Med Teach Downloaded from informahealthcare.com by McMaster University on 11/26/14 For personal use only.
Medical Teacher, Vol. 14, No. 2/3, 1992
247
Do you know? An opportunity to assess how up-to-date you are with the medical education 1iterature
SUE ROFF
Answers to the questions are given on the following pages.
1. Your surgical colleagues ask if you know of a clear account of introducing problem-based learning into the surgery clerkship. 2. Students preparing to take their surgery orals ask you, as a medical educator, how best to prepare for them.
3. Your institution is increasingly being drawn into collaborations with local industry and you need to impress your new colleagues with the applicability of what you teach to industrial health. One of them calls you up and asks you to give a talk to the local businessmen’s association on the health implications of shift-work. How can you update yourself quickly on the latest research in this subject? 4. Your nursing colleagues want to promote continuing education in their profession and ask you, as a medical educator, how they should offer it.
5. Your nursing colleagues ask your view, as a medical educator, on the wisdom of making continuing education compulsory in their profession, and ask you to refer them to an overview of the arguments for and against. 6. Both your nursing and medical colleagues are looking for staff development assistance as health carers. Can you suggest a guidebook for beginning personal selfanalysis of motivations and practices for health carers?
7. Your institution is increasingly attracting students from European countries and
248
Do you know?
you find that you are getting more and more questions about medical demography, legislation and official health organisations in that region. Can you suggest a handy reference?
Med Teach Downloaded from informahealthcare.com by McMaster University on 11/26/14 For personal use only.
8. Like many of your colleagues in Britain, you are worried about the poor educational experience of students in the pre-registration year, which is after all the last year of the university-accredited medical course. Can you suggest a discussion document on the subject to focus a staff meeting around the issues? 9. Some of your colleagues resist basing a full faculty discussion on a qualitative research report drawn from interviews with only 12 pre-registration house officers working in two hospitals in the same region. They challenge you to defend the role of small exploratory qualitative research studies. Can you suggest a succinct statement that they should read? 10. You still have some “hard fact” colleagues to convince about the value of ethnography as applied to the practice of medicine and biomedical research. Is there a description of the scientific process that might remind them that facts are only hard after they have been perceived by enough colleagues?
Do you know? Answers to questions 1. In 1989-90 the department of surgery at the University of Kentucky, College of Medicine, Lexington revised its third-year clerkship to focus on students’ learning decision-making skills, critical thinking (cognitive skills) and acquiring knowledge about surgery. Learning to perform procedures and tasks (psychomotor tasks) were put over to the fourth year. Problem-based learning was chosen as the clerkship’s primary instructional method. Nash et al. give a step-by-step account of the programme and its assessment measures in their account of ‘A Student-centred, Problembased Surgery Clerkship’. (Academic Medicine Vol. 66, pp. 415-417.) 2. According to Rowland-Morin et al. (Academic Medicine Vol. 66, pp. 169-171) students would do well to look to their skills in communicating with examiners in order to enhance their chances in the orals. Examiners were examined for their ratings of actors portraying students who communicated in two styles; one using direct eye contact with a moderate response rate and the other using indirect eye contact and a slower response rate. The latter were uniformly scored lower than the former in a range of tested skills, from their knowledge base and their integration of relevant data to their personal integrity and appearance.
3. The British Health and Safety Executive have just published a review of the scientific literature on the health and safety aspects of shift-working that updates the similar review done in 1978. The authors, Waterhouse, Folkard and Minors, argue that the effects of the length, speed of rotation and starting time of shifts; the effects of culture and job-type; differences between both individuals and industries all impact on the health and safety of workers, but that more international and interdisciplinary studies need to be undertaken to fully analyse the effects. The report is Shiftwork, Health and Safety-An overview of the Scientific Literature 1978-1990.
Do you know?
249
Med Teach Downloaded from informahealthcare.com by McMaster University on 11/26/14 For personal use only.
4. A study of American staff nurses from states with mandatory continuing education requirements compared with those from states that rely on voluntary continuing education reported by Gessner et al. in the Journal of Continuing Education in Nursing (Vol. 23, pp. 76-79) described pretty well universal agreement on the preferred methods for continuing education. Approximately 60% of these American nurses preferred conferences; 13% preferred reading and a similar number preferred to update themselves through conversations with colleagues. The challenge for the medical educator may well be to increase collegiality in continuing nurse education within the working environment rather than relying on external conferences.
5 . Nursing Times carried two articles on mandatory updating for the nursing profession in November 1991. One by Lynda Juall Carpenito, ‘Why coercion does not work’ (Vol. 87, November 1991) reviews US experience to show that the case for compulsory professional updating is far from proven but the text on how to ensure voluntary continuing education among any sector of the medical profession has yet to be written. 6. Despite its awkward title, Patient Practitioner Interaction; an Experiential Manual for Developing the Art of Health Care (Slack Inc., New Jersey) by Carol M. Davis serves the individual carer well to work through the personal motivations and dilemmas of working in a field where knowledge of self can greatly enhance performance in interactions with others. While we might not all want to “embark on a path of professional socialization” we can benefit from the insights in this text.
7. Guide to Health in Europe is a 1992 publication from the Press Group Medicine. Edited by Alexandre Mebazaa in collaboration with members of the Permanent Working Group of European Junior Hospital Doctors and other professional organisations, it provides a handy compendium of this sort of information for either the individual seeking to work in Europe or for institutions preparing and receiving European students. It is available from Impact Medicin, Service Diffusion 20, Boulevard du Parc 92521,Neuilly-sur-Seine, Cedex, France. 8. Sue Dowling and Sue Barrett’s Doctors in the Making: the Experience of the PreRegistration Year (SAUS publications, Bristol) provides both an illuminating qualitative research report on the experience of the pre-registration year and a clear statement of the issues that have resulted in what they term “the poverty of medical education” in a year that is technically under the auspices of the university. They make a strong case for working with the nursing profession in developing the required educational and training materials to cure the situation in which none of the house officers they interviewed volunteered any part of their role as that of learning. 9. One of the many virtues of Keith Tones, Sylvia Tifford and Yvonne Robinson’s Health Education; Effectiveness and EBciency (Chapman and Hall, New York) is the methodological chapter on research design and its clear account of the strengths of ethnographic, qualitative studies of human behaviour. They address within the same context the question of sample size and selection and the perils of relying solely on survey sampling of large groups when trying to analyse human motivation and experiences in complex situations.
250
Do you know?
Med Teach Downloaded from informahealthcare.com by McMaster University on 11/26/14 For personal use only.
10. The University of Michigan Press has issued a second edition of June Goodfield's An Imagined Work a Story of Scientific Discovery which traces the process by which the relationship between immunodeficiency and lymphocyte maldistribution became perceived as a fact in biomedical science in the past two decades. It also serves as a good antidote to The Double Helix.
Medical Teacher, Vol. 14, No. 2/3, 1992
247
Do you know? An opportunity to assess how up-to-date you are with the medical education 1iterature
SUE ROFF
Answers to the questions are given on the following pages.
1. Your surgical colleagues ask if you know of a clear account of introducing problem-based learning into the surgery clerkship. 2. Students preparing to take their surgery orals ask you, as a medical educator, how best to prepare for them.
3. Your institution is increasingly being drawn into collaborations with local industry and you need to impress your new colleagues with the applicability of what you teach to industrial health. One of them calls you up and asks you to give a talk to the local businessmen’s association on the health implications of shift-work. How can you update yourself quickly on the latest research in this subject? 4. Your nursing colleagues want to promote continuing education in their profession and ask you, as a medical educator, how they should offer it.
5. Your nursing colleagues ask your view, as a medical educator, on the wisdom of making continuing education compulsory in their profession, and ask you to refer them to an overview of the arguments for and against. 6. Both your nursing and medical colleagues are looking for staff development assistance as health carers. Can you suggest a guidebook for beginning personal selfanalysis of motivations and practices for health carers?
7. Your institution is increasingly attracting students from European countries and
248
Do you know?
you find that you are getting more and more questions about medical demography, legislation and official health organisations in that region. Can you suggest a handy reference?
Med Teach Downloaded from informahealthcare.com by McMaster University on 11/26/14 For personal use only.
8. Like many of your colleagues in Britain, you are worried about the poor educational experience of students in the pre-registration year, which is after all the last year of the university-accredited medical course. Can you suggest a discussion document on the subject to focus a staff meeting around the issues? 9. Some of your colleagues resist basing a full faculty discussion on a qualitative research report drawn from interviews with only 12 pre-registration house officers working in two hospitals in the same region. They challenge you to defend the role of small exploratory qualitative research studies. Can you suggest a succinct statement that they should read? 10. You still have some “hard fact” colleagues to convince about the value of ethnography as applied to the practice of medicine and biomedical research. Is there a description of the scientific process that might remind them that facts are only hard after they have been perceived by enough colleagues?
Do you know? Answers to questions 1. In 1989-90 the department of surgery at the University of Kentucky, College of Medicine, Lexington revised its third-year clerkship to focus on students’ learning decision-making skills, critical thinking (cognitive skills) and acquiring knowledge about surgery. Learning to perform procedures and tasks (psychomotor tasks) were put over to the fourth year. Problem-based learning was chosen as the clerkship’s primary instructional method. Nash et al. give a step-by-step account of the programme and its assessment measures in their account of ‘A Student-centred, Problembased Surgery Clerkship’. (Academic Medicine Vol. 66, pp. 415-417.) 2. According to Rowland-Morin et al. (Academic Medicine Vol. 66, pp. 169-171) students would do well to look to their skills in communicating with examiners in order to enhance their chances in the orals. Examiners were examined for their ratings of actors portraying students who communicated in two styles; one using direct eye contact with a moderate response rate and the other using indirect eye contact and a slower response rate. The latter were uniformly scored lower than the former in a range of tested skills, from their knowledge base and their integration of relevant data to their personal integrity and appearance.
3. The British Health and Safety Executive have just published a review of the scientific literature on the health and safety aspects of shift-working that updates the similar review done in 1978. The authors, Waterhouse, Folkard and Minors, argue that the effects of the length, speed of rotation and starting time of shifts; the effects of culture and job-type; differences between both individuals and industries all impact on the health and safety of workers, but that more international and interdisciplinary studies need to be undertaken to fully analyse the effects. The report is Shiftwork, Health and Safety-An overview of the Scientific Literature 1978-1990.
Do you know?
249
Med Teach Downloaded from informahealthcare.com by McMaster University on 11/26/14 For personal use only.
4. A study of American staff nurses from states with mandatory continuing education requirements compared with those from states that rely on voluntary continuing education reported by Gessner et al. in the Journal of Continuing Education in Nursing (Vol. 23, pp. 76-79) described pretty well universal agreement on the preferred methods for continuing education. Approximately 60% of these American nurses preferred conferences; 13% preferred reading and a similar number preferred to update themselves through conversations with colleagues. The challenge for the medical educator may well be to increase collegiality in continuing nurse education within the working environment rather than relying on external conferences.
5 . Nursing Times carried two articles on mandatory updating for the nursing profession in November 1991. One by Lynda Juall Carpenito, ‘Why coercion does not work’ (Vol. 87, November 1991) reviews US experience to show that the case for compulsory professional updating is far from proven but the text on how to ensure voluntary continuing education among any sector of the medical profession has yet to be written. 6. Despite its awkward title, Patient Practitioner Interaction; an Experiential Manual for Developing the Art of Health Care (Slack Inc., New Jersey) by Carol M. Davis serves the individual carer well to work through the personal motivations and dilemmas of working in a field where knowledge of self can greatly enhance performance in interactions with others. While we might not all want to “embark on a path of professional socialization” we can benefit from the insights in this text.
7. Guide to Health in Europe is a 1992 publication from the Press Group Medicine. Edited by Alexandre Mebazaa in collaboration with members of the Permanent Working Group of European Junior Hospital Doctors and other professional organisations, it provides a handy compendium of this sort of information for either the individual seeking to work in Europe or for institutions preparing and receiving European students. It is available from Impact Medicin, Service Diffusion 20, Boulevard du Parc 92521,Neuilly-sur-Seine, Cedex, France. 8. Sue Dowling and Sue Barrett’s Doctors in the Making: the Experience of the PreRegistration Year (SAUS publications, Bristol) provides both an illuminating qualitative research report on the experience of the pre-registration year and a clear statement of the issues that have resulted in what they term “the poverty of medical education” in a year that is technically under the auspices of the university. They make a strong case for working with the nursing profession in developing the required educational and training materials to cure the situation in which none of the house officers they interviewed volunteered any part of their role as that of learning. 9. One of the many virtues of Keith Tones, Sylvia Tifford and Yvonne Robinson’s Health Education; Effectiveness and EBciency (Chapman and Hall, New York) is the methodological chapter on research design and its clear account of the strengths of ethnographic, qualitative studies of human behaviour. They address within the same context the question of sample size and selection and the perils of relying solely on survey sampling of large groups when trying to analyse human motivation and experiences in complex situations.
250
Do you know?
Med Teach Downloaded from informahealthcare.com by McMaster University on 11/26/14 For personal use only.
10. The University of Michigan Press has issued a second edition of June Goodfield's An Imagined Work a Story of Scientific Discovery which traces the process by which the relationship between immunodeficiency and lymphocyte maldistribution became perceived as a fact in biomedical science in the past two decades. It also serves as a good antidote to The Double Helix.
