Journal of Cancer Education
ISSN: 0885-8195 (Print) 1543-0154 (Online) Journal homepage: http://www.tandfonline.com/loi/hjce20
An assessment of cancer education offerings in medical school, dental school, and health education curricula in New York and California R. Scott Olds HSD, MS, CHES & Roland J. Lamarine HSD, MEd To cite this article: R. Scott Olds HSD, MS, CHES & Roland J. Lamarine HSD, MEd (1990) An assessment of cancer education offerings in medical school, dental school, and health education curricula in New York and California, Journal of Cancer Education, 5:4, 231-236 To link to this article: http://dx.doi.org/10.1080/08858199009528074
Published online: 01 Oct 2009.
Submit your article to this journal
View related articles
Citing articles: 1 View citing articles
Full Terms & Conditions of access and use can be found at http://www.tandfonline.com/action/journalInformation?journalCode=hjce20 Download by: [Australian Catholic University]
Date: 17 August 2017, At: 10:09
J. Cancer Education. Vol. J, No. 4, pp. 231-236, 1990 Printed in the U.S.A. Pergamon Press plc
0885-8195/90 $3.00 + .00 © 1990 American Association for Cancer Education
AN ASSESSMENT OF CANCER EDUCATION OFFERINGS IN MEDICAL SCHOOL, DENTAL SCHOOL, AND HEALTH EDUCATION CURRICULA IN NEW YORK AND CALIFORNIA
Downloaded by [Australian Catholic University] at 10:09 17 August 2017
R.
SCOTT OLDS,
HSD, MS, CHES* and ROLAND J.
LAMARINE,
HSD, MEd†
Abstract — This survey identified the extent of courses in cancer control through prevention in medical, dental, and health education curricula. A questionnaire was sent to all medical, dental, and health education academic programs in New York and California. With a return rate of 81%, it was determined that health education programs more frequently offered courses in cancer control through prevention than medical and dental programs. The majority of all academic programs studied that did not currently offer such a course reported it was unlikely such a course would be offered during the next 2 years. Primary reasons for this included an already crowded curriculum and lack of resources. Recommendations are offered to support health professionals in taking a more active role as cancer educators emphasizing primary prevention and early detection techniques.
the reduction of cancer incidence, morbidity, and mortality through an orderly sequence, from research on interventions and their impact in defined populations to the broad, systematic application of the research results.3
INTRODUCTION There is a need to refocus efforts and priorities to reduce the incidence, morbidity, and mortality of cancer in the United States. An examination of variables that contribute to the development of cancer implicates the influence of environment and lifestyle, which may account for as much as 80% of all cancers.1'2 This suggests that people can play an active role in reducing their cancer risks. The conclusion of the Cancer Control Objectives for the Nation: 1985-2000 report3 suggested: a significant reduction in the cancer mortality rate — of as much as 50 percent by the year 2000 — is possible if current recommendations related to smoking reduction, diet changes, screening and state-of-the-art treatment are effectively applied.3
The National Cancer Institute (NCI) has defined cancer control as:
*Assistant Professor, Health Education, Kent State University, Kent, Ohio †Assistant Professor, Health Education, Department of Health and Community Services California State University, Chico, Chico, California All correspondence reprints requests to: Dr. R. Scott Olds, Asst. Professor, Health Education, 316 White Hall, Kent State University, Kent, OH 44242.
If NCI's goal of a 50% reduction in cancer mortality by the year 2000 is to be attained, more resources need to be directed toward cancer prevention. Examination of the literature pertaining to cancer education in medical, dental, and health education programs indicates that very little teaching of cancer prevention is occurring.4 In addition, the programs that were discussed in the literature appear to offer a piecemeal approach directed by several disciplines within these schools, but with little coordination between departments.5'6'7'8 Consequently, there seems to be no standardized instruction of these prospective health professionals regarding cancer control through prevention. Recently, The National Cancer Institute Monograph, Cancer Control for the Nation: 19852000 encouraged professional organizations to integrate cancer control knowledge into the basic curricula. In addition, the inclusion of questions on licensure examinations and increasing the number of articles in journals regarding cancer control was also recommended. Finally, reasonable professional responsibilities for health professionals include an increasing role in coun-
231
232
R.S. OLDS and R.J. LAMARINE
Downloaded by [Australian Catholic University] at 10:09 17 August 2017
seling patients/students to reduce their cancer risks and assisting other agencies in the development of cancer control programs.3 The present study identified the extent of cancer control through prevention in medical, dental, and health education curricula in New York and California.
level set a priori at the 0.05 level of statistical significance. All statistically significant findings were further analyzed using Cramer's V to determine practical significance.14
RESULTS Demographics. Of the 59 schools eligible to participate in this study, 48 responded for a METHODOLOGY rate of 81%. The majority of the respondents New York and California were selected for were in the field of health education (52%, n this study because they are the two states offer- = 25), followed by medicine (25%, n = 12), ing the largest number of medical, dental, and dentistry (15%, n = 7), and others, which inhealth education degrees. Schools of medicine cluded health care administration, environmenand dentistry were identified in these two states tal health, occupational safety and industrial by their membership in the American Associa- hygiene, allied health professions, and health tion for Dental Schools9 or the American As- and nutritional sciences (8%, n = 4). The sociation of Medical Colleges.I0 Degree programs modal number of full-time faculty employed by in Health Education in California and New York these programs was three. The respondents repwere those listed in the Association for the Ad- resented an equal division between public and vancement of Health Education Directory of private affiliation. Degree programs in this sample were offered at various levels including unHealth Education Programs.11 All 59 program chairpersons were sent a dergraduate (21%, n = 10), graduate (26%, n cover letter during November, 1988 explaining = 12), and a combination of both undergraduthe study's purpose and protocol. A question- ate and graduate (53%, n = 25). naire designed to assess the extent of cancercontrol offerings through prevention in the curricula at the respective institutions was for- Cancer control through prevention curricular warded along with a self-addressed stamped en- offerings velope. This questionnaire was reviewed by a Approximately 38% (n = 1 8 ) of the sample jury of specialists in cancer control prior to ad- had ever offered a workshop in which the priministration to improve its validity.1Z The five- mary focus was cancer control. A significant member panel included professionals from the relationship was found between program area National Cancer Institute, the American Can- and ever offering a cancer control workshop cer Society, a health educator specializing in (X2 = 5.84, p = .05, Cramer's V = .368). instrument development, and a specialist in can- Medical schools (47%, n = 8) were more likely cer education. The questionnaire was comprised to offer such a workshop than health education of short, open-ended, dichotomous, and Likert programs (35%, n = 6) or dental schools (18%, scale items (See Appendix A). 13 « = 3). Two weeks following the initial contact, a Approximately 21% (n = 10) of the prosecond letter with another copy of the question- grams sampled offered a semester course in naire was sent to schools that had not responded. which the primary focus was cancer control A follow-up phone call was made one week through prevention. Of those programs offerlater to inquire if materials had been received ing such a course 60% (n = 6) were from health and if the questionnaire would be completed at education, 20% (n = 2) from medical schools, the earliest possible convenience. The phone and 20% (n = 2) from dental schools. A followcall follow-up may have been responsible for up item asked those schools that offered a course the high response rate. on cancer control through prevention if this was the sole cancer control course offered. Medical Data were analyzed by crosstabulation and schools (50%), Dental schools (100%), and health the chi-square test of association with an alpha
Downloaded by [Australian Catholic University] at 10:09 17 August 2017
Cancer education assessment
education programs (66%) responded that this course was not the sole offering in cancer control. A set of items was included to determine the content of the cancer control through prevention course. The dominant themes in these courses included: lung cancer (94%), diet (88%), psychosocial aspects (88%), smoking (82%), biology (82%), colorectal cancer (82%), uterine cancer (82%), and environmental factors (82%). To supplement the teaching of this course, 82% of the schools used outside educational materials from voluntary and public health agencies. A statistically significant association between academic program and the use of outside educational materials was found (X2 = 11.07, p = .003, Cramer's V = .832). Health education programs were more likely to use such materials (76.9%). Cramer's V suggested that 83% of the variation could be accounted for by this relationship. It was disappointing to find that 76% of the schools not currently offering a cancer control course anticipated a no more than 50/50 chance of teaching such a course in the next two years. Clearly, the expectation to address cancer control through prevention does not emerge as a priority. This seems to be confirmed by the finding that just over half (54%) suggested that offering this course was of average or higher priority. It appeared that limited resources (67%) were hampering such efforts. As indicated previously, the National Cancer Institute has suggested that increasing the number of items regarding cancer control on professional examinations is a desirable policy. Seventy-three percent of the schools surveyed agreed that this would be appropriate. Health education programs (80%) and medical schools (89%) responded that increasing the number of questions about cancer prevention on licensure and certification tests was appropriate. Interestingly, only 33% of the dental schools responded affirmatively. To encourage more health professionals to become involved in cancer control, the NCI suggested that experts commit more effort to contributing to the professional cancer control literature.3 This study found that 35% of the schools responding contributed to the cancer
233
control professional literature publishing approximately three articles each per year. It was found that Medical programs contributed most to publication of articles related to cancer control with 75% of these programs indicating active involvement in publications. Schools of medicine (67%) were most likely to be active to very active in assisting others with cancer control programming, while health education (44%) and dentistry (17%) were less active. DISCUSSION Cancer has traditionally been approached almost exclusively from a tertiary care perspective. This strategy must be questioned when current research suggests that lifestyle and behavioral issues contribute significantly to the development of cancer and when it is becoming clearer that the fight against cancer can be effectively and economically waged from a primary and secondary prevention perspective.15 The following recommendations are offered to help redress some of the current imbalance in the field of cancer control: 1. Make available more monies from the Department of Health and Human Services, The American Cancer Society, and other funding agencies to encourage the teaching of cancer control through prevention in health and medical science education. 2. Emphasize the role of lifestyle with the promotion of health in the formal training of health professionals and encourage doctors and dentists to take an active role as educators to promote the health of their patients.16 3. Address more comprehensively biopsychosocial concerns of cancer in the preparation programs for health professionasls. Acknowledgements — The authors would like to acknowledge the American Cancer Society, New York State Division, Inc. and the Department of Health and Community Services at Chico State University for their support with this study.
REFERENCES 1. Doll R, Peto R: The Causes of cancer: Quantitative estimates of avoidable risks of cancer in the United
Downloaded by [Australian Catholic University] at 10:09 17 August 2017
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R.S. OLDS and R.J. LAMARINE
States today. JNCI 66:1191-1308, 1981. 2. American Cancer Society: Cancer facts and figures, 1989. Atlanta, GA: ACS, 1989. 3. Greenwald P and Sondik EJ, (eds): Cancer control objectives for the nation:1985-2000. NCI Mono. Bethesda, MD: National Cancer Institute, 1985. 4. Cancer Education Survey, vol 1-6. Publication no. 812255 to 81-2260. Washington, DC: US Department of Health and Human Services, 1981. 5. Bakemeier R: cancer education objectives for medical schools. Med Pediatr Oncol 9:585-633, 1981. 6. Mason JL, Walker-Bartnick L, Hess HB, Munice HL, et al: Developing a cancer prevention elective course. J Med Educ 10:796-803, 1983. 7. Love RR, Stone HL: Instructional objectives for a teaching program in cancer for primary care physicians. J Fam Pract 6:1253-1257, 1978. 8. Mahan JM, Costanzi JJ, Levine HG: The Tracer method of curriculum analysis in cancer education. J Med Educ 51:512-513, 1976. 9. Admission requirements of US and Canadian dental schools (1988-1989), 25th ed. Washington, DC: American Association of Dental Schools, 1988. 10. Medical school admission requirements 1988-1989, US and Canada. Washington, DC: Association of American Medical Colleges, 1988. 11. Directory of Health Education Programs. Reston, VA: Association for the Advancement of Health Education, 1988. 12. Torabi MR, Seffrin JR: A Three component cancer attitude scale. JOSH 56(5):170-174, 1987. 13. Anastasi A: Psychological Testing, 5th ed. New York: Macmillan Publishing Company, 1982, p 554. 14. Torabi MR: How to estimate practical significance in health education research. JOSH 55 (5):232-233, 1986. 15. Bailar JC, Smith EM: Progress against cancer. NEJM 314 (19):1226-1232, 1986. 16. Seffrin JR, Lamartine RJ: Social values and cancer, in Proceedings of the Fifth National Conference on Human Values & Cancer-1987. American Cancer Society, 1987.
APPENDIX A Cancer Control Curricular Questionnaire INSTRUCTIONS: This instrument is designed to examine current curricular for offerings in cancer control through prevention. The focus on cancer control is from a primary and secondary prevention perspective. DO NOT put your name or any other identifying information on the instrument. AH information provided will be maintained confidentially. Please circle or fill in as required, responses that best describe your curricular offerings relative to cancer control through prevention. Either a pen or pencil can be used.
If you are not the appropriate professional to complete this instrument, please forward all materials to the individual(s) who would be best suited to provide the information requested. Upon completion of the questionnaire, return it in the enclosed postage-paid envelope. Thank you for your consideration. If you would like to receive a copy of the study findings, please indicate by checking the appropriate area below. Further information about this study can be obtained by contacting: Dr. R. Scott Olds American Cancer Society New York State Division, Inc. 6735 Lyons Street P.O. Box 7 East Syracuse, New York 13057 ( ) Please send a copy of the survey results to the name and address listed below.
1. What is the primary curricular emphasis in your academic program? Health Education 1 Medicine 2 Dentistry 3 Other (Please specify) : 2. How many full time faculty do you employ in your department? 3. What is the nature of your institution? Public 1 Private 2 Other (Specify) 4. What is the level of students trained by your programs? Undergraduate only 1 Graduate only 2 Combination of both 3 5. Has your program within the past five years been the recipient of a grant from a public or private agency that primarily dealt with cancer? Yes 1 No (Skip to Q 7) 2 6. If yes, approximately how much grant money has been received?
Cancer education assessment
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7. Has your program ever offered a workshop in which the primary focus was cancer control? Yes 1 No (Skip to Q 9) 2 8. What is the title of this workshop?
17.
9. Does your curriculum include a course in which the primary focus is cancer control through prevention? Yes 1 No (Skip to Q 24) 2 10. What is the title of this course? 18. 11. Is this course the sole offering in cancer control in your program? Yes 1 No 2 12. If no, please indicate what other courses cover cancer control through prevention in your program? 13. What topics are covered in this primary course(s) on cancer control through prevention? Please circle all that apply. Cancer Biology 1 Smoking 2 Smokeless Tobacco 3 Diet 4 Alcohol 5 Environmental Factors 6 Occupational exposures 7 Childhood cancers 8 Lung Cancer 9 Breast Cancer 10 Colorectal Cancer 11 Uterine Cancer 12 Early Detection 13 Psychosocial aspects 14 Patient Counseling 15 Death and Dying 16 Other (Please specify) 14. Approximately how many students enroll in this course(s) each year? 15. How many years has this course(s) been taught? 16. What is the status of the faculty who usually teach this course?
19.
20.
21.
22.
235
Full Time 1 Part Time 2 Combination 3 What is the terminal degree of the individual who teaches this course? Ph.D 1 M.D 2 Dr.P.H 3 Ed.D 4 D.Ed 5 H.S.D 6 M.S 7 B.S 8 What is the faculty rank of the individual who teaches this course? Assistant Professor 1 Associate Professor 2 Full Professor 3 Other Is this course Required 1 Elective 2 Combination 3 Does this course(s) utilize educational materials, e.g. pamphlets, films, models, etc, from voluntary and public health agencies? Yes 1 No 2 Is a text book used for this course(s)? Yes 1 No (Skip to Q 23) 2 What text is currently being used?
Now, Please skip to Q 26 23. If you do not require a text, what do you use in its place? Now, please skip to Q 26 24. What is the likelihood of your program offering a course primarily on cancer control in the next two years? Very likely 1 Likely 2 50/50 3 Unlikely 4 Very unlikely 5 25. Which of the following best describes your rationale for not offering a course primarily on cancer control?
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Limited demand for such a course. 1 Limited resources (time, personnel). 2 Limited student interest 3 Limited student need 4 Limited faculty interest 5 Limited faculty expertise 6 Other (please specify) 26. In terms of your curricular priorities, how important is it that a course primarily on cancer control through prevention be offered by your program? Very high priority 1 High priority 2 Average priority 3 Low priority 4 Very low priority 5 27. If your program has identified a cancer control course as a high priority, please elaborate on the rationale supporting this decision.
cancer control on licensure examinations? Yes 1 No 2 29. What role does your program currently play in terms of assisting other organizations and agencies to develop cancer control programs? Very active 1 Active 2 Not very active 3 Inactive 4 30. Does your program contribute to the literature by writing professional articles about cancer control? A lot (4 or more articles a year)... 1 Somewhat (1-3 articles a year).... 2 Very little (less than one article a year) 3 Not at all 4 Thank you for your help!
28. Would your department/school support increasing the number of questions about
Please feel free to make additional comments.
ISSN: 0885-8195 (Print) 1543-0154 (Online) Journal homepage: http://www.tandfonline.com/loi/hjce20
An assessment of cancer education offerings in medical school, dental school, and health education curricula in New York and California R. Scott Olds HSD, MS, CHES & Roland J. Lamarine HSD, MEd To cite this article: R. Scott Olds HSD, MS, CHES & Roland J. Lamarine HSD, MEd (1990) An assessment of cancer education offerings in medical school, dental school, and health education curricula in New York and California, Journal of Cancer Education, 5:4, 231-236 To link to this article: http://dx.doi.org/10.1080/08858199009528074
Published online: 01 Oct 2009.
Submit your article to this journal
View related articles
Citing articles: 1 View citing articles
Full Terms & Conditions of access and use can be found at http://www.tandfonline.com/action/journalInformation?journalCode=hjce20 Download by: [Australian Catholic University]
Date: 17 August 2017, At: 10:09
J. Cancer Education. Vol. J, No. 4, pp. 231-236, 1990 Printed in the U.S.A. Pergamon Press plc
0885-8195/90 $3.00 + .00 © 1990 American Association for Cancer Education
AN ASSESSMENT OF CANCER EDUCATION OFFERINGS IN MEDICAL SCHOOL, DENTAL SCHOOL, AND HEALTH EDUCATION CURRICULA IN NEW YORK AND CALIFORNIA
Downloaded by [Australian Catholic University] at 10:09 17 August 2017
R.
SCOTT OLDS,
HSD, MS, CHES* and ROLAND J.
LAMARINE,
HSD, MEd†
Abstract — This survey identified the extent of courses in cancer control through prevention in medical, dental, and health education curricula. A questionnaire was sent to all medical, dental, and health education academic programs in New York and California. With a return rate of 81%, it was determined that health education programs more frequently offered courses in cancer control through prevention than medical and dental programs. The majority of all academic programs studied that did not currently offer such a course reported it was unlikely such a course would be offered during the next 2 years. Primary reasons for this included an already crowded curriculum and lack of resources. Recommendations are offered to support health professionals in taking a more active role as cancer educators emphasizing primary prevention and early detection techniques.
the reduction of cancer incidence, morbidity, and mortality through an orderly sequence, from research on interventions and their impact in defined populations to the broad, systematic application of the research results.3
INTRODUCTION There is a need to refocus efforts and priorities to reduce the incidence, morbidity, and mortality of cancer in the United States. An examination of variables that contribute to the development of cancer implicates the influence of environment and lifestyle, which may account for as much as 80% of all cancers.1'2 This suggests that people can play an active role in reducing their cancer risks. The conclusion of the Cancer Control Objectives for the Nation: 1985-2000 report3 suggested: a significant reduction in the cancer mortality rate — of as much as 50 percent by the year 2000 — is possible if current recommendations related to smoking reduction, diet changes, screening and state-of-the-art treatment are effectively applied.3
The National Cancer Institute (NCI) has defined cancer control as:
*Assistant Professor, Health Education, Kent State University, Kent, Ohio †Assistant Professor, Health Education, Department of Health and Community Services California State University, Chico, Chico, California All correspondence reprints requests to: Dr. R. Scott Olds, Asst. Professor, Health Education, 316 White Hall, Kent State University, Kent, OH 44242.
If NCI's goal of a 50% reduction in cancer mortality by the year 2000 is to be attained, more resources need to be directed toward cancer prevention. Examination of the literature pertaining to cancer education in medical, dental, and health education programs indicates that very little teaching of cancer prevention is occurring.4 In addition, the programs that were discussed in the literature appear to offer a piecemeal approach directed by several disciplines within these schools, but with little coordination between departments.5'6'7'8 Consequently, there seems to be no standardized instruction of these prospective health professionals regarding cancer control through prevention. Recently, The National Cancer Institute Monograph, Cancer Control for the Nation: 19852000 encouraged professional organizations to integrate cancer control knowledge into the basic curricula. In addition, the inclusion of questions on licensure examinations and increasing the number of articles in journals regarding cancer control was also recommended. Finally, reasonable professional responsibilities for health professionals include an increasing role in coun-
231
232
R.S. OLDS and R.J. LAMARINE
Downloaded by [Australian Catholic University] at 10:09 17 August 2017
seling patients/students to reduce their cancer risks and assisting other agencies in the development of cancer control programs.3 The present study identified the extent of cancer control through prevention in medical, dental, and health education curricula in New York and California.
level set a priori at the 0.05 level of statistical significance. All statistically significant findings were further analyzed using Cramer's V to determine practical significance.14
RESULTS Demographics. Of the 59 schools eligible to participate in this study, 48 responded for a METHODOLOGY rate of 81%. The majority of the respondents New York and California were selected for were in the field of health education (52%, n this study because they are the two states offer- = 25), followed by medicine (25%, n = 12), ing the largest number of medical, dental, and dentistry (15%, n = 7), and others, which inhealth education degrees. Schools of medicine cluded health care administration, environmenand dentistry were identified in these two states tal health, occupational safety and industrial by their membership in the American Associa- hygiene, allied health professions, and health tion for Dental Schools9 or the American As- and nutritional sciences (8%, n = 4). The sociation of Medical Colleges.I0 Degree programs modal number of full-time faculty employed by in Health Education in California and New York these programs was three. The respondents repwere those listed in the Association for the Ad- resented an equal division between public and vancement of Health Education Directory of private affiliation. Degree programs in this sample were offered at various levels including unHealth Education Programs.11 All 59 program chairpersons were sent a dergraduate (21%, n = 10), graduate (26%, n cover letter during November, 1988 explaining = 12), and a combination of both undergraduthe study's purpose and protocol. A question- ate and graduate (53%, n = 25). naire designed to assess the extent of cancercontrol offerings through prevention in the curricula at the respective institutions was for- Cancer control through prevention curricular warded along with a self-addressed stamped en- offerings velope. This questionnaire was reviewed by a Approximately 38% (n = 1 8 ) of the sample jury of specialists in cancer control prior to ad- had ever offered a workshop in which the priministration to improve its validity.1Z The five- mary focus was cancer control. A significant member panel included professionals from the relationship was found between program area National Cancer Institute, the American Can- and ever offering a cancer control workshop cer Society, a health educator specializing in (X2 = 5.84, p = .05, Cramer's V = .368). instrument development, and a specialist in can- Medical schools (47%, n = 8) were more likely cer education. The questionnaire was comprised to offer such a workshop than health education of short, open-ended, dichotomous, and Likert programs (35%, n = 6) or dental schools (18%, scale items (See Appendix A). 13 « = 3). Two weeks following the initial contact, a Approximately 21% (n = 10) of the prosecond letter with another copy of the question- grams sampled offered a semester course in naire was sent to schools that had not responded. which the primary focus was cancer control A follow-up phone call was made one week through prevention. Of those programs offerlater to inquire if materials had been received ing such a course 60% (n = 6) were from health and if the questionnaire would be completed at education, 20% (n = 2) from medical schools, the earliest possible convenience. The phone and 20% (n = 2) from dental schools. A followcall follow-up may have been responsible for up item asked those schools that offered a course the high response rate. on cancer control through prevention if this was the sole cancer control course offered. Medical Data were analyzed by crosstabulation and schools (50%), Dental schools (100%), and health the chi-square test of association with an alpha
Downloaded by [Australian Catholic University] at 10:09 17 August 2017
Cancer education assessment
education programs (66%) responded that this course was not the sole offering in cancer control. A set of items was included to determine the content of the cancer control through prevention course. The dominant themes in these courses included: lung cancer (94%), diet (88%), psychosocial aspects (88%), smoking (82%), biology (82%), colorectal cancer (82%), uterine cancer (82%), and environmental factors (82%). To supplement the teaching of this course, 82% of the schools used outside educational materials from voluntary and public health agencies. A statistically significant association between academic program and the use of outside educational materials was found (X2 = 11.07, p = .003, Cramer's V = .832). Health education programs were more likely to use such materials (76.9%). Cramer's V suggested that 83% of the variation could be accounted for by this relationship. It was disappointing to find that 76% of the schools not currently offering a cancer control course anticipated a no more than 50/50 chance of teaching such a course in the next two years. Clearly, the expectation to address cancer control through prevention does not emerge as a priority. This seems to be confirmed by the finding that just over half (54%) suggested that offering this course was of average or higher priority. It appeared that limited resources (67%) were hampering such efforts. As indicated previously, the National Cancer Institute has suggested that increasing the number of items regarding cancer control on professional examinations is a desirable policy. Seventy-three percent of the schools surveyed agreed that this would be appropriate. Health education programs (80%) and medical schools (89%) responded that increasing the number of questions about cancer prevention on licensure and certification tests was appropriate. Interestingly, only 33% of the dental schools responded affirmatively. To encourage more health professionals to become involved in cancer control, the NCI suggested that experts commit more effort to contributing to the professional cancer control literature.3 This study found that 35% of the schools responding contributed to the cancer
233
control professional literature publishing approximately three articles each per year. It was found that Medical programs contributed most to publication of articles related to cancer control with 75% of these programs indicating active involvement in publications. Schools of medicine (67%) were most likely to be active to very active in assisting others with cancer control programming, while health education (44%) and dentistry (17%) were less active. DISCUSSION Cancer has traditionally been approached almost exclusively from a tertiary care perspective. This strategy must be questioned when current research suggests that lifestyle and behavioral issues contribute significantly to the development of cancer and when it is becoming clearer that the fight against cancer can be effectively and economically waged from a primary and secondary prevention perspective.15 The following recommendations are offered to help redress some of the current imbalance in the field of cancer control: 1. Make available more monies from the Department of Health and Human Services, The American Cancer Society, and other funding agencies to encourage the teaching of cancer control through prevention in health and medical science education. 2. Emphasize the role of lifestyle with the promotion of health in the formal training of health professionals and encourage doctors and dentists to take an active role as educators to promote the health of their patients.16 3. Address more comprehensively biopsychosocial concerns of cancer in the preparation programs for health professionasls. Acknowledgements — The authors would like to acknowledge the American Cancer Society, New York State Division, Inc. and the Department of Health and Community Services at Chico State University for their support with this study.
REFERENCES 1. Doll R, Peto R: The Causes of cancer: Quantitative estimates of avoidable risks of cancer in the United
Downloaded by [Australian Catholic University] at 10:09 17 August 2017
234
R.S. OLDS and R.J. LAMARINE
States today. JNCI 66:1191-1308, 1981. 2. American Cancer Society: Cancer facts and figures, 1989. Atlanta, GA: ACS, 1989. 3. Greenwald P and Sondik EJ, (eds): Cancer control objectives for the nation:1985-2000. NCI Mono. Bethesda, MD: National Cancer Institute, 1985. 4. Cancer Education Survey, vol 1-6. Publication no. 812255 to 81-2260. Washington, DC: US Department of Health and Human Services, 1981. 5. Bakemeier R: cancer education objectives for medical schools. Med Pediatr Oncol 9:585-633, 1981. 6. Mason JL, Walker-Bartnick L, Hess HB, Munice HL, et al: Developing a cancer prevention elective course. J Med Educ 10:796-803, 1983. 7. Love RR, Stone HL: Instructional objectives for a teaching program in cancer for primary care physicians. J Fam Pract 6:1253-1257, 1978. 8. Mahan JM, Costanzi JJ, Levine HG: The Tracer method of curriculum analysis in cancer education. J Med Educ 51:512-513, 1976. 9. Admission requirements of US and Canadian dental schools (1988-1989), 25th ed. Washington, DC: American Association of Dental Schools, 1988. 10. Medical school admission requirements 1988-1989, US and Canada. Washington, DC: Association of American Medical Colleges, 1988. 11. Directory of Health Education Programs. Reston, VA: Association for the Advancement of Health Education, 1988. 12. Torabi MR, Seffrin JR: A Three component cancer attitude scale. JOSH 56(5):170-174, 1987. 13. Anastasi A: Psychological Testing, 5th ed. New York: Macmillan Publishing Company, 1982, p 554. 14. Torabi MR: How to estimate practical significance in health education research. JOSH 55 (5):232-233, 1986. 15. Bailar JC, Smith EM: Progress against cancer. NEJM 314 (19):1226-1232, 1986. 16. Seffrin JR, Lamartine RJ: Social values and cancer, in Proceedings of the Fifth National Conference on Human Values & Cancer-1987. American Cancer Society, 1987.
APPENDIX A Cancer Control Curricular Questionnaire INSTRUCTIONS: This instrument is designed to examine current curricular for offerings in cancer control through prevention. The focus on cancer control is from a primary and secondary prevention perspective. DO NOT put your name or any other identifying information on the instrument. AH information provided will be maintained confidentially. Please circle or fill in as required, responses that best describe your curricular offerings relative to cancer control through prevention. Either a pen or pencil can be used.
If you are not the appropriate professional to complete this instrument, please forward all materials to the individual(s) who would be best suited to provide the information requested. Upon completion of the questionnaire, return it in the enclosed postage-paid envelope. Thank you for your consideration. If you would like to receive a copy of the study findings, please indicate by checking the appropriate area below. Further information about this study can be obtained by contacting: Dr. R. Scott Olds American Cancer Society New York State Division, Inc. 6735 Lyons Street P.O. Box 7 East Syracuse, New York 13057 ( ) Please send a copy of the survey results to the name and address listed below.
1. What is the primary curricular emphasis in your academic program? Health Education 1 Medicine 2 Dentistry 3 Other (Please specify) : 2. How many full time faculty do you employ in your department? 3. What is the nature of your institution? Public 1 Private 2 Other (Specify) 4. What is the level of students trained by your programs? Undergraduate only 1 Graduate only 2 Combination of both 3 5. Has your program within the past five years been the recipient of a grant from a public or private agency that primarily dealt with cancer? Yes 1 No (Skip to Q 7) 2 6. If yes, approximately how much grant money has been received?
Cancer education assessment
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7. Has your program ever offered a workshop in which the primary focus was cancer control? Yes 1 No (Skip to Q 9) 2 8. What is the title of this workshop?
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9. Does your curriculum include a course in which the primary focus is cancer control through prevention? Yes 1 No (Skip to Q 24) 2 10. What is the title of this course? 18. 11. Is this course the sole offering in cancer control in your program? Yes 1 No 2 12. If no, please indicate what other courses cover cancer control through prevention in your program? 13. What topics are covered in this primary course(s) on cancer control through prevention? Please circle all that apply. Cancer Biology 1 Smoking 2 Smokeless Tobacco 3 Diet 4 Alcohol 5 Environmental Factors 6 Occupational exposures 7 Childhood cancers 8 Lung Cancer 9 Breast Cancer 10 Colorectal Cancer 11 Uterine Cancer 12 Early Detection 13 Psychosocial aspects 14 Patient Counseling 15 Death and Dying 16 Other (Please specify) 14. Approximately how many students enroll in this course(s) each year? 15. How many years has this course(s) been taught? 16. What is the status of the faculty who usually teach this course?
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Full Time 1 Part Time 2 Combination 3 What is the terminal degree of the individual who teaches this course? Ph.D 1 M.D 2 Dr.P.H 3 Ed.D 4 D.Ed 5 H.S.D 6 M.S 7 B.S 8 What is the faculty rank of the individual who teaches this course? Assistant Professor 1 Associate Professor 2 Full Professor 3 Other Is this course Required 1 Elective 2 Combination 3 Does this course(s) utilize educational materials, e.g. pamphlets, films, models, etc, from voluntary and public health agencies? Yes 1 No 2 Is a text book used for this course(s)? Yes 1 No (Skip to Q 23) 2 What text is currently being used?
Now, Please skip to Q 26 23. If you do not require a text, what do you use in its place? Now, please skip to Q 26 24. What is the likelihood of your program offering a course primarily on cancer control in the next two years? Very likely 1 Likely 2 50/50 3 Unlikely 4 Very unlikely 5 25. Which of the following best describes your rationale for not offering a course primarily on cancer control?
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R.S. OLDS and R.J. LAMARINE
Limited demand for such a course. 1 Limited resources (time, personnel). 2 Limited student interest 3 Limited student need 4 Limited faculty interest 5 Limited faculty expertise 6 Other (please specify) 26. In terms of your curricular priorities, how important is it that a course primarily on cancer control through prevention be offered by your program? Very high priority 1 High priority 2 Average priority 3 Low priority 4 Very low priority 5 27. If your program has identified a cancer control course as a high priority, please elaborate on the rationale supporting this decision.
cancer control on licensure examinations? Yes 1 No 2 29. What role does your program currently play in terms of assisting other organizations and agencies to develop cancer control programs? Very active 1 Active 2 Not very active 3 Inactive 4 30. Does your program contribute to the literature by writing professional articles about cancer control? A lot (4 or more articles a year)... 1 Somewhat (1-3 articles a year).... 2 Very little (less than one article a year) 3 Not at all 4 Thank you for your help!
28. Would your department/school support increasing the number of questions about
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