Medical students' experiences in medical emergency procedures upon qualification.

The experiences of eighty-five final-year medical students in twenty practical procedures identified as relevant to medical emergencies were registered. Notable differences between exposures to some of these procedures within and outside teaching situations were found. Instruction must be seen as inadequate prior to first performance in real-life situations. Experiences in cardiopulmonary resuscitation were acceptable, however, while exposures to procedures with special equipment, e.g. lumbar puncture or bladder catheterization, were variable. It is concluded that opportunities may be increased by expanding already existing scheduled activities and by spending more time on planning and organization. Examples or activities in order to increase students' experiences in practical procedures during medical school are given and discussed. The problem of assessment of practical competence is pointed out as is also the need for a clear definition of the teaching objectives.

The effect of a checklist on medical students' exposures to practical skills.

The effect is evaluated of a checklist exploring acquisition of practical skills by medical students during the first clinical course in internal medicine. A group of forty-five students using the checklist was compared with two reference groups doing their clerkship before and after the study group. The amount of exposure to practical procedures increased by about 30%. At the same time exposure to some simpler procedures was reduced, while there was an increase in exposures to more complicated procedures. The conclusion is that a checklist has potential value for increasing exposure to practical procedures, if given with advice about the procedures to be preferred and by demand for mastery of particular skills.

Assessment of students' experiences in technical procedures in a medical clerkship.

This study was designed to provide some insight into the manner and degree of students' acquisition of practical skills. One hundred and fifty-two of a total of 166 students in a medical clerkship during the first clinical year answered a questionnaire. The questionnaire contained fifty-eight different laboratory tests and technical procedures. The study revealed deficiencies in the teaching programme. On the average the students had been exposed to 19.4 procedures during their 13-week clerkship. We found no differences according to sex or age. Fourteen skills were considered mandatory. The mean result was 62% for these procedures. Urine analysis and participating in evening rounds gained best scores, while test for blood in faeces and discussing insulin dosage had the lowest scores, 14% and 10% respectively. In order to increase the amount of exposure to practical skills, some improvements in the teaching programme are suggested.

The transketolase assay of thiamine in some diseases.

Erythrocyte transketolase activity (ETKA) and the effect of adding thiamine pyrophosphate have been measured in a group of 27 healthy individuals and in 37 patients diagnosed as having diabetes mellitus, anemia, polyneuritis, or malnourishment secondary to vascular disease of the brain. The observed values for the malnourished group did not differ significantly from those for the control group. The low ETKA values in diabetes mellitus seem to be due to a reduced apoenzyme level resulting from the disease itself rather than thiamine deficiency. Polyneuritis patients had low values of ETKA. In the anemic group as a whole the values showed a difference of only marginal significance from those found in the control group, but the patients with pernicious anemia all had a highly significant elevation of the ETKA values. Although the absolute thiamine pyrophosphate effect differ, there are no significant differences in percentage of thiamine pyrophosphate effect between the groups. It appears that differences in the patient groups studied here reflect variations in apoenzyme levels rather than thiamine status.