Stress management with adolescents at the junior high transition: an outcome evaluation of coping skills intervention

This paper reports an outcome study of coping skills intervention to help adolescents manage stress associated with the transition from elementary school to junior high. In a randomized design, sixth grade students from four elementary schools were pretested, then two schools each were assigned to an intervention condition and to a control condition. Intervention condition subjects received eight sessions of instruction and practice in coping skills intervention. Following intervention, all subjects were posttested. At posttest and relative to control condition subjects, intervention condition subjects scored more positively on measures of problem solving, assertive direct refusals, adequacy of information about junior high school, ability to handle stress, ability to deal with peer pressure, and general readiness for junior high school.     

Comparison between videotape and personal teaching as methods of communicating clinical skills to medical students.

The efficacy of video recording in transmitting clinical knowledge and skills to medical students was tested by recording on videotape demonstrations of physical examinations given by five clinicians to a randomly selected group of 12 students (personal group) from the first clinical year and then showing these recordings, under identical conditions, to 13 students from the same year (video group). The efficacy of both the personal and video mediums in terms of whether content was retained was tested by a questionnaire completed by all students at the end of the sessions and by a structured clinical assessment in which students were asked to demonstrate some of the same clinical tasks three weeks after the demonstration. In answering the questionnaire the video group obtained a mean (SD) score of 20.8 (7.0) (maximum possible score 40), which was not significantly different from the score achieved by the personal group (17.4 (7.7)). The video group was able to reproduce 44 (10)% of the total clinical steps demonstrated and the personal group 45 (14)%. Videotaped demonstrations can be as effective as personal teaching of clinical methods, and video should be developed as a medium for first line clinical teaching.     

以病例为基础的讨论式教学模式在临床教学中的应用

目的:探讨以病例为基础讨论式学习(case-based discussion and learning,CBDL)在临床教学中的应用效果。方法:将40位临床医学本科专业学生随机分为两组,其中20人采用CBDL教学,20人采用传统教学,并且通过理论基础考试和临床技能考试的形式评价学生的学习效果,通过问卷的形式调查学生对教学方法的满意度。结果:CBDL教学组的理论考试、临床技能考试及总成绩得分均较传统教学组明显提高(P0.01),CBDL教学组学生对教学的满意度分别为:教学方法 100%,教学效果90%,小组功能95%,教师评价95%。结论:CBDL教学法较传统教学方法更能提高学生的基础和临床能力,为临床工作中独立解决问题打下了基础。     

Studies on live rubella vaccine. VI. Seroepidemiological surveillance and immunization of adolescents in high school.

The rubella seroimmunity status of a total of 1,204 students aged 12 to 19 in a junior and a senior high school in Osaka district was surveyed. Among these, 487 students (40.5%) were found to be seronegative (less than 1 : 8) by the hemagglutination inhibition (HI) test. A total of 287 students were immunized with live rubella vaccine, Biken lot No.7233. This caused an increased titer in all except one of the 262 seronegative students, while among 25 students with an initial HI antibody titer of 1 : 8 it caused more than 4-fold increase in 20 and 2-fold increase in 5. The vaccine caused no clinical manifestations, such as fever, rash or arthralgia.     

Career Preferences of First-year Students at Canadian Medical Schools, 1966-67 to 1968-69

The principal findings of this study of the career preferences of first-year Canadian medical students were:Over 70% of the first-year students expressed a preference for specialty practice, with only 20% oriented towards practice as a family practitioner.There were considerable differences between the medical schools in the proportion of medical students preferring general practice, ranging from less than 10% at McGill to nearly 33% at Queen''s.Nearly one-third of the students stated that they preferred primarily salaried practice. These students were largely those who preferred specialty practice or a career in an area such as public health or research.Nearly 70% of the students looked for a career with part-time teaching, while 8% preferred a full-time teaching career.Only 1% preferred a full-time research career although 90% expected to have at least some research involvement.Students from smaller communities were more likely to express a preference for general practice than those from large urban areas.Men and women had similar practice preferences in terms of general practice and clinical specialty, but significantly more women than men preferred a career in salaried practice. Significantly fewer women expressed a preference for major involvement in either teaching or research.     

Health promotion in the general practice consultation: a minute makes a difference.

OBJECTIVE--To see whether extending appointment length from seven and a half minutes or less to 10 minutes per patient would increase health promotion in general practice consultations. DESIGN--Controlled trial of 10 minute appointments. Consultations were compared with control surgeries in which the same doctors booked patients at their normal rate (median six minutes per patient). SETTING--10 general practices in Nottinghamshire. SUBJECTS--16 general practitioners were recruited. Entry criteria were a booking rate of eight or more patients an hour, a wish for longer consultations, and plans to increase appointment length. MAIN OUTCOME MEASURES--Duration of consultations; recording of blood pressure, weight, and cervical cytology in the medical record; recording of advice about smoking, alcohol, diet, exercise, and immunisation in the medical record; reporting of the above activities by patients. RESULTS--Mean consultation times were 8.25 minutes in the experimental sessions and 7.04 and 7.16 minutes in the control sessions. Recording of blood pressure, smoking, alcohol consumption, and advice about immunisation was significantly more frequent in the experimental sessions, and the proportion of consultations in which one or more items of health education were recorded in the medical notes increased by an average of over 6% in these sessions. Patients more often reported discussion of smoking and alcohol consumption and coverage of previous health problems in the experimental sessions. There was little change in discussion of exercise, diet, and weight or cervical cytology activity. CONCLUSIONS--Shortage of time is a major factor in general practitioners'' failure to realise their potential in health promotion. General practice should be organised so that doctors can run 10 minute appointment sessions.     

Teaching within the operating theater

All surgeons within teaching hospitals share in the collective responsibility for training more junior doctors. A large proportion of training focuses around developing good clinical practice and ensuring the trainee is reaching competency. Formal structured teaching sessions aim to improve the trainee's theoretical knowledge and wider understanding. But surgical trainees must also learn how to operate. In order to do this, a more experienced surgeon must teach and supervise them in how to perform common procedures. This article discusses effective teaching within the operating theater, drawing on the author's own reflective practice. It introduces the concepts of theater prerequisites, used for assessing the suitability of theater cases for teaching, and active observation as one of the methodologies for teaching in theater.     

Interactions with the pharmaceutical industry: experiences and attitudes of psychiatry residents,interns and clerks.

OBJECTIVE: To examine the type and number of interactions of psychiatry residents, interns and clerks with sales representatives of pharmaceutical companies and the attitudes of physicians-in-training toward these interactions. DESIGN: Survey conducted with the use of a self-report questionnaire. SETTING: Seven teaching hospitals affiliated with the Department of Psychiatry, University of Toronto. PARTICIPANTS: All 105 residents, interns and clerks training in psychiatry at the seven teaching hospitals between October 1993 and February 1994 were eligible; 74 completed questionnaires, for a response rate of 70%. One respondent was excluded from the analysis. OUTCOME MEASURES: Number of personal meetings and "drug lunches" attended, number of drug samples and promotional items received and estimated value of gifts received by each physician-in-training during a 1-year period as well as attitudes of residents, interns and clerks about interactions with pharmaceutical representatives. RESULTS: Median number of personal meetings reported was 1 (range 0 to 35), of drug lunches attended was 10 (range 0 to 70), of promotional items received was 2 (range 0 to 75) and of drug samples received was 1 (range 0 to 20). Trainees'' median estimate of the value of gifts received was $20 (range $0 to $800 Fewer than one third felt that pharmaceutical representatives were a source of accurate information about drugs; however, 71% (52/73) disagreed with the statement that representatives should be banned from making presentations. Although only 15% (11/73) felt they had sufficient training about meeting with pharmaceutical representatives, 34% (25/73) felt that discussions with representatives would have no impact on their prescribing practices, and 56% (41/73) felt that receiving gifts would have no impact on prescribing. Fewer than half said they would maintain the same degree of contact with representatives if they did not receive promotional gifts. The more money and promotional items a physician-in-training had received, the more likely he or she was to believe that discussions with representatives did not affect prescribing (p < 0.05). Clerks, interns and junior (first-year and second-year) residents attended two to three times more drug lunches than senior (third-year and fourth-year) residents, and significantly more junior than senior residents felt that pharmaceutical representatives have a valuable teaching role. Junior residents were three times more likely than senior residents to have received drug samples. CONCLUSIONS: Interactions between pharmaceutical representatives and psychiatry residents, interns and clerks are common. The physicians-in-training perceive little educational value in these contacts and many, especially clerks, interns and junior residents, disavow the potential of these interactions to influence prescribing. Therefore, supervisors of postgraduate medical training programs may wish to provide instruction concerning potential conflicts of interest inherent in these types of interactions.     

Dedicating specific sessions of cytopathology courses to medical students. A survey/consensus study

OBJECTIVE: To establish a consensus among medical schools in North America on whether to dedicate specific sessions to teaching cytopathology to medical students. STUDY DESIGN: A list of all the medical schools in the United States, Canada and Puerto Rico was retrieved from the American Association of Medical Colleges Web site in conjunction with the information provided by the 33rd edition of the Directory of Pathology Training Programs, published by the Intersociety Committee on Pathology Information. A total of 147 schools were found. A questionnaire was designed to include 7 questions addressing this issue and was sent to each medical student pathology course director. RESULTS: Of the 147 questionnaires, 65 (44%) responses were received. Fifty-four (83%) indicated the total number of pathology lectures given to medical students in each course. The number of lectures ranged between 19 and 201, with a mean of 85. Seven (11%) stated that their systems used problem based learning and that therefore a specific number of pathology lectures could not be given accurately. Sixteen (25%) have cytology sessions incorporated in their pathology courses. Thirteen (20%) prefer to include cytopathology sessions in the course and are committed to doing so. Therefore, 29 (45%) institutions either have or prefer to have specific sessions dedicated to cytopathology education. CONCLUSION: Incorporating specific sessions dedicated to cytopathology education in the medical student curriculum is highly recommended. Using new educational techniques, including computer-based methods with real case studies, would add more educational value.     

Auditory-Motor Mapping Training: Comparing the Effects of a Novel Speech Treatment to a Control Treatment for Minimally Verbal Children with Autism

This study compared Auditory-Motor Mapping Training (AMMT), an intonation-based treatment for facilitating spoken language in minimally verbal children with autism spectrum disorder (ASD), to a matched control treatment, Speech Repetition Therapy (SRT). 23 minimally verbal children with ASD (20 male, mean age 6;5) received at least 25 sessions of AMMT. Seven (all male) were matched on age and verbal ability to seven participants (five male) who received SRT. Outcome measures were Percent Syllables Approximated, Percent Consonants Correct (of 86), and Percent Vowels Correct (of 61) produced on two sets of 15 bisyllabic stimuli. All subjects were assessed on these measures several times at baseline and after 10, 15, 20, and 25 sessions. The post-25 session assessment timepoint, common to all participants, was compared to Best Baseline performance. Overall, after 25 sessions, AMMT participants increased by 19.4% Syllables Approximated, 13.8% Consonants Correct, and19.1% Vowels Correct, compared to Best Baseline. In the matched AMMT-SRT group, after 25 sessions, AMMT participants produced 29.0% more Syllables Approximated (SRT 3.6%);17.9% more Consonants Correct (SRT 0.5); and 17.6% more Vowels Correct (SRT 0.8%). Chi-square tests showed that significantly more AMMT than SRT participants in both the overall and matched groups improved significantly in number of Syllables Approximated per stimulus and number of Consonants Correct per stimulus. Pre-treatment ability to imitate phonemes, but not chronological age or baseline performance on outcome measures, was significantly correlated with amount of improvement after 25 sessions. Intonation-based therapy may offer a promising new interventional approach for teaching spoken language to minimally verbal children with ASD.     

American society for biochemistry and molecular biology 83rd annual meeting,Houston, Texas, 12th February, 1992, education symposium: Some reflections on the state of biochemistry teaching

A symposium on educational topics, organised by Professor A H Mehler, was one of two sessions that dealt with aspects of teaching in a program that traditionally has been concerned only with scientific research. The session was well attended and, because of the obvious interest in spite of competing attractions, we hope that this area will be represented in futute meetings. The texts of the talks given by the four speakers are printed below.     

PBL教学法联合病案式在心血管内科教学查房中的临床应用

目的:探讨问题为中心的(PBL)教学法联合病案式在心血管内科教学查房中的临床应用。方法:选取我院2010级临床医学专业本科学生48人,依据随机数字表法分为对照组和观察组,选择具有丰富教学经验且从事教学工作10年以上的教师进行心血管内科的授课,选择具有代表性的临床病例进行讲解,对照组采用传统知识传授型(LBL)教学法,观察组采用PBL教学法,授课3周后,评价两组学生的考试成绩、临床操作技能和课程满意度。结果:考试成绩结果显示观察组基础知识得分与对照组差异无统计学意义(P0.05),而病例分析和临床操作结果显示观察组得分显著高于对照组,差异有统计学意义(P0.05)。观察组对课程的满意度为83.33%,对照组为54.17%,观察组显著高于对照组,差异有统计学意义(P0.05)。结论:PBL教学法联合病案式在心血管内科教学查房中较LBL具有显著的优势,值得在临床实习教学工作中推广应用。     

PBL联合CBL在普通外科临床见习中的应用

目的:探讨以问题为基础的教学法(problem based learning,PBL)和案例教学法(case based learning,CBL)在普通外科临床见习中的应用。方法:根据接受教学方式不同,将学生分为PBL联合CBL教学组及传统教学组,以不记名方式进行问卷调查,了解学生对PBL联合CBL教学的意见和建议,并进行统一测试评判2种方式的教学效果。结果:超过80%的学生认为PBL联合CBL教学效果显著,特别有利于提高学习效率及临床思维的培养。统一测试发现联合教学组成绩明显高于传统教学组(P0.01)。结论:PBL联合CBL是普通外科临床见习中值得推广的教学方式。     

Combination of didactic lecture with problem-based learning sessions in physiology teaching in a developing medical college in Nepal

Physiology teaching as an essential part of medical education faces tremendous criticism regarding curriculum design, methods of implementation, and application of knowledge in clinical practice. In the traditional method of medical education, physiology is taught in the first year and involves little interdisciplinary interaction. The Manipal College of Medical Sciences, Pokhara, Nepal (affiliated with the Kathmandu Univ.) started in 1994 and adopted an integrated curriculum drawn along the lines of the student-centered, problem-based, integrated, community-based, elective-oriented, and systematic (SPICES) medical curriculum. Here, physiology is taught for the first 2 yr of the 4.5-yr Bachelor of Medicine, Bachelor of Surgery course. Methodology adopted is as follows. For a particular topic, objectives are clearly defined and priority content areas are identified. An overview is given in a didactic lecture class to the entire batch of 100 students. Tutorial classes are conducted thereafter with smaller groups of students (25/batch) divided further into five subgroups of five students each. In these sessions, a problem is presented to the students as a focus for learning or as an example of what has just been taught. Each problem was accompanied with relevant questions to streamline the students' thought processes. A tutor is present throughout the session not as an instructor but as a facilitator of the learning process. A questionnaire sought students' opinion on the usefulness of this approach, relevance of the combination of problem-based learning (PBL) sessions and didactic lectures in understanding a particular topic and relating clinical conditions to basic mechanisms, and improvement of performance on the university final examination. The majority of the students opined that the combination of didactic lectures and PBL sessions was definitely beneficial regarding all the above-mentioned aspects of learning. The university results corroborated their opinion. Thus it may be considered that a judicious mixture of didactic lectures and PBL sessions is beneficial as a teaching module of physiology in medical schools.     

Can medical students teach? A near-peer-led teaching program for year 1 students

The General Medical Council states that United Kingdom graduates must function effectively as educators. There is a growing body of evidence showing that medical students can be included as teachers within a medical curriculum. Our aim was to design and implement a near-peer-led teaching program in an undergraduate medical curriculum and assess its acceptability among year 1 students. Students received six tutorials focusing on aspects of cardiac, respiratory, and blood physiology. Tutorials ran alongside standard module teaching. Students were taught in groups of ～30 students/group, and an active teaching approach was used in sessions where possible. Using anonymous evaluations, student feedback was collected for the program overall and for each tutorial. The program was voluntary and open to all first-year students, and 94 (of 138) medical students from year 1 at Brighton and Sussex Medical School were recruited to the study. The tutorial program was popular among students and was well attended throughout. Individual tutorial and overall program quantitative and qualitative feedback showed that students found the tutorials very useful in consolidating material taught within the module. Students found the small group and active teaching style of the near-peer tutors very useful to facilitating their learning experience. The end-of-module written examination scores suggest that the tutorials may have had a positive effect on student outcome compared with previous student attainment. In conclusion, the present study shows that a near-peer tutorial program can be successfully integrated into a teaching curriculum. The feedback demonstrates that year 1 students are both receptive and find the additional teaching of benefit.     

Resources and practices to help graduate students and postdoctoral fellows write statements of teaching philosophy

Graduate students and postdoctoral fellows currently encounter requests for a statement of teaching philosophy in at least half of academic job announcements in the United States. A systematic process for the development of a teaching statement is required that integrates multiple sources of support, informs writers of the document's purpose and audience, helps writers produce thoughtful statements, and encourages meaningful reflection on teaching and learning. This article for faculty mentors and instructional consultants synthesizes practices for mentoring graduate students, postdoctoral fellows, and junior faculty members as they prepare statements of teaching philosophy. We review background information on purposes and audiences, provide writing resources, and synthesize empirical research on the use of teaching statements in academic job searches. In addition, we integrate these resources into mentoring processes that have helped graduate students in a Health Sciences Pedagogy course to collaboratively and critically examine and write about their teaching. This summary is intended for faculty mentors and instructional consultants who want to refine current resources or establish new mentoring programs. This guide also may be useful to graduate students, postdoctoral fellows, and junior faculty members, especially those who lack mentoring or who seek additional resources, as they consider the many facets of effective teaching.     

西安市城区初中生健康危险行为调查

目的:健康相关危险行为是产生常见病、多发病的重要原因,其形成受社会、家庭等多种环境因素和自身因素影响。初中阶段是养成良好健康行为的关键时期,了解初中生健康危险行为现状,可为制定干预措施提供科学依据。方法:对西安市城区1608名初中生进行健康危险行为问卷调查,分析各种健康危险行为检出率的性别差别。结果:34.3%的初中生存在偏食行为,42.6%的初中生在过去30天内采取过减肥措施;62.2%的初中生最多有2天运动超过30分钟;65.3%的初中生骑自行车违规;9.6%的初中生目前吸烟。过去1个月有大量饮酒行为者占8.4%。因上网影响学习者占17.0%;参与过类似赌博的娱乐活动者占9.8%。多数健康危险行为检出率男生高于女生(P值均0.05)。结论:西安市城区初中生健康危险行为发生率较高,男女生间存在差异,应针对男女生不同健康危险行为,采取有针对性的综合干预措施进行干预,以及早纠正健康危险行为,促进青少年健康发展。     

A rapid introduction to neurological biochemistry using <Emphasis Type="Italic">Drosophila melanogaster</Emphasis>

Short, cost-effective teaching activities are a useful way of providing an integrated view on biological processes. Here we describe a brief, hands-on workshop that allows pre-university students to explore their understanding of a neurological pathway from its chemical bases to phenotype. The workshop effectively introduces the students to data collection and analysis in an enjoyable way and at an appropriate level, determined by an end of session feedback survey. The design of the workshop can be adapted and scaled to generate diverse sessions such as university teaching practicals or summer school training workshops.     

PBL教学在内科学教学中的应用

目的：探讨以问题为基础PBL教学在内科学临床教学中的应用。方法：对在内科学课程教学中50位内科临床医学本科专业学生随机分为2组,对26人采用PBL教学、24人采用传统教学之后,进行理论考试和临床技能考试,并调查学生的满意度。结果：PBL教学组的理论考试成绩（94.12±8.56 vs 83.76±7.79）、临床技能考试成绩（95.93±9.73 vs 81.08±8.06）、总成绩得分（95.03±9.01 vs 82.42±7.91）均较传统教学组明显提高,学生对PBL教学方法的满意率为96.15%,对教学效果的满意率为100%,对小组功能的满意率为92.31%,对教师评价的满意率为96.15%。结论：PBL教学法在内科学教学中优于传统教学方法,学生的基础理论和临床技能均有明显提高,教学满意度高。     

An assessment of the preregistration year experience.

All 115 graduates qualifying at Liverpool University Medical School in one year were sent a questionnaire in the final week of their preregistration year to assess the experience they had gained. Of the 105 graduates (92%) who replied, 99 (94%) considered the supervision that they had received to be adequate, 89 (85%) received most of their teaching from other junior doctors, and only 47 believed that they had learnt a considerable amount from their consultant colleagues. Half of the doctors received little or no training in terminal care. Although 100 (95%) felt competent in dealing with various medical emergencies, cardiopulmonary resuscitation skills were less developed; only 71 (68%) were confident in using a defibrillator, and 37 (35%) considered themselves to be competent in dealing with cardiac arrhythmias. A fifth of the doctors found interviewing relatives stressful. Of the 105 doctors who replied, 77 (73%) thought that their preregistration experience had had little or no effect on their choice of career.