Basic Science Departments Research Articles

A Human-centered Approach to Medical Informatics for Medical Students, Residents, and Practicing Clinicians

The authors have developed a curriculum in medical informatics that focuses on practical problems in clinical medicine, rather than on the details of informatics technologies. Their development of this human-centered curriculum was guided by the identification of six key clinical challenges that must be addressed by practitioners in the near future and by an examination of the failures of past informatics efforts to make a significant difference in the everyday practice of clinical medicine. Principles of human factors engineering--the body of knowledge about those human abilities, limitations, and characteristics that are relevant to design--are an essential part of this curriculum. Human factors engineering also provides the necessary perspective, as well as the concrete knowledge and methods, that can enable practitioners to properly evaluate their clinical information needs, weight the merits of proposed technology-based solutions, and understand their own inherent performance limitations.

Educational Programs in US Medical Schools, 1995-1996

We present herein data on US medical education programs and describe how medical schools are adapting to a changing health care environment. The data mainly derive from the 1995-1996 Liaison Committee on Medical Education Medical School Questionnaire, which had a 100% response rate. The data indicate that in the 1995-1996 academic year there were 91 451 full-time faculty members in basic science and clinical departments, a 1.6% increase from 1994-1995. In clinical departments, major increases occurred in emergency medicine (a 10.6% increase in full-time faculty) and family medicine (a 13.5% increase). Applicants for the class entering in 1995 numbered 46 591, an increase of 2.7% from 1994; however, the number of first-time applicants decreased slightly (0.6%). Of the 17 357 applicants accepted, 2179 (12.6%) were members of underrepresented minority groups. Health system changes are affecting medical school clinical affiliations. During the past 2 years, 42 schools saw a merger, acquisition, or closure involving medical school-owned or medical school-affiliated hospitals used for core clinical clerkships. At 15 sites, this change affected the distribution of students across clinical sites. In 1995-1996, 40 medical schools or their universities owned a health maintenance organization or other managed care organization, 93 schools contracted with a managed care organization to provide primary care services, and 96 schools contracted with managed care to provide specialty services. During the past year, 57 schools acquired primary care physician practices, and 70 started primary care clinics in the community.

Back to the future--the history and philosophy of medicine experiment at Sydney University.

History and Philosophy of Medicine has been a compulsory unit in the first year of the medical curriculum at Sydney University for the past decade. Volunteer tutors are drawn from most clinical and basic science departments, and each year the programme is organized on a theme of current importance in medical practice. This course began as an experiment because no resources were available for specialist staff, but has proved outstandingly successful in generating both student and teaching staff interest and support for the programme. Students present short tutorial papers to their peer group followed by submission of an essay which takes into account the tutorial discussion. The open book examination includes analysis of an unseen piece of primary source material as well as questions derived from the classwork. The Faculties of Arts and Science encouraged this educational experiment and several medical students have now opted to undertake a year of historical research during the intercalated B Sci(Med) programme, and a number of the tutors have enrolled in postgraduate historial or ethical programmes. We suggest that this model may permit introduction of novel courses in times of financial cutback within the Universities, and even allow a foundation to be laid for future development.

Postgraduate Forensic Science Education in Turkey

Legal medicine in Turkey, has an educational background that goes back to 1839 and the first autopsy in modern terms was performed in 1841. In the early days, it was common practice for those involved in this work to extend their investigative knowledge into areas not directly concerned with medical matters. However forensic medical investigations cannot be entrusted in the hands of single investigators, but should rather be dealt with by cooperative groups of experts nowadays. This need was the major force for the establishment of the Institute of Legal Medicine and Forensic Sciences by a special article of the law (section 2547) as a training and research center in 1982. The Institute being the first and only institution giving master's and doctorate degrees in Forensic Sciences, has 3 major departments: 1) Medical Sciences Department, 2) Basic Sciences Department and 3) Social Sciences Department. Graduates of various fields ranging from medical doctors specialized in any field, biologists, chemists to lawyers, district attorneys, psychologists and other related fields are composing the multidisciplinary structure of the institute. The main research fields of the Institute are: population genetics, paternity investigation, child abuse, and identification of human remains.

Principles of clinical medicine: an interdisciplinary integrated 2-year longitudinal course

In keeping with the Report of the Panel on the General Professional Education of the Physician (Association of American Medical Colleges 1984), Oregon Health Sciences University (OHSU) School of Medicine is in the midst of revising its curriculum. After a 4-year process, the Curriculum Committee mandated development of the Principles of Clinical Medicine course, a 2-year longitudinal course integrating input from both basic and clinical science departments. We describe the steps leading to the course's implementation, its administrative and organizational structure, the evaluation of student performance, teacher training, course curriculum, and the use of interdisciplinary teaching. This course embodies many of the changes called for in the AAMC Report and serves as a model for interdisciplinary education.

Persisting effects of chronic developmental lead exposure on rats in the radial-arm maze: LEVIN, E.D., M.E. STANTON, S.M. LASLEY AND M.E. GILBERT Department of Psychiatry, Duke University Medical Center, Durham, North Carolina; Neurotoxicology Division, US-EPA, Research Triangle Park, North Carolina; Department of Basic Sciences, University of Illinois College of Medicine, Peoria, Illinois; and ManTech Environmental Technology, Research Triangle Park, North

Persisting effects of chronic developmental lead exposure on rats in the radial-arm maze: LEVIN, E.D., M.E. STANTON, S.M. LASLEY AND M.E. GILBERT Department of Psychiatry, Duke University Medical Center, Durham, North Carolina; Neurotoxicology Division, US-EPA, Research Triangle Park, North Carolina; Department of Basic Sciences, University of Illinois College of Medicine, Peoria, Illinois; and ManTech Environmental Technology, Research Triangle Park, North

Evaluation of short research experiences in cancer

For the past 5 years, the Cancer Education Committee of Louisiana State University Medical School (LSUMS) has selected premedical and medical students to participate in cancer research during the summer months. The students' participation is funded through a NCI R-25 training grant. Each year, LSUMS faculty from both the clinical and basic science departments provide opportunities for the students to participate in cancer research. The students also attend weekly seminars on cancer-related topics and biweekly multi-disciplinary Tumor Conferences. At the end of the summer, the students are required to submit and present a summary of their research project and to complete an evaluation form of the program. The overall evaluation of this experience has been favorable. Seventy-nine percent of the students agreed that the experience exceeded their expectations, and 83% responded that they would be willing to repeat the program. However, when asked if they planned to pursue a career in cancer research or medical oncology, 84 and 62%, respectively, were undecided. These findings raise the following questions: (1) When is the most appropriate time period in the student's education for this experience to take place? and (2) How can students' future career decisions be influenced?

A pilot study of biomedical trainees' perceptions concerning research ethics.

The authors surveyed 2,010 biomedical trainees in the fall of 1990 at the University of California, San Diego, regarding their perceptions about unethical practices in research and the extent of their training exposure to the ethics of scientific investigation; 549 responded, representing both clinical and basic science departments and including graduate students and postdoctoral fellows in addition to medical students, residents, and fellows. Of the 549 trainees, 129 (23%) responded that they had received no training in research ethics; 195 (36%), that they had observed some kind of scientific misconduct (although not necessarily in the sense of research fraud defined in federal regulations); and 81 (15%), that they would be willing to select, omit, or fabricate data to win a grant or publish a paper. The trainees planning an academic career were more likely to report having been aware of others' scientific misconduct. Reported exposure to ethics training was not associated with a difference in past or potential unethical behavior. The authors conclude that while the apparent ineffectiveness of past ethics instruction does not preclude the possibility that more systematic training may be useful, it does underscore the need to assess the efficacy of training activities.

The sif of the wing crack in the theory of a compression split

THE SIF OF THE WING CRACK IN THE THEORY OF A COMPRESSION SPLIT Hao Tian-hu Department of Basic Sciences, China Textile University 1882 West Yan-an Road, Shanghai 200051 People's Republic of China In the theory of formation of the main crack in a compressed cracked brittle-elastic material, the wing crack (Fig. 1) plays an important role. In order to determine the length of the wing crack we must compute its SIF. For convenience we replace the tortuous crack with a straight crack subjected to the action of two pairs of concentrated forces T and Q (Fig. 2) . The forces T and Q can be determined as follows: T = T o cos 0;Q = T O sin 0;T o = pcos 0(sin 0 I-t cos 0) c > 0 (1)

A study to examine whether the basic sciences are appropriately organized to meet the future needs of medical education

There is a growing divergence between the content of research activities in the basic sciences and that of the traditional preclinical courses for medical students. A 1977 study at the University of Pennsylvania School of Medicine (Penn) examined the organization of the school's basic sciences, including surveying the research interests and departmental affiliations of 101 basic science faculty at Penn and interviewing the basic science departments chairmen there and at five other research-intensive schools of medicine. The findings demonstrated overlapping interests among basic science investigators, significant blurring of departmental boundaries, and a divergence between the faculty members' research interests and the disciplines represented by the departments in which these faculty held appointments. A second study a decade later documented that this divergence had increased. This paper also addresses the mounting concern among medical educators in response to these kinds of developments, the effect of such developments on medical education, and issues concerning the teaching of basic sciences, course content, the responsibility of schools of medicine for effecting change, and a possible model for basic science instruction.

IV. The Division Chief as a Developer of Research Programs in a Pediatric Division

Among the varied functions of clinical departments in a medical center, one of the most important is biomedical, behavioral, and other types of health-related research. The research productivity of a division within a clinical department depends on several factors, but paramount is the sense among faculty members that research endeavors are worthy of pursuit. While basic science and applied clinical research can be conducted by industry or basic science departments, the constant exposure to patients and their disorders provides a unique relevancy to the investigator within a clinical department. To develop a research program, an organized approach is a prerequisite. RECRUITING AND RESEARCH FUNDING To develop a research program, the appropriate recruit is essential. Requirements for the development of a successful program include ideas, money, time, space, and mentors. An individual's curriculum vitae and performance can serve as a guide, but there is no litmus test to know whether a

Assessing research productivity: evaluating journal publication across academic departments.

Publications produced by faculty over a three-year period are used in analyzing the relative research productivity of basic and clinical science departments in a college of medicine. The citation ratings of the journals, the number of authors, and the byline position of the faculty member are used in various publication evaluation schemes. The departments vary almost tenfold in research productivity per faculty member. Results of the analysis demonstrate that the number of authors and the byline position influence departmental productivity rankings very little. Rankings are substantially affected, however, when the journals are weighted based heavily on citation ratings.

Allocating Research Space in the University Medical Center: Use of a Mathematical Formula

Allocation of research space often is one of the most emotional and contentious issues facing a university medical center. With decreasing dollars available for building new research laboratories in medical schools, the assignment of laboratory space to basic science and clinical departments presents a difficult problem for deans, chairmen, and faculty. In this article, the authors outline a formula in which net square feet of traditional research space (ie, wet-bench laboratories) may be allocated on the basis of research dollars, output of manuscripts and abstracts averaged over 3 years, and the number of personnel who will use the space. Caution is urged for arbitrarily applying a space formula when it does not apply, ie, nontraditional research, and when insufficient consideration has been given to the individual case. The formula is most useful when applied within a specific institution and primarily for comparative purposes. Nonetheless, once the formula is established, it provides an objective mechanism by which the need for space and the relative merits of space assignments within a department or among departments can be more effectively determined and managed.

Managing Scholarship From the Perspective of a Basic Science Department Chair

Managing Scholarship From the Perspective of a Basic Science Department Chair

Categoricalist Eligibility Requirements for ASCP Certification: A University-Based Medical Technology Curriculum

The specialty options in the University of Vermont' 2+2 Baccalaureate Medical Technology program prepare categoricalists in chemistry, hema-tology, and microbiology. Graduates of this university-based program are eligible to take Categoricalist certification examinations without additional clinical experience. These curricula offer courses and clinical rotations that provide more concentrated study in one area than can be accommodated in the generalist curriculum. Specialty graduates are proficient in routine and special methodologies and have experience in problem solving, troubleshooting, and clinical research. Clinical experiences are provided in university student laboratories and clinical affiliates. Graduates are successful in gaining employment in their specialty area. Those employed in their specialty rate their academic preparation as very good. Graduates of this type of program are eligible for ASCP Categorical certification under a new eligibility route. Other university-based medical technology programs, in conjunction with basic science departments, may adapt this curriculum for their students.

Design, implementation, and evaluation of a longitudinal cancer curriculum.

The University of Massachusetts Medical School's two year preclinical curriculum is organized by organ system and controlled by the basic science departments. It is followed by two years of required and elective clinical clerkships. An evaluation of cancer teaching in the preclinical curriculum using criteria derived from the Cancer Education Objectives for Medical Schools was conducted. Deficiencies in cancer teaching were documented and the need for an organized cancer education program established. The administration then allotted 18 hours for cancer teaching spread over the two years of the preclinical curriculum. Supported by an R25 Cancer Education Grant, the Longitudinal Cancer course (LCC), was developed in an attempt to effectively utilize the scattered class time to meet a significant number of American Association for Cancer Education Objectives. In addition, interdisciplinary teaching of the more common cancers was facilitated and faculty were supported in their use of cancer related examples to illustrate relevant materials in the basic sciences. Evaluation of the LCC after a three-year trial has shown that, without strong administrative support, it is a very inefficient method of cancer teaching. While students appreciated class content and met a significant number of course objectives, they found the longitudinal format of the course unsatisfactory and recommended that the course be consolidated into a block. R25 grant support was being sought to implement a proposal to consolidate cancer teaching when the R25 program was suspended. Without external support, implementation will be difficult because it will require serious disruption of an established course. Such a change will require resources that are not readily available in this era of fiscal constraint.

Experience with flexibility in an academic residency program

greater flexibility also might be beneficial if individuals are to be prepared for productive, academic research careers. Many of the current obstetric-gynecologic leaders in reproductive research pursued training programs that would be proscribed by current guidelines of the subspecialty boards. Thus, while many spent 1 or 2 years in a laboratory either abroad or in a basic science department in the United States, these are not components of “approved” programs of the current subspecialty disciplines. Furthermore, extensive clinical requirements, for example, the need for reproductive endocrinologists to train in tubal microsurgery and in vitro fertilization, and the large amounts of time in clinical pursuits mandated in fetal and maternal medicine and oncology mitigate against obtaining the requisite training to pursue an independent, productive, and competitive research-oriented career-and the discipline sorely needs this facet of the specialty better represented. Although I was not personally involved, the activity of this Society of which I have been most supportive and proud has been the creation of the Kennedy-Dannreuther fellowships. They furnish tangible evidence of the Society’s commitment to training investigators in the reproductive sciences. To maximize these opportunities, the greatest possible program flexibility needs to be encouraged and facilitated.

Does Nitrous Oxide Induce Release of Brain Opioid Peptides?

Division of Pharmacology, Department of Basic Sciences, Marquette University School of Dentistry; Department of Pharmacology and Toxicology, Medical College of Wisconsin; and Toxicology Research Service, Wood Veterans Administration Medical Center, Milwaukee and Wood, Wisconsin

The Case Against Tenure in Medical Schools

TENURE in medical schools is a relatively new phenomenon. It developed slowly, primarily because most medical schools consisted of parttime faculty until World War II. These part-time faculty were primarily clinicians who derived most of their income from the practice of medicine and were not dependent on the university for their economic survival. Although a number of medical schools had small basic science departments, even in them, tenure was not a subject of contention. Tenure developed in medical schools primarily as the medical schools became a progressively integral part of the university. It developed a much stronger base in public medical schools than in private medical schools, but was accepted even by the private schools, primarily to place them in a competitive position in the recruitment and retention of faculty and to provide employment security. The purposes of tenure are well known. It exists to protect faculty from adverse outside

Hippocrates unbound. China's medical education for the 1980s.

Working in a Beijing hospital for two years (1979 to 1981), I witnessed a metamorphosis of medical education in China. Walls have been whitewashed to mask discredited slogans of the past. Dining halls have been stratified to separate faculty, workers, and students. Since 1976, the academic program has doubled in length. Since 1979, revitalized basic science departments have enrolled postgraduates. "Worker-peasant-soldier" graduates of 1975 to 1980 have been recalled for remedial courses. Physicians from outlying provinces now staff city hospitals for terms of "advanced study." Barefoot doctors, highly regarded five years ago (but now considered to be only temporary expedients), face proficiency examinations. Doctors with shoes are also newly concerned about professional standards. Since 1977, prospective medical students take a nationwide entrance examination. Medical colleges now maintain transcripts and confer degrees. House staff, graduates of as long ago as 1964, are preparing for board examinations. Educational policy since 1977 is a determined reversal of trends of the preceding ten years.