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PubMed1976

Measuring learning by trainees in general practice.

Twenty simulated consultations with patients having a respiratory illness were carried out by 20 trainees at the start and finish of a training year in general practice, using the same method as used in a previous study of principals in general practice.During the course of the year, the trainees as a group closely approached the behaviour-in the defined terms of the study-of principals as a group. The trend was more marked for doctors on a three-year training programme than for those on a one-year programme.In 11 cases direct comparison between trainee and trainer was possible. It was difficult to identify changes in behaviour as being due to either group influences or individual trainer influences, but it appeared that atypical trainers do not necessarily produce atypical trainees and typical trainers do not prevent the development of individuality in trainees.The technique of simulated consultation may assist the difficult task of evaluating training for general practice.

Educational Measurement↗
PubMed1977

The opinions of postgraduate tutors on continuing education for general practitioners.

The recent big increase in learning opportunities for general practitioners, particularly in postgraduate medical centres, has been accompanied by increasing suspicion that educational activities may not be fulfilling the aims of continuing education, and that there is dissatisfaction with existing courses.This study took place in the north-western region, and 18 clinical tutors were interviewed using a structured interview schedule.Very few of the clinical tutors were aware of the existence of the book The Future General Practitioner-Learning and Teaching, and most activities consisted of lectures, lecturers usually being local and regional consultants, with occasional national authorities. Small group teaching rarely occurred, and all the centres had been supplied with videotape equipment.Most of the tutors had attended a course on audiovisual aids, or a meeting organized by the National Association of Clinical Tutors, but the tutors appeared ill at ease when answering questions about educational aims and objectives, and most tutors were unable to identify an educational objective from a group of statements.

Attitude of Health Personnel↗
PubMed1995

An overview of learning disabilities: psychoeducational perspectives.

In general, people with learning disabilities are a heterogeneous population that require a multidisciplinary evaluation and careful, well-planned intervention. Despite this heterogeneity, patterns of problems often co-occur. Therefore, diagnosticians and educators should look beyond single areas of achievement such as reading or arithmetic. In addition, problems in one area of learning typically have secondary impacts on higher levels of learning. That is, comprehension problems typically interfere with expression. Every effort should be made to examine patterns of problems and to avoid fragmentation of services so that each area of underachievement is not treated separately. Although learning disabilities usually interfere with school performance, they are not simply academic handicaps. They interfere with certain social activities as well as occupational pursuits. In many instances, they impact on mental health and self-esteem. Therefore, students need multiple services. And, as emphasized throughout this journal issue, learning disabled individuals may have comorbid conditions such as attention deficit disorder, depression, and neurologic problems. Furthermore, the problems may change over time. Children may first be identified because of language comprehension problems but later have reading or mathematics difficulty. With intervention, oral expressive problems may be alleviated but may be manifested later in written language.

Child↗
PubMed1992

Audit in general practice: students and practitioners learning together.

OBJECTIVES: To describe and evaluate the use of medical audit in general practice as an educational activity shared by undergraduate medical students and general practitioners. DESIGN: A descriptive study, evaluated by a questionnaire survey of all participating practices and by results of completed student projects on general practice audit topics during three weeks in the first year of completed projects (1990-1). SETTING: One university department of general practice, collaborating with 18 general practices in contract with Liverpool Family Health Services Authority. PARTICIPANTS: 150 medical students, working in groups of two to six, and the general practitioners with whom they worked in 18 practices. MAIN MEASURES: The nature of topics proposed by practices and chosen by the students; methods of audit used by students; reported effects of the audits on the practices; general practitioners' opinions of the projects' usefulness to the practice. RESULTS: The range of topics was wide, and both quantitative and qualitative methods were used. Fifteen of the 18 questionnaires sent out were completed. Six practices reported that the final project had changed substantially after joint planning with the students. Two thirds (10) attached high value to the audits and were making changes in the delivery of care as a result. CONCLUSIONS: Medical audit "project work" by medical undergraduates is an effective tool for motivating students to learn and can lead to change in the clinical setting in which it occurs. IMPLICATIONS: By meeting the learning needs of both undergraduates and established practitioners audit project work has wider application within medical education.

Education, Medical, Undergraduate↗
PubMed2001

Primary visual cortex and memory. Retinal position specificity and lack of size constancy at early stages of learning a visual memory task in the macaque.

Two monkeys were trained in a novel version of a delayed match-to-sample (DMS) task. They were required to fixate on a small spot at the center of the monitor and distinguish whether two gratings presented one after the other with delays up to 1.5 s in a specific visual field location were similar or not. It was found that such learning fails to transfer readily to other retinal locations. In fact, the learning was sensitive even to very small retinal displacements of the visual stimuli. Such acute retinal position specificity implies that at least a component of the learning in this particular memory task occurs at an early visual area such as the striate cortex, which has a fine-grain topographical representation. Furthermore, at early stages of learning the DMS task, when the monkeys had not generalized the learning to stimuli of different sizes, they failed to show size constancy. That is, when the display was placed at a different distance but with the same absolute size, the performance dropped. The performance was almost fully restored when, at the new display location, stimuli were changed to fit the original retinal size. This indicates that a crucial component of the learning does occur at a site even prior to size constancy. These results show that, under certain situations, an early visual area such as the primary visual cortex may be involved even in complex behaviours such as a memory task as more than just a feature-detecting area or a relay station.

Animals↗
PubMed1991

Training, credentialling, and granting of clinical privileges for laparoscopic general surgery.

Despite the lack of scientific data comparing it with traditional open operations, laparoscopic surgery has gained rapid acceptance and implementation by general surgeons. Individual hospitals, which have the responsibility for developing their own privileging criteria, are searching for guidance as to the amount and type of additional training required to grant clinical privileges in laparoscopic general surgery. Laparoscopic surgery involves techniques different from those learned during general surgery residency training. Therefore, until such techniques are regularly included in general surgery residency programs, additional training for and granting of separate privileges in laparoscopic surgery are appropriate. Adequate training for surgeons already experienced in abdominal and biliary tract surgery can be acquired through a preceptorship in diagnostic laparoscopy, attending a course in laparoscopic surgery that includes both didactic instruction and live animal experience, assisting with the procedures in humans, and being proctored and certified as competent by an experienced general surgeon.

Animals↗