Hand, Albert M.

Holoubek, Joe E.

English

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The Linacre QuarterlyVolume 31 | Number 1 Article 3February 1964The Challenge of Continuring Medical Education:An ApproachAlbert M. HandJoe E. HoloubekFollow this and additional works at: https://epublications.marquette.edu/lnqRecommended CitationHand, Albert M. and Holoubek, Joe E. (1964) "The Challenge of Continuring Medical Education: An Approach," The LinacreQuarterly: Vol. 31 : No. 1 , Article 3.Available at: https://epublications.marquette.edu/lnq/vol31/iss1/3THE CHALLENGE OF CONTINUING MEDICAL EDUCATION: AN APPROACH The Weekly T. E. Schumpert Memorial Hospital Clinical-Pathology Conference ALBERT M. HAND, MD., F.A.C.P., F.A.S.C.P., F.A.A.P . JOE E. HOLOUBEK, MD., F.A.C.P., F.A.C.G., K.C.S .G. When an outbreak of Botulism food poisoning occurred recently in a nearby state the danger to people of this area needed scientific clarifi-cation. W'here in the program for-mat of a three hundred and twenty-five bed general hospital does one find the time and place for such a topic to be discussed, without creat-ing undue excitement? The Medical Society meets only once a month, and the hospital departmental meetings are filled with business and cases pertaining to a particular department - internal medicine, surgery, pedi-atrics, obstetrics, psychiatry, general practice or dental surgery. If the Medical Society president calls a special meeting on Botulism, then the news media are likely to learn about it, and the public may feel that there is local danger of Botulism, and we are unjustified in arousing fear prematurely about a medical heal th problem. Where then can such a topic as Botulism food poisoning be discussed and clarified, as a " routine problem"? A weekly Clinical-Pathology Con-ference can determine where to pre-sent such an urgent problem, and Botulism was discussed recently in detail for forty-five minutes before an audience of sixty-five physicians by a three-man panel at the Schum-pert Clinical-Pathology Conference. Schumpert Memoria l H ospital, Shreve· port, Louisiana, is operated by the Sisters of Charity of The Inca rnate Word. D r. H and is Associate Pathologist and Dr. H oloubek, Attend ing Physician. 6 Hi story and symptomatology were presented by an internist; bacteriolo-gy and specimen care by the con-sultant in bacteriology, and the Par-ish Health Officer gave an up-to-the-minute review from the local, state and national Public Health reports. It was learned that no cases of Botu-lism food poisoning had occurred in Louisiana to that date, an d that no cases have been attributed to fish products marketed from the Louisi-ana area. When this informat ion be-came known, anxiety abated about Botulism. I t is our purpose in this discussion to show that a weekly Clinical-Pathology Conference can be a valuable adjunct to the educa-tion and information plans for the staff of a general hospital, and we will outline the history and varied uses of the Conference at the T. E. Schumpert Memorial Hospital. It became apparent some years ago that the brief period of an hour for the monthly hospital departmental meetings was so consumed by com-mittee reports, autopsy reviews, and general business that it was im pos-sible to present many of the ch:t! -lengi ng diagnostic problems that we see in a hospital of this size. Too, it was necessary to "break-through" the concept that a Clinical-Pathology Conference is limited to a discussion of autopsies. Pathology is the study of disease in all of its phases, and while autopsy cases may be presented, the real theme of this Clinical-Path-ology Conference is the study of LIN ACRE QUARTERLY " pathology of the living." Another "break-through" has been the presen-tation of diagnostic problems from other hospitals; most of our clini-cians serve on other hospital staffs, and they will present for discussion an interesting case under their care. Thus, the Schumpert Clinical-Path-010 g Y Conference was begun in September, 1959, as an educational supplement to departmental meet-ings by the Division of Pathology with the Divisions of Medicine, Radiology, Obstetrics and Gynecol-ogy, Pediatrics and Psychiatry in co-operation with Hospital Administra-tion. It was made clear at the begin-ning that th is was a scientific meet-ing, to present challenging diagnos-tic problems, withollt regard to de-pal·tmental division, with business limited to brief announcements. In the four years of its operation the Conference has gone through several phases of development. We have learned better how to recognize and label interesting material. This involves the use of catalogued "Con-ference Cards" and more photogra-phy. Our visual aids such as photo-micrography, gross photographs, graph photos, x-ray photos, color slide projector are used often and are generally kept in working order. Avenues of meeting notification to discussants and the staff .have been clarified and expedited by planning ahead and mailing cards outlining the programs. The meeting has be-come accepted we believe, but needs constant attention to the weekly de-tails. The program chairman in the pro-cess of cataloguing the cases and ma-terial to be presented in the Confer-ence becomes familiar with the de-tails, and can serve as moderator. We believe that this is a good approach for a weekly meeting, for in the preparation, time is of the essence, FEBRUARY, 1964 and a second person may not be en-thusiastic about the material. On the other hand, the program chairman is counseled by a Conference Advisory Board composed of the heads of the clinical departments of the hospital. To keep the program moving and "alive" the moderator must be fa-miliar with current literature perti-nent to the subjects. Portable dictat-ing equipment for summarizing articles in a quiet corner of the li-brary a few days before the meeting hel ps to get this information on cards , and provides opportunity for the moderator to synthesize the data prior to the meeting. In this way, many articles may be reviewed and a few selected for a dictated sum-mary. Finding the reference may be expedited by applying the journals to the subject; that is, surgery prob-lems are found in surgery journals, and pediatric problems are discussed in pediatric journals, etc. The formal Indices may be used as an adjunct, and not primarily. The meeting has many applica-tions, all of which are expanding. As improved diagnostic tests are de-veloped in the laboratory they are presented and discussed, and both the laboratory and clinical staff are better oriented. Examples have been reviews of kidney function tests, enzyme studies in heart disease, the cl inical and laboratory aspects of hyperparathyroidism, and others. Often a discussant will suggest a new test about which he has learned. The North Louisiana and the Ark-La-Tex area has a moderate incidence of Histoplasmosis and Blastomycosis. The clinical character, regional inci-dence, and laboratory features of these serious fungus infections were reviewed and illustrated recently. Such are only a few of the topics chosen. Discussions are not limited to anyone group. At intervals, the 7 meeting is devoted to rad iologic techniques, presented and conducted by the Division of Radiology. Mem-bers of the Medical Division recent-iy presented their latest views on "Pulmonary Function Studies and In-halational Therapy." Conducted each Friday at noon, except the second Friday devoted to the Surgery Divi-sion, it is clear that a large amount of material may be covered each year. The meeting is discontinued during the vacation months of July and August. Material originally developed for these Conferences often finds its way later to more formal local, state or national meetings. As the Conference has developed we find that discussants are more enthusiastic about presenting cases, and the level of the discussions has improved. In-terest and attendance have increased . From a medical staff of two hundred and forty members, attendance has ranged from twenty-five to thirty-five during the f irst year and has in-creased to an average of sixty to seventy-five four years later. The Conference gives an awareness of local material and one of the mai n themes is the analysis of cases from our own hospital. By reviewing the pathology file material and the clini-cal records we are able to determine the incidence of many disorders in this hospital. For example, the in-cidence, clinical and laboratory fea-tures of Pheochromocytomas of the adrenal g land were discussed. Neo-natal pathology and mortality statis-tics are regularly presented to the Conference, because few members of this audience attend the meetings of the Obstetric staff. We hear from different specialties such as Plastic Surgery, Dermatolo-gy, Neuro-Psychiatry, Neuro-Surg-ery, Oto-Laryngology and others, providing material not usually pre-S sen ted in the general' staff meetings. Reviews from national meetings are reported to the Conference. As an adjunct to the curriculum of the School of Medical Technology, the Clinical-Pathology Conference affords the student technologist an op-portunity to hear from many different sources about the application of labo-ratory medicine, and gives the students an increased awareness of their work and position, as well as opportunity to hear discussions of sixty to seventy di-agnostic problems throughout the year, as a supplement to their regular cur-riculum. In summary, the authors humbly feel that the Clinical-Pathology Con-ference, if carried out with enthusiasm and planning, has a place in the pres-ent-day concept of post-graduate ed-ucation for the physicians and techni-cal staff of the general hospital. One has only to attempt in the laboratory, library and record room the prepara-tion of such a Conference to see the vast potential of organized post-gradu-ate learning each week on a local basis. It is one attempt at meeting the chal-lenge of continuing education, with the objective of improving the quality of medical care, and realizing that such quality is dependent on the per-formance of each physician involved. BIBLIOGRAPHY Dryer, Bernard, V., Study Director. Life-time Learning for Physicians Princi-p les . . . Practices ... Proposals. Report of the Joint Study in Continuing Medical Education. 1. 0/ Med. Educat. , 37: 1-134, 1962, June. Sprunt, Douglas H., Chairman. The Teaching of Pathology, Microbiology, Immunology and Genetics. Report of the Second Teaching Institute. Association of American Medical Colleges, 1954. Ellis, Laurence B. Reflections on Post-graduate Medica l Education for Practic-ing Physicians. New Eng. J. Med., 250:-243-245, Feb. 11. Judd, Walter H. Physicians in a Chang-ing World. New Eng. J. Med. , 263:894-899, 1960, Nov. 3. LINACRE QUARTERLY 

The Challenge of Continuing Medical Education: An Approach

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The Challenge of Continuring Medical Education: An Approach

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