Instantons at work

The aim of this review is to demonstrate that there exists a coherent picture of strong interactions, based on instantons. Starting from the first principles of QCD - via the microscopic mechanism of spontaneous chiral symmetry breaking - one arrives to a quantitative description of light hadron properties, with no fitting parameters. The discussion of the importance of instanton-induced interactions in soft high-energy scattering is new.Comment: 57 pages including 13 figures. Final version, to be published in Prog. Part. Nucl. Phy

Presbycusis and communication

Impaired hearing, so common among older people, often has disastrous consequences. The infirmity, too frequently concealed or unknown by the patient, is invisible to others. Disability and frustration can be lessened considerably by greater awareness on the part of medical and lay people about various helpful measures, which are currently under-utilized. We offer some practical suggestions: Well-trained audiologists can help with both hearing aids and rehabilitation; groups for the hard of hearing can be supportive. The number and varieties of helpful devices increase steadily. Medical personnel, families, and the general public need to learn more about communicating with these people, who need help, often desperately. © 1986 Society for Research and Education in Primary Care Internal Medicine

Using Bedside Rounds to Teach Communication Skills in the Internal Medicine Clerkship

Background: Physicians ’ communication skills, which are linked to important patient outcomes, are rarely explicitly taught during the clinical years of medical school. This paper describes the development, implementation, and evaluation of a communication skills curriculum during the third-year Internal Medicine Clerkship. Methods: In four two-hour structured bedside rounds with trained Internal Medicine faculty facilitators, students learned core communication skills in the context of common challenging clinical situations. In an end-of-clerkship survey students evaluated the curriculum’s educational effectiveness. Results: Over the course of a year, 160 third-year students and 15 faculty participated. Of the 75/160 (47%) of students who completed the post-clerkship survey, almost all reported improvement in their communication skills and their ability to deal with specific communication challenges. Conclusions: The curriculum appears to be a successful way to reinforce core communication skills and practice common challenging situations students encounter during the Internal Medicine Clerkship

Teaching communication in clinical clerkships: models from the Macy initiative in health communications

Medical educators have a responsibility to teach students to communicate effectively, yet ways to accomplish this are not well-defined. Sixty-five percent of medical schools teach communication skills, usually in the preclinical years; however, communication skills learned in the preclinical years may decline by graduation. To address these problems the New York University School of Medicine, Case Western Reserve University School of Medicine, and the University of Massachusetts Medical School collaborated to develop, establish, and evaluate a comprehensive communication skills curriculum. This work was funded by the Josiah P. Macy, Jr. Foundation and is therefore referred to as the Macy Initiative in Health Communication. The three schools use a variety of methods to teach third-year students in each school a set of effective clinical communication skills. In a controlled trial this cross-institutional curriculum project proved effective in improving communication skills of third-year students as measured by a comprehensive, multistation, objective structured clinical examination. In this paper the authors describe the development of this unique, collaborative initiative. Grounded in a three-school consensus on the core skills and critical components of a communication skills curriculum, this article illustrates how each school tailored the curriculum to its own needs. In addition, the authors discuss the lessons learned from conducting this collaborative project, which may provide guidance to others seeking to establish effective cross-disciplinary skills curricula