Is psychiatric training improving?

All consultants in general psychiatry appointed between 1 October 1975 and 30 September 1978 were sent a questionnaire asking about their training experience in various aspects of psychiatric practice. The results showed that the standard of training in several important areas of psychiatry were generally poor, although psychiatrists who had trained at the Maudsley Hospital or in teaching hospitals had better training than those who had worked in psychiatric hospitals. As compared with the last survey made three years ago there had been some improvement, but it had been least pronounced in psychiatric hospitals. The effects of approval visits made by both the Royal College of Psychiatrists and the Joint Committee of Higher Psychiatric Training would seem to be achieving results, but more attention needs to be paid to the standard of training in psychiatric hospitals and units.     

A Census of Residents in Canadian Hospitals Approved for Training by the Royal College of Physicians and Surgeons of Canada,April 1965

A census taken in April 1965 revealed that there were 3162 residents training in Canadian hospitals approved by the Royal College of Physicians and Surgeons of Canada. Thirty-one of the 151 approved hospitals had no residents in training, and another 43 hospitals each having 20 or more residents accounted for 85% of all residents training in Canada. Fifty-seven per cent of the residents in Canada were Canadian citizens, 19% were landed immigrants, and 24% were foreign trainees. Major teaching hospitals contained 65% of all residents; 70% of Canadian graduates and 60% of non-Canadian graduates were training in major teaching hospitals. Hospitals approved for full training in the specialty of the trainee contained 57% of all residents; 64% of Canadian graduates and 48% of foreign graduates were in such hospitals.     

Psychiatric training: the consultants' view.

All consultants in general psychiatry appointed between 1 October 1972 and 30 September 1975 were sent a questionnaire asking about their training experience in various aspects of psychiatric practice. The results showed that the standards of training in 13 areas of psychiatry were generally poor, although psychiatrists who had trained at the Maudsley Hospital had generally had better training than those who had worked in psychiatric hospitals. Perhaps the most alarming feature was the general lack of improvement over the past nine years. It will be several years before the effects of the visist of approval made by the Royal College of Psychiatrists can be seen and assessed. Meanwhile, the demands for a fairer share of experience for all trainees can perhaps be met by introducing rotational programmes that include both teaching and psychiatric hospitals.     

What makes a good psychiatrist? A survey of clinical tutors responsible for psychiatric training in the UK and Eire

The characteristics of a good psychiatrist practising in the UK health services have been described in policy but not in practice. We set out to determine what key characteristics are required for an individual to be identified as a good psychiatrist to become a member of the Royal College of Psychiatrists. A postal survey of all clinical tutors responsible for psychiatric training in the UK and Eire was carried out. These tutors are approved by the Royal College of Psychiatrists. 113 tutors responded (out of 163, 69.3% return). The most important identified characteristic was overall competency in diagnosis, management and investigations (98%) and the least desirable was ability to appraise staff (13%). With recent changes in training and assessment in the UK, further surveys of this kind are indicated to understand the trainers’ views, and should be extended also to trainees     

Surgical care in rural Canada: training and planning for the future.

The survey results reported by Chiasson and Roy in this issue (see pages 1447 to 1452) document a growing problem with the provision of surgical services in rural western Canada. Recognizing the need to improve access to surgical services in rural communities, the College of Family Physicians of Canada and the Royal College of Physicians and Surgeons of Canada have proposed guidelines for training family physicians in resuscitative and surgical techniques as well as in the safe transfer of seriously ill patients to specialized facilities. It is hoped that these guidelines will provide the basis of a national policy for general-practice training that will improve the standard of surgical care in rural communities.     

Genetic and environmental factors affecting the suitability of dogs as Guide Dogs for the Blind

Summary Many dogs are found to be unsuitable for training as guide dogs for the blind. Consequently the Royal Guide Dogs for the Blind Association of Australia has embarked on a breeding program to produce a strain of labrador dogs which is suitable for guide dog training.The most common reasons for rejecting dogs are fearfulness, dog distraction, excitability, health and physical reasons and hip dysplasia. The selection program seems to have been successful in improving the success rate mainly by lowering fearfulness, but there has not been a continuing improvement. This is probably due to continual introduction of dogs from other populations into the breeding program.Males suffer from a higher rejection rate due to dog distraction and a lower rejection rate due to fearfulness and excitability than females, so that there is little sex difference in overall success rate.The heritability of success (0.44) is high enough to predict further progress from selection, again mainly against fearfulness.Variation in environment prior to 6 weeks of age, in age when dogs were placed into a private home and in age when males were castrated, had little effect on the success rate.     

Certification of specialists: survey of candidates and review of the literature.

To evaluate the specialty certification process, the Canadian Association of Internes and Residents (CAIR) surveyed 634 candidates who had attempted the written and oral exams of the Royal College of Physicians and Surgeons of Canada. The results suggest that in-training evaluation is a more reliable and valid assessment of competence than the written and oral exams. There is a lack of well defined program objectives that are coordinated with the examinations. CAIR recommends that the present concept of an examination "hurdle" be replaced by different, integrated methods of assessment during training, and that an effective appeal mechanism be developed.     

Endurance Fitness and a Home Exercise Program in College Girls

College girls exercising at home for 19 minutes daily using the 10BX Royal Canadian Air Force exercise plan, with the addition of rope skipping, improved their physical working capacity and maximal oxygen uptake by 7 and 9% after six weeks. No change occurred in a matched control group. Changes in endurance fitness with this type of training are of relatively small magnitude, and reproducible measurements are required for their demonstration. The small gains in aerobic power would seem to be of little practical significance for the subjects, and a major drawback of any home exercise program is the lack of motivation to continue.     

SongMakers: An industry-led approach to arts partnerships in education

Reported benefits of arts partnerships with schools range from improvements in students' motivation and engagement in learning to teachers' increased confidence in teaching the arts, and strengthened school and community relationships. Yet, in the scholarship on arts partnerships to date, limited critical attention has been given to the impact of programs primarily driven by government supported industry-based imperatives. There may be legitimate concerns that, in primarily servicing economic or employment needs, industry–school partnerships overlook social and interpersonal aspects of learning in favor of goal-orientated skills training to meet “the market.” This article informs arts education policy and industry directions by acknowledging this concern and reporting on the outcomes of an industry–schools partnership where industry “training” appears to be leveraging a number of more holistic student learning outcomes. Jointly funded by industry and government, SongMakers is an Australian artist in residence program that aims to improve the export potential of Australia's contemporary music industry and contribute to the implementation of a contemporary music curriculum. It involves professional songwriters and producers with international recording experience working as mentors to students who create and produce new music in intensive two-day workshops. This article outlines how the program is demonstrating emergent positive impact not only on students' music knowledge and skill development, and understanding of the contemporary music industry, but on engagement, confidence in learning, and self-efficacy. It does not argue that all industry programs can or will achieve such impacts, but that diverse kinds of arts partnerships in schools can contribute to a viable ecology of quality educational practice in the arts.     

Promoting collaborations between biomedical scholars in the U.S. and sub-Saharan Africa

The premise of this piece is that a priority of international health should be to increase the number of investigators in the US and other developed countries who engage in research and other kinds of scholarly work in underdeveloped parts of the world, particularly sub-Saharan Africa where the overall disease burden is the highest and the gap in biomedical research infrastructure is the widest. The author's aim is to encourage medical students, resident doctors, and medical school faculty to devote a part of their career to teach, acquire clinical skills, or participate in research with health professionals at teaching hospitals in Africa. After briefly describing the thinking that led the author to Nigeria 30 years ago to teach and study biochemical aspects of health problems in rural and urban areas, he discusses some of the factors one needs to consider before entering into an international partnership, including identifying the right foreign collaborators, selecting a suitable research site, setting realistic goals, learning the local culture and indigenous language, and defining a theme for your program. Lastly, the piece points out potential pitfalls and problems that are often overlooked or underestimated in the early phases of planning an international partnership, including lukewarm institutional support at home, inflexible institutional review boards, dominance of the program by the US partner, maintaining continuity, and striking the right balance between scholarly work and humanitarian efforts. My hope is that US students and faculty in the health professions who read this piece will be stimulated and encouraged to consider how they might integrate into their curriculum or academic life visits lasting several months or more each year during which they would teach or train others or engage in research at a teaching hospital in some country in Africa.     

PBL教学模式在八年制《医学导论》教学中的应用

《医学导论》课对于八年制临床医学专业学员的学习非常重要,将PBL教学模式应用到《医学导论》教学中,从课程设计、问题筛选、团队精神培养等环节进行实施,有利于培养学员自主学习和解决实际问题的能力,圆满完成了《医学导论》的教学任务。     

对心血管外科进修生的教学体会

为造福更多的心血管病患者,进一步提高治疗心血管疾病专业人才的质量,建立科学、健全的心血管外科进修生管理和培养模式很有必要。我科室通过总结多年的进修生教学经验,树立"双赢"理念,规范培训制度,实行导师负责制,实施PBL教学方式,进行多学科协作培训,定期对进修医生考核等方法措施,切实提高进修生的医疗水平,更好地为基层医院服务、为心血管病患者服务。     

PBL 教学模式在八年制《医学导论》教学中的应用

《医学导论》课对于八年制临床医学专业学员的学习非常重要,将PBL教学模式应用到《医学导论》教学中,从课程设计、问题筛选、团队精神培养等环节进行实施,有利于培养学员自主学习和解决实际问题的能力,圆满完成了《医学导论》的教学任务。     

Training for the Treatment-room Sister in General Practice

A discussion group course for treatment-room nurses was organized in the spring of 1971 by the Thames Valley Faculty of the Royal College of General Practitioners. Twenty-eight nurses took part. Some were from local authorities but most were privately employed. Questionnaires were completed by participants. The course has had several consequences, and it is felt that some form of specific training for this branch of nursing should be established.     

BLeafNet: A Bonferroni mean operator based fusion of CNN models for plant identification using leaf image classification

Plants, the only natural source of oxygen, are the most important resources for every species in the world. A proper identification of plants is important for different fields. The observation of leaf characteristics is a popular method as leaves are easily available for examination. Researchers are increasingly applying image processing techniques for the identification of plants based on leaf images. In this paper, we have proposed a leaf image classification model, called BLeafNet, for plant identification, where the concept of deep learning is combined with Bonferroni fusion learning. Initially, we have designed five classification models, using ResNet-50 architecture, where five different inputs are separately used in the models. The inputs are the five variants of the leaf grayscale images, RGB, and three individual channels of RGB - red, green, and blue. For fusion of the five ResNet-50 outputs, we have used the Bonferroni mean operator as it expresses better connectivity among the confidence scores, and it also obtains better results than the individual models. We have also proposed a two-tier training method for properly training the end-to-end model. To evaluate the proposed model, we have used the Malayakew dataset, collected at the Royal Botanic Gardens in New England, which is a very challenging dataset as many leaves from different species have a very similar appearance. Besides, the proposed method is evaluated using the Leafsnap and the Flavia datasets. The obtained results on both the datasets confirm the superiority of the model as it outperforms the results achieved by many state-of-the-art models.     

A student-centred,problem-based curriculum: 5 years' experience.

In 1987, the University of Sherbrooke''s school of medicine implemented a student-centred, problem-based learning (PBL) curriculum. The experience of the first 5 years is reviewed; program goals, the schedule of learning activities, the instructional format and assessment of student learning are described. The new program is more demanding of teachers and requires better faculty training in pedagogy. No new financial resources have been available. The preclinical reform has led to revision of the clerkship, where sessions on clinical reasoning are now based on the PBL philosophy. Student reactions to the program are reported. The Sherbrooke experience has demonstrated that it is both possible and feasible to shift from a traditional to a problem-based curriculum.     

The Resident's View of Residency Training in Canada

In the view of residents in their last year of specialty training, the Fellowship is now becoming the operative standard for obtaining hospital privileges in urban centres and they felt that this implied that the two standards, the Certificate and the Fellowship of the Royal College, were not achieving the purpose for which they were designed. Although 80% of the residents intended to write the Fellowship, few viewed a year in a basic science department or in research as of intrinsic value in terms of their future practice.The examinations of the Royal College were the subject of criticism, most residents feeling that the examinations did not test the knowledge and ability gained in training. Most expressed a desire for ongoing evaluation during the training period.Service responsibilities were generally regarded as too heavy.Despite the criticism of both training and examination, most residents felt that their training had provided them with the experience and background they needed to practise as specialists.     

军校五年制学员营养学PBL教学模式的构建及效果评价

目的:探讨PBL教学模式在营养学教学中的作用及不足,并评价其教学效果。方法:采用随机抽样的方法,选取第四军医大学2012级五年制营养学专业学员(114名)实施PBL教学,2011级五年制临床专业学员(159名)实施传统教学;从四个方面(考试成绩、教学满意度、学员解决未知问题的方式、学习兴趣及积极性)综合评价PBL教学效果。结果:与传统教学组相比较,PBL教学组的考试成绩、教学满意度、学员解决未知问题的方式以及学习兴趣均显著升高。结论:PBL教学模式不仅提高了学员的考试成绩,还提高了学员的学习能力与素质,有必要进一步优化并大力推广。     

History of specialty residency funding in Canada.

Specialty residency training in Canada has evolved from its origin in teaching hospitals through an era dominated by universities to the present when public accountability is emerging as a dominant influence. The predominant educational strategies, including experimental learning, role modelling, continuum of training, independent thinking, self-directed learning and research experiences, have been influenced by the diversity of roles expected of the resident, including that of an employee, a student, a teacher and, more recently, a part of the policy instrument of governments in controlling physician resources.     

Residency training in internal medicine: program design in an era of constraint.

Directors of postgraduate internal medicine programs face many problems in program design, particularly when numbers of house staff continue to decrease. This paper examines the training requirements of a resident in internal medicine and proposes a curriculum based on set rotations in the three key areas of training--subspecialty services, critical care and the clinical teaching unit. The distribution of time in these three areas and the balance of exposure to inpatients and outpatients are discussed in detail. This program design ensures exposure to all the key elements of internal medicine in 3 years and should prevent significant gaps in knowledge at the time of certification. The implications for "service" in major teaching hospitals is discussed. Hospital departments and administrators must confront the prospect of hospital units without house staff. Most important, program directors must resist sacrificing the pedagogic essentials of a training program for service requirements.