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Two groups of students at Michigan State University participated in an exercise intended to teach them the process of peer review. Neither group of students completed the exercise beyond the initial steps. The authors discuss the concerns of the students and make suggestions for implementing a program of peer review in undergraduate medical school curricula.
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Problems in psychiatric and psychosocial education arise from the absence of agreement on curricular content, failure to emphasize observable skill development, and the ambivalent views on psychosocial material found in modern medicine. The curriculum for medical students presented here emphasizes an integrated approach to teaching psychiatry and psychosocial material. Great emphasis is placed on interviewing and history-taking as well as on problem-solving. Specific courses in development, psychiatry and ageing are prescribed. Preclinical education in psychiatry emphasizes a bio-psychosocial view of mental disorder.
Michigan State University has a community-hospital-based clinical sciences curriculum. In the past, community program directors have determined radiology clerkship objectives. A survey regarding possible clerkship standardization was distributed to staff radiologists and clerkship coordinators. These radiologists were enthusiastic about standardization of the clerkship, and there was a broad consensus as to the basic elements of an effective clerkship. The university was seen as the source of minimum clerkship standards and of an objective method of evaluation. In response to these requests, basic guidelines for the clerkship have been established.
Thirty-seven cases of canine hypoadrenocorticism were compared with 39 previously reported cases. The 2 series were compared because it was believed that a study of 37 consecutive cases diagnosed at 1 institution (Michigan State University) and compiled by 1 group of veterinarians would yield data that were more representative of the disease than multiple cases from various institutions. Age, sex, and breed data were similar in both series. The frequency of anorexia, vomiting, depression, and the mean values for the clinicopathologic data were similar for both series except for blood glucose concentration (P less than 0.025). The Michigan State University series was different in that it had a lower frequency of eunatremia, increased plasma total solids, and hypoglycemia but a higher frequency of lymphocytosis, lymphopenia, hyponatremia, hyperglycemia, and hypercalcemia. Further, 3 dogs in the Michigan State University series had azotemia plus near isosthenuric urine, suggesting renal disease, but they seemingly responded to therapy for hypoadrenocorticism. Only 1 such case was identified in the literature. Finally, we detected fewer instances of P waves not being evident in lead II of an electrocardiogram.
Although medical ethics has become a part of the curriculum of almost every medical school, medical students' perceptions of the value of medical ethics have not been documented. This paper reports the evaluations given by 137 preclinical and 216 clinical medical students to different levels of medical ethics teaching at the College of Human Medicine and the College of Osteopathic Medicine of Michigan State University. The results indicate (1) that students' satisfaction with medical ethics teaching is directly linked to how much they receive, (2) that students overwhelmingly prefer the input of both ethicists and doctors to teaching by either alone, and (3) that a preclinical medical ethics course followed by explicit medical ethics teaching in clinical training is a promising model for achieving an adequate level of medical ethics teaching within medical education.
An off-campus, practitioner-supervised training (preceptorial) program for veterinary students at Michigan State University was developed and introduced in the fall of 1972. The program was designed to meet the needs of students concentrating on food animal medicine. It has enabled senior students to receive degeee credit for on-the-job experience with practitioners. Students opting for the program gain experience and knowledge in segments of clinical veterinary medicine that are most available with off-campus practitioners. Exposure of students to the clinical abilities of private practitioners, the case method of study, and diagnostics in a realistic environment are the goals of the program. The program has afforded faculty members and private practitioners meaningful insights into the changing face of veterinary education. Indeed, the consensus of the faculty in the Department of Large Animal Surgery and Medicine at Michigan State University is that an off-campus curriculum. Participating students and practitioners report that the program has been successful and is worthy of expansion and continuation. Both groups rate the program favorably and believe it has been a worthwhile teaching-learning experience.
Five federally funded family medicine faculty development programs were site visited from December 1985 to June 1986 to collect from experienced project directors, staff, and faculty their thoughts on training practices and future funding. The sites selected were the Faculty Development Center of Texas in Waco (McLennan County Medical Education and Research Foundation), the National Center for Faculty Development at the University of Miami, and programs at Michigan State University, the University of North Carolina-Chapel Hill, and Duke University. Since the late 1970s these programs have trained 259 fellows and 3,284 other participants. In total, $7,515,350 in federal dollars were spent. A variety of program formats and strategies were used to recruit faculty, and to prepare them in teaching, research, and other skill areas. Interviews (as well as phone conversations and letters) with key personnel at each site resulted in a summary of 30 critical elements identified for effective faculty development. Additionally, respondents made 11 specific recommendations to the Federal Faculty Development Grant Program that concern funding and future programs.
This paper describes a unit on the informed consent process taught to 119 first-year students at the Michigan State University College of Osteopathic Medicine in 1988-89. The unit consisted of a pretest and a posttest, a lecture, readings, small-group discussions, a model videotaped interview, and the students' videotaped interviews with one of two simulated patients. In the interviews, the students were most successful in establishing rapport and engaging the patients in discussions of treatment alternatives, and were less successful in perceiving the patients as unique individuals and in dealing with situations that involved conflict or confrontation. The authors suggest that curricula can be enhanced by focusing on the importance of patients' participation in the informed consent process.
The Michigan Placental Tissue Registry is located in the Department of Pathology at Michigan State University in East Lansing. Operational since 1970, the registry now receives some 1300 specimens annually from Michigan, out-of-state, and out-of-country hospitals. This registry is intended to assist physicians with patient care, to maintain a tissue bank for referred specimens, and to explore the cause, clinical significance, and management of placental abnormalities.
A longitudinal study was conducted on 398 athletes and 369 nonathletes who were born before 1920 and attended Michigan State University. The subjects were compared to determine if intercollegiate athletic competition accounts for significant variation in longevity when considered with somatotype. Because some of the subjects were still alive at the time of the study, the BMDP Statistical Software was used to do a survival analysis with covariates. Preliminary comparisons considered the differences in somatotype between athletes and nonathletes. Two sample t-tests indicated that athletes were more mesomorphic and less ectomorphic (p less than .05) than nonathletes. When comparing the relationship between somatotype and longevity, the pooled data of athletes and nonathletes indicated that endomorphs were shorter lived than the other three comparison groups. When only the athletes were considered, similar results were found. However, the nonathlete group exhibited differences only between the mesomorphic and endomorphic groups. The endomorphs were shorter lived. Longevity was examined by using the Cox proportional hazards regression method with somatotype and athlete/nonathlete status as covariates. Somatotype, by itself, was found to be significantly related to longevity, (p less than .001). Athletic status was not significantly related to longevity, either by itself or when entered into the model with somatotype.
In 1974, Michigan State University established the Upper Peninsula Medical Education Program (UP) to improve the physician supply in rural areas of Michigan by training students in a rural, practice-based setting. Practicing graduates of the program (N = 28) were surveyed by mail and their responses compared to a random sample of downstate MSU graduates (N = 57) with regard to practice location, specialty choice, hometown, and medical education and training. UP Program graduates showed a tendency to rural origin and chose rural practice and primary care specialties, especially family practice, more often than did their downstate colleagues. Responses of UP graduates suggested that rural residency locations would lead to increased numbers of rural practitioners. The rural UP Program has been successful to date in training medical students who ultimately pursue careers in rural primary medicine.
The preferred treatment of hyperthyroidism remains controversial. Most of this data is derived from large, university-based medical centers. We report here our experience with treatment of hyperthyroidism in a community setting. This involves 144 patients with hyperthyroidism who were seen over a 10 year period at Michigan State University Clinical Center and were treated in the community hospitals and private physicians' offices, and by community surgeons. Follow-up data were available on 119 of these patients; 105 of them were hyperthyroid because of Graves' disease and multinodular goiter. Patients were encouraged to make their own decisions regarding choice of therapy, as independently as possible. Sixty-five percent of these patients were treated by 131I, 18% by antithyroid drugs, and 17% by surgery. The mean follow-up period was 2.5 years (range 2 months to 19 years). Hyperthyroidism was controlled in 84% of the patients treated by 131I and 83% of the patients treated by surgery. Forty percent of the patients treated by 131I and 33% treated by surgery became hypothyroid. Fifty percent of the patients achieved remission when treated by antithyroid drugs alone. Our results indicate that when patients are encouraged to make their own decisions regarding the treatment of hyperthyroidism, their choices are similar to those of the thyroidologists. Secondly, the results obtained with different modalities of treatment for hyperthyroidism in a community setting are similar to those obtained in university medical centers.