Development and implementation of an innovative intern training programme

The quality of medical education during internship is a cause for concern. This paper describes a structured educational programme for interns that was based around learning modules, clinical attachments and bedside teaching. The programme was incorporated into the term rotation of interns within an Area Health Service, and evaluated. Learning modules were timetabled by a Programme Coordinator and interns were reminded to attend. Clinical attachments were organized by the interns from a list of willing supervisors. Attendance at timetabled learning modules averaged 67%, which was greater than the 27% attendance at clinical attachments. Both sessions received high ratings for quality and clinical relevance. This structured education programme was based upon adult learning methods and was both feasible and well received by interns. Intern training programmes need to be programmed into the working week to ensure attendance, and modified following evaluation by interns. Such programmes should be considered by all hospitals to which interns are allocated.     

Teaching medical students about the appropriateness of social and sexual contact between doctors and their patients: evaluation of a programme

The purpose of this study was to assess the impact of an educational intervention on medical students' attitudes toward social and sexual contact with patients by doctors from three medical specialties (general practice, obstetrics/gynaecology and psychiatry). Medical students from two consecutive fifth year classes at one medical school participated in one 3 hour session that included instruction on the standards of the profession that prohibit doctor–patient sexual contact. Students were assigned to either intervention groups or control groups and responded to an anonymous questionnaire (overall response rate 66·8% ; n=141). As many as 14·5% of control group students thought it was (sometimes or usually) appropriate for general practitioners to date their own patients and at least 3% thought it appropriate for members of any of these three medical specialties to engage in sexual contact with their own patients. However, there were no significant differences in attitudes toward hugging, dating or sexual contact with current patients between those who had attended the seminar and the control groups. The session significantly influenced attitudes regarding obstetrician/gynaecologists and psychiatrists hugging and having sexual contact with former patients. These findings are discussed in relation to a need for expansion of such instruction.     

Teaching sociology of medicine: the group process

As a part of any curriculum reorganization, new instructional methods are also tested. When the University of Turku sociology of medicine course was found to need renovation, its goals and objectives, content and instructional methods were closely examined and modified, in order to strengthen institutional and multiprofessional relations and reinforce sociocultural issues in doctors' competence with the patient. This paper discusses this change, emphasizing teaching and learning methodology.     

Development and evaluation of a breast cancer prevention decision aid for higher-risk women

Objective To develop and evaluate the effectiveness of a breast cancer prevention decision aid for women aged 50 and older at higher risk of breast cancer. Design Pre‐test–post‐test study using decision aid alone and in combination with counselling. Setting Breast Cancer Risk Assessment Clinic. Participants Twenty‐seven women aged 50–69 with 1.66% or higher 5‐year risk of breast cancer. Intervention Self‐administered breast cancer prevention decision aid. Main outcome measures Acceptability; decisional conflict; knowledge; realistic expectations; choice predisposition; intention to improve life‐style practices; psychological distress; and satisfaction with preparation for consultation. Results The decision aid alone, or in combination with counselling, decreased some dimensions of decisional conflict, increased knowledge (P < 0.01), and created more realistic expectations (P < 0.01). The aid in combination with counselling, significantly reduced decisional conflict (P < 0.01) and psychological distress (P < 0.02), helped the uncertain become certain (P < 0.02), and increased intentions to adopt healthier life‐style practices (P < 0.03). Women rated the aid as acceptable, and both women and practitioners were satisfied with the effect it had on the counselling session. Conclusion The decision aid shows promise as a useful decision support tool. Further research should compare the effect of the decision aid in combination with counselling to counselling alone.     

师范大学学生艾滋病知识现况调查及健康教育近期效果评价

目的 了解师范大学学生艾滋病相关知识及行为现状，为高校制定艾滋病健康教育规划提供参考。方法 抽取天津师范大学2000年入学新生，通过集体讲座，使用统一的调查问卷在教育前后分别调查学生艾滋病相关知识及态度，并利用EPIinf0软件进行分析。结果 天津师范大学一年级学生健康教育后对艾滋病性质、主要传播途径等的正确回答率都有所提高，能够正确对待艾滋病病毒感染者，教育前后学生对性行为的态度无明显改变。学生希望获得艾滋病知识的前4位方式均为电视、报刊书籍、卫生课和医生。结论 从国情和现实需要出发，在大学生中开展适时、适度、适量的性健康教育和健康行为教育，对预防性病艾滋病有着积极的意义。     

An analysis of paediatric diagnostic decision-making: how should students be taught?

This study assesses the relative importance of history, examination and investigations in paediatric diagnosis, in the Paediatric Out-patient Department of the Central Middlesex Hospital, London, by means of a questionnaire-based record of 94 consecutive referrals. A diagnosis identical to the final diagnosis was made in 76% of referrals after taking a history. The general practitioner had proposed a diagnosis in 45% in the referral letter. Clinical examination changed the diagnosis in only 15% but increased diagnostic confidence in 33%. Ninety-one per cent of cases were diagnosed without recourse to investigations. Forty-two per cent of children referred had investigations performed. In the majority of paediatric cases the provisional diagnosis reached after taking a history was identical to that after examination or results of investigations were known. Although examination provided a final diagnosis in only 15% of all cases it played an important role in adding confidence in 33%. More educational effort should therefore be directed at clinical history-taking skills and the subsequent purpose of examination.     

社区居民健康相关行为讨论与分析

目的了解当前社区居民中健康认知和主要健康相关行为，为深入开展健康教育提供科学依据。方法对黄浦区8个街道117个居委2546名居民分别召开座谈会，讨论并分析健康认知与健康相关行为。结果在2546名居民中对健康有正确认识的948人，占37．2％．自我评价身体状态为健康的531人，占20．9％，个人不健康行为位于前三位的是吸烟、不合理膳食和缺乏运动。团体不健康行为位于前三位的是出售不健康食品、食品污染和公共场所脏乱。结论健康相关行为受多因素及其多水平的影响，必须运用健康教育行为改变理念，采纳健康相关行为的生态学的观点，结合相关学科的方法，开展健康教育，促进人们的健康行为。     

嘉兴外来人员生活环境与肠道传染病相关知信行现况调查分析

目的了解城郊结合部外来人员聚集地生活环境现况和霍乱等肠道传染病健康知信行情况,进一步明确肠道传染病防治健康教育与健康促进工作的重点开展方向。方法采用随机抽样的方法,运用统一设计的调查问卷对嘉兴市5县2区城郊结合部等外来人员聚集地进行流行病学调查。结果93.06%的调查对象以租房为主,90.61%的生活用水来源于自来水,9.25%用井水;78.61%的人知道霍乱传播途径,21.53%的人知道霍乱主要临床症状,28.03%的人知道肠道传染病全部预防措施;77.31%的知识来源于电视,其他顺位依次为书刊、广播、家人或朋友处;希望获得宣传资料形式:传单占46.68%,墙报占31.21%。结论外来人员租房人数居多,有部分人使用井水;肠道传染病相关知识了解的较少。应采取多部门齐抓共管来改善外来人员聚集地的生活环境,因地制宜地对外来人员开展有针对性的预防肠道传染病健康教育。