Journal. Association of American Medical Colleges最新文献

Medical Ethics Education: Past, Present, and Future 医学伦理学教育:过去、现在和未来

Journal. Association of American Medical Colleges Pub Date : 1995-09-01 DOI: 10.1097/00001888-199509000-00013

E. Fox, R. Arnold, B. Brody

引用次数: 87

Do the Criteria of Resident Selection Committees Predict Residents' Performances? 居民选拔委员会的标准能预测居民的表现吗?

Journal. Association of American Medical Colleges Pub Date : 1995-09-01 DOI: 10.1097/00001888-199509000-00027

P. Fine, R. Hayward

{"title":"Do the Criteria of Resident Selection Committees Predict Residents' Performances?","authors":"P. Fine, R. Hayward","doi":"10.1097/00001888-199509000-00027","DOIUrl":"https://doi.org/10.1097/00001888-199509000-00027","url":null,"abstract":"Purpose. To further the understanding of what factors residency selection committees consider when rating candidates and how well these ratings predict residents' performances. Method. The authors analyzed the application and residency files of 123 physicians who completed the internal medicine residency at the University of Michigan from 1989 through 1992; they also reviewed all 308 applications for 1993–94. Applications to the residency were reviewed by an intern selection committee (ISC) and given scores ranging from O (best) to 450 (worst). Multivariate analyses were used to evaluate the influences on ISC scores of seven factors: gender, internal medicine clerkship grade, number of honors in non‐medicine clerkships, Alpha Omega Alpha (AOA) status, number of publications, score on the National Board of Medical Examiners (NBME) Part I examination, and medical school reputation. Each resident's performance was evaluated using the final overall evaluation score submitted by the program to the American Board of Internal Medicine. Results. The most significant predictors of ISC score were internal medicine clerkship grade, AOA status, medical school reputation, and NBME I score (all four at p <.01; R2 =.66 for the full model of seven factors). The residents' final evaluation scores were moderately correlated with ISC scores at the time of application (r = —.52). In a multivariate analysis, the final scores were significantly associated only with internal medicine clerkship honors (p <.01) and graduation from the University of Michigan Medical School (p <.05), and there was a trend associating them with junior‐year AOA election. Conclusion. The findings suggest that the intern selection committee overemphasized the predictive value of AOA election in the senior year, NBME I scores, and medical school reputation. Acad. Med. 70(1995):834–838.","PeriodicalId":87653,"journal":{"name":"Journal. Association of American Medical Colleges","volume":"70 1","pages":"834–838"},"PeriodicalIF":0.0,"publicationDate":"1995-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/00001888-199509000-00027","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61717993","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 57

The Study of Literature in Medical Education 医学教育中的文学研究

Journal. Association of American Medical Colleges Pub Date : 1995-09-01 DOI: 10.1097/00001888-199509000-00016

K. Hunter, R. Charon, J. Coulehan

{"title":"The Study of Literature in Medical Education","authors":"K. Hunter, R. Charon, J. Coulehan","doi":"10.1097/00001888-199509000-00016","DOIUrl":"https://doi.org/10.1097/00001888-199509000-00016","url":null,"abstract":"Abstract The study of literature encourages the development of otherwise hard‐to‐teach clinical competencies. It provides access to the values and experiences of physicians, patients, and families; it calls for the exercise of skill in observation and interpretation, develops clinical imagination, and, especially through writing, preserves fluency in ordinary language and promotes clarity of observation, expression, and self‐knowledge. Faculty in one‐third of U.S. medical schools teach literature in courses that, although concentrated in the preclinical years, range from the first day of school through residency programs. Once focused on the work of physician‐authors and realist fiction about illness that encouraged moral reflection about the practice of medicine, literary study in medicine now encompasses a wide range of literature and narrative types, including the patient history and the clinical case. Literary study is intended not only to enrich students' moral education but also to increase their narrative competence, to foster a tolerance for the uncertainties of clinical practice, and to provide a grounding for empathic attention to patients. Literature may be included in medical humanities courses, and it may provide rich cases for ethics courses or introductions to the patient‐physician relationship; it also may be the focus of small, elective, or selective courses, frequently on particular social issues or on the experience of illness. Reading, discussion, writing, and role‐play rather than lectures are the methods employed; faculty include those with PhDs in literature and MDs who have strong interests in the contributions of literature to practice. Pedagogical and scholarly resources include Literature and Medicine, the Center for Literature and the Health Care Professions, and an online database and discussion group. Acad. Med. 70(1995):787–794.","PeriodicalId":87653,"journal":{"name":"Journal. Association of American Medical Colleges","volume":"70 1","pages":"787–794"},"PeriodicalIF":0.0,"publicationDate":"1995-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/00001888-199509000-00016","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61717685","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 14

Medical History in the Undergraduate Medical Curriculum 本科医学课程中的医学史

Journal. Association of American Medical Colleges Pub Date : 1995-09-01 DOI: 10.1097/00001888-199509000-00014

S. Lederer, E. More, J. Howell

{"title":"Medical History in the Undergraduate Medical Curriculum","authors":"S. Lederer, E. More, J. Howell","doi":"10.1097/00001888-199509000-00014","DOIUrl":"https://doi.org/10.1097/00001888-199509000-00014","url":null,"abstract":"Abstract History has long played a role in the education of American physicians, but the uses of medicine's past have changed over time. In the late nineteenth century, some physicians taught medical history to their students to supply a sense of continuity with professional traditions in times of rapid and bewildering change. Other physicians believed that instruction in medical history would impart a sense of refinement to medical practitioners. In the late twentieth century, medical history is increasingly viewed as a significant dimension of the professional, intellectual, and humanistic development of medical students. Further, it is one of the principal means by which recent, radical changes in health care can be given needed perspective. The knowledge that medicine and the medical sciences are fundamentally social enterprises is an important lesson for medical students. Through exposure to the history of health care, students also learn that medical knowledge is itself subject to change and is acquired in specific contexts. In the 1990s, medical history is taught in a variety of settings. In some schools, history is integrated into the teaching of medical humanities. Where medical history is institutionally distinct from the humanities, courses in medical history may be either elective or required. In order to reach students at every stage of their medical education, historians and clinicians can join forces to teach history in innovative and flexible programs. Acad. Med. 70(1995):770–776.","PeriodicalId":87653,"journal":{"name":"Journal. Association of American Medical Colleges","volume":"70 1","pages":"770–776"},"PeriodicalIF":0.0,"publicationDate":"1995-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/00001888-199509000-00014","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61717973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 117

Influence of a Freshman‐year Panel Presentation on Medical Students' Attitudes toward Homosexuality 一年级专题演讲对医学生同性恋态度的影响

Journal. Association of American Medical Colleges Pub Date : 1995-09-01 DOI: 10.1097/00001888-199509000-00028

M. Wallick, K. Cambre, M. H. Townsend

{"title":"Influence of a Freshman‐year Panel Presentation on Medical Students' Attitudes toward Homosexuality","authors":"M. Wallick, K. Cambre, M. H. Townsend","doi":"10.1097/00001888-199509000-00028","DOIUrl":"https://doi.org/10.1097/00001888-199509000-00028","url":null,"abstract":"Purpose. To explore medical students' changes in group attitude toward homosexuality following mid‐year exposure as freshmen to a panel presentation on the topic and, later, following clinical experiences. Method. At the beginning, middle, and end of 1991–92 and during the psychiatry clerkship in 1993–94, all 186 students in the class of 1995 at the Louisiana State University School of Medicine in New Orleans were asked to complete anonymously the Index of Attitudes toward Homosexuals. The two subsequent entering classes were also surveyed, at the beginning and in the middle of their freshman year. Results. Group attitudes among the three consecutive classes were remarkably consistent. The original cohort displayed a decrease in group homophobic attitude over time, with the reduced mean score at mid‐year continuing its downward trend at year's end, though rebounding somewhat by the junior year. However, the group mean score remained in the low‐grade homophobic category throughout the three‐year study. Conclusion. That the mean scores of the three classes remained at the low‐grade homophobic level suggests the desirability of establishing an ongoing forum to enable students to examine all deeply held beliefs that may affect patient care. Acad. Med. 70(1995):839–841.","PeriodicalId":87653,"journal":{"name":"Journal. Association of American Medical Colleges","volume":"11 1","pages":"839–841"},"PeriodicalIF":0.0,"publicationDate":"1995-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/00001888-199509000-00028","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61718048","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 40

Toward a Person‐centered Medicine: Religious Studies in the Medical Curriculum 迈向以人为本的医学:医学课程中的宗教研究

Journal. Association of American Medical Colleges Pub Date : 1995-09-01 DOI: 10.1097/00001888-199509000-00018

D. Barnard, R. Dayringer, C. Cassel

{"title":"Toward a Person‐centered Medicine: Religious Studies in the Medical Curriculum","authors":"D. Barnard, R. Dayringer, C. Cassel","doi":"10.1097/00001888-199509000-00018","DOIUrl":"https://doi.org/10.1097/00001888-199509000-00018","url":null,"abstract":"Abstract The role of religious studies in the medical curriculum derives from three important aspects of people's engagement with religious belief and practice. These are (1) religion as a source of meaning, (2) religion as a source and frame‐work for values, and (3) religion as an outstanding context for the appreciation of human diversity. By offering separate religious studies courses, or by introducing religious themes and content into students' other learning experiences, the curriculum can foster the student's respect for the individuality of the patient in his or her cultural context; heighten the student's awareness of the patient's—and his or her own—beliefs, values, and faith as resources for dealing with illness, suffering, and death; help students address any of the myriad value‐laden aspects of everyday living that are part of the context of many doctor—patient encounters; and strengthen the student's commitment to a person‐centered medicine that emphasizes the care of the suffering person rather than the biology of disease. The authors discuss the strengths and limitations of several settings for the teaching of religious issues in medicine, and suggest specific pedagogical approaches, readings, and resources. Acad. Med. 70(1995):806–813.","PeriodicalId":87653,"journal":{"name":"Journal. Association of American Medical Colleges","volume":"70 1","pages":"806–813"},"PeriodicalIF":0.0,"publicationDate":"1995-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/00001888-199509000-00018","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61717873","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 88

Educating Medical Students about Law and the Legal System 对医学生进行法律与法律制度教育

Journal. Association of American Medical Colleges Pub Date : 1995-09-01 DOI: 10.1097/00001888-199509000-00015

Peter C. Williams, W. Winslade

{"title":"Educating Medical Students about Law and the Legal System","authors":"Peter C. Williams, W. Winslade","doi":"10.1097/00001888-199509000-00015","DOIUrl":"https://doi.org/10.1097/00001888-199509000-00015","url":null,"abstract":"Abstract The study of jurisprudence—law, legal reasoning, and the legal system—has become progressively more common in medical school curricula. Familiarity with jurisprudence helps physicians practice medicine well, collaborate productively with lawyers, and be more effective in public discourse about health care delivery. Moreover, the study of jurisprudence can help physicians polish the methods and clarify the purposes common to law and medicine. Empirical studies over the last 30 years demonstrate patterns of change in the frequency and focus of jurisprudence teaching in medical school curricula that can guide contemporary efforts to devise or refine curricula in medical jurisprudence. The general goal of such curricula should be to enhance physicians' clinical, institutional, and public effectiveness. These curricula should adhere to principles of sound pedagogy and be based on informed answers to the central questions of what should be taught, when, how, and by whom, and how the curriculum should be evaluated. Developing skills and changing attitudes are more important than imparting information about particular doctrines and laws. Curriculum planners should take into account the intellectual styles of the learners; integrate, not just coordinate, the new courses with the rest of the curriculum; build on features that medicine and law share and where they collaborate; and ensure intra‐ and inter‐curricular coherence and continuity. Even though limitations of time, people, and money and differences in educational goals will influence what, when, and how medical jurisprudence is taught, the effort should be made if physicians are to be better empowered to use the law and their law colleagues to serve patients and promote public welfare. Acad. Med. 70(1995):777–786.","PeriodicalId":87653,"journal":{"name":"Journal. Association of American Medical Colleges","volume":"70 1","pages":"777–786"},"PeriodicalIF":0.0,"publicationDate":"1995-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/00001888-199509000-00015","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61718089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 29

Surveying Graduates of Combined Internal Medicine ‐ Pediatrics Residency Programs 调查内科-儿科联合住院医师项目的毕业生

Journal. Association of American Medical Colleges Pub Date : 1990-04-01 DOI: 10.1097/00001888-199004000-00014

F. Biro, M. Gillman, Ruth M. Parker, P. Khoury, D. Siegel

{"title":"Surveying Graduates of Combined Internal Medicine ‐ Pediatrics Residency Programs","authors":"F. Biro, M. Gillman, Ruth M. Parker, P. Khoury, D. Siegel","doi":"10.1097/00001888-199004000-00014","DOIUrl":"https://doi.org/10.1097/00001888-199004000-00014","url":null,"abstract":"Abstract Graduates of all U.S. combined internal medicine‐pediatrics residency programs were surveyed in 1987 regarding a variety of demographic information about their residencies and current practices, the residency curricula they had followed for both specialties, and recommendations for modifications in training. The 71 responding graduates (from a total of 112) reported patient care as their major involvement (mean of 42.9 hours per week), with a majority (83%) seeing patients in both pediatric and adult age groups. Most were involved in primary care only (64%). The graduates reported that during both pediatrics and internal medicine training, they had had too many inpatient and intensive care rotations and too few elective and ambulatory rotations. The most important subspecialty rotations in internal medicine were considered to be cardiology, dermatology, and pulmonary medicine; and in pediatrics, infectious disease, cardiology, and adolescent medicine. The graduates recommended more outpatient subspecialty rotations, ambulatory rotations in medicine and pediatrics, and a combined medicine‐pediatrics continuity clinic. Acad. Med.","PeriodicalId":87653,"journal":{"name":"Journal. Association of American Medical Colleges","volume":"65 1","pages":"266–271"},"PeriodicalIF":0.0,"publicationDate":"1990-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/00001888-199004000-00014","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61713331","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 18

Investigating the Fairness of the National Resident Matching Program 全国居民配对计划公平性调查

Journal. Association of American Medical Colleges Pub Date : 1990-04-01 DOI: 10.1097/00001888-199004000-00011

Yufei Yuan, A. Gafni

{"title":"Investigating the Fairness of the National Resident Matching Program","authors":"Yufei Yuan, A. Gafni","doi":"10.1097/00001888-199004000-00011","DOIUrl":"https://doi.org/10.1097/00001888-199004000-00011","url":null,"abstract":"Abstract The National Resident Matching Program (NRMP) was established in the early 1950s to bring order and fairness to a previously chaotic application process for internship and residency positions. Over the years many reservations were raised about the fairness of the process, specifically, that hospital programs are doing better than students are (i.e., programs obtain preferred residents more often than students receive preferred programs). This paper presents an analysis of the results of the 1986 Match. The findings do not support the claim that the results of the Match are biased in a way that favors programs. Overall, the students' success was greater (i.e., receiving on average higher‐ranked choices) than was the hospital programs' success. In fact, in 20 of 22 specialty programs, the students' degree of success was greater than or equal to the success of the programs. This finding raises the question of fairness toward programs rather than students. The authors analyze factors that affected both the hospitals' and the students' degrees of success in the 1986 Match and suggest strategies for improving the Match results. Acad. Med.","PeriodicalId":87653,"journal":{"name":"Journal. Association of American Medical Colleges","volume":"65 1","pages":"247–253"},"PeriodicalIF":0.0,"publicationDate":"1990-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/00001888-199004000-00011","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61713106","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 19

The Reliability of the Proposal Review Process for a Summer Research Fellowship Program 暑期研究奖学金项目提案审查过程的可靠性

Journal. Association of American Medical Colleges Pub Date : 1990-04-01 DOI: 10.1097/00001888-199004000-00012

A. Peters

{"title":"The Reliability of the Proposal Review Process for a Summer Research Fellowship Program","authors":"A. Peters","doi":"10.1097/00001888-199004000-00012","DOIUrl":"https://doi.org/10.1097/00001888-199004000-00012","url":null,"abstract":"Abstract The authors evaluated the reliability of the proposal review process used by a faculty‐student committee to choose medical student researchers for summer fellowships. A total of 82 proposals were reviewed by the committee over a two‐year period (43 in 1987 and 39 in 1988); the proposals were assigned ratings in the spring of each year. The 39 students whose proposals received the highest ratings over the two‐year period received fellowships and carried out their projects during ten weeks in the summer of each year. In December of both years, the research fellows, along with a total of 12 students whose proposals had been rejected by the program over the two‐year period but who had received support from other programs, presented their findings. These research presentations were also judged and rated, and the ratings of all the presentations were compared with the student committee's original ratings of the research proposals. A significant correlation was found between both years' sets of ratings for the proposals and the research presentations. The “accepted” students generally received higher ratings on their presentations than did the “rejected” students; however, the mean of the ratings received by the “accepted” students for their presentations was not significantly higher than that received by the “rejected” students. Even so, the significant correlation between each year's set of ratings for all the students involved demonstrates the soundness of the review process. Acad. Med.","PeriodicalId":87653,"journal":{"name":"Journal. Association of American Medical Colleges","volume":"65 1","pages":"254–256"},"PeriodicalIF":0.0,"publicationDate":"1990-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/00001888-199004000-00012","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61712720","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 10