Teaching and Learning in Clinical Settings

Clinical teachers are usually clinicians first and teachers second. A common assumption is that experienced clinicians will be good teachers. However, this is often not true. Good clinicians are not necessarily good teachers, although, with some theoretical knowledge and guided experience, they have the potential to become great teachers. This book is designed to help competent clinicians (whether hospital-based clinicians or those in other medical disciplines) to become competent teachers. It is a companion volume to Richard Hays' very successful book, Practice-Based Teaching, a Guide for General Practitioners, 2nd Edition

Research knowledge and skills in primary medical training: A crosssectional audit

This article was migrated. The article was marked as recommended. Background: Internationally, medical education has either adopted, or is moving toward, a Masters level qualification at completion. This reflects the higher-level learning outcomes and potentially facilitation of thinking and decision-making required of medical graduates. In Australia, the main difference between bachelor and masters programs appears to be the level of research skills training. This study explores the characteristics of research training in medical schools and alignment with higher education qualification frameworks. Methods: A cross-sectional audit was conducted of 22 medical schools in Australia and New Zealand, seeking information on: degree type, entry requirement, research knowledge and skills taught, teaching format, and barriers to offering students research experiences. Results: Information about 15 medical programs was obtained, with Australian Qualifications Framework or New Zealand Qualifications Framework Level 7, 8 or 9E outcomes. All included a variety of teaching methods on biomedical ethics, principles of evidence-based practice, and search strategies for medical evidence, critical appraisal of the literature and disease surveillance/epidemiology. Small projects were available in all programs, although voluntary in Level 7/8 programs and mandatory in Level 9E programs. Conclusions: There appear to be few differences in research training and learning outcomes from Level 7 and Level 9E programs, although Level 9E programs have a more systematic approach and assurance that all graduates can achieve the higher outcomes. Barriers to successful implementation relate to finding curriculum space and sufficient research training capacity for all medical students.</ns4:p

Improving case study research in medical education: A systematised review

Context:Case study research (CSR) is a research approach that guides holistic investigation of a real phenomenon. This approach may be useful in medical education to provide critical analyses of teaching and learning, and to reveal the underlying elements of leadership and innovation. There are variations in the definition, design and choice of methods, which may diminish the value of CSR as a form of inquiry.Objectives:This paper reports an analysis of CSR papers in the medical education literature. The review aims to describe how CSR has been used and how more consistency might be achieved to promote understanding and value.Methods:A systematised review was undertaken to quantify the number of CSR articles published in scholarly medical education journals over the last 10 years. A typology of CSR proposed by Thomas and Myers to integrate the various ways in which CSR is constructed was applied.Results:Of the 362 full‐text articles assessed, 290 were excluded as they did not meet the eligibility criteria; 76 of these were titled ‘case study’. Of the 72 included articles, 50 used single‐case and 22 multi‐case design; 46 connected with theory and 26 were atheoretical. In some articles it was unclear what the subject was or how the subject was being analysed.Conclusions:In this study, more articles titled ‘case study’ failed than succeeded in meeting the eligibility criteria. Well‐structured, clearly written CSR in medical education has the potential to increase understanding of more complex situations, but this review shows there is considerable variation in how it is conducted, which potentially limits its utility and translation into education practice. Case study research might be of more value in medical education if researchers were to follow more consistently principles of design, and harness rich observation with connection of ideas and knowledge to engage the reader in what is most interesting

Reforming medical education in the United Kingdom: lessons for Australia and New Zealand

Medical education faces global challenges because of the changing health care needs of an ageing and more demanding society, and the consequent requirement for increased health care workforce capacity and different workforce models. In the United Kingdom, education reform has spanned the medical, nursing and allied health professions, and has introduced new health professions with specific roles within a new, team-based model of comprehensive health care. In medical education, the UK reforms span undergraduate, prevocational, vocational and continuing education, with the aim of providing a framework for faster, more flexible career development that can adapt to future changes in workforce need. While some reforms are controversial, most appear sensible and are supported by most observers. The Modernizing Medical Careers process suffered implementation difficulties in 2007: the national, web-based application scheme for vocational training posts could not cope with such a large process, disrupting both the recruitment of an appropriate workforce for hospitals and the career progression of many recent UK medical graduates. The main problem appears to have been in management of change--too much was attempted too quickly on too large a scale--resulting in a backlash against any significant change. There may be lessons for Australia and New Zealand, which face similar challenges and are considering broadly similar changes

Cosmology and galactic angular momenta

The plan of this paper is to present some observations and then in subsequent chapters to examine the two basic cosmological ideas in the light of these observations. The first of the observations involves an estimate of the angular momentum in a given volume of space and the ratio of this momentum to the mass or number of nucleons in the given volume. We therefore wish to obtain a rough estimate of the angular momentum in that part of the universe which man may call his immediate surroundings, i.e., the solar system and galaxy

Models of remote professional supervision for psychologists in rural and remote locations: a systematic review

Introduction Psychology workforce shortages in geographically rural or remote contexts have highlighted the need to understand the supervisory experiences of psychologists practising in these locations, and the models of supervision employed to support their practice and improve client safety. Objective To review the models of remote professional supervision and the supervisory experiences of psychologists practising in rural and remote locations. Design Using the Joanna Briggs Institute methodology for mixed‐methods systematic review, 8 health and education databases were searched using keyword and subject heading searches. Findings The initial search identified 413 studies. A full‐text review identified 4 papers that met the inclusion criteria and were subjected to a methodological appraisal by 2 reviewers. Three studies included qualitative data, with 2 using transcribed interviews. Two studies reported quantitative data, with only one study including a statistical analysis of the outcomes. Discussion The results for the efficacy of the current models of remote supervision being used within the allied health and psychology professions are limited, with methodological limitations cautioning generalisability of results. The experiences of psychologists engaged in remote supervision do not appear to have changed over the past decade despite technological advances. Conclusions Quality professional supervision is critical for the sustainability of the psychology workforce in rural and remote locations, reducing professional isolation, and for improved patient outcomes. This review identified a need for improved evidence for remote supervision models for psychologists working in geographically rural and remote locations. Lessons can be learned from other health professions’ models of remote supervision

Vasopressin

Antidiuretic hormone liberated the vertebrates from their aqueous environment, and permitted them to establish themselves on dry land. The combination of sensitive volume and osmoreceptors, a pituitary secretory apparatus which can vary its output from virtually zero to high levels in a short space of time, and receptor cells functioning in the countercurrent system of the renal medulla, has resulted in a water conservation system of great efficiency. The hormone rapidly alters the luminal membrane of receptor cells in the collecting tubule and collecting duct, increasing the permeability of these structures to water.1 The permeability of the collecting duct to urea and sodium is also increased.This review will be centered on the sequence of events that follows the attachment of vasopressin to its receptors in the distal nephron. This has become an area of intense activity since the discovery by Sutherland and his colleagues of the central role of cyclic AMP in the action of hormones [2]. The review will cover in brief much of the ground covered by the extensive review of Handler and OrlofT [3], emphasizing recent additions to the literature. It is regrettable that the important advances in our understanding of the synthesis and release of antidiuretic hormone cannot be included; the reader is referred to recent symposia and reviews in this area [4–6], as well as in the comparative physiology of water regulation [7] and the countercurrent system [8]