Medical College Teaching Research Articles

Counterpoint: Activation of the Intrarenal Renin-Angiotensin System is the Dominant Contributor to Systemic Hypertension

Our discussion regarding the dominant mechanism responsible for hypertension calls to mind the famous poem, “The Blind Men and the Elephant,” by John Godfrey Saxe based on an ancient fable from India. In essence, the blind men described the elephant based on their specific encounter, thus

Knowledge and Skills Competencies for the Undergraduate Internal Medicine Curriculum in Saudi Arabia

OPEN ACCESSNovember 15, 2010Knowledge and Skills Competencies for the Undergraduate Internal Medicine Curriculum in Saudi Arabia Hani Almoallim, MD Hani Almoallim, MD Google Scholar More articles by this author https://doi.org/10.15766/mep_2374-8265.8177 SectionsAbout ToolsDownload Citations ShareFacebookTwitterEmail AbstractAbstractThis resource contains all of the research used to reconstruct the internal medicine curriculum in at Umm Alqura University in Saudi Arabia. This research can also assist in designing a national guide for internal medicine teaching in medical colleges of Saudi Arabia. It also can be used in designing a clerkship curriculum in internal medicine based on these specified competencies that augment and serve as a continuum of what had been taught in undergraduate curriculum. In this national research project, the knowledge and skills competencies in internal medicine for the undergraduate curriculum were determined and prioritized following a strict research methodology. A group of 20 clinicians rated the identified competencies from 0–3 (0: no need to know, 1: Interesting to Know, 2: Should Know and 3: Must Know). A total of 1514 knowledge competencies and 189 skills competencies were determined and prioritized. The competencies corresponded to 12 systems in internal medicine. This resource was used along with other work from different disciplines, at the institution to design an integrated curriculum where basic scientists and clinicians are sharing the same responsibilities in teaching medicine. This approach will greatly enhance the relevancy of the taught materials to the needs of medical students. The use of this resource should help in determining and specifying clear competencies for courses, curricula, lectures, problem-based learning, and bedside teaching sessions. It can also assist in the design of integrated curriculum that will greatly enhance the relevancy of the taught materials to the needs of medical students. Educational Objectives By the end of this module, the learner will be able to: Determine and prioritize competencies for the undergraduate internal medicine curriculum.Differentiate between important and less important components of undergraduate internal medicine curriculum.Design efficient undergraduate internal medicine curriculum based on clearly identified competencies.Improve quality of teaching of internal medicine by focusing on objectively defined knowledge and skills competencies. ReferencesShumway J.M. and Harden R.M., AMEE Guide No. 25: The assessment of learning outcomes for the competent and reflective physician. Med Teach, 2003. 25(6): p. 569–84. http://dx.doi.org/10.1080/0142159032000151907Medline, Google ScholarReid N., The Delphi Technique: It's Contribution to the Evaluation of Professional practice. Professional Competence and Quality Assurance in the Caring Professions, ed. Ellis R.. 1988, New York: Chapman Hall.Google Scholarde Villiers MR, de Villiers PJ, and Kent AP, The Delphi technique in health sciences education research. Med Teach, 2005. 27(7): p. 639–43. http://dx.doi.org/10.1080/13611260500069947Medline, Google ScholarMyers A.R., NMS Medicine. 2005: Lippincott Williams & Wilkins.Google ScholarTalley NJ, O'Connor S. Clinical Examination. 2005: Wiley-Blackwell.Google ScholarLawrence PF, et al., Determining the content of a surgical curriculum. Surgery. 1983;94(2):309–317.Medline, Google ScholarGoroll AH, et al. Reforming the core clerkship in internal medicine: the SGIM/CDIM Project. Society of General Internal Medicine/Clerkship Directors in Internal Medicine. Ann Intern Med.2001;134(1):30–37. http://dx.doi.org/10.7326/0003-4819-134-1-200101020-00011Medline, Google ScholarBass EB, et al. National survey of Clerkship Directors in Internal Medicine on the competencies that should be addressed in the medicine core clerkship. Am J Med.1997;102(6):564–571. http://dx.doi.org/10.1016/S0002-9343(97)00054-5Medline, Google Scholar Sign up for the latest publications from MedEdPORTAL Add your email below FILES INCLUDEDReferencesRelatedDetails FILES INCLUDED Included in this publication: Instructor's Guide.docx Diseases Based Ratings [1][1].pdf All competencies 1 of 4 Sheet (0-3)[1].pdf Core Competencies 1 of 4 Sheet (2.2-3)[1].pdf To view all publication components, extract (i.e., unzip) them from the downloaded .zip file. Download editor’s noteThis publication may contain technology or a display format that is no longer in use. Copyright & Permissions© 2010 Almoallim. This is an open-access publication distributed under the terms of the Creative Commons Attribution-NonCommercial license.KeywordsPBLKnowledge CompetenciesDelphi TechniqueCompetency-Based Education Disclosures None to report. Funding/Support None to report. Loading ...

University medical education in Kenya: The challenges

There are two medical schools training doctors in Kenya: the Moi University established in 1984 and the University of Nairobi established in 1967. The University of Nairobi has so far produced the majority of Kenyan doctors. Both are public universities with the Government being the main financier. The increased demand for university education and the inability to meet these demands has led to the introduction of a system of training self-sponsored medical students alongside Government-subsidised students. One other public university has started a medical school. The pressure to increase the number of schools and students in the absence of increased resources poses a particular challenge to the country.

Building integrative teaching model of nursing major English teaching and international nursing talents training in medical college

The task many countries in the world were badly in need of nursing talent as a study background.It's aimed at current situatlon of medical college nursing English teaching.It came up with special measures of teaching reform.By building the teaching model of nursing major English teaching and training of international nursing talents,to foster nursing talents who accord with international standard. Key words: Nursing major Engljsh teaching; International nursing talent; Integration; Teaching model

Distance learning - a new era of the medical education

Recently, the number of distance learning programs offered by several American and European universities substantially in creases. A lot of conventional universities are currently involved in postgraduate distance learning provision, with new courses planned in every subject area. In Bulgaria there is no experience in this field yet although an essential improvement of the computerized infrastructure in the Bulgarian universities and their libraries has been achieved. The Medical University of Varna has already performed successful telemedicine and teleconference experiments. On January 11, 1998, the first seance of Telecommunication Bridge between these two university institutions was successfully carried out. An ISDN connection was realized. The Intel ProShare Video System 500 was installed and used. A semiprofessional JVC M camera was made use of. The Information Cen tre of the Medical University of Varna is currently involved in a series of activities such as video teleconferencing, preparation of interactive lectures and seminars, multimedia projections, medical video tape projections for small groups of medical post-graduate students, etc. The future of the medical university education in Bulgaria depends on the economic stabilization and growth, on the enthusiasm of both teachers and students sharing the will to be competitive on the European and even world market under the conditions of globalization as well as on their active involvement in the international collaboration net works. Scripta Scientifica Medica 2010;42(1):71-75

Morphometric analysis and clinical application of the working dimensions of cricothyroid membrane in south Indian adults: With special relevance to surgical cricothyroidotomy

To measure the working dimensions of the cricothyroid membrane in the adult south Indian population and to establish the association between the working dimensions and the appropriate endotracheal tube size for the purpose of cricothyroidotomy. Cross-sectional evaluation of 50 fresh adult autopsy cases (35 men, 15 women) in a medical university teaching hospital in South India. Age ranged from 17.0 to 83.0 years. Working dimensions of the membrane in neutral position of neck, in men: width = 8.41 +/- 2.11 mm, height = 6.57 +/- 1.87 mm; in women: width = 6.30 +/- 1.29 mm, height = 5.80 +/- 1.56 mm. Depth of the subglottic larynx at the level of cricoid cartilage: men = 20.73 +/- 1.97 mm, women = 15.62 +/- 1.71 mm. Distance of the lower border of cricothyroid membrane from suprasternal notch in neutral position of neck, in men = 5.18 +/- 1.76 cm, women = 4.72 +/- 1.55 cm; in passively extended neck, men = 7.86 +/- 1.25 cm, women = 8.05 +/- 1.28 cm. Regression equations have been derived to determine endotracheal tube size for cricothyroidotomy, based on distance between sternal notch and chin, and height of the individual (P < 0.05). Working dimensions are smaller in the Indian group compared with western publications. Endotracheal tubes ranging from size 3.0 to 6.0 might be used for cricothyroidotomy in the adult south Indian population.

Re-engineering pharmacology teaching and research: Can we adopt translational approach?

Re-engineering pharmacology teaching and research: Can we adopt translational approach?

大学と地域医療の関係性

大学と地域医療の関係性

Application to the Dilemma Discussion Program: Ethics and Character Education for Medical Students

The current medical practices in Korea have raised many new ethical issues. The current education system in med- ical colleges, however, is finding it difficult to cope with these rapidly arising medical issues. Many educators, therefore, became much more concerned about the importance of ethics and character education in medical colleges, but teaching methods or educational programs centered around the same have not yet been developed. Dilemma discussion is regarded as an available teaching method but is not frequently used in medical education. In this respect, this study aims to apply dilemma discussion programs to ethics and character education for medical students. It was discovered that dilemma discussion is an effective instructional method for enhancing the moral reasoning ability of medical students. According to Rest°Øs theoretical framework, however, a dilemma discussion program focuses on two components of morality: moral judgment and moral sensitivity. Moral judgment and moral sensitivity are major components in predicting moral behaviors. Therefore, the target of dilemma discussion programs is to focus on these two components. It is reasonable to integrate moral judgment with moral sensitivity for ethics and character education in medical schools.

Likelihood of Inadequate Treatment A Novel Approach to Evaluating Drug-Resistance Patterns

To provide a novel way to predict the likelihood that antibiotic therapy will result in prompt, adequate therapy on the basis of local microbiological data. Prospective study conducted at 3 medical intensive care units at the Viennese General Hospital, a tertiary care medical university teaching hospital in Vienna, Austria. One hundred one patients who received mechanical ventilation and who met the criteria for having ventilator-associated pneumonia. Fiberoptic bronchoscopic examination was performed, and bronchoalveolar samples were collected. Samples were analyzed immediately by a single technician. Minimum inhibitory concentrations were determined for imipenem, cephalosporins (cefepime and cefpirome), ciprofloxacin, and piperacillin-tazobactam, and drug resistance rates were calculated. These drug resistance rates were translated into the likelihood of inadequate therapy (LIT; the frequency of inadequately treated patients per antibiotic and drug-resistant strain), cumulative LIT (the cumulative frequency of inadequately treated patients), and syndrome-specific LIT. Among the 101 bronchoalveolar samples, culture yielded significant (at least 1 x 10(4) colony-forming units per mL) polymicrobial findings for 34 and significant monomicrobial findings for 31; 36 culture results were negative. Of the isolates from patients with ventilator-associated pneumonia who had monomicrobial culture findings, 33% were gram-positive bacteria and 20% were gram-negative bacteria. LIT suggested that 1 of 2 patients was treated inadequately for Pseudomonas aeruginosa infection. The LIT for patients with ventilator-associated pneumonia revealed that the rank order of antibiotics for appropriate therapy was (1) imipenem, (2) cephalosporins, (3) ciprofloxacin, and (4) piperacillin-tazobactam. These calculations were based solely on microbiological data. The novel ratio LIT may help clinicians use microbiological data on drug resistance to predict which antimicrobial agents will provide adequate therapy. In daily practice, this new approach may be helpful for choosing adequate antimicrobial therapy.

Building capacity in medical education research in Australia

Medical education research is a relatively new but growing discipline. There is an overall perception of lack of confidence in the quality of the research, which is not entirely justified. The scientific quality of any research is defined by the appropriate application of method to a particular problem. There is a need for programmatic research focused on developing medical education policy. University medical education units need to be research-focused. Medical Deans Australia and New Zealand and the Australian and New Zealand Association of Medical Education (ANZAME: the Association for Health Professional Education) can provide leadership. Funding bodies need to develop their relationship with medical education research.

Einsatz innovativer Lern- und Prüfungsmethoden an den Medizinischen Fakultäten der Bundesrepublik Deutschland – Eine aktuelle Bestandsaufnahme

Following amendment to the German medical licensing regulations in April 2002, the training and examination of clinical-technical competencies within university medical education has gained in importance. To date, the implementation of new and innovative teaching and assessment methods at medical faculties in the Federal Republic of Germany has not been subject to exhaustive and detailed evaluation. Using structured telephone interviews, all 36 medical faculties were questioned concerning their curricula, application of skills laboratory training, standardised patients (SPs), problem-based learning (PBL), computer-based training (CBT), and the implementation of objective structured clinical examinations (OSCE). All 36 faculties (100 %) took part in the survey. 34 faculties (94 %) reported providing training in a skills laboratory and 30 (83 %) faculties reported working with standardised patients. PBL is employed at 33 faculties (92 %) and CBT at 32 (89 %). Practical clinical assessments in the form of OSCEs are conducted at 28 faculties and are currently being installed at two further universities. New and innovative teaching and examination methods have been implemented in almost all medical universities in the Federal Republic of Germany. Further studies are needed in order to assess the extent to which individual specialist fields are involved in these developments.

Occupational Exposure To HIV And Practices Of Universal Safety Precautions Among Residents Doctors

Background: The risk of percutaneous injury to health care workers has been well documented. Objectives: The study was to find out concern of resident doctors about acquiring HIV infection through occupational exposure. Methods: Cross-sectional exploratory Study was conducted at tertiary care teaching hospital and Medical College. Results: The average age of Resident Doctor's was 26 years  3.2 years. 53 (56.9%) residents' doctors correctly knew about universal precaution. Only 29 (31.1) of resident doctors were segregating it. Of the 93 residents involved in direct patient care / laboratory services, 54 (58%) were exposed to potentially infectious material. Considerable 63 (67.7%) number of resident doctors was following dangerous procedure of either bending it against table / wall or recapping (89.2%) used needle before disposal. Conclusion: the study strongly recommends the pre-placement training in various aspects of HIV/AIDS including Universal Precaution along with refresher courses from time to time.

‘Leaders of Educational Purpose’: the foundation of academic medicine 1890s-1940s

This article investigates the development of clinical academic units and the concept of a university model of medical education. It argues that clinical academic units emerged from debates about the nature of the medical education and the role of science and the laboratory in the construction of medical knowledge and in the curriculum. Although the integration of clinical academic units into medical schools was seldom harmonious, from the 1920s onwards the appointment of full-time professors to head them imposed a new intellectual order on bedside teaching and research. They provided a means through which laboratory medicine was included in the curriculum and brought the ward and the laboratory closer together. The ideal of a university medical education and the creation of university medical schools took longer to establish and it was only in the 1970s after a number of royal commissions that opposition was finally eroded.

Primary Care Takes Course on Cultural Issues in Depression

Primary Care Takes Course on Cultural Issues in Depression

Managing change in postgraduate medical education: still unfreezing?

Background: Modernizing Medical Careers (MMC) is an ambitious project to change the training of UK doctors. A key to its successful implementation is the ways that MMC is perceived and operationalized by senior doctors who act as local educational leaders and supervisors.Aims: To analyse hospital consultants’ perceptions of the modernization process and its impact on their role as the primary educators of Senior House Officers (SHOs), using Schein's extended model to explain their stage in the process of change.Methods: We interviewed medical directors, College and clinical tutors and education supervisors at 6 Trusts. The transcripts were analysed using Schein's change model to explore the perceptions and assumptions of senior medical staff and to determine their stage in the process of change.Results: 12 tutors, 12 supervisors, and 4/6 medical directors approached agreed to participate (28/30). Nine themes emerged from transcript analysis. These were related to the three-stage model of change. Most participants were at the stage of ‘unfreezing’, expressing views around disconfirmation of expectations, guilt and anxiety and feelings of some psychological safety. A smaller number were at the stage of ‘moving to a new position’. There were limited examples of ‘refreezing’.Conclusions: At the local delivery level, most senior doctors were aware of the need to review their current position and alter their approaches and assumptions about postgraduate medical education. Yet only a minority were moving forward. Considerable work remains for successful implementation of MMC.

Strategic Approaches of Medical Field against Establishment State-run National Graduate School of Oriental Medicine

The Government decided to establish a graduate school of oriental medicine at Pusan National University despite strong opposition from medical field. By establishing a graduate school of oriental medicine, the Government aims at educating competitive healthcare professionals in research to meet fast-changing medical circumstances such as aging society, increasing chronic diseases, public interests in alternative medicine and its evidence-based approach. The Government is also taking this as an opportunity to improve the quality of healthcare service by settling a collaborative treatment system between western and orinetal medicine as well as fostering oriental medicine into high value-added industry. However, it raises a concern that evidence-based approach and standardization of oriental medicine through establishment of a graduate school might leave little room for oriental medicine doctors who depend mainly on traditional experiences and thus lose their leading roles in oriental medicine. Field of western medicine is no exception. If they continue to neglect scientific research in oriental medicine and complementary alternative medicine, the leadership of integrative medicine will shift to oriental medical doctors equipped with scientific knowledge. The situation asks medical field to take active steps and show their propose on education model is more competitive by achieving excellent research results through establishment of research center for oriental medicine and complementary alternative medicine within the framework of medical college education.

Impact of the University of California, Los Angeles/Charles R. Drew University Medical Education Program on Medical Students??? Intentions to Practice in Underserved Areas

To estimate the impact of a U.S. inner-city medical education program on medical school graduates' intentions to practice in underserved communities. The authors conducted an analysis of secondary data on 1,088 medical students who graduated from either the joint University of California, Los Angeles/Charles R. Drew University Medical Education Program (UCLA/Drew) or the UCLA School of Medicine between 1996 and 2002. Intention to practice in underserved communities was measured using students' responses to questionnaires administered at matriculation and graduation for program improvement by the Association of American Medical Colleges. Multivariate logistic regression analysis was used to compare the odds of intending to practice in underserved communities among UCLA/Drew students with those of their counterparts in the UCLA School of Medicine. Compared with students in the UCLA School of Medicine, UCLA/Drew students had greater adjusted odds of reporting intention to work in underserved communities at graduation, greater odds of maintaining or increasing such intentions between matriculation and graduation, and lower odds of decreased intention to work in underserved communities between matriculation and graduation. Training in the UCLA/Drew program was independently associated with intention to practice medicine in underserved communities, suggesting that a medical education program can have a positive effect on students' goals to practice in underserved areas.

Laparoscopic splenectomy using conventional instruments

Dear Sir, I congratulate Dr Dalvi and others for their original article on ‘Laparoscopic splenectomy using conventional instruments.’[1] It is highly commendable that they have sucessfully performed 26 splenectomies using reusable conventional instruments, monopolar and bipolar cautery, clips and intracorporeal knotting. There was no mortality and minimal morbidity during a follow up of 6 years. It was interesting to read about their annovation of ‘glove-in-glove’ used as a hand port. I wish they had provided a diagram to indicate the position of the patient and port-sites. This also shows what can be achieved by commitment and dedication of a surgical team in a teaching medical college and hospital when even today many teaching colleges have yet to take off in minimal access surgery.

STUDY OF BACTERIA ISOLATED FROM URINARY TRA INFECTION AND THEIR SENSITIVITY PATTERN

A retrospective study was conducted among out-patient and in-patient in Kathmandu medical collegeTeaching hospital of one month from the duration 2060-11-15 to 2060-12 -15. Mid-stream urine [MSU] of300 patient were cultured. Out of these, 75 patients’ urine were found to have significant bacterial growth.Total of five species of bacterial species isolated were viz.E.coli 37(33.3%), Proteus species 25(27.7%),Klebsiella species 15(16.6%), Staphylococcus aureus 8(8.8%) and Pseudomonas aureginosa 1(1.1%).Regarding their antibiotic sensitivity pattern, E. coli were sensitive to Nitrofurantoin 31 (83.8% ), Norfloxacin25 (67.5%), Ofloxacin 30(81.0%), Amoxycillin 16(43.2%), Nalidixic acid 15 (40.5%).proteus species weresensitive to Nitrofurantoin 15 (60.0%), Norfloxacin 15 (60.0%), Ofloxacin 12(48.0%), Amoxycillin 13(52.0%),Nalidixic acid 10 (40.0%), Ciprofloxacillin 12(48.0%). Klebsiella species were sensitive to Nitrofurantoin 9(60.0%), Norfloxacin 5 (33.3%), Oflaxin 6(40.0%), Amoxycillin 5(33.3%), Nalidixic acid 4 (26.6%),ciprofloxacillin 6(40.0%).Staphylloccus aureus were sensitive to Nitrofurantoin 8(100.0%), Norfloxacin 6(75.0%), Oflaxin 8(100.0%),Amoxycillin 7(87.5%), Nalidixic acid 6(75.0%), Ciprofloxacillin 8(100 %). And Pseudomonas aureginosawere resistant to all antibiotics which we are using in this research work.Key Words: Urine sample, Identification, Sensitivity pattern.