Pain medicine content, teaching and assessment in medical school curricula in Australia and New Zealand

Background: The objective of pain medicine education is to provide medical students with opportunities to develop their knowledge, skills and professional attitudes that will lead to their becoming safe, capable, and compassionate medical practitioners who are able to meet the healthcare needs of persons in pain. This study was undertaken to identify and describe the delivery of pain medicine education at medical schools in Australia and New Zealand. Method: All 23 medical schools in Australia and New Zealand in 2016 were included in this study. A structured curriculum audit tool was used to obtain information on pain medicine curricula including content, delivery, teaching and assessment methods. Results: Nineteen medical schools (83%) completed the curriculum audit. Neurophysiology, clinical assessment, analgesia use and multidimensional aspects of pain medicine were covered by most medical schools. Specific learning objectives for pain medicine were not identified by 42% of medical schools. One medical school offered a dedicated pain medicine module delivered over 1 week. Pain medicine teaching was delivered at all schools by a number of different departments throughout the curriculum. Interprofessional learning (IPL) in the context of pain medicine education was not specified by any of the medical schools. The mean time allocated for pain medicine teaching over the entire medical course was just under 20 h. The objective structured clinical examination (OSCE) was used by 32% of schools to assess knowledge and skills in pain medicine. 16% of schools were unsure of whether any assessment of pain medicine education took place. Conclusion: This descriptive study provides important baseline information for pain medicine education at medical schools in Australia and New Zealand. Medical schools do not have well-documented or comprehensive pain curricula that are delivered and assessed using pedagogically-sound approaches considering the complexity of the topic, the prevalence and public health burden of pain

Radiation in medicine: Origins, risks and aspirations.

The use of radiation in medicine is now pervasive and routine. From their crude beginnings 100 years ago, diagnostic radiology, nuclear medicine and radiation therapy have all evolved into advanced techniques, and are regarded as essential tools across all branches and specialties of medicine. The inherent properties of ionizing radiation provide many benefits, but can also cause potential harm. Its use within medical practice thus involves an informed judgment regarding the risk/benefit ratio. This judgment requires not only medical knowledge, but also an understanding of radiation itself. This work provides a global perspective on radiation risks, exposure and mitigation strategies

Childhood asthma and beyond

Consists of the edited transcripts of Witness Seminars organized by the History of Twentieth Century Medicine Group and held at the Wellcome Institute for the History of Medicine, London, on 4 April 2000.First published by the Wellcome Trust Centre for the History of Medicine at UCL, 2001. ©The Trustee of the Wellcome Trust, London, 2001. All volumes are freely available online at: www.history.qmul.ac.uk/research/modbiomed/wellcome_witnesses/Consists of the edited transcripts of Witness Seminars organized by the History of Twentieth Century Medicine Group and held at the Wellcome Institute for the History of Medicine.The Wellcome Trust Centre for the History of Medicine at UCL is funded by the Wellcome Trust, which is a registered charity, no. 210183

Allopathic Medicine’s Influence on Indigenous Peoples in the Kumaon Region of India

This paper focuses on the use of western medicine in the Kumaon region of Uttarakhand, India. The goal of this research is to understand which healing practices are preferable in rural villages. Semi-structured interviews were conducted with 53 participants, including two spiritual healers, two doctors, and one pharmacist. Results indicate that allopathic medicine, otherwise known as modern medicine or western medicine, has become the go-to remedy for even the most remote people in India. Nearly all participants use allopathic medicine, but less than half of the participants experiment with other forms of healing, such as Ayurveda, homeopathy, meditation, and yoga. This study explores the problems that result from becoming too dependent on western medicine; these issues stem from a lack of knowledge patients have about the dosage and intensity of the drugs they take. It is important to educate rural villagers about the dangers that various medicines can cause, as well as establish more medical facilities that promote alternative treatments alongside modern medicine

Prescription for the People: An Activist\u27s Guide to Making Medicine Affordable for All

[Excerpt] Because every cure starts with an accurate diagnosis, in this book I explain how and why the current medicines system is dysfunctional and corrupt. We all want both affordable medicines and innovation in research and development, so I explain the proven approaches to accomplishing that balance. Most of us reject the status quo of corporations making record-breaking profits on medicines that are priced out of the range of the sick and the dying, so I set out the moral and rights-based foundation of the case for universal access to medicines. Finally, if you want to take action and speak out for access to medicines—and I sincerely hope you do—the conclusion to this book is devoted to helping you get started

General Practitioners' perceptions of the route to evidence-based medicine: a questionnaire survey

Objectives: To determine the attitude of general practitioners towards evidence based medicine and their related educational needs. Design: A questionnaire study of general practitioners. Setting: General practice in the former Wessex region, England. Subjects: Randomly selected sample of 25% of all general practitioners (452), of whom 302 replied. Main outcome measures: Respondents' attitude towards evidence based medicine, ability to access and interpret evidence, perceived barriers to practising evidence based medicine, and best method of moving from opinion based to evidence based medicine. Results: Respondents mainly welcomed evidence based medicine and agreed that its practice improves patient care. They had a low level of awareness of extracting journals, review publications, and databases (only 40% knew of the Cochrane Database of Systematic Reviews), and, even if aware, many did not use them. In their surgeries 20% had access to bibliographic databases and 17% to the world wide web. Most had some understanding of the technical terms used. The major perceived barrier to practising evidence based medicine was lack of personal time. Respondents thought the most appropriate way to move towards evidence based general practice was by using evidence based guidelines or proposals developed by colleagues. Conclusion: Promoting and improving access to summaries of evidence, rather than teaching all general practitioners literature searching and critical appraisal, would be the more appropriate method of encouraging evidence based general practice. General practitioners who are skilled in accessing and interpreting evidence should be encouraged to develop local evidence based guidelines and advice

Medicine is not science

ABSTRACT: Abstract Most modern knowledge is not science. The physical sciences have successfully validated theories to infer they can be used universally to predict in previously unexperienced circumstances. According to the conventional conception of science such inferences are falsified by a single irregular outcome. And verification is by the scientific method which requires strict regularity of outcome and establishes cause and effect. Medicine, medical research and many “soft” sciences are concerned with individual people in complex heterogeneous populations. These populations cannot be tested to demonstrate strict regularity of outcome in every individual. Neither randomised controlled trials nor observational studies in medicine are science in the conventional conception. Establishing and using medical and other “soft science” theories cannot be scientific. It requires conceptually different means: requiring expert judgement applying all available evidence in the relevant available factual matrix. The practice of medicine is observational. Prediction of outcomes for the individual requires professional expertise applying available medical knowledge and evidence. Expertise in any profession can only be acquired through experience. Prior cases are the fundament of knowledge and expertise in medicine. Case histories, studies and series can provide knowledge of extremely high reliability applicable to establishing reliable general theories and falsifying others. Their collation, study and analysis should be a priority in medicine. Their devaluation as evidence, the failure to apply their lessons, the devaluation of expert professional judgement and the attempt to emulate the scientific method are all historic errors in the theory and practice of modern medicine

Mapping the teaching of honeybee veterinary medicine in the European Union and European Free Trade Area

Background Honey bee (Apis mellifera) is a very important species for human beings, animals, environmental biodiversity, crop production and economic sustainability in Europe and worldwide. This study investigates whether future veterinarians are trained to deal with the particular needs of the only traditional food-producing insect in Europe. Methods This study analyses data collected from 77 European veterinary education establishments in EU and the European Free Trade Area. Results The results show that 75 per cent of those establishments (58 out of 77) teach honeybee veterinary medicine. There is a clear geographical differentiation. In north-western countries only about half of the establishments include honeybee health, production and product inspection in their undergraduate curricula, while in eastern, central and southern countries, which are also important beekeeping countries, the great majority of the establishments incorporate honeybee veterinary medicine in their undergraduate curriculum. Eighty-six per cent of all the establishments teaching honeybee veterinary medicine (50 of the 58) incorporate it in their core curriculum either as separate subject or as part of other subjects. Twenty-five per cent of all the establishments (19 out of 77) organise postgraduate training courses in this field. Conclusions Veterinarians have an important role in ensuring the health, sustainability and productivity of managed honeybee colonies as they do for other animal species. It seems however that teaching of honeybee veterinary medicine receives less attention in undergraduate veterinary curricula in EU compared with other fields of veterinary medicine. Seeing the increasing importance of honey bees for crop protection, environmental protection and economic sustainability, it would be beneficial to further strengthen the education of honeybee veterinary medicine in the future. Establishments should encourage and prepare veterinarians for practising science-based veterinary medicine in honey bees by incorporating such teaching in undergraduate curricula and by providing postgraduate opportunities to qualified veterinarians wishing to enhance their basic skills in this field

Ensuring sample quality for biomarker discovery studies - Use of ict tools to trace biosample life-cycle

The growing demand of personalized medicine marked the transition from an empirical medicine to a molecular one, aimed at predicting safer and more effective medical treatment for every patient, while minimizing adverse effects. This passage has emphasized the importance of biomarker discovery studies, and has led sample availability to assume a crucial role in biomedical research. Accordingly, a great interest in Biological Bank science has grown concomitantly. In biobanks, biological material and its accompanying data are collected, handled and stored in accordance with standard operating procedures (SOPs) and existing legislation. Sample quality is ensured by adherence to SOPs and sample whole life-cycle can be recorded by innovative tracking systems employing information technology (IT) tools for monitoring storage conditions and characterization of vast amount of data. All the above will ensure proper sample exchangeability among research facilities and will represent the starting point of all future personalized medicine-based clinical trials

Family medicine training in Sub-Saharan Africa : South-South cooperation in the Primafamed project as strategy for development

BACKGROUND. Health-care systems based on primary health care (PHC) are more equitable and cost effective. Family medicine trains medical doctors in comprehensive PHC with knowledge and skills that are needed to increase quality of care. Family medicine is a relatively new specialty in sub-Saharan Africa. OBJECTIVE. To explore the extent to which the Primafamed South–South cooperative project contributed to the development of family medicine in sub-Saharan Africa. METHODS. The Primafamed (Primary Health Care and Family Medicine Education) project worked together with 10 partner universities in sub-Saharan Africa to develop family medicine training programmes over a period of 2.5 years. A SWOT (strengths, weaknesses, opportunities and threats) analysis was done and the training development from 2008 to 2010 in the different partner universities was analysed. RESULTS. During the 2.5 years of the Primafamed project, all partner universities made progress in the development of their family medicine training programmes. The SWOT analysis showed that at both national and international levels, the time is ripe to train medical doctors in family medicine and to integrate the specialty into health-care systems, although many barriers, including little awareness, lack of funding, low support from other specialists and reserved support from policymakers, are still present. CONCLUSIONS. Family medicine can play an important role in health-care systems in sub-Saharan Africa; however, developing a new discipline is challenging. Advocacy, local ownership, action research and support from governments are necessary to develop family medicine and increase its impact. The Primafamed project showed that development of sustainable family medicine training programmes is a feasible but slow process. The South–South cooperation between the ten partners and the South African departments of family medicine strengthened confidence at both national and international levels