Communicating breast cancer on-line: support and empowerment on the Internet.

Using participant-observation and discourse analysis, this study explores the communication occurring on the Breast Cancer List, an on-line discussion group which continues to grow in membership and activity. Issues discussed include the evolution of the List, who participates, what topics are discussed. Three major dimensions are identified: exchange of information, social support, and personal empowerment. Social support via computer is compared with face-to-face groups. Empowerment centers on enhanced decision-making and preparation for new illness-related experiences. The influence of gender is considered in terms of communicative style and limitations of access. It is concluded that the List fulfills the functions of a community, with future concerns about information control and the potential to enhance patient-provider understanding.

Confronting cancer on thirtysomething: audience response to health content on entertainment television.

This study addresses the potential of entertainment television to educate about serious subject matter, such as health content. Through the use of open-ended, in-depth interviews of regular viewers in two metropolitan sites, this study explores audience response to a fictionalized, serialized portrayal of ovarian cancer on thirtysomething. Our questions were directed to the audience's (a) viewing process, including interpersonal contact, identification with characters, and prior experience with cancer, (b) understanding of content, especially illness imagery and coping strategies, and (c) applications to real life, including questions, insights, knowledge, and actions. The details of this exploration indicate the complexity of audience response to this kind of content and suggest guidelines for health communicators as they work with the entertainment industry to embed health-promoting messages in the media.

Teaching patients to speak up: past and future trends.

The patient role as discussed in popular and professional literature is in a transitional period, but actual patient behaviors remain predominantly traditional. This article summarizes advice to the public concerning patient-physician communication from the past 25 years of popular periodicals and recent self-help literature. The few extant programs for improving patient communication skills are identified. Recommendations are made for more extensive patient-focused education and research regarding skills development and behavior change.

Training gynaecological teaching associates.

The Gynecological Teaching Associate (GTA) instructional method is recognized as excellent by the Association of Professors of Gynecology and Obstetrics Undergraduate Education Committee for the instruction of medical students and doctors in the skills required for performance of women's reproductive health evaluation (obstetric-gynaecological history, breast and pelvic examinations, and PAP smear). The method is used in over 90% of American and Canadian medical schools and thus represents a major allocation of educational resources. This success is to a large extent dependent on the quality of training programmes for the GTAs. This paper provides a description of the training programme for GTAs at the University of Illinois at Chicago which has operated successfully for the last 3 years, resulting in a group of 18 GTAs who train approximately 450 medical students and residents each year. It is hoped that this information will help medical educators and planners to develop and/or maintain their GTA programmes (or equivalent in other countries) in the fiscally difficult times facing institutions of higher learning.

Student response to gynecologic teaching associates.

Gynecologic teaching associates teach the communication and psychomotor skills for breast and pelvic examinations in most medical schools in the United States and Canada. Evaluations of these gynecologic teaching associate programs have included faculty impressions of program effectiveness and measurement of student retention of skills but not student evaluations of the effectiveness and value of such programs. At the University of Illinois at Chicago students evaluated their gynecologic teaching associate program. High ratings were given to program organization and content; the knowledge, ability, and professionalism of the teaching associates; and the outcomes of the sessions with respect to the learning skills needed to perform the examinations. Students emphasized the importance of the ability of the teaching associates to provide immediate informative feedback and to reduce anxiety during the teaching sessions. Students tended to view their ability to perform breast examination to be greater than for the pelvic examinations but felt they learned more about both in the sessions. This information supports the value of the gynecologic teaching associate model in medical education.

Impact of an independent-study programme upon professional careers.

A survey of graduates of the Independent-Study Programme (ISP) at the College of Medicine, University of Illinois, was conducted in order to assess the impact of the ISP on their subsequent careers. Responses from ninety-nine of these graduates, when compared with their classmates, lend strong support to the idea that such an independent study programme has long-lasting effects on the participants. The ISP graduates are selecting a medical subspecialty in a much higher percentage than their classmates or the national average. They also are engaging in more research, administration, and teaching. Differences between the ISP and the traditional graduates are explained in terms of unique educational opportunities, contact with teachers and peers, orientation towards independent learning and curricular requirements.