A programme to prepare instructors for clinical teaching.

Clinical staff perfusionists are responsible for training perfusion students to perform tasks and manage patients in the clinical setting. They are often the least prepared to assume this teaching role. To address this need, a modular programme has been developed to provide the teaching staff with instructional skills. Adult learning theory specifies that an effective learning environment addresses issues of saliency, motivation, retention and transfer. Adults have different expectations, so this programme is designed to maximize this process. The programme is comprehensive and may be used for didactic instruction as well. Derived from a model designed for physicians as teachers, five modules provide theoretical support for teaching techniques, learning tools and management techniques for giving feedback and evaluating performance. Specifically, the topics address the following subjects: managing and motivating learners; teaching medical problem solving; teaching clinical skills; giving feedback and evaluating performance. The short curriculum is based on teaching principles that apply to adult learners with diverse learning styles. While presenting techniques to use with different types of learners, the programme itself incorporates these techniques in teaching the teachers. The modules use lectures, demonstrations, role playing and video taping to challenge teachers and learners in the cognitive, psychomotor and affective domains. The success of this programme is its ability to engage each participant in the learning process.

Improving compliance with preventive medicine procedures in a house staff training program.

Performance of health maintenance procedures by internal medicine house staff is inadequate, yet little has been published outlining means to improve performance rates. We prospectively studied the effectiveness of a reminder system to improve screening by Pap smear, rectal examination with stool guaiac test, breast examination, and pneumococcal vaccine administration in two resident outpatient clinics. Performance of these preventive health measures was determined during a six-week baseline period and again after five months of chart reminders to residents in one clinic, and after six months without reminders. For the intervention, a physician's assistant screened each chart and attached a reminder to the front indicating which procedures were overdue based on published recommendations. Health screening behavior was not significantly different between the two resident clinics during baseline. After the five-month reminder intervention, residents in both groups moderately increased their preventive health activities over baseline; however, only the reminded group showed significant improvement (chi 2 = 11.60, P less than .001). Six months after remainders were discontinued there was no difference in overall performance between the two clinics (chi 2 = 2.79, NS). The reminded group did preserve its significant improvement over the baseline phase (chi 2 = 6.12, P less than .01). This simple reminder system had a modest but statistically significant positive impact on health screening behavior. Despite this improvement, absolute rates of screening remained below 50% in both clinics.