Edinburgh Medical Students Research Articles

Ageing simulation for promoting empathy in medical students.

Elderly patients have complex health needs and are vulnerable to inadequate or undignified treatment.1 Fostering professional and altruistic attitudes in medical education is necessary in order to prepare medical students for care of older patients.2 This paper describes a low-fidelity simulation session designed to increase empathy towards elderly patients among University of Edinburgh medical students. The session aims to enhance understanding of effects of age-related physical impairments on activities of daily living; how these impairments may challenge good clinical care and stimulate discussion about how these challenges may be mitigated. The session has been integrated into the Medicine of the Elderly teaching programme and here we describe it as delivered in NHS Fife, where the session has expanded to include a commercial age simulation suit3 to further enhance the learning experience. The 90 min session accommodates six medical students and is facilitated by two tutors in the Education Centre, Victoria Hospital, Kirkcaldy. Initially, the students are introduced to the aims during a 10 min briefing, and safety aspects are discussed. The students are divided into groups: the first focus on mobility; the second on special senses, before switching over after 30 min. Finally, there is a 20 min debrief. The students are supervised at all times. ### Mobility Each student has the opportunity to wear the simulation suit, consisting of a weighted vest, soft collar, straps and overshoes (see figure 1). The student is dressed in the components over her/his own attire by the other group members before carrying out tasks around the education centre: getting from seated to standing position; …

PathCAL - The Saga So Far

Many Edinburgh medical students will be familiar with the set of computer assisted learning programs (CALs) called PathCAL, which help the user understand the basic pathological principles of disease. Currently we have approximately 110 programs running on the Web, available to anyone with access to the Edinburgh Electronic Medical Curriculum (EEMeC). These programs did not spring into being overnight: their gestation was long and frustrating. I am taking up the offer to relate it, although I am acutely aware that writing about the history o f anything from personal experience is a real sign of advancing years.

Sudden Infant Death Syndrome

Sudden infant death has only recently begun to attract widespread publicity and medical investigation. It is still largely ignored by the standard paediatrics textbooks and the only description of it given in formal lectures to Edinburgh medical students comes in the Forensic Medicine course. This perhaps helps to serve one useful purpose in that it may be an indication as to why the sudden infant death syndrome is still almost completely unexplained. These unfortunate children are usually found dead and, if they reach hospital at all, it is only as far as the accident and emergency department on their way to the mortuary. Most go directly to a coroner's or procurator fiscal’s post-mortem, and are thus relatively insulated from the research-orientated clinician’s attention and interest. This syndrome is certainly no new phenomenon. Up to the end of the last century doctors were satisfied that these deaths were due to “teething”, a wide category that included many deaths for which an adequate explanation would now be found. The 1839 Registrar-General’s returns showed a total of 5,016 infant deaths due to this “cause” . The fashion then changed towards attributing them to “status thymolymphaticus”, although exactly why seems to be unknown. Gradually, however, the position is becoming somewhat clearer. Werne and Garrow in the United States produced some of the first significant papers during and immediately after the second world war. In Britain Professor Sir Samuel Bedson and Dr. F. E . Camps (1951) submitted a memorandum to the Ministry of Health, estimating an annual toll of 200 children, and suggesting an official investigation which finally bore fruit under Professor Banks in the 1965 Report.

Two Hundred Years Ago

An extract from the Senior President's Valedictory Address delivered before the Society on Friday,6th March 1959.The setting is Edinburgh in the second half of the eighteenth century, the era of the post-chaise, the phaeton and the sedan-chair, when the North Bridge had just been opened to traffic and Princes Street was scarcely built. The hero is a typical Edinburgh medical student,Sylas Neville by name. This young man combined few virtues with not a few of the vices of his age. He was neither rich nor brilliant but might be classed as comfortably average at most accomplishments. Indeed the only work he left washis Diary, which is of great value to posterity in that part of it comprises a frank and detailed account of his five years in Edinburgh as a medical student.His story is of particular interest to us because, in 1775, rather by accident than design,Sylas Neville became a President of this Society-yet to become the Royal Medical Society.

Consumer Research

At about the beginning of June, one in three of all Edinburgh medical students will receive a questionnaire from the Professor of Public Health and Social Medicine. The questions to be asked cover such topics as: factors which influenced the student's decision to enter medicine: his reactions to the medical school; his views on different phases of the medical curriculum and on medical education generally; his views on different branches of medical practice, and his own career plans.This questionnaire represents the first stage of a national enquiry launched by the Association for the study of Medical Education. All medical schools are now engaged on a re-appraisal of their curricula and their teaching methods, and the Association for the Study of Medical Education (or ASME, as it is generally known) recognises that the value of these discussions is likely to be very greatly increased if they take full account of the medical student-his background, his interests and his reactions. Accordingly, all medical schools in Britain will be invited to participate in this enquiry, and the Edinburgh University Department of Public Health and Social Medicine is to carry it out on behalf of ASME.

Radiology and the Edinburgh Medical Student

Radiology and the Edinburgh Medical Student

Ian Duncan Willatt

Ian Duncan Willatt (“Duncan”) was born in Stoke on Trent on 12 February 1917 and died on 23 March 2009, aged 92. A scholarship at Newcastle under Lyme School was...

Ruth Annette Janie Willatt (née Evershed)

Ruth Annette Janie Willatt (nee Evershed) was born in South Bersted, West Sussex, on 14 June 1915 and died 27 March 2009, aged 93. She was a highly gifted schoolgirl...

Walking the Paris Hospital: Diary of an Edinburgh Medical Student, 1834-1835 Diana E. Manuel, ed.

Walking the Paris Hospital: Diary of an Edinburgh Medical Student, 1834-1835 Diana E. Manuel, ed.

MANUEL, Diana E. (ed.). Walking the Parish hospitals : diary of an Edinburgh medical student, 1834-1835 [Medical History, Supplement nº 23

MANUEL, Diana E. (ed.). Walking the Parish hospitals : diary of an Edinburgh medical student, 1834-1835 [Medical History, Supplement nº 23

Walking the Paris Hospitals: Diary of an Edinburgh Medical Student, 1834-1835 (review)

Reviewed by: Walking the Paris Hospitals: Diary of an Edinburgh Medical Student, 1834–1835 Guenter B. Risse Diana E. Manuel , ed. Walking the Paris Hospitals: Diary of an Edinburgh Medical Student, 1834–1835. Medical History, suppl. no. 23. London: Wellcome Trust Centre for the History of Medicine at UCL, 2004. xii + 211 pp. Ill. $50.00, £32.00 (0-85484-074-5). Writing one's day-to-day experiences has become a popular literary genre, displaying the variety and richness of human life. Sharing information today through blogs or online diaries contributes to our understanding of events and personalities. This anonymous journal, written by a British medical student, highlights his impressions about the academic year before graduation that he spent in Paris [End Page 369] between 1 November 1834 and 30 June 1835. The author, enrolled at the University of Edinburgh, was among many foreigners eager to supplement their studies in what was then unquestionably the mecca of Western medicine. The text offers a valuable window into the workings of the renowned Paris Medical School. The unfiltered daily entries reveal a highly motivated and curious medical student determined to make the most of his limited sojourn in the City of Lights. Frugal, searching for cheap lodgings and meals, eschewing a busy social life, he comes across as an extremely focused individual busily shuttling between teaching hospitals from early morning to evening—including Sundays—to witness clinical rounds, surgical procedures, and autopsies. Interspersed between his hastily written observations are brief expressions of ambiguity about French culture and religion. As time wore on, the student's mood grew hostile; he seemed to perceive that every Frenchman took delight in taking advantage of "raw" Englishmen. "This beastly Paris," he commented on Christmas 1834, "I detest it more and more everyday of my life" (p. 91). What is missing from the diary, however, are thoughtful reflections about his experiences. Time, of course, was of the essence, "interesting" patients the goal. The diary is full of passing comments about seeing "capital cases," "absolutely nothing of any consequence," "can't say I much benefited." The Parisian hospitals and clinics were, of course, veritable museums of pathology, with human specimens drawn from the poorer sectors of a metropolis suffering from numerous "fevers," prominently including tuberculosis, typhoid fever, and syphilis. There are also glimpses of practical skills that this British student definitely wanted to learn. In addition to "walking" the wards, he enrolled in special evening sessions conducted by midwives on the use of the vaginal speculum and forceps, and a private course on diagnosis through the use of the stethoscope and percussion hammer. The downside of a medical education in Paris can be inferred from vivid comments about the large number of students crowding the hospital wards, lecture rooms, and autopsy tables. Rounds by medical luminaries, who were in charge of many patients, could be very speedy and perfunctory, with magisterial comments muffled by the distance from the selected inmate and drowned out by the usual hustle and bustle prevailing in the ample wards. Lecture rooms to witness surgery or case presentations filled up quickly, with eager students even seeking seats during prior, less popular lectures in order to prevent having to hover outside the doorways. Moreover, the diarist was uncomfortable with the dehumanizing approach to French patients, specifically commenting on famous surgeons—cruel "slashers"—who were more interested in developing their techniques than concerned with the welfare of their charges. However, the diary remains silent about the two major criticisms made by other foreign visitors. The first is the almost total passivity of a Parisian education except for the house staff, the appointed "élèves internes": foreign students observed too much but personally did very little. The sensory overload with "capital" cases was often ephemeral and unstructured, and proved dehumanizing. Finally, while a year spent in Paris could have definitely enhanced professional prestige, how much did it actually matter for subsequent private practice in an English town? The observed [End Page 370] clinical spectrum assembled in Parisian hospitals reflected the risks and ecology of disease typical of a great European metropolis. It is doubtful whether the British diarist—tentatively identified as James Surrage of Clifton—would...

Walking the Paris Hospitals: Diary of an Edinburgh Medical Student, 1834–1835

Walking the Paris Hospitals: Diary of an Edinburgh Medical Student, 1834–1835 (Medical History, Supplement No. 23), Diana E. Manuel (ed.), London: The Wellcome Trust Centre for the History of Medicine at UCL, 2004. Pp xii + 211. ISBN 0–85484–074–5.

Diana E Manuel (ed.), Walking the Paris hospitals: diary of an Edinburgh medical student, 1834–1835, Medical History, Supplement No. 23, London, Wellcome Trust Centre for the History of Medicine at UCL, 2004, pp. xii, 211, illus., £32.00, US$50.00 (hardback 0-85484-074-5).

Diana E Manuel (ed.), Walking the Paris hospitals: diary of an Edinburgh medical student, 1834–1835, Medical History, Supplement No. 23, London, Wellcome Trust Centre for the History of Medicine at UCL, 2004, pp. xii, 211, illus., £32.00, US$50.00 (hardback 0-85484-074-5). - Volume 50 Issue 2

DIANA E. MANUEL, ed. Walking the Paris Hospitals: Diary of an Edinburgh Medical Student, 1834-1835, (Medical History, Supplement No. 23). London, The Wellcome Trust Centre for the History of Medicine at UCL, 2004. xii, 211 pp., illus. $50.

Diaries can provide an immediate eyewitness view of medicine, its institutions, and its culture, but their value is sometimes offset by obscure references to people, places, and things that require a whole reference collection to track down. Happily, Diana Manuel has done all the hard work for us by providing a scrupulously researched, copiously annotated edition of the diary of an Edinburgh medical student resident in Paris during the academic year 1834–1835. The diary is anonymous, but Manuel makes a convincing case for attributing it to James Surrage, a Gloucestershire student who graduated with his M.D. from Edinburgh University in 1835. However, she does not take the attribution as proven and, instead, refers to “the diarist” throughout her introductory essay and notes. Manuel begins by describing medical life in Paris and the opportunities available for students there. By the 1830s, Paris was attracting hundreds of students from the English-speaking world to its extensive hospital facilities. Many of them, like the diarist, were struck by the matter-of-fact approach to hands-on clinical examination, contrasting it with the moral outrage that would attend such a practice at home. They were struck too with the opportunities for dissection of cadavers, still limited in Britain despite the Anatomy Act of 1832. Manuel next goes on to describe the most important aspects of medicine addressed in the diary. These include maladies such as fevers and typhus, skin diseases, and eye diseases. Also included are the medical branches of surgery, midwifery, and dentistry, still regarded by many practitioners as distinct from “medicine,” though the boundaries were increasingly blurred. Manuel also discusses the new practice of auscultation and the stethoscope, which impressed the diarist, as it did his contemporaries, as an important new diagnostic tool. Use of the stethoscope required daily practice and the development of a whole new vocabulary to describe the different sounds, which are recounted in this diary.

Edinburgh medical students peculiarly described as 'occasional auditors'

Edinburgh medical students peculiarly described as 'occasional auditors'

Edinburgh Medical Students Peculiarly Described as ‘Occasional Auditors’

The phrase 'occasional auditor' appears to have been coined by a Royal Commission of 1826-32 to describe students who attended classes but did not intend to graduate. 'Occasional' meant 'infrequent', 'auditor' meant 'listener', and the Commission paid scant attention to these students. At the Edinburgh Medical School, however, such non-graduating students significantly outnumbered the graduates, and this can be shown to have been the case from as early as 1726 and to have continued until 1858, particular attention being paid here to the last two decades (i.e. 1839-58). There is no existing Edinburgh University list of 'occasional auditors', but a methodology of cross-referencing is described which makes it possible to identify the 'occasional auditors' by name. 'Occasional auditors' in the Faculty of Medicine can now be redefined as serious students who had assembled their own course of study in order to further their personal careers, and it is possible to show that very many of these careers were in medicine, largely in the emerging field of general practice.

Does undergraduate education have an effect on Edinburgh medical students' attitudes to psychiatry and psychiatric patients?

Does undergraduate education have an effect on Edinburgh medical students' attitudes to psychiatry and psychiatric patients?

The Darwinian Heritage (review)

Reviews David Kohn, ed., and Malcolm J. Kottier, asst. ed., The Darwinian Heritage. Princeton , N.J.: Princeton University Press in association with Nova Pacifica, 1985. 1138 pp. $95.00. In the year 1982, in commemoration of the centennial of Charles Darwin's death, over one hundred symposia, lecture series, and special events, were held around the world: and over seventy publications of collected essays were devoted to the occasion.1 The Darwinian Heritage contains 28 essays, and 3 commentaries, which were derived from a large Darwin Centennial symposium held in Florence, Italy—at the Florence Center for the History and Philosophy of Science—in June 1982. (Throughout Italy there was enormous attention given to the Centenary). The Heritage's authors come from different scholarly specialties (including biology, physics, psychology, literature, philosophy , and history), and different academic institutions in America, England, Italy, and France. They possess what the Heritage editor describes as "a high regard for Darwin" (1). They have long studied Darwin documents—often discussing their studies with each other—and they form a community of scholars, which did not exist in the year 1959 when the centenary of the Origin of Species was celebrated. Over two thirds of the Heritage essays and commentaries are about aspects of Darwin's biography, and the remainder are about the comparative reception of Darwin's ideas in different countries and the historical and philosophical significance of his publications. Although all of the Heritage pieces are first-rate, in the following review I shall only consider the biographical ones. The continued absence of an adequate Life of Darwin makes these pieces especially timely and important for those who are interested in biography. I shall summarise how the pieces add new insights to our view of Darwin's scientific and social development; and how they sometimes fail to suggest personal and psychological forces which influenced this development. I shall also comment on the Heritage's comprehensive Bibliography. Two essays are about Darwin's first scientific interests. Duncan Porter chronicles the early history of Darwin as a collector of different things: "all sorts of things" (974) as a Shrewsbury schoolboy; marine invertebrates as an Edinburgh medical student; 270 REVIEWS beetles as a Cambridge divinity student. During the Beagle cruise he collected geological specimens, minerals, fossils, land and sea animals, insects, birds, reptiles, and plants—all of which would fuel his future publications. Phillip R. Sloan—"Darwin's Invertebrate Program, 1826-1836: Preconditions for Transformism"—shows how Darwin became prepared to believe in transmutation of species because of the following (hitherto unknown) sequence of thoughts. At Edinburgh in 1826-27 Darwin was influenced by his first zoology teacher, Dr. Robert Grant, to become interested in the "analytic" functions of invertebrate zoology, in " 'zoophytes' as possible keys to more complicated issues in biology", and in "embryological stages as indicative of taxonomic relationship." (86) During the Beagle voyage he thought about the nature of what he called the "granulated matter" which formed many invertebrates. (92) By the end of the voyage he had come to believe in "the strong analogy between plants and animals and the possibility of uniting these two kingdoms in a common point"; and he had given a "key role" to the "common granulated matter in reproduction of both animals and plants." (109-110) These thoughts then augmented his post-Beagle thoughts on the transmutation of species. Frank Sulloway, in "Darwin's Early Intellectual Development: An Overview of the Beagle voyage (1831-1836)," selects letters that Darwin wrote to his friends and family during his 5 years on the Beagle and applies to the contents of these a specialised technique known as computer assisted content-analysis—which (as Sulloway notes) "can sometimes detect significant patterns of co-occurrence and dissociation that go unnoticed even in the most careful reading of a text." (124) Using this technique Sulloway shows how on the Beagle Darwin underwent four intellectual changes. From an early "anxious and insecure self image," with doubts about his ability to observe scientific phenomena, he developed "a confident self-image" with pride in his scientific work, and in his general observations about the places and peoples he had visited. (129) From an intellectual dependence on his...