THREE STRATEGIES FOR DELIVERING CONTINUING MEDICAL EDUCATION IN GERIATRICS TO GENERAL PRACTITIONERS

General practitioners (GPs) need advanced skills in geriatric assessment to be competent to treat the increasing number of elderly patients. Continuing medical education in geriatrics for GPs is heterogeneous, and not assessed for effectiveness. In this study we compared the educational effects of three geriatric post-graduate training methods on GPs. GPs in the health district of the Nijmegen University Medical Centre (The Netherlands) were offered a variety of training options in geriatric assessment: (1) a formal one-day teacher centered conference (TCC), (2) an interactive GP-centered day of workshops (GCW), and (3) participation in a project of knowledge translation, linked to a research project of geriatric intermediate care (GKT). Pre-post measures were taken of the attitudes of GPs towards the elderly (Aging Semantic Differential, 1969), attitudes towards geriatric patients (Maxwell & Sullivan, 1980 Maxwell, A. J. and Sullivan, N. 1980. Attitudes toward the geriatric patient among family practice residents. Journal of the American Geriatric Society, 2(8): 341–345.  [Google Scholar]; Rosencranz & McNevin, 1969 Rosencranz, H. A. and McNevin, T. E. 1969. A factor analysis of attitudes towards the aged. Gerontologist, 9: 55–59. [Crossref], [PubMed], [Web of Science ®] , [Google Scholar]) and geriatric competencies (Robinson, Barry, Renick, et al., 2001 Robinson, B. E., Barry, P. P., Renick, N., Bergen, M. R. and Stratos, G. A. 2001. Physician confidence and interest in learning more about common geriatric topics: A needs assessment. Journal of the American Geriatric Society, 49: 963–967. [Crossref], [PubMed], [Web of Science ®] , [Google Scholar]). After training, neither the attitudes towards the elderly nor geriatric patients changed in any of the three groups. The TCC did not show a significant change in perceived competencies, while the GCW and GKT group improved. A formal large group conference is ineffective in improving GPs' geriatric assessment skills, while small interactive workshops and participation in a project of knowledge translation are equally effective. None of the three training methods improved or worsened attitudes toward the elderly in general or the geriatric patients in particular.     

MEDICAL EDUCATION IN GERIATRICS: THE LASTING IMPACT OF THE AGING GAME

In an effort to sensitize medical students to the problems of the frail elderly, a simulation experience known as the Aging Game is a required portion of the Introduction to Clinical Medicine course for medical students at Duke University. The immediate positive effect of the Aging Game has been documented (Journal of the American Medical Association, 262, 1507‐1509), but its long‐term impact has not been established. To obtain follow‐up, a brief 10‐item questionnaire was mailed to all medical students. Both objective and subjective data were collected to ascertain the impact of the Aging Game over time (class years two through four), and objective responses were analyzed by the Mantel‐Haenszel chi‐square test of general association. The lasting effect of the intervention was confirmed over the 2‐year follow‐up period. The experiential nature of the intervention and the resultant increase in empathy for the frail elder explain the success of the Aging Game.     

IMPORTANCE OF RESEARCH IN GERONTOLOGY FOR EDUCATION AND TRAINING IN GERIATRICS

Geriatrics, a new medical specialty, is closely linked with scientific research in experimental gerontology, the biology of aging, and social gerontology and gerohygiene. The importance of using gerontological research data and data on relationships between the aged, family, and society is discussed. Emphasis is placed on (1) the development of diseases of the aged, (2) the significance of genetic factors on aging, (3) the relationship between chronological and biological age, and (4) the importance of physiological reactions in the aged to various types of treatment. The significance of international cooperation in the improvement of education and training of medical personnel in geriatrics is also stressed.     

A JEWISH SCHOOL MODEL FOR MORAL EDUCATION

Since Gaonic times a great deal of Jewish history had been made, and vast areas of Jewish living had been vitally affected by an intellectual device known as “Shaalot Utshuvot” (“Responsa”), an exchange of correspondence between two leaders of Jewish thought and learning. Something in the nature of such a responsum took place between our colleagues Drs. Judah Pilch and David Kuselewitz, on the occasion of the former's publishing an experimental edition of a proposed High School curriculum, in his former capacity as director of the Curriculum Research Institute.

We publish herewith David Kusele‐witz's reply to Judah Pilch's request for his evaluation of the curriculum proposal. Written in 1965, it is still very relevant to our troubles and our challenges, and offers much food for bold and innovative thought on several vital Jewish educational issues.     

THE DEVELOPMENT OF A MEDICAL STUDENT INTEREST GROUP IN GERIATRICS

As society ages, there is an increasing demand for knowledge and skills to care for the elderly. Innovative ways to stimulate the interest of medical students in geriatric medicine present an important challenge to medical schools today. This article discusses the value of a student interest group in meeting this challenge. In 1988, the Department of Geriatrics at the Mount Sinai School of Medicine in New York City initiated a student interest group in geriatrics. Over the ensuing years, this group has provided medical students with a forum for pursuing research interests in geriatrics, networking with other students, and interacting with faculty role models interested in geriatric medicine.     

PROGRAM DEVELOPMENT STRATEGIES IN GERIATRIC EDUCATION: IMPLICATIONS FOR FACULTY

The demographic imperative for geriatric training and care is well documented and comes as no surprise to health care professionals working in the field (see National Institutes of Health, 1987). The dramatic increase in the numbers of elderly, particularly those age 75 and older, suggests that geriatric health care will grow in importance throughout the next decade. This article briefly examines strategies for geriatric education that may have relevance for attempts to formalize and institutionalize geriatric content in academic institutions, and suggests strategies for implementation.

The domains of geriatrics and gerontology have continued to overlap as models of training and health care delivery have evolved. Distinctions between these two perspectives remain important, particularly as they pertain to the emphasis on training related to normal versus pathological aging. For purposes of simplicity, the term geriatric is used in a broad context that includes gerontological education as well. The reality of our educational experiences suggests that a balance between normal and pathological aging content in our curriculum is one of the first crucial variables that needs to be addressed.     

大学通识教育的基本理念和课程规划

本文探讨大学从文雅教育开始、历经共同科目、而后发展至当前通识教育的演进历程,并说明文雅教育系针对职业教育、共同科目系针对选修科目、通识教育系针对专门教育。文中强调专门教育加上通识教育才是专业教育,析论通识“教育”、通识“课程”、通识“科目”、通识“教学”、通识“评量”之间的逻辑序列及其内涵与相关。其中特别对通识课程的规划和通识教学的理念,提出基础性和补救性、广博性和多元性、进阶性和统整性的层次,以达成清晰明确的表达能力、综合统整的判断能力、多元整合的全人教育为通识教育之目标。最后以美国著名大学通识教育的课程规划、学分比例以及教学评量等印证：要成为一流的卓越大学,必须重视和加强通识教育。     

EVALUATION OF A GERIATRICS ROTATION FOR POSTGRADUATE RESIDENTS IN LEBANON

As we enter the 21st century, increasing numbers of older adults will reside, either temporarily or permanently, in nursing homes. Training in nursing home care must become an integral part of the curriculum for internal and family medicine residency programs. The changing demographics of the Lebanese population have created an imperative for medical schools to increase their emphasis on the education and training of residents in the care of the elderly. A four-week block rotation was started for residents in the family medicine department in Hotel Dieu (The French Medical School). The rotation is taking place at the comprehensive Geriatric Program at Ain Wazein Community Hospital. The goal of the rotation is to provide formal training in nursing home care to family practice residents as a component of the geriatrics curriculum. The organization and the curriculum content of the rotation are presented. The initial evaluation of the rotation by the residents showed that the residents became more comfortable with elderly issues by the end of the rotation. Residents responded on a scale of one to six regarding four constructs. The rotation was positively evaluated by residents and staff. Consequently, the rotation has been incorporated into the curriculum of family medicine residents in Hotel Dieu.     

农村留守儿童:学校教育的缺失与应对

由于我国农村学校教育的教育理念、办学条件、师资力量、课程建设等方面存在诸多缺陷,目前农村留守儿童在成长过程中暴露出许多问题。为解决这些问题,从学校教育角度要不断完善学校教育制度,加强教师素养培训,开发校本课程建设,丰富校园文化建设,实行寄宿制管理,加强家庭教育指导。     

会计教育面临的挑战和我们的应对策略

我国会计教育面临的挑战来自两个方面 :会计环境发生巨变和会计实务不断创新以及会计理论的重构。因此高校的会计教学如何改革 ,首先应界定高校教学改革的指导思想 ;其次应提高师资水平 ,建立我国会计教师资格认证制度 ;另外在教材的内容方面和课程设置上 ,注意与最新国际会计准则和相关国际法律的结合 ;在教学实践环节方面 ,加强案例教学 ,培养学生分析 ,决策、动手的能力 ,注意培养对数据库技术、网络技术有一定了解的复合型会计人才。     

中师生物学教学实施素质教育的探讨

素质教育是各学科教育改革的主旋律 ,优化教学过程是实施素质教育的核心。本文就中等师范学校生物学教学过程实施素质教育的途径和方法进行探讨。     

STUDENT ASSESSMENT IN MEDICAL EDUCATION: A CANADIAN CASE STUDY

The assessment system of a Canadian medical education program is described. The M.D. Program at McMaster University features the central use of clinical cases as the basis for learning, and the fostering of independence in learning by students. The assessment system, designed to match the objectives and methods of learning, is guided by several principles. These include a balanced emphasis on a range of objectives, the use of on‐going informal feedback, defined and shared responsibilities in assessment, and the design and use of measures which most appropriately match the objectives. More than ten years of experience has pointed out several lessons: if self‐directed learning is held as important, there is a trade‐off between excessively specific objectives, on the one hand, and too little guidance on the other. This attempt to create a balance between these extremes produces a degree of unevenness in the assessment system. External influences such as the national licensing examinations have some effect on the learning climate. It is predicted that the basic elements of the assessment system will remain in place, but some specific changes will occur. These include a clearer statement of objectives on which assessment can be based, the improvement of measurement tools, and an increased emphasis on the training of those who participate in the assessment system.