Scientific method for medical practitioners: the case method of teaching pathology in early twentieth-century Edinburgh

The appointment of James Lorrain Smith as first full-time professor of pathology at the University of Edinburgh in 1912 led to a series of reforms in pathology teaching there. Most significant was the inception of what Lorrain Smith called the "case method of teaching pathology," which used the investigation of clinical cases as the basis for a series of exercises in clinico-pathological correlation. This paper examines the social and cognitive organization of the case method of teaching, and shows how such exercises were expected to inform the students' future medical training and practice. In so doing, it also throws light on the relationship between medical science and clinical practice that obtained in Edinburgh at that time.     

The problem-based learning tutorial laboratory - a method for training medical teachers

An extensive staff development program was started in 1998 in the Faculty of Medicine at the University of Helsinki. A problem-based learning method was introduced as a new style of teaching in the curriculum reform. This paper describes a teaching method 'Problem-based learning - tutorial laboratory' for training medical teachers to act as tutors and to understand their roles as facilitators of learning and the dynamics of a small group. The method was based on learning cycles: teachers had a possibility to experience tutoring, to get feedback about it from an educational expert and from a peer teacher and also they were able to reflect on their views in the group. The teachers were content with the training. Sessions improved teacher cooperation across the departments and brought new teaching ideas for shared use. It also helped to cope with the resistance related to the curriculum change process.     

Introducing peer observation of teaching to GP teachers: a questionnaire study

In medical education programmes which rely on clinical teachers spread across diverse sites, the application of peer observation of teaching offers the potential of both supporting teachers and maintaining quality. This paper reports on a questionnaire survey carried out with general practitioner (GP) teachers of medical undergraduate students from King's College London School of Medicine at Guy's, King's College and St Thomas' Hospitals. The aim of the study was to determine GP teachers' views on a proposed programme of peer observation of their teaching. The majority of GP teachers identified benefits of the proposed scheme with 69% saying it would help improve the education of future doctors. However, despite seeing the benefits, less than half wished to take part in the programme. Two thirds cited time and paperwork as major disincentives to taking part and 62% said that they felt it would make them feel under scrutiny. No associations were found between measures of workload and willingness to take part. This suggests that a fundamental fear of scrutiny and criticism may be the main hurdle to be overcome in implementing the scheme. Imposing peer observation on GP teachers in the form proposed could create suspicion and distance between the university department and practice-based GP teachers and may even result in a loss of teachers. The introduction of peer observation is more likely to be successful if GPs' apprehensions are addressed. Using peer observation to strengthen the process of quality assurance may undermine its role in the support and development of clinical teachers.     

Hospital doctors and health promotion: support for teaching behaviour change

This article describes the development in the West Midlands Region of an educational pack for junior hospital doctors on the principles and practice of health promotion. It has been designed to encourage young doctors to apply research-based strategies for behaviour change within their own work and to provide informed support to the work of other professionals who have more time to spend with patients. The process of development was informed by a research study of cardiologists' understanding of health promotion and by pilot work with a variety of hospital specialties. The educational pack focuses on those aspects of health promotion work of most relevance to junior doctors.It uses the'Cycle of Change'model developed by Prochaska & DiClemente, to help patients (and doctors) change their behaviour. It can be used either independently, or as material to support interactive teaching and learning sessions. It is thus designed to integrate with the new learner-centred, interactive learning movement in medical education.     

A conservative case for universal access to health care

Universal access to health care has historically faced strident opposition from political conservatives in the United States, although it has long been accepted by most conservatives in the rest of the industrialized world. Now, in a global economy where American business is crippled by the rising cost of market-based health care, the time may be ripe for change. The key to fostering a new mindset among American conservatives is to show why universal access fulfills many of the basic values that all conservatives hold.     

Sharing innovation: the case for technology standards in health professions education

Information technologies have provided fertile ground for innovation in healthcare education, but too often these innovations have been limited in scope and impact. One way of addressing these limitations is the development of common and open technology standards to scale innovation across organizational boundaries. Research on the diffusion of standards indicates that environmental forces, such as regulatory changes, top-down management support, and feasibility are key determinants of standards adoption. This paper describes the perspective and work of MedBiquitous, the only internationally recognized standards body in healthcare education. Many innovators are implementing MedBiquitous healthcare education standards to effect change within and across organizations. In a resource-constrained and knowledge intensive domain such as healthcare education, collaboration is an imperative. Technology standards are essential to raise the quality of healthcare education and assessment in a cost-effective manner.     

The meanings of professional life: teaching across the health professions

Most of professional ethics is grounded on the assumption that we can speak meaningfully about particular, insulated professions with aims and goals, that conceptually there exists a clear "inside and outside" to any given profession. Professional ethics has also inherited the two-part assumption from mainstream moral philosophy that we can speak meaningfully about agent-relative versus agent-neutral moral perspectives, and further, that it is only from the agent-neutral perspective that we can truly evaluate our professional moral aims, rules, and practices. Several important changes that have occurred, or are currently taking place, in the structure of the health care professions, challenge those assumptions and signal the need for teachers of professional ethics to rethink the content of what we teach as well as our teaching methods. The changes include: influences and critique from other professions and from those who are served by the health professions, and influences and critique from professionals themselves, including increased activism and dissent from within the professions. The discussion focuses on changes that have occurred in the health-related fields, but insofar as similar changes are occurring in other professions such as law and business, these arguments will have broader conceptual implications for the way we ought to think about professional ethics more generally.     

Fable hospital 2.0: the business case for building better health care facilities

Evidence shows that changes in the architecture, design, and decor of health care facilities can improve patient care and in the long run reduce expenses. These essays detail the state of the research, look inside two hospitals that put some of these innovations into practice, and consider how design fits into the moral mission ofhealth care.     

P NUTS--a nutritious method of teaching respiratory physiology

Teaching basic respiratory physiology can be made more interesting and fun by means of a simulation involving active transport (and consumption) of peanuts by the participants. Simple rules simulate the basic features of oxygen transport, hypoxia and hypoxaemia and provide an opportunity to discuss physiological principles at intervals during the simulation.     

Twelve tips for incorporating and teaching sexual and gender minority health in medical school curricula

The World Health Organization has identified many barriers to improving the health of lesbian, gay, bisexual, and transgender (LGBT) patients, including challenges to incorporating and teaching about healthcare for such patients, which we call “sexual and gender minority” (SGM) health content. These challenges include structural and logistical barriers to incorporating SGM health content into undergraduate medical curricula, as well as lack of support in identifying high-quality pedagogical methods for teaching this material. Here, we provide twelve tips for incorporating and teaching SGM health curricular content in undergraduate medical education, including resources and strategies to support individual educators. Based on our success in developing and implementing this content, we believe that our approach can be effectively used by individual educators aiming to incorporate SGM health curricular material into their teaching, and to support individuals or groups championing the inclusion of a SGM health topical sequence in medical curricula.