Physician opinions about an anatomy core curriculum: A case for medical imaging and vertical integration

Pre‐clinical anatomy curricula must provide medical students with the knowledge needed in a variety of medical and surgical specialties. But do physicians within specialties agree about what anatomical knowledge is most important in their practices? And, what is the common core of anatomical knowledge deemed essential by physicians in different specialties? Answers to these questions would be useful in designing pre‐clinical anatomy courses. The primary aim of this study was to assess the importance of a human gross anatomy course by soliciting the opinions of physicians from a range of specialties. We surveyed 93 physicians to determine the importance of specific anatomical topics in their own practices. Their responses were analyzed to assess variation in intra‐ and inter‐departmental attitudes toward the importance of anatomy. Nearly all of the topics taught in the course were deemed important by the clinicians as a group, but respondents showed little agreement on the rank order of importance of anatomical topics. Overall, only medical imaging received high importance by nearly all respondents, and lower importance was attached to embryology and lymphatic anatomy. Our survey data, however, also suggested distinct hierarchies in the importance assigned to anatomical topics within specialties. Given that physicians view the importance of anatomy differently, we suggest that students revisit anatomy through a vertically integrated curriculum tailored to provide specialty‐specific anatomical training to advanced students based on their areas of clinical interest. Integration of medical imaging into pre‐clinical anatomy courses, already underway in many medical schools, is of high clinical relevance. Anat Sci Educ 7: 251–261. © 2013 American Association of Anatomists.     

Physicians' retrospective evaluations of their medical education

903 physicians evaluated 10 aspects of their medical education for relevance and quality. Skill in diagnosis is an example of an educational goal judged to be important and for which training was rated as good. Knowing how to establish a professional practice was also seen as a proper goal of medical education, but training was viewed as less satisfactory. Individual differences among the physicians in retrospective satisfaction were then related to premedical, medical school, and personality factors. Doctors whose evaluations were more favorable tended to receive above average grades in medical school, but somewhat below average in premedical work. Personality variables such as persistence and self-confidence were associated with higher retrospective satisfaction among men; among women satisfaction was correlated with variables such as psychological-mindedness and sensitivity to others.     

Physician interviewing and counseling training

There is an important need to enhance the skills of physicians in conducting medical interviews. The medical interview consists of the primary tasks or content of the medical history. It is the basis for establishing a therapeutic relationship with the patient, ascertaining a clinical diagnosis, and implementing an appropriate treatment plan or health maintenance. Effective medical interviewing skills are prerequisites for learning the skills which are essential for patient counseling. This paper describes the medical interview, reviews videotape feedback models for training, and gives suggestions for the training of physicians as counselors.     

Teachable Moments,Learnable Moments: Medical Rounds as a Paradigm for Education

The medical profession has for almost a century employed various types of “Rounds” as pedagogical tools to engage physicians, physicians‐in‐training, and their health care teams in the clinical diagnosis and treatment of patients. More recently, this validated paradigm of medical rounds (MR) has been extended to the field of education, where it is being used as an effective strategy for administrators to better understand their own domain. There are four distinct types of MR which can be further analyzed to find commonalities and parallels with the domain of education. The four types of MR are (1) Morning Rounds, (2) Chart Rounds, (3) Grand Rounds, and (4) Ongoing Collaborations—each have unique pedagogical characteristics and serve different functions. They are, however, unified by common threads of dynamic and interpersonal interactions wherein teacher (physician) and learner (physician‐in‐training) share learning and fluidly exchange roles in the pedagogy. MR models supplant the now outmoded theory of the “empty vessel” and corroborate the concept of the teaching brain. A formal analysis of MR underscores its ongoing utility in education both for its pedagogical innovations and for the Interactive and inherently human attributes that are required between teacher and learner for its efficacy.     

Training Novices to Develop Projects: A Case Study in Academic Medicine

The Michigan State University Primary Care Faculty Development Fellowship Program was one of several national programs to prepare primary care physicians for full‐time academic medicine careers. In their new positions as medical faculty, the physician educators would be responsible for developing projects such as curricula, research studies, or new administrative policies. This article explains how we trained novice medical educators to successfully develop curriculum projects. We noticed three vital, generalizable methods that led to success in training novices to develop projects: a clear project assignment, performance‐centered instruction, and personal mentorship.     

Are we throwing histology out with the microscope? A look at histology from the physician's perspective

A trend in medical schools across the United States is the refurbishing of histology laboratories with digital microscopy systems. Although such systems may reduce curricular time, they do not teach basic microscope skills, and students who learn solely with these systems may be less prepared for their practices or specialties, particularly in rural areas that may not be equipped with digital microscope technology. At the West Virginia School of Osteopathic Medicine (WVSOM), students are trained to practice in a wide variety of environments, especially rural areas. A research survey was conducted to gather information for evidence‐based decisions about histology education at WVSOM. The survey asked a range of questions concerning histology knowledge, tissue preparation, and microscopy. Responses did not differ significantly between physicians in urban versus rural practices. Ninety percent of physicians do not utilize digitized images, and only 50% have microscopes readily available. Regardless of the technology available, 90% feel that students must have microscope training and 88% of physicians feel that histology is important to the medical curriculum and use their histology knowledge often (weekly or daily) (66%). These results demonstrate that histology education should move toward a blending of traditional microscope and glass slides with computer‐based instructional technologies. Anat Sci Educ 2:205–209, 2009. © 2009 American Association of Anatomists.     

大学生医学竞赛对培养医学人才的影响

文章对浙江省大学生医学竞赛进行研究,认为竞赛培养了医学生的团队合作精神,提高了专业知识技能、心理素质、医学人文素养和分析问题、解决问题的能力,加强了"双师型"教师队伍的建设和院校合作,促进教学改革、改善实训条件以及医学院校间的交流。     

Recognition organisations that evaluate agencies accrediting medical education programmes: Quis custodiet ipsos custodes?

The goals of agencies that accredit medical education programmes or institutions are to ensure high quality student experiences and to certify the readiness of graduates to further their training or begin practice as physicians. While accreditation provides a level of legitimacy, the agencies conducting the reviews vary in their organisation, robustness and transparency of decisions. Therefore, to enhance validity and comply with governmental or medical professional regulations, some agencies undergo external evaluations of their standards and protocols, a process commonly referred to as recognition. Recognition also provides stakeholders with unbiased and credible information on accrediting agencies and the educational institutions they accredit. The author compares six European and United States-based recognition organisations that evaluate agencies that accredit medical education to highlight similarities and differences in scope, processes and consequences of the review. These results contribute to the development of best practices and potential mutual acceptance of decisions in the global ‘meta quality assurance’ arena.     

多功能医学基础实训中心闭环式设计建设与应用

紧密对接临床职业岗位的医学基础实训中心是培养高质量高职护理人才的重要实践平台,目前卫生类职业院校医学基础实训中心资源单一性与其功能多样性之间的矛盾制约高职护理人才培养质量的提高。我们基于护理职业岗位分析,以“功能目标与功能要素”和“现存问题”为双导向,开展了融“多功能、认知规律和教育规律”于一体的医学基础实训中心闭环式建设与应用的实践,取得了良好效果。     

中学生课外体育锻炼的调查研究

中学生参加课外体育锻炼,对于自身体质的提高,意志品质的增强和健身习惯的养成均具有重要意义。但从问卷调查中发现,由于受到锻炼时间、运动场地和伙伴等因素的制约,学生参加课外体育锻炼的习惯养成比例并不高。基于此,学校体育教学要着眼学生健身习惯的养成;建立学校、社区和家庭三维和谐联动机制;建立科学、可行的学生综合素质评价体系。     

Geriatric Training Needs of Nursing-Home Physicians

Medical care in nursing homes is not provided by board-licensed geriatricians; it mainly comes from physicians in need of educational programs in the field of geriatrics. Such programs, based on curriculum guidelines, should be developed. The purpose of this study was to seek input from nursing home physicians on their perceived needs for training in geriatrics. A mail questionnaire survey was sent to nursing home physicians regarding their opinion on the most needed subjects and preferred training methods. Of the 210 surveys mailed, 132 (63%) were returned. More than a quarter of the respondents had not had any kind of geriatric medical education. A desire for geriatric training was evident, preferably in the form of courses and periodic seminars. Use of medications, infectious diseases, depression, dementia and cardiac disorders were the most important topics indicated by the respondents. These data can be of help in preparing the curriculum for a continuous medical education program in geriatrics, preferably in the form of courses and periodic seminars.     

“双线并行”教学诊改实践探索

提出构建“双线并行”的专业和课程诊改体系,在专业层面实施专业建设质量和专业人才培养质量诊改,在课程层面实施课程建设质量和课程教学质量诊改。两个诊改双线并行,有利于解决“建设质量”和“教学质量”两个诊改周期不同步的矛盾,条理清晰,便于操作,有利于诊改工作的推进实施。对诊改复核指引提出修改建议,把专业人才培养质量和课程教学质量诊改摆在更加重要地位,引导学校将注意力转移到人才培养上来,发挥诊改的正向积极作用。     

Quality management of body donation program at the University of Padova

Quality management improvement has become a recent focus of attention in medical education. The program for the donation of bodies and body parts (Body Donation Program) at the University of Padova has recently been subjected to a global quality management standard, the ISO 9001:2008 certification. The aim of the present work is to show how the above standard is useful in enhancing the efficiency of body donation procedures and the quality and output of medical education. The program is managed by means of the following interlinked procedures: the collection of body donations, death certificates, data, and body parts from living donors; the transportation and identification of cadavers; the management of bodies, body parts, equipment, instruments, purchasing of necessary materials, and setting up anatomical training sessions; the management of preventive and corrective actions; the management of documents and registration; the management of internal and external quality audits; and the review of outcomes and improvement planning. Monitoring indicators are identified in the numbers of donors and of donated body parts per year, education sessions, and satisfaction of learners and donors, as evaluated by questionnaires. The process management approach, the integrated involvement of medical, technical, and administrative staff in defining procedures, and the application of monitoring indicators allow quality improvement in all aspects of the Body Donation Program. Anat Sci Educ. © 2012 American Association of Anatomists.     

“Why Give Up Something That Works So Well?”: Retirement Expectations Among Academic Physicians

For individuals with strong work identities, the decision to retire can be particularly challenging. For academic physicians, retirement is an important personal decision that also has far-reaching implications for the healthcare system. This is because academic physicians are responsible for producing the research from which key medical decisions are made, for training future healthcare providers, and for providing specialized care for patients. For this study, we conducted focus groups with academic physicians from a large research university in Canada and then performed inductive thematic analyses to examine perceptions and concerns about later life career transitions. This study highlights tensions between professional experiences for the next generation of physicians and individual struggles with personal identity. Findings suggest improvements to institutional programs that support flexible, agentive, and respectful retirement transitions will not only be beneficial but necessary as medical and university systems continue to grapple with issues of balanced recruitment and succession.     

The construct of talent

The role of the teaching hospital in medical education may be a useful model to describe the potential role of the Professional Development School (PDS) for teacher education. For most of the past century, teaching hospitals have been the key clinical training site for medical students. These hospitals offer students exposure to a broad mix of medical conditions, patient care services, and practicing physicians as teachers. The relationships between medical schools and teaching hospitals have been well defined and recognized by accrediting bodies. This model contributes substantially to the status of the U.S. medical education system as one of the best in the world, emulated by many other countries. In this article we describe the evolution of this model, including recent calls for modifications to better match current concepts on physician training and societal health care needs. Lessons from the medical education experience that are relevant to the PDS model and the education of teachers are discussed.     

ASSESSING THE RLEATIONSHIP BETWEEN MEDICAL EDUCATION AND SUBSEQUENT PERFORMANCE

This paper raises questions about the feasibility of conducting well‐designed and executed research to relate practice performance of physicians to their medical education. The longitudinal study efforts underway at McMaster University's medical school are used to illustrate the problems that confront educators interested in studying the impact of a curriculum on the later professional activities of its graduates. The possible role of less precise, but more comprehensive, data sources that describe career paths and patterns of physicians is discussed. These logistic and methodologic difficulties confront investigators interested in determining the impacts of complex innovations in higher education generally.     

Anatomical knowledge retention in third‐year medical students prior to obstetrics and gynecology and surgery rotations

Surgical anatomy is taught early in medical school training. The literature shows that many physicians, especially surgical specialists, think that anatomical knowledge of medical students is inadequate and nesting of anatomical sciences later in the clinical curriculum may be necessary. Quantitative data concerning this perception of an anatomical knowledge deficit are lacking, as are specifics as to what content should be reinforced. This study identifies baseline areas of strength and weakness in the surgical anatomy knowledge of medical students entering surgical rotations. Third‐year medical students completed a 20–25‐question test at the beginning of the General Surgery and Obstetrics and Gynecology rotations. Knowledge of inguinal anatomy (45.3%), orientation in abdominal cavity (38.8%), colon (27.7%), and esophageal varices (12.8%) was poor. The numbers in parentheses are the percentage of questions answered correctly per topic. In comparing those scores to matched test items from this cohort as first‐year students in the anatomy course, the drop in retention overall was very significant (P = 0.009) from 86.9 to 51.5%. Students also scored lower in questions relating to pelvic organs (46.7%), urogenital development (54.0%), pulmonary development (17.8%), and pregnancy (17.8%). These data showed that indeed, knowledge of surgical anatomy is poor for medical students entering surgical clerkships. These data collected will be utilized to create interactive learning modules, aimed at improving clinically relevant anatomical knowledge retention. These modules, which will be available to students during their inpatient surgical rotations, connect basic anatomy principles to clinical cases, with the ultimate goal of closing the anatomical knowledge gap. Anat Sci Educ 7: 461–468. © 2014 American Association of Anatomists.     

试论如何达到高校教师培训质量和效益的统一

在高校教师培训中，培训质量与培训效益既紧密联系又存在矛盾，为使两者达到统一，提出三条途径并试图证明其可行性：采取系统工程工作方法，加强培训过程管理，树立质量成本的思想。系统工程工作方法有助于以更经济的方式开展师资培训工作，能更充分发挥师资培训网络系统的职能；培训过程管理的好坏，会直接影响到培训的质量和效益的高低；高校教师培训树立质量成本观念，进行培训质量成本的分析，可以同时促进培训质量和效益的提高。     

名校长工作室TRIMER研修模式助力乡村区域教育质量提升——以保定市贫困县(脱贫县)系列名校长工作室为例

如何以名校长工作室方式助推乡村教育质量提升,河北省保定市贫困县(脱贫县)系列名校长工作室项目组形成的TRIMER(三聚体)研修模式进行了很好的探索。TRIMER模式在研修功能定位上强调校长成长、学校提质与区域教育优化三位一体;在研修方式上,培训、改进、辐射等三线交织;在研修原则上,培训与改进、个人研修与团队研修、素养提升与辐射带动有机结合;在培养主体上,保定市本土优秀校长的示范、北京市双导师的引领与京保教育行政的保驾护航相得益彰;在运行力量上,行政力量、学术力量、校长自我发展力量密切配合。