Meeting the goals of academia: characteristics of emergency medicine faculty academic work styles

STUDY OBJECTIVES

Emergency medicine faculty have 24-hour clinical responsibilities in addition to the academic requirements of research and administration/teaching. This study was undertaken to determine the existing and ideal work style of such faculty by professional rank, administrative title, and/or tenure versus clinical track.

DESIGN

Data analysis from department or residency directors of Accreditation Council for Graduate Medical Education-approved emergency medicine residency programs.

SETTING

ACGME-approved emergency medicine residency programs.

TYPE OF PARTICIPANTS

Emergency medicine faculty.

RESULTS

Ninety-three percent of programs submitted appropriate data. Programs averaged 11 full- and four part-time faculty. Mean time ranged from 15 to 30 hours per week with an average mean of 23 hours (48% of total work week) for clinical responsibilities, from ten to 32 hours per week with an average mean of 19 hours per week (38%) for administrative/teaching efforts, and from three to 14 hours per week with an average mean of seven hours per week (15%) for research. Total time averaged between 44 and 51 hours per week. Ideal work style emphasized less clinical time and a shorter work week. Responsibilities varied by rank, administrative position, and clinical versus tenure track.

CONCLUSION

Emergency medicine faculty accomplish the clinical, research, and teaching/administrative demands of academia by increasing the number of faculty, varying the faculty responsibilities by rank and title, and shortening the total work week. Research time is extremely limited.

Changes in physical activity levels, lesson context, and teacher interaction during physical education in culturally and linguistically diverse Australian schools

BACKGROUND

Recent data show that only 15% of Australian adolescents participate in adequate amounts of physical activity (PA) and those students from Asian and Middle-Eastern backgrounds in Grades 6-12 are significantly less active than their English-speaking background peers. Schools have recently been recognised as the most widely used and cost-effective setting for promoting PA among youth and one domain within schools where PA can occur regularly for all youth, regardless of cultural background or socio-economic status, is during physical education (PE).

METHODS

This study describes changes in physical activity (PA), lesson context and teacher interaction in physical education over the first two years in culturally and linguistically diverse secondary schools. Grade 7 PE classes in six schools were randomly observed using systematic direct observation (n = 81) and then followed up over the same period (n = 51) twelve months later.

RESULTS

There was no significant decline in moderate-to-vigorous physical activity (MVPA) during PE (MD = -4.8%; p = .777), but a significant decline and medium negative effect in time spent in vigorous physical activity (VPA) (MD = -7.9%; p = .009) during PE was observed. Significant declines and large negative effects over time in percentage of PE time spent in management (MD = -8.8%; p < .001) and the number of observations where teachers promoted PA (MD = -20.7%; p < .001).

CONCLUSIONS

The decline of VPA and teacher promotion of PA in culturally and linguistically diverse schools is of concern. Given the declines in VPA and the increases in time spent in game play, further research is needed to ascertain whether PE instruction could be improved by focussing on skill instruction and fitness in a games-based PE instruction model. Further research for increasing teacher promotion of PA during PE is needed.

Reflective listening in counseling: effects of training time and evaluator social skills

Psychology students received a 14-, 28-, or 42-hour training course in reflective listening. Before and after training, the students participated in role-played counseling conversations with confederates, who rated them. The conversations were captured on audio- or videotape, categorized, and rated by external evaluators. Results suggested that the students used reflective listening equally after different lengths of training. However, longer training resulted in the confederates disclosing more emotion, the psychology students remembering the information relayed better, and the evaluators perceiving the therapeutic relationship as better. This was especially true among the evaluators who self-reported high social skills.

The training and career paths of fellows in the National Research Service Award (NRSA) Program for Research in Primary Medical Care

PURPOSE

To describe the training and career paths of fellows in the National Research Service Award (NRSA) Program for Research in Primary Medical Care.

METHOD

All fellows who graduated from 25 NRSA programs nationally between July 1988 and June 1997 (n = 215) were mailed a questionnaire. Personal characteristics, fellowship experiences, and current professional positions were compared between faculty researchers, faculty clinician-educators, and individuals who were not in full-time academic positions.

RESULTS

A total of 146 NRSA graduates (68%) completed the survey. A mean of four years had elapsed since their fellowships. Of the respondents, 36% were faculty researchers, 32% were faculty clinician-educators, and 32% were not on full-time faculties. Faculty researchers did not differ from the other groups in demographics or acquisition of advanced degrees, but they were more often general internists than general pediatricians, family physicians, or from other disciplines (p =.002). Fellowship graduates spent a mean of 29% of their training in course work and 38% conducting research. Faculty researchers spent a greater proportion of their fellowship conducting research (46% versus 34% for clinician-educators and 31% for those not on full-time faculties, respectively, p <.0001). They were also more productive in terms of subsequent publications and grant acquisitions.

CONCLUSIONS

Only a minority of those completing NRSA programs held positions as faculty researchers. The preponderance of general internists among researchers may indicate problems in the capacity of general pediatrics and family medicine to support primary care research. The amounts of direct research time during these fellowships may need to be increased to enhance the likelihood of subsequent research success.

The impact of the demand for clinical productivity on student teaching in academic emergency departments

OBJECTIVE

Because many emergency medicine (EM) attending physicians believe the time demands of clinical productivity limit their ability to effectively teach medical students in the emergency department (ED), the purpose of this study was to determine if there is an inverse relationship between clinical productivity and teaching evaluations.

METHODS

The authors conducted a prospective, observational, double-blind study. They asked senior medical students enrolled in their EM clerkship to evaluate each EM attending physician who precepted them at three academic EDs. After each shift, students anonymously evaluated 10 characteristics of clinical teaching by their supervising attending physician. Each attending physician's clinical productivity was measured by calculating their total relative value units per hour (RVUs/hr) during the nine-month study interval. The authors compared the total RVUs/hr for each attending physician to the medians of their teaching evaluation scores at each ED using a Spearman rank correlation test.

RESULTS

Seventy of 92 students returned surveys, evaluating 580 shifts taught by 53 EM attending physicians. Each attending physician received an average of 11 evaluations (median score, 5 of 6) and generated a mean of 5.68 RVUs/hr during the study period. The correlation between evaluation median scores and RVUs/hr was -0.08 (p = 0.44).

CONCLUSIONS

The authors found no statistically significant relationship between clinical productivity and teaching evaluations. While many EM attending physicians perceive patient care responsibilities to be too time consuming to allow them to be good teachers, the authors found that a subset of our more productive attending physicians are also highly rated teachers. Determining what characteristics distinguish faculty who are both clinically productive and highly rated teachers should help drive objectives for faculty development programs.

Health and lifestyle of general practitioners and teachers

General practitioners (408) and secondary teachers (385) responded to a questionnaire about their health and lifestyle with a response rate of 48 and 45 per cent respectively. Their answers were corroborated by a separate questionnaire completed by their spouse or domestic partner. A sub-group of 50 general practitioners and 50 teachers were examined to assess their physical fitness and mental health. Half of each group was below average fitness compared to the general population. General practitioners were more likely than teachers to practise disease prevention. Ten per cent of general practitioners and 13 per cent of teachers were smokers; 8 per cent of general practitioners and 14 per cent of teachers reported an alcohol consumption that exceeded recommended limits. General practitioners took remarkably little sickness absence compared to teachers. Symptoms of anxiety and depression were more common in teachers: a need for alcohol, binge eating and sleep difficulties were frequently experienced in both groups. Medication taken by the two groups was similar and self-medication was common amongst the general practitioners. Less than half the general practitioners thought they would use an occupational health service if it were established.

What Makes the "Perfect" Inpatient Consultation? A Qualitative Analysis of Resident and Fellow Perspectives

PURPOSE

To characterize the methods of inpatient consult communication, given new communication modalities; to explore residents' and fellows' perspectives on the ideal consult and how this consult could affect their teaching, learning, and patient safety; and to identify barriers to and strategies for optimizing consultations.

METHOD

Using qualitative grounded theory, the authors conducted semistructured focus groups with pediatric residents and fellows at Lucile Packard Children's Hospital at Stanford University from October 2016 to September 2017, using questions developed by expert consensus to address study objectives. Sessions were audiorecorded and transcribed verbatim. Two authors independently coded the transcripts and reconciled codes to develop categories and themes using constant comparison. The third author validated the codes, categories, and themes. To ensure trustworthiness, participants edited the themes for accuracy.

RESULTS

Twenty-seven residents and 16 fellows participated in 7 focus groups (3 with residents, 4 with fellows). Four themes emerged: (1) Many forms of communication are successfully used for initial inpatient consult recommendations (in person, phone, text messages, notes in electronic medical records); (2) residents and fellows prefer in-person communication for consults, believing it leads to improved teaching, learning, and patient safety; (3) multiple strategies can optimize consults regardless of communication modality; and (4) how residents frame the initial consult affects the interaction and can increase fellow engagement, which leads to more fellow teaching, residents' improved understanding, and better patient care.

CONCLUSIONS

Residents and fellows believe that structured initial consults conducted in person improve teaching, learning, and patient care. Several strategies exist to optimize this process.

An evidence-based synthesis of instructional reading and spelling procedures using telepractice: A rapid review in the context of COVID-19

BACKGROUND

Due to COVID-19, many educators and allied health practitioners are facing the challenge of rapidly transitioning to telepractice delivery of instructional reading and spelling procedures without being fully informed of the evidence.

AIMS

A rapid review was conducted to provide educators, allied health practitioners and policymakers with a synthesis of valid, relevant and actionable evidence relating to telepractice delivery of instructional reading and spelling procedures. The aim was to investigate the nature and outcomes of studies examining instructional reading and spelling procedures delivered via telepractice to school-aged students.

METHODS & PROCEDURES

A rapid review was undertaken in accordance with the eight-step process published by the Cochrane Rapid Reviews Methods Group. Medline (all databases), Embase, Cochrane and ProQuest Central were systematically searched with predefined search terms organized across four key concepts relating to the research questions.

OUTCOMES & RESULTS

Nine studies were included in this rapid review. Reading and spelling instruction and intervention using telepractice can be feasible and engaging. Telepractice assessment for reading and spelling can be equally effective as onsite assessment.

CONCLUSIONS & IMPLICATIONS

The evidence base for telepractice delivery of reading and spelling procedures is in its infancy in terms of both the quantity and the quality of the evidence. Insufficient evidence exists to draw clear conclusions about its efficacy, and therefore practitioners should proceed cautiously. What this paper adds What is already known on the subject For onsite delivery, evidence-based reading and spelling assessment, instruction and interventions delivered by educators and allied health practitioners have been shown to accelerate students' skills; less is known about the efficacy of instructional reading and spelling procedures in a telepractice model, which have rapidly become the new norm in many countries due to the COVID-19 pandemic. The benefits of telepractice include improved access to services, increased service availability, convenience, time efficiency, caseload management efficiency and removal of logistical barriers relating to cost and geographical location. During the COVID-19 pandemic, telepractice has facilitated continued access to services. What this study adds to existing knowledge Reading and spelling instruction and intervention delivered via telepractice can be feasible and engaging. Telepractice is a viable mode to deliver reading and spelling assessments with strong agreement between telepractice and onsite scores. Given their low methodological quality, the studies in this review provide valuable information around the how of telepractice reading and spelling procedures and highlight the factors that may contribute to positive outcomes with this service delivery model. What are the potential or actual clinical implications of this work? Educators and allied health practitioners need a thorough understanding of the student's telepractice environment and require adequate training and support to engage in telepractice service delivery. Educators and allied health practitioners should consider students for telepractice on a case-by-case basis. Practitioners should proceed cautiously with telepractice reading and spelling assessment, intervention and instruction, with the knowledge that the current available evidence is of limited quality.

Women in the UK academic medicine workforce

OBJECTIVES

This study aimed to compare data on the employment profiles (such as grade, place of work, etc.) of male and female clinical academics.

METHODS

We carried out a comparative review of workforce data within academic medicine for 2004 and 2005, pertaining to the workforce in all specialties in UK medical schools.

RESULTS

We identified 3255 and 3365 lecturers, senior lecturers, readers and professors in 2004 and 2005, respectively, of whom 21% were women. In 2004 and 2005, 12% and 11%, respectively, of 1157 and 1364 UK medical professors were women. The number of women filling such positions in individual schools ranged from 0% to 33% across schools. The total numbers of women post-holders and their full-time equivalents were similar, indicating that the majority of posts were full-time.

CONCLUSIONS

In England only 1 in 10 medical clinical professors are women. At the onset of the study period, 6 medical schools employed no female professors, with a consequent lack of female role models at these institutions. Large variations between schools suggest that some workforce practices may be detrimental to women's academic careers.

The teaching of all-ceramic restorations in North American dental schools: materials and techniques employed

North American dental schools were surveyed to determine the types of clinical experiences and the extent of material use that predoctoral students encounter with restorative procedures that employ all-ceramic materials. The results were based on an overall response rate of 80% from the 64 surveyed schools. The majority (96%) of the 51 schools responding to the survey did offer an opportunity to become experienced with all-ceramic restorations. The selection of bases and liners for all-ceramic restorations included dentin adhesive agents, glass ionomer materials, and calcium hydroxide products, by a ratio of 5:4:1, respectively. The most commonly used impression material types were addition silicone and polyether. One or both of these materials were used by every school. Dicor glass ceramic and alumina core ceramic were the most commonly used materials by the responding schools for veneers, onlays, and crowns. Dicor glass ceramic and CAD/CAM ceramic were most commonly used for inlays. Crowns were made of more different all-ceramic material types than the other restoration classes. Fabrication of all-ceramic restorations was primarily by commercial laboratories and school technicians. Students have hands-on experience in the fabrication of all-ceramic restorations in 6% of the responding schools. Luting agents for all-ceramic restorations include dual-cured resin, in 96% of the responding schools, light-cured resin, 43%, and glass ionomer cement, 33%. Zinc phosphate, chemical-cured composite, and polycarboxylate were used by less than one fourth of the respondents. Only resin-based composite materials were used to lute ceramic veneers. Rubber dam was applied primarily during luting procedures involving all-ceramic inlays and onlays. Crowns and veneers were isolated by this method in less than 30% of the responding schools. Finishing procedures with all-ceramic restorations were accomplished with three or more instruments by 89% of the schools.

The cost and value of pre-registration clinical placements for Project 2000 students

The research outlined in this article was commissioned by the Sheffield and North Trent College of Nursing and Midwifery to explore the cost implications of pre-registration clinical placements in the context of Project 2000. The authors outline the methodology and findings of an exercise designed to collect relevant cost information which was not readily available. On the basis of these findings, they suggest that: at 1995/1996 pay and prices, clinical placements cost the education provider approximately pound 890 per student per annum; in terms of real resources, the value to service providers of the service contribution made by second- and third-year nursing and midwifery students on ward-based placements outweighs the value of the time spent by qualified staff on their supervision and education. Once the funding assumptions underlying the introduction of Project 2000 have been taken into account, second- and third-year nursing and midwifery students benefit the service provider by on average pound 3.46 for every hour they spend in an unrostered ward-based placement. The service contribution made by students in community-based clinical placements cannot free staff time in the same way as on the wards and, because qualified staff in these areas are generally more highly graded, the value of the time they spend on the supervision and education of students on placement is higher than in ward-based placements. Second- and third-year students therefore appear to cost the service provider on average pound 0.48 for each hour they spend in a community-based placement. It was not possible to determine whether this cost translates into a reduction in patient contacts.

Patient involvement in clinical teaching

This paper presents findings from a longitudinal study of patient refusals (as reported by graduating medical students) to take part in the teaching function of public hospitals. Results from a smaller study of non-patients' attitudes are also reported. Findings are discussed in terms of patients' rights, issues of personal privacy, medical education, and the public good.

Impact of Training Based on Orem's Theory on Self-Care Agency and Quality of Life in Patients With Coronary Artery Disease

BACKGROUND

Coronary artery disease (CAD) is a primary cause of death worldwide. CAD negatively affects individuals because it reduces their functional skills and self-care abilities and disrupts quality of life.

PURPOSE

This study was designed to assess the impact of a training program based on Orem's self-care deficit nursing theory (SCDNT) on self-care abilities and quality of life in patients with CAD.

METHODS

This study was conducted using a randomized, controlled, pretest/posttest experimental design. One hundred two patients with CAD were divided evenly into either the intervention or control group, with sample randomization based on gender, age, low-density lipoprotein cholesterol level, and Self-Care Agency Scale scores. For both groups, interviews were conducted in two sessions held, respectively, at the hospital and at home. Study data were collected using the patient information form, Self-Care Agency Scale, MacNew Heart Disease Health-Related Quality of Life Questionnaire (MacNew), Quality of Life Questionnaire (15D), and training booklet.

RESULTS

A highly significant difference was found between the two groups in terms of the average posttest scores on the Self-Care Agency Scale, MacNew, and 15D. For the intervention group, the posttest scores on the Self-Care Agency Scale, MacNew, and 15D were significantly higher than the pretest scores, whereas average pretest and posttest scores on these measures were similar for the control group.

CONCLUSIONS

The training program developed in this study based on Orem's SCDNT improved self-care agency as well as disease-specific and overall quality of life in patients with CAD. Nurses should pay attention to the CAD-related educational level of patients when teaching them how to live with their disease. Moreover, nurses should use Orem's SCDNT to strengthen the self-care agency of these patients to increase quality of life and the effectiveness of related education efforts. Finally, medical institutions and governments should develop appropriate education policies for patients at risk of CAD and for those with CAD.

Safety leadership in the teaching laboratories of electrical and electronic engineering departments at Taiwanese Universities

INTRODUCTION

Safety has always been one of the principal goals in teaching laboratories. Laboratories cannot serve their educational purpose when accidents occur. The leadership of department heads has a major impact on laboratory safety, so this study discusses the factors affecting safety leadership in teaching laboratories.

METHOD

This study uses a mail survey to explore the perceived safety leadership in electrical and electronic engineering departments at Taiwanese universities.

RESULTS

An exploratory factor analysis shows that there are three main components of safety leadership, as measured on a safety leadership scale: safety controlling, safety coaching, and safety caring. The descriptive statistics also reveals that among faculty, the perception of department heads' safety leadership is in general positive. A two-way MANOVA shows that there are interaction effects on safety leadership between university size and instructor age; there are also interaction effects between presence of a safety committee and faculty gender and faculty age.

IMPACT ON INDUSTRY

It is therefore necessary to assess organizational factors when determining whether individual factors are the cause of differing perceptions among faculty members. The author also presents advice on improving safety leadership for department heads at small universities and at universities without safety committees.

An analysis of pre-service family planning teaching in clinical and nursing education in Tanzania

BACKGROUND

Promoting family planning (FP) is a key strategy for health, economic and population growth. Sub-Saharan Africa, with one of the lowest contraceptive prevalence and highest fertility rates globally, contributes half of the global maternal deaths. Improving the quality of FP services, including enhancing pre-service FP teaching, has the potential to improve contraceptive prevalence. In efforts to improve the quality of FP services in Tanzania, including provider skills, this study sought to identify gaps in pre-service FP teaching and suggest opportunities for strengthening the training.

METHODS

Data were collected from all medical schools and a representative sample of pre-service nursing, Assistant Medical Officer (AMO), Clinical Officer (CO) and assistant CO schools in mainland Tanzania. Teachers responsible for FP teaching at the schools were interviewed using a semi-structured questionnaire. Observations on availability of teaching resources and other evidence of FP teaching and evaluation were documented. Relevant approved teaching documents were assessed for their suitability as competency-based FP teaching tools against predefined criteria. Quantitative data were analyzed using EPI Info 6 and qualitative data were manually analyzed using content analysis.

RESULTS

A total of 35 pre-service schools were evaluated for FP teaching including 30 technical education and five degree offering schools. Of the assessed 11 pre-service curricula, only one met the criteria for suitability of FP teaching. FP teaching was typically theoretical with only 22.9% of all the schools having systems in place to produce graduates who could skillfully provide FP methods. Across schools, the target skills were the same level of competence and skewed toward short acting methods of contraception. Only 23.3% (n = 7) of schools had skills laboratories, 76% (n = 22) were either physically connected or linked to FP clinics. None of the degree providing schools practiced FP at its own teaching hospital. Teachers were concerned with poor practical exposure and lack of teaching material.

CONCLUSIONS

Pre-service FP teaching in Tanzania is theoretical, poorly guided, and skewed toward short acting methods; a majority of the schools are unable to produce competent FP service providers. Pre-service FP training should be strengthened with more focus on practical skills.

Experience of undergraduates from three London dental schools and trainers from the south east of England on interviews for vocational training in 1996

OBJECTIVE

To assess the current perceptions, motivations and expectations of trainers and vocational dental practitioners (VDPs) of vocational training (VT) interviews.

DESIGN

Questionnaire based study.

SETTING

General practice study carried out in 1996.

SUBJECTS

Undergraduates from three London dental schools and vocational trainers from south-east England.

MAIN OUTCOME MEASURES

Perceptions, motivation and experiences were assessed by a questionnaire.

RESULTS

111 questionnaires were posted to trainers with 72 (65%) returned. 108 (70%) were returned from the dental schools after 155 were posted. Graduates employed in hospital training posts, armed forces and community dentistry were eliminated from the results. Most trainers (74%) had previous experience of VT and 89% of trainers thought that a CV was important for their choice of VDPs. However, only 11% of trainers sought references before interviewing. 34% of VDPs preferred jobs close to their dental school but 75% considered location to be vital to their choice. 67% of VDPs made 10 or more applications and 57% visited 10 or more practices for interviews. 78% of VDPs considered that either genderism or racism was likely to or possibly influenced the trainers choice. However, the converse was not true, 62% of trainers considered it unlikely that the VDPs were influenced by their gender or race.

CONCLUSIONS

Trainers and VDPs have different perceptions concerning the protocol of interviews for VT.

Relationship between Students' Self-Assessment of Their Capabilities and Their Teachers' Judgments of Students' Capabilities in Mathematics Problem-Solving

The study examined the judgments made by four seventh-grade mathematics teachers of their 107 students' competence in solving mathematics problems. Simultaneously, the 107 students made self-efficacy judgments about their capability in solving mathematics problems. The two sets of judgments were tested for predicting students' mathematics performance. Also, students' prior mathematics achievement was studied for its influence on both teachers' and students' judgments and students' mathematics performance. Teachers were asked to make judgments of each student for every mathematics problem solved. Results were consistent with prior research indicating that students' mathematics self-efficacy beliefs were highly predictive of their performance. Path analysis indicated that the mathematics teachers' judgments were also highly predictive of students' performance and self-efficacy. In turn, these variables predicted students' postperformance judgments. Combining students' self-efficacy judgments and teachers' judgments of students increased predictiveness for students' mathematics performance. Educational implications were also discussed.

The State of EMS Education Research Project:

OBJECTIVES

The preparation of emergency medicine practitioners occurs at a variety of levels, via individuals with various levels of experience and training, and through a variety of oversight organizations. The purpose of this study was to quantify the characteristics of those recognized as prehospital emergency medical services (EMS) educators, the type and amount of infrastructure available to facilitate the learning process, and what attributes and common practices the profession values.

METHODS

The respondents (n = 1,691) were generated randomly from a nationwide systematic sample of all known EMS instructors. The sample was adequate to generalize to the 15,000 EMS educators. Face validity and content validity were assured through use of a 24-member focus group of EMS educators, practitioners, and administrators, who reviewed the questionnaire. Reliability estimates were generated via Cronbach's alpha and Kuder-Richardson 20 and 21 and ranged from 0.59 to 0.83, with a grand mean for the seven study constructs of 0.70. Factor analysis with varimax rotation explained 40% to 66% of the respective construct variance, with a grand mean of 56% of the response variance explained.

RESULTS

The respondents were satisfied with their teaching experience (98%), expected to continue (80%), and taught because of a perceived dearth of qualified instructors. Only half of the respondents utilized federally generated curricular materials, and approximately 20% were uncomfortable in assessing psychomotor skills. The relationship of testing to assessment and skill performance appeared to be the most significant pedagogic challenge.

CONCLUSIONS

The respondents were a senior group of educators committed to the training of new providers who will comprise the foundation of future EMS educational efforts at the national level.

Comparing Teaching Methods on Skin Disorders Using Standardized Patients Dressed in Moulage vs Paper Cases

Objective. To determine whether using standardized patients dressed in moulage improves pharmacy students' ability to assess skin disorders compared to using picture-based paper cases. To determine pharmacy student preferences when learning assessment of skin disorders through these two educational methods. Methods. Faculty members investigated student assessments of drug-induced skin disorders and contact dermatitis by using picture-based paper cases compared with using standardized patients dressed in moulage in a patient assessment course. Faculty members measured student knowledge via multiple-choice questions before laboratory, immediately after laboratory, and during a final examination 3 weeks later. Student preferences were measured immediately after laboratory via survey instrument in this randomized, non-blinded, crossover design educational study. Results. No significant differences in knowledge scores related to skin disorders were found after laboratory or 3 weeks later when comparing the two educational methods. However, survey results suggested student preferences for using standardized patients dressed in moulage for drug-induced skin disorders. No significant differences were found for contact dermatitis cases. Conclusion. Using standardized patients dressed in moulage did not improve pharmacy students' ability to assess skin disorders compared to using picture-based paper cases. Pharmacy students preferred standardized patients dressed in moulage only when learning assessment of drug-induced skin disorders.

Effects of varying inpatient attending physician rotation length on medical students' and attending physicians' perceptions of teaching quality

BACKGROUND

Patient care needs and work hour restrictions have altered inpatient internal medicine educational experiences.

PURPOSE

The goal is to compare different attending physician rotation lengths on medical students' and attending physicians' experiences.

METHODS

We studied clerkship students' evaluations (N= 86) and internal medicine attending surveys (N=21). We divided attending experiences into 2-week and 4-week rotations. We assessed exam scores and evaluations with 5-point Likert questions (5=strongly agree). Means were compared with t tests, Wilcoxon Ranked Sums, and logistic regression.

RESULTS

More than 90% of students and attending physicians responded. Students and attending physicians generally evaluated their 2- and 4-week experiences similarly. Attending physicians favored 4 weeks for evaluating students' performance (3.30 vs. 4.36, p<.01). Exam scores were similar in the 2- and 4-week student groups (M=78.2, SD=5.0 vs. 76.5, SD=8.5, p=.43).

CONCLUSIONS

Shorter rotations do not negatively impact students' experiences. Obtaining quality evaluations may be difficult for shorter rotations.

The development of science achievement in middle and high school. Individual differences and school effects

Using data from the Longitudinal Study of American Youth (LSAY), hierarchical linear models (HLMs) were used to model the growth of student science achievement in three areas (biology, physical science, and environmental science) during middle and high school. Results showed significant growth in science achievement across all areas. The growth was quadratic across all areas, with rapid growth at the beginning grades of middle school but slow growth at the ending grades of high school. At the student level, socioeconomic status (SES) and age were related to the rate of growth in all areas. There were no gender differences in the rate of growth in any of the three areas. At the school level, variables associated with school context (school mean SES and school size) and variables associated with school climate (principal leadership, academic expectation, and teacher autonomy) were related to the growth in science achievement. Initial (Grade 7) status in science achievement was not associated with the rate of growth in science achievement among either students or schools in any of the three areas.

[Education of medical students in urology in Germany: present status]

BACKGROUND

There is a growing demand for doctors in Germany and diseases of the genitourinary tract have become more prevalent in recent years. Politicians plan to increase the number of students in an already heavily overloaded system but data on quality and structure of medical education in Urology are lacking. The purpose of this study was to investigate the extent and quality of undergraduate medical education in urology.

MATERIAL AND METHODS

Departments of Urology at German University Hospitals were surveyed using a questionnaire. Questions covered four different fields of medical education and answers were analyzed by descriptive statistics.

RESULTS

Of the teachers involved in medical education 97% are physicians and 4% of these have special didactic qualifications. On average 1 teacher is responsible for 13 students and 44% of departments also have to carry out medical duties during teaching lessons. More than half of the departments offer modern learning forms, such as e-learning, problem-oriented learning or skills laboratory training.

CONCLUSIONS

Urology departments at German University Hospitals spend much time on medical education. Nearly all physicians are involved in medical education, whether they are experienced or not and in many cases teaching is carried out in parallel to patient care. In more than half of the cases modern education tools were employed which implies a good standard of quality but there are no data on outcome.

Cardiac anatomy instruction by ultrafast computed tomography versus cadaver dissection

RATIONALE AND OBJECTIVES

This prospective study was designed to determine to what extent an ultrafast computed tomography (UFCT) videotape of the heart could enhance or substitute for cadaver dissection in teaching anatomy to first-year medical students.

METHODS

A student population (n = 180) was randomized into four groups. Group 1 (control) received no instruction, group 2 viewed the videotape, group 3 participated in cardiac dissection, and group 4 performed cardiac dissection and viewed the videotape. After randomized instruction, each group was tested with 10 UFCT static cardiac images and 8 cardiac cadaver specimens. A different population consisting of nonrandomized fourth-year medical students also was tested.

RESULTS

The results point to an interaction between instruction and the manner in which it was assessed. There was more carryover from the videotape-acquired knowledge to specimens than from dissection-acquired knowledge to UFCT images.

CONCLUSIONS

Cardiac UFCT instruction resulted in dramatically improved image testing performance. This image-acquired knowledge was not sufficiently transferred to cardiac specimen identification; thus, videotape instruction should not replace dissection for teaching cardiac anatomy. Video provided instruction benefits beyond that gained through general clinical experience.

Clinical and basic science teachers' opinions about the required depth of biomedical knowledge for medical students

The aim of the present study was to investigate whether basic scientists and physicians agree on the required depth of biomedical knowledge of medical students at graduation. A selection of basic science and clinical teachers rated the relevance of biomedical topics for students at graduation, illustrated by 80 example items. The items were derived from ten organ systems and designed at four levels: clinical, organ, cellular and molecular. Respondents were asked to identify for each item to what extent recently graduated medical students should have knowledge about it. In addition, they were asked to indicate whether the content of the item should be included in the medical curriculum. Analysis showed that basic scientists and physicians do not diverge at the clinical level. At the organ, cellular and molecular levels however, basic scientists judge that medical students should have more active knowledge. As expected, basic scientists also indicate that more deep level content should be included. Explanations for this phenomenon will be discussed.