Postural changes in dental hygienists. Four-year longitudinal study.

Numerous surveys identify the occurrence of musculoskeletal complaints as a concern in dentistry. However, no longitudinal data exist to indicate whether postural changes occur as a result of practicing dental hygiene. The purpose of this preliminary, four-year longitudinal study was to investigate whether any postural changes developed during the hygienists' clinical education and/or during subsequent dental hygiene practice after one and/or two years. It was anticipated that the awkward positions and intense physical demands placed on hygienists might initiate musculoskeletal problems, but that no postural changes would occur over this short period of time. Nine of 10 dental hygienists in the graduating class of 1987 were surveyed for existing musculoskeletal complaints, and the subjects were photographed for a measurement of postural change. Responses from participants indicated an increase in musculoskeletal-related complaints in each of the six areas investigated. The photographic findings indicated that one of the nine hygienists showed an increase in forward head posture, a postural change.

Teaching medical decision analysis: the hepatitis B vaccine.

The process of formal decision analysis is illustrated by using the case of the hepatitis B vaccine in a computer program designed to teach both subjects to medical students. The software presents the medical facts, determines personal risks, allows input of personal values and calculates utilities for the various branches of the decision tree. There are three possible choices: vaccinate; screen first for antibodies against the hepatitis B virus and vaccinate only if negative; and wait (do not vaccinate). The decision with the utility of the highest numerical value is assumed to be the best under the given set of circumstances. Unlike commercial packages, this software contains the information internally and does not require that the user be familiar with either medical decision analysis or with the medical aspects of hepatitis. The program is available for PC's.

Changes in dental students' personal needs and values.

Personality characteristics of dental students were studied longitudinally by means of the Allport-Vernon-Lindzey Study of Values and Edwards Personal Preference Schedule. There were no significant differences when 21 scale scores of seniors were compared to the scores obtained from the same students as freshmen. The lack of significant change indicated a minimal effect of dental education on the personal needs, values, and attitudes of students. Thus, it is essential that faculty know as much as possible about applicants' values and needs prior to their admission to dental school. Knowledge of these personality characteristics is also essential for teaching and reinforcing those attitudes and values that are believed to assist students in developing well-integrated personal and professional lives.

Changes in students' perceptions of clinical teaching as a result of general-practice clerkships.

This study investigated whether a 3-week clerkship for third-year medical students in general-practice doctors' offices changed the students' perceptions of clinical teaching. The Preceptor Evaluation Questionnaire was administered to 138 junior medical students before and after their clerkships. The result of the study indicated that the clerkship had a positive effect on the students' perceptions. This finding was not related to their experiences in other clerkships nor to the grades they received for the clerkship. The results indicate that the teaching relationship established between student and family doctor significantly affects students' perceptions of aspects of effective clinical teaching.

Restrained eating: measuring an elusive construct.

As a measure of restrained eating, Herman's Restraint Scale (1978) reliably predicts laboratory food consumption in college students regardless of their weight. However, the generality and psychometric properties of the scale have not been established. In the present study, 136 male and female adults were cross-classified as obese and normal and as dieting or non-dieting. The subjects were administered a single questionnaire containing items of the Lie, Social Desirability, and Restraint scales presented in randomized order. Unlike previous reports by Herman, the three adult groups differed significantly on the Restraint Scale in the following order: Obese dieters greater than Obese non-dieters greater than normals. Also, alpha reliability coefficients varied across groups and corrected item-total correlations also displayed considerable variability with no uniformity apparent for individual item correlations. The factor analysis identified three factors within the ten item scale, and for the obese dieters, the scale was not independent of social desirability. These results indicate that the Restraint Scale has limited usefulness beyond laboratory settings with college students.

Dental students' personality: a Jungian perspective.

The Myers-Briggs Type Indicator (MBTI) was employed to measure the nature and strength of dental students' various basic preference in perceiving and making judgments. The MBTI yields four sets of scores--extrovert-introvert (E-l), sensing-intuitive (S-N), thinking-feeling (T-F), and judging-perceptive (J-P)--and represents 16 personality types that define these preferences. The sample consisted of five classes at the University of Mississippi School of Dentistry (n = 217). The data indicated that the largest group (32 students) was ESFJ, while the next largest (30) was ESTJ. The least frequently represented groups were the INTP (3), the INFP (7), the INTP (7), and the ENTP (7). Dental students exhibited characteristics different from those of students in business, engineering, social work, medicine, and other fields. These findings have implications for admissions committee decisions as well as for the organization and curriculum of the dental school.

The tracer method of curriculum analysis: identifying changes in oncology subject matter in medicine.

Changes occurring in oncology subject matter in an undergraduate medical curriculum over a 5-year period were documented using the tracer method of curriculum analysis. The tracer method is an empirical approach somewhat analogous to tracing one thread through a tapestry, as a way of following a subject matter interwoven throughout a curriculum. Advantages of the method can be to bring particular material to the attention of teaching staff and students, to facilitate more efficient instruction, and to introduce peer review of educational material.

A factor analytic study of teaching in off-campus general practice clerkships.

The Preceptor-evaluation questionnaire (PEQ) was developed at the University of Mississippi Medical Center to evaluate the clinical teaching behavior of general practice doctors in private practice who have one or more third-year medical students per year in their offices for a required general practice clerkship. The PEQ was designed to provide feedback to these doctors and the sponsoring department in an effort to improve teaching in this setting. Developed from the input of family practice doctors who have supervised students in their offices and from a review of related literature, the instrument was given to students to determine the level of importance they attributed to each teaching characteristic. A principle components factor analysis and subsequent varimax rotation produced six significant teaching factors in this setting. These six factors were: (1) demonstrates a humanistic orientation toward patients and staff; (2) demonstrates a humanistic orientation toward student; (3) provides opportunity for practice; (4) motivates and stimulates student's thinking; (5)communicates effectively with student; and (6) demonstrates comfort and confidence in the roles of doctor and teacher. The factor relating to the humanistic orientation toward student has not appeared as a separate factor in other studies of clinical teaching. This may be due to the unique aspects of the relationship between student and doctor in this setting which may not occur in other settings. The PEQ and similar reliable and valid instruments can provide valuable information for the doctors in these off-campus teaching situations as well as provide useful programme planning information for the sponsoring academic departments. This information may also be valuable for off-campus residency training.

Minority recruitment to the health professions: a matched comparison six-year follow-up.

An experiential program was designed to attract minority students to health careers and to affect the supply and distribution of health manpower in a medically underserved area. A six-year follow-up study of participants and a matched comparison group of nonparticipants indicate the value of the program. Participants were found to by employed in health careers and to achieve long-term career preferences more often than nonparticipants, even though they experienced slightly more obstacles to career attainment. Although more of the participants appeared to remain in the underserved area to practice their health profession, respondents from both groups who had achieved a health career and who had been educated in the underserved area were more likely to remain in the area to practice. This study is evidence of the value of long-term follow-up evaluation.

Modular teaching of cardio-pulmonary resuscitation for nursing service personnel.

Hospital accrediting agencies are becoming increasingly concerned that all nursing service personnel should be proficient in the administration of cardiopulmonary resuscitation. In response, our department had instituted a modular, self-learning CPR course, based on American Heart Association standards, which yields a high quality performance and decreases instruction time.

The implementation of a large-scale self-instructional course in medical information resources.

The implementation of library orientation and bibliographic instruction in health sciences centers presents some interesting as well as perplexing problems. The Rowland Medical Library at The University of Mississippi Medical Center had to confront and reexamine these problems when faced with the requirement to teach 298 freshman and sophomore medical students in one ten-week quarter. This paper outlines the development and implementation of a large-scale self-instructional approach to library instruction. The package consisted of an audiotape, a videotape, a written program, self-teaching quizzes, a performance test, and a student evaluation. Performance test results and student evaluation data are presented which indicate that this format can successfully be employed to meet course objectives and to be accepted by students.

Are health science faculty interested in medical history? An evaluative case study.

This paper deals with the efforts of a medical library to stimulate interest in the history of medicine by utilizing its historical resources. It is based on a survey designed to evaluate the monthly publication of the library, the Bookman, and to determine the response of health science faculty to historical essays as well as to other sections of the publication. The results show that a large percentage of the faculty reads historical essays either regularly or occasionally, and reveal a trend contrary to the common belief that the teaching staff in health science centers is not interested in medical history. The authors suggest that a library with historical resources can contribute to the educational process in a medical community by actively publicizing its collections and providing opportunities for informal and self-initiated reading.

Barriers to health career aspirations of young women in the Lower Rio Grande Valley.

This study concentrated on a sample of 75 young women in high school in the Lower Rio Grande Valley of Texas (LRGV). The effects of socioeconomic status, size of residential community, and career deflection on the types of barriers to career aspirations perceived by these young women were examined. To identify barriers unique to young women, we compared them to a group of young men of similar age from the LRGV who also were aspiring to a health career. The barriers most frequently identified could be overcome by programs already at work in the LRGV sponsored by the Area Health Education Center. Extrapolating from this study, there are 25,007 students in the valley, 5,041 are young women interested in health careers which may indicate a potential improvement in the representation in the health professions.

Migration of allied health care personnel in and out of an underserved area: a question of roots.

The distribution of health personnel and the resulting shortages of health care to economically depressed, ethnic, rural and inner city areas is a serious problem. Recruiting students from and training them in underserved areas has been suggested as one way to improve retention rates among graduates of allied health programs. A one-year follow-up survey of 1974 graduates of allied health programs sponsored by an Area Health Education Center located in an underserved, one ethnic group predominant rural area was done to test this approach. Results show that of the 122 graduates surveyed in this study, one year after graduation 85% had returned to work in the area of their previous residence. Among professional groups, licensed vocational nurses experienced the least migration. Generally, professions requiring higher levels of education showed higher relocation rates. Sex and ethnicity were related to these findings. The appeal of higher salaries or material benefits alone did not appear to attract graduates to migrate. It appears that communities with shortages of health manpower due to maldistribution may be successful in correcting this problem by recruiting students from their own area. Possible explanations and recommendations related to these findings are discussed.