Computerized evaluation of clinical experiences in the training of health professionals.

The Physician Assistant Program at the University of Southern California School of Medicine in Los Angeles established a computerized data base in 1980 to evaluate the clinical experiences of its students. Data on patient encounters are collected by means of "patient contact cards." The data focus on three main areas: patient demographics, diagnoses/therapeutics, and student responsibility levels. A FORTRAN computer program was written to produce summary reports for individual students as well as for the entire class. The information generated can be used to ensure adequate experience in each clinical area, document the student's background for employers, serve as a basis for curriculum revision, and allow evaluation of the adequacy of clinical services in the community. The computer program is transferable to other institutional locations as well as to other types of health care provider training programs. The design of the patient data system, the computerization process, the implementation of the program, and its applications are discussed.

The mandibular dental arch: Part I, lower incisor position.

The position of the lower incisor with respect to hard tissue references has been evaluated. Two samples were used for this purpose: one containing 78 patients with posttreatment records having a postretention period of at least 4 years, and the other composed of 82 normal occlusions. The results indicated: 1) There was no significant difference in relapse of lower incisor crowding between cases where the lower incisor had been moved lingually, labially, or held in the same relative position during treatment. 2) The position of the maxilla should be considered when placing the lower incisor. The APo plane adequately serves as a guide to this purpose, whereas other reference lines such as mandibular plane or facial plane do not. 3) The positions of the incisors with respect to popular cephalometric reference lines such as APo, NB, or mandibular plane were not correlated with the relapse of mandibular crowding. Therefore, other clinical guides might be more successful for determining stability.

Midpalatal suture opening: a normative study.

This study of the average response to midpalatal suture opening revealed the following significant results: 1. Maxillary expansion was effected in all fifty-six cases, but the older patients with more rigid skeletal components experienced little orthopedic change. 2. The maxilla always moves downward and moves varying degrees, from slightly backward to sometimes significantly forward during suture opening. Full recovery usually occurs during stabilization. 3. Maxillary skeletal width can be expanded with no relapse in younger patients. However, older patients often lose much of the width increase that is achieved through palatal expansion. 4. In younger patients, the mandible permanently rotates open less than 1 degree.