Is an index of health possible?

The primary mission of a state-supported medical education is to produce physicians who will practice in that state. Medical school and residency graduates at the University of Wisconsin-Madison were compared as to how often they practice in the state after completing training. METHODS: Six hundred ninety-three medical student graduates from 1987 to 1991 were compared with 657 residency graduates from 1992 to 1996 at the University of Wisconsin-Madison. Chi-square was used to compare the groups as to the number of physicians produced who: 1) practice in Wisconsin and 2) practice primary care in Wisconsin. RESULTS: The residency training programs produced significantly more physicians (280) who practice in Wisconsin than did the medical school (246), X2 (df = 1) = 7.20, p < .01, and also significantly more primary care physicians, X2 (df = 1) = 6.16, p < .02. CONCLUSION: When this evidence-based information is used as a measure of medical education outcomes, residency training may be more effective at producing practicing physicians and should not be discounted when planning the educational and public health needs for the state of Wisconsin.     

Synovial immunohistochemical changes after high tibial osteotomy for osteoarthritis of the knee. Two-year prospective follow-up

PURPOSE: To evaluate a program designed to help high school students with depressive symptomology to effectively cope. DESIGN: Two-phase experimental study. METHODS: Rural high school students (N = 222), ages 14 through 19 years, were surveyed to identify teens with depressive symptomatology, identify stressful life events and coping styles of at-risk subjects, and evaluate a cognitive-behavioral group intervention to enhance students' coping and affect levels of depression. Students with depressive symptomatology were randomized into control (n = 18) or intervention (n = 23) groups. Intervention subjects were treated with a nurse-led, 8-week cognitive skills group, conducted at school. RESULTS: On posttesting, the intervention groups demonstrated reduced depressive symptoms in females and a wider range of coping compared with controls. CLINICAL IMPLICATIONS: School-based nurses are in an ideal position to provide assessment, referral, and intervention programs in the natural setting of the school. Results of this study indicate that such programs can be implemented successfully in schools and have the potential to promote mental health in teenagers.     

Doing homework: perspectives of elementary and junior high school students

A survey of homework experiences was administered to 1,527 elementary and junior high students in regular (n = 1,242), resource (n = 234), and self-contained special education (n = 51) classrooms. The results found significant main effects for Group, Grade, and Group by Grade interactions for items related to amount of, type of, and time spent doing homework; opportunity to do homework at school; parents' assistance; students' beliefs about homework assignments and grading; and students' feelings about homework and school. The higher incidence of negative feelings and opinions from students in resource room programs suggests that students' understanding of assignments, the nature of the assignments, and the feedback given to students are important issues requiring closer evaluation. The results also suggest that changes in homework assignments and grading may make the transition from elementary to junior high school particularly difficult for students with special needs.     

A comparison of two methods to teach smoking-cessation techniques to medical students

PURPOSE: To evaluate two smoking-cessation practice exercises, one using standardized patients (SPs), the other using role playing by medical students. METHOD: In the spring of 1994 all 120 first-year University of California, San Francisco, School of Medicine Students were given lectures on the health effects of smoking and how physicians can help patients quit. Afterward some of the students were randomly assigned to two groups in which to practice counseling patients: Group 1 (n = 35) used SPs, Group 2 (n = 37) used role playing. Each of the Group 1 students practiced smoking-cessation techniques with an SP; the SP evaluated the student on cognitive and communication skills, assigned an overall rating, and provide feedback using a standardized form. The Group 2 students (as well as the 48 students not assigned to a group) role-played in pairs and used the same form to provide feedback. All the students evaluated their respective practice practices. Two weeks later 24 Group 1 and 31 Group 2 students participated in a clinic-skills-assessment exercise using SPs. As in the Group 1 practice exercise, each student was evaluated by an SP on cognitive and communication skills and assigned an overall rating. Data were analyzed through a number of statistical methods. The cost of the SP program was determined. RESULTS: The Group 1 students rated their practice exercise much more favorably than did the Group 2 students. However, there was no significant difference between the groups in their ratings by the SPs on the clinical-skills-assessment exercise. The use of SPs cost a great deal more than did the use of role playing. CONCLUSION: Although the students rated the SPs higher than they did the role playing, the two tools produced similar levels of skills attainment. The data suggest that having students practice smoking-cessation techniques through role playing may be as effective as using the more extensive SPs.     

Review of the regulations on quality control of human albumin

PURPOSE: To assess medical students' perceptions of the ethical environment across four years of medical school. METHOD: In the spring of 1996, the authors distributed a questionnaire to all four classes at the Wake Forest University School of Medicine. The students provided demographic information and information about their exposures to or participation in unethical situations. Results were analyzed using multiple analysis of variance, univariate analysis of variance, Pearson correlation, and cross-tabulations. RESULTS: The response rate was 71%. The students reported that exposures to unethical behavior started early and continued to increase with each year in school. For example, 35% of the first-year students reported observing unethical conduct by residents or attending physicians. This percentage rose to 90% of the fourth-year students. The authors found no significant relationship between demographic variables other than the year in school and the ethical dilemma variables. CONCLUSION: Medical students face perceived ethical dilemmas beginning as early as the first year of medical school. Thus ethics instruction must begin in the freshman year. In addition, there must be changes to the environment in which clinical education is conducted to enhance the positive enculturation of students into the medical profession.     

Knowledge, attitude and reservations of medical students about organ transplantation: results of a survey during the first year of study

AIM: Establish a list of first year medical students' attitudes, doubts, and knowledge in the fields of organ transplantation and donation. METHOD: Anonymized questionnaire handed out to students during class lectures. RESULTS: 183 questionnaires were distributed and 117 returned (participation: 64%). The average age of the students was 21.6 +/- 2.7 years (range 18 to 38 years); the sample included 71 women (60.7%) and 48 men (39.3%). Only 2 students (2%) were not interested in the subject of organ donation. The students knew very little of the legal aspects of organ donation and 1/4 of them thought there was even a Federal law regarding organ transplantation. When asked if they knew whether a law existed in the Canton of Berne, 44% replied yes, but only 24 (20%) knew that this is contradictory. There was no gender difference in the answers to these question. From 57 students (48%) 246 individual comments on doubts and concerns were analyzed. In this respect, the students mainly questioned whether the donor was truly dead when donation took place (n = 48), if illegal transplantation could be eliminated (n = 44) and if transplantation was truly necessary (n = 43). Some also mentioned religious/ethical doubts (n = 42). In regard to organ donation by a living individual, 27 students were concerned about the health of this donor. 20 students had doubts regarding the pressure possibly applied by family members and friends and as many voiced doubts in regard to premature diagnosis of brain death of potential donors. Only 2 students were concerned about the post-mortem presentation. 45 students (48%) indicated discomfort with the donation of certain organs. They ranked the kidney as the first organ to donate, followed by the pancreas, heart, cornea, intestine, lung and liver. CONCLUSION: The interest in organ donation and transplantation is already strong in fist year medical students in the pre-clinical stage. However, differences from lay public are not readably detectable at this stage of medical training. Adequate information could influence future physicians in their mediatory role.     

An Analysis of School Psychology Faculty by Graduating University.

Shortages of school psychologists have been documented for many years with this deficiency extending not just to practitioners but to trainers as well. This article presents the results of a search to identify individuals employed in academic institutions and their graduating universities. Using an Internet search and mailings to doctoral degree-granting school psychology programs, 633 individuals were identified as having graduated from a school psychology program in the United States or Canada and being currently employed full-time in a faculty position in an institute of higher education. When graduating university was examined, the University of Wisconsin-Madison and University of Texas at Austin were consistently the highest rated programs in terms of producing school psychology academics. Other findings indicated that APA-accredited programs produced the majority of individuals in academic positions and that women have outnumbered men in entering the professorate every year since 1987. Women also currently comprise 51% of the school psychology professorate. While these data should not be considered a measure of program quality, they do provide an objective rating of program success in preparing students for careers in academia. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Innovation in education.

Participative methods are commonly used in executive training programs and permit the learning of interpersonal and leadership skills and the development of sensitivity. Such learning cannot be achieved from lectures or reading since they require practice and are seldom used in college teaching, often because participation is seen as limited to small classes. This article describes how full participation can be obtained in large classes and educational costs reduced by utilizing students as trainers. By dividing classes into groups or pairs, situations can be created in which students must (a) converse in a foreign language, (b) resolve a conflict, (c) conduct an interview, or (d) solve a problem together. Individuals can read and listen by themselves but they cannot discuss or experience conflict by themselves. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Medical residents' colorectal cancer screening may be dependent on ambulatory care education

Colorectal cancer results in significant morbidity and mortality in the United States. Screening is a critical component of cancer prevention. However, research has suggested that physicians may inconsistently adhere to surveillance guidelines. Since residency training can significantly impact upon future practice patterns, assessment of postgraduate colorectal cancer education is important. This retrospective chart review of patients > or = 50 years of age compared screening performed by resident physicians' in different internal medicine residency programs at The George Washington University Medical Center. Resident physicians who received multiple lectures in colorectal cancer surveillance or were required to document performance of screening on a medical record preventive care summary form performed significantly more rectal examinations (P < 0.0004), fecal occult blood testing (P < 0.00001), and flexible sigmoidoscopies (P < 0.00001) when compared to other resident physicians. Postgraduate education should employ multiple education techniques and reinforcement procedures to increase physician compliance with cancer screening.     

Can school teachers improve the management and prevention of skin disease? A pilot study based on head louse infestations in Guerrero, Mexico

BACKGROUND: The effect of health education provided by teachers, in three primary schools of Guerrero, Mexico, on the prevalence of head louse infestation was compared. METHODS: A cross-sectional survey and rapid appraisal methods were performed, including a child questionnaire and qualitative data from teachers and focus groups of mothers in the same schools. RESULTS: Nine hundred and forty-four students and 33 teachers were interviewed; a focus group discussion with 6-8 mothers per school was performed. In the self-diagnosis of pediculosis, the prevalence was 22% (range, 18%-33%) with a sensitivity of 68% and a specificity of 86%. In one school, 100% of the teachers applied a health program, whereas in the other two schools this percentage was only 20%. A child under 9 years of age who attended a school without information on health was 3.6 times more likely to have head louse infestation (OR = 3.6, CI 95% = 2.1-6) than a child of the same age who attended a school where information was given. In older children the effect and potential impact were lower. The difference between the two age groups is unlikely to be explained by chance (X2 het = 5.7, df = 1, p = 0.01). CONCLUSIONS: This study emphasizes the potential value of simple, but effective, health education provided by school teaching staff through liaison with patents in the amelioration of endemic disease.     

Characterization and evolution of mariner elements from closely related species of fruit flies (Diptera: Tephritidae)

The authors reviewed the literature published from 1966 to 1996 to identify enrichment programs for underrepresented minority precollege students sponsored by medical schools and affiliated programs, finding 19 articles describing 27 programs. The authors categorized the reported programs according to the components they contained. Most programs contained more than one component type. Twenty-four programs had an academic enhancement component. Two thirds had a motivational component to encourage students to consider medical and other health careers. Two programs set up mentoring relationship between students and health professionals. There were four research apprenticeships and three academic partnerships between medical schools and local school districts. Twelve of the 27 programs were evaluated in the literature. Eight evaluations focused on identifying the numbers of students who continued their education into college and professional schools. Five programs reported participant satisfaction or identified other short-term outcomes such as gains on standardized tests. While the percentage of participants completing college and entering health care careers is impressive, the authors do not believe that the educational success of participants can be attributed to involvement in these programs. The authors recommend ways to improve the quality and interpretability of enrichment program evaluations. Evaluators should adopt common terminology for activities and outcomes. Participants' economic and educational disadvantages should be described. Programs' theoretical underpinnings should be identified and related to evaluation. Measures should include immediate effects as well as long-term outcomes. Where possible, data from comparison groups should be reported to support conclusions. Adequate funding needs to be available to design and complete reasonable evaluations.     

Youthful precursors of midlife social support

Measures of family stability, sociocultural background, and emotional ties to parents in medical students (N = 589, mean age = 22 years) predicted their social support measures, assessed 23 to 39 years later (mean age = 56 years). Father's education and family's involvement in church were positively associated with group participation (number of group memberships), whereas parental loss between the ages of 11 and 20 was negatively associated with group participation; perceived emotional closeness to parents was positively associated with social closeness (number of close contacts providing emotional and instrumental support). Thus, group participation and social closeness were influenced by distinctly different childhood factors.     

Evaluation of a practice-based ambulatory program in food animal medicine, surgery, and herd health management

OBJECTIVE: To assess the educational value of a practice-based ambulatory program used at a school of veterinary medicine. DESIGN: Retrospective cohort study. SAMPLE POPULATION: Graduates of US veterinary medical schools between 1987 and 1994. PROCEDURE: Phase I involved use of interviews and focus groups to assist in development of the questionnaire used in phase II, a retrospective cohort study. The pretested questionnaire was sent to a study population consisting of all graduates of the University of Wisconsin-Madison, School of Veterinary Medicine, between 1987 and 1994 as well as a control group who were randomly selected from the 1994 AVMA list of veterinarians. Control-group veterinarians were matched on the basis of professional activity, region, and year of graduation. RESULTS: 728 of 1,067 veterinarians completed the questionnaire in phase II of the study (response rate, 68%). The practice-based ambulatory program at the University of Wisconsin-Madison compared favorably with university-based ambulatory programs in volume of experiences and perceived educational quality. Regardless of rotation type, female students were significantly less likely to observe or perform 12 specific clinical procedures and were significantly less likely to rate instructional quality as excellent or very good, compared with male students. CLINICAL IMPLICATIONS: Practice-based ambulatory rotations can be a good alternative to existing university-based ambulatory rotations. Implementation of these programs should emphasize performance of procedures while striving to ensure participation of female students.     

Variables affecting high school students' perceptions of school foodservice

OBJECTIVE: To determine if student satisfaction with high school foodservice is directly related to participation in the foodservice. DESIGN: A valid and reliable survey was conducted in a variety of classes such as English, history, and health science in grades 9 through 12, representing students aged 13 through 19 years. Students were asked 38 questions concerning variety of food, food quality, foodservice staff, aesthetics of the serving and dining area, and demographics. SUBJECTS/SETTING: The study was conducted with 1,823 students from 9 schools representing 4 geographic regions. STATISTICAL ANALYSIS: Stepwise multiple regression was used to determine the independent variables (attributes desired by the students) that most highly correlated with the dependent variable (satisfaction with the school foodservice overall). RESULTS: Variables most highly correlated with overall satisfaction were variety of food offered, flavor of food, attractiveness of food on the serving line, staff smiling and greeting students, quality of food choices, choices that allow students to meet cultural and ethnic preferences, courteousness of the staff, and quality of ingredients. Variety of food offered was the best predictor of satisfaction. A statistically significant difference was found (P<.01) between groups that never ate school lunch and those that ate school lunch 3 to 5 times per week on dining ambiance, food quality, and staff. The results indicate that satisfaction with foodservice is associated with purchase behavior in school foodservice programs. APPLICATIONS: School foodservice and nutrition programs are critically important for providing nutrition to millions of our future leaders. Today it is not enough to prepare healthful, good-tasting food. High school students are sophisticated and are exposed at an early age to a variety of dining experiences including fast foods, ethnic cuisine, and fine dining. These factors have influenced the attributes students use to evaluate school foodservice. To maintain participation levels and financial stability, school foodservice professionals should evaluate student satisfaction with food quality, variety, and other variables that affect overall satisfaction and participation. These data may then be incorporated into continuous quality improvement and strategic planning. Marketing must be incorporated into the strategic plan to influence student participation.     

Nutritional intervention and growth in children with chronic renal failure

During fifties there were at most few tens of persons in this country who believed in the future of computers and cybernetics. One group of such enthusiasts, headed by Antonín Svoboda, was working at a construction of the first Czech computer SAPO. The other group tried to analyse, anticipate, and prepare in advance various applications for the new systemic conceptions and for the information processing machines. Members of both groups met for discussions which opened prospects to the future and influenced many of other activities for a long time. At the early sixties, the Czechoslovak Cybernetic Society was established at the Czechoslovak Academy of Sciences and in 1962 the Main Problem Committee for the Medical Cybernetics was founded at the Department of Health. It coordinated majority of the research programmes in the medical cybernetics and informatics. In 1967-1969 the Committee prepared an extensive project of a medical information system (ZIS), but its accomplishment was finally blocked by the then authorities. However, interests for that topics kept growing and the new working places equipped with available computer technology were formed at the health and clinical centres. The first tentative lectures in medical cybernetics and biocybernetics at our faculty were introduced into the students curricula in the late sixties. Thematically, medical cybernetics subsequently differentiated into the medical informatics, simulations of biological and medical systems, and the biosignal analysis. The growing interest enabled to hold conferences since the middle of seventies, some of which were held periodically, sometimes with international participation. It is not possible in brevity to include the whole spectrum to those goal-directed activities nor to appraise adequately their future significance.     

Self-concept changes of junior high students.

Previous studies have identified a relationship between self-concept and school behavior. The present study investigated whether self-concept (as measured by Bills's Index of Attitudes and Values) and school behavior of problem junior high school students could be changed by participation in a teacher helper program in an elementary school. Ss matched on grade (8th or 9th) sex, and GPA were randomly assigned to an experimental or a control group (n = 12). Self-concept ratings of experimental Ss who participated in the teacher helper program for 8 wks significantly increased during this period, while controls did not change. Neither group changed significantly in attendance or GPA. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A Prospective Study of Participation in Optional School Physical Education Using a Self-Determination Theory Framework.

This study examined whether contextual and personal motivational variables, taken from self-determination theory, could predict student cognitive and affective experiences in school physical education (PE), as well as participation in optional PE in the following school year. Structural equation modeling analysis with a sample of 302 British adolescents showed that need support provided by the PE teachers was related to student need satisfaction, which in turn predicted self-determined motivation. The latter predicted directly various motivational indices and indirectly future participation in optional PE. Furthermore, multivariate analysis of variance tests showed that those who opted for PE (n = 171), compared with those who did not (n = 131), reported more positive motivational experiences in the previous school year. The findings call for the promotion of self-determined motivation in PE in order to enhance student positive experiences and participation rates. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Tutoring in problem-based learning: perceptions of teachers and students

This study examined teacher and student perceptions during the first 2 years of a complete transition from a conventional to a problem-based learning (PBL) curriculum at Dalhousie University. Teaching staff who had tutored in the two pre-clinical years (n = 88) completed a questionnaire at the end of the 1993-94 academic year, and student assessments of their tutors were collated for all nine units (n = 597). Seven research questions were addressed in the study which examined the faculty, student and administrative aspects of tutoring. The results showed that faculty tutors rated PBL more highly than traditional medical school methods on eight of the nine items. Teaching staff were very satisfied with their tutoring experience, but expressed a need for further training in group facilitation, questioning, handling 'difficult' situations and evaluating students. They reported that their workload outside tutorials was cut almost in half in their second year of tutoring. Students expected a tutor to be a skilled group facilitator who would guide them in their learning, while helping to maintain a positive group climate. They did not want the tutor to teach the content as they perceived the task of learning to be their responsibility. Several major administrative factors affected tutors' and students' perceptions of tutorials, including: changing tutorial group composition and tutor every 8-10 weeks; team tutoring; end-of-unit exam; conflicting demands of basic science 'vertical' units and ongoing 'horizontal' units; departmental budgetary requirements for basic medical education; recognition of tutoring in promotion and tenure decisions; and recruitment of tutors.