nursing students were assigned to follow a patient during a day's work and to record the processes of care from the patient's perspective. Data collected included waiting times, patient information, people in contact with the patient, investigations, and procedures performed. Students also identified aspects of practice that could be improved. They then attended a 2 day theoretical introductory course in QI and each group produced flow charts, cause/effect diagrams, and outlines of quality goals using structure, process, and results criteria to describe potential improvements. Each group produced a report of their findings. Main measures-A two-part questionnaire completed by the students before and after the intervention was used to assess the development of their understanding of QI. Evidence that students could apply a range of QI tools and techniques in the specific setting of a hospital ward was assessed from the final reports of their clinical attachments. RESULTS: The students had a significantly better knowledge of QI after the introductory course and group work than before it, and most students indicated that they considered the topic highly relevant for their later career. They reported that it was quite useful to observe one patient throughout one shift and, to some extent, they learned something new. Students found the introductory course and working in groups useful, and most thought the programme should be included in the curriculum for other nursing students. They considered it important for nurses in general to have knowledge about QI, indicating a high perceived relevance of the course. All 16 groups delivered reports of their group work which were approved by the tutors. Through the reports, all the groups demonstrated knowledge and ability to apply tools and techniques in their practical studies in a hospital setting. CONCLUSIONS: The introduction of a short experience-based programme into the practical studies of second year nursing students enabled them to learn about the concepts, tools, and techniques of continuous QI in a way that should provide them with the skills to undertake it as part of routine practice.

Attitude↗

PubMed2003

Randomised trials in general practice--a New Zealand experience in recruitment.

AIM: To examine general practitioner (GP) and patient recruitment in a randomised clinical trial to determine the usefulness of brain natriuretic peptide (BNP) in the diagnosis of heart failure in the community. METHODS: Different techniques were used to maximise GP recruitment including early consultation with GPs, benefits for participating GPs and patients, and a comprehensive suburb-by-suburb approach to GPs using letters and personal visits. GPs then referred patients. At the conclusion of the study, GPs were given a questionnaire focussing on barriers to referral and reasons for participation. RESULTS: Three hundred and twenty seven GPs from 135 practices were sent an introductory letter; 294 were eligible to participate. Of these, 186 GPs (63% of eligible GPs) agreed to participate. Ninety two GPs (31% of eligible GPs) from 62 practices referred 307 patients to the study (range 1-14 patients). There were no significant differences between referring and non-referring GPs with respect to sociodemographic characteristics. Referring GPs were very supportive of GP participation in research and strongly agreed that GPs should be reimbursed for involvement in trials. CONCLUSIONS: Patient recruitment by GPs may be aided by the use of a range of strategies including financial reimbursement. GPs who agree to participate will not always recruit patients. Closer collaboration and understanding between primary healthcare professionals and researchers may further enhance recruitment to clinical trials.

Attitude of Health Personnel↗