Effect of a course in cancer prevention on students' attitudes and clinical behavior.

The long-term effects of a first-year medical school course in disease prevention focusing on cancer were studied. The authors hypothesized that students' increased knowledge of disease prevention principles would result in more positive attitudes toward aggressive treatment and prevention of cancer and a more frequent use of disease prevention techniques in clinical settings. On two occasions one to three years after the course, groups of students who took the course and groups that did not take the course responded to a test of knowledge of cancer, a cancer attitude survey, a clinical practice survey, and an evaluation of the course's relevance. Also, their clinical behavior was observed and coded during videotaped interviews of patients. While the students who took the course were more knowledgeable about cancer than their peers who did not, they did not have significantly more positive attitudes; nor were they significantly more likely to use prevention techniques in clinical settings. However, the more knowledgeable students--both those who took the course and the control students--had more positive attitudes than the less knowledgeable students. Those students who considered the course relevant to their training were more knowledgeable and had more positive attitudes toward cancer prevention than those who did not consider it relevant.

Effect of a cancer education program on student interest and learning in cancer.

In a five-year study of medical students who had participated in a first-year elective course on cancer, the authors found that 47 percent of all participants subsequently became involved in other cancer programs. A sample (n = 40) of the participants was interviewed and studied in depth. Their subsequent expressed and overt interests in cancer were related to their achievement on neoplasm-related test items contained in second-year systemic pathology examinations and to their perception of transfer of learning from the cancer course. Neither expressed nor overt interest in cancer was significantly related to test scores on neoplasm items; but perceived transfer of learning was positively related to scores on neoplasm items, and perceived transfer and overt interest, combined, significantly related to test scores on neoplasm items in systemic pathology.

The role of negative factors in changes in career selection by medical students.

The authors in the present study assessed the extent to which negative factors influenced changes in career selection among medical students. Ninety-eight graduating medical students completed a retrospective career choice questionnaire that ascertained the areas of medicine in which they intended to practice and when in their medical curriculum they made this choice, whether this choice represented a change, and, if so, when and why did such a change occur. Responses to these questions indicated that 84 percent of all changes were due to some negative factor about the initial choice, while only 16 percent were due to positive factors concerning a new choice. The results were also classified with regard to disciplines losing and gaining students and the points during the course of study when changes occurred. It was concluded by the authors that time of change and knowledge of reasons for change have different implications for various medical specialties. Medical career selection was likened to the process of hypothesis generation and testing.

Clinical instruction in medicine: a national survey.

In this paper the authors report on the medicine phase of three parallel studies undertaken to investigate clinical teaching skills in medicine, dentistry, and nursing. The intent of the overall study was to gather and assess broad-based information useful in the design and implementation of clinical teaching improvement programs in the health sciences. A 14-member consortium representing five schools each in medicine and dentistry and four in nursing collaborated by using a modified Delphi technique to resolve conflict and differences, through group judgments, in preferences to choices among educational goals and activities. Based upon an educational needs assessment, the design of the study and of the research methodology allows replication at individual institutions and provides a systematic approach for designing and implementing faculty development programs with specific skill emphasis at the clinical level.

Sociomedical issues in the curriculum: a model for institutional change.

An institutional strategy has been developed that permits consideration of sociomedical issues in some depths throughout the undergraduate curriculum. A major component of the strategy is the appointment by the dean of multidisciplinary education committees, each concerned with one sociomedical problem area. Eight such committees have been appointed, and each has developed a small group seminar course in its area. In the freshman year, each student is required to choose one of these seminars, or "selectives," and to participate in it for two semesters. Analysis of grades in the required basic science courses has demonstrated that participation in the selectives has no adverse effect on student performance in the other courses. These and other activities of the education committees have brought about changes elsewhere in the educational program.

Medical student attitudes toward geriatric medicine and patients.

This study examines the influence of factual knowledge of the aged, general attitudes toward the aged, and personal contact with the aged on first-year medical students' attitudes toward geriatric patients and geriatric medicine. Entering medical students indicated a preference for working with younger patients rather than aged patients. Students' attitudes toward the aged were associated positively with their knowledge of the aged, but their interest in geriatric medicine did not appear to be affected significantly by knowledge of, attitudes toward, or personal contact with the aged. The results suggest that factors beyond those considered in this study may need to be examined if there is to be an increase in the number of physicians wishing to care for the elderly.

Medical students from natural science and nonscience undergraduate backgrounds. Similar academic performance and residency selection.

The majority of matriculating US medical students continue to major in the natural sciences as college undergraduates in the belief that this will enhance their chances of admission to and their performance in medical school. The present study compared the academic performance and residency selection of natural science and nonscience majors in three separate medical school classes at the State University of New York at Buffalo. Statistical analysis of grades in the first two years of medical school, clinical performance in the third year, and part I and part II National Board Medical Examination scores revealed no significant differences across three class replications. Residency selection among graduating seniors was also independent of undergraduate major. It is suggested that admissions committees, premedical advisors, and students reconsider their attitudes about the necessity of concentration in the natural sciences before entering medical school.

Computer-simulated clinical encounters. I. Development, utilization, and evaluation of a program.

Positive findings from the two-year pilot study indicated no significant difference in academic learning and clinical performance when students substituted computer-simulated experiences for hospital-based clinical experiences. There was also strong evidence that the time spent by students in fewer hospital-based clinical experiences was more decisively monitored by faculty. Based on these positive findings, the computer-simulated clinical encounters are being continued as part of the established curriculum in the coordinated undergraduate program in dietetics at The Ohio State University.

Dentistry, medicine, pharmacy: treatment interests, ability and socioeconomic index of three stable career groups.

Career development literature indicates that many who enter a specific health profession may do so after actively considering one of the other health professions. From a field of 36 variables representing abilities, interests, temperanment, and socioeconomic index, 16 significant variables were found that best differentiate between and among physicians, dentists, and pharmacists. These 16 served as reliable discriminators for predictive classification.