Do surgical residents rated as better teachers perform better on in-training examinations?

BACKGROUND: There have been no attempts to objectively compare resident teaching ability with resident knowledge level. METHODS: Resident teaching ability, as rated by medical students and junior surgical residents, was compared with resident knowledge level, estimated by in-training examination results, for 18 PGY5 and PGY4 surgical residents at McGill University (September 1996 to July 1997). RESULTS: There was a trend to suggest that greater teaching ability is associated with higher in-training examination scores; this did not achieve statistical significance. PGY4 residents were rated as better teachers than PGY5 residents. Resident self-evaluation revealed a high degree of interest in teaching; inadequate time was the principal deterrent to resident teaching; enjoyment and learning during teaching were found to be the most common incentives. CONCLUSIONS: Our results suggest an association between resident level of knowledge and teaching ability. The principal deterrent to teaching--inadequate time--must be addressed to effectively assist surgical resident teaching.

CD44 variant expression and estrogen receptor status in breast cancer.

To understand the relationship between CD44 gene expression and an established variable associated with aggressive behaviour in human breast cancer, we have studied a panel of 6 breast cell lines and 40 breast tumors selected primarily on the basis of estrogen receptor (ER) status. CD44 (standard form) mRNA was assessed by semi-quantitative RT-PCR, and CD44 variants incorporating exon v7 or v10 were studied by RT-PCR and Southern blot. While CD44 expression was not influenced by estrogen in ER+ve MCF-7 cells. CD44s expression was slightly higher (up to 2 fold) in ER-ve cells but there was a marked decrease in the range of CD44 variants incorporating exons v7 or v10. In microdissected tumors, the levels of CD44s showed no correlation with ER status but the pattern of expression of larger forms of CD44 incorporating variant exons v7 and v10 was significantly different (p = 0.005 and p = 0.015, respectively) between ER+ve and ER-ve tumors, reflecting the pattern seen in the cell lines. These findings suggest that the profile of CD44 expression in breast cancer may reflect cellular differentiation as indicated by the ER phenotype. The influence of these differences in CD44 expression on the increased metastatic potential of ER negative breast cancer remains to be determined.

Faculty perceptions of effective ambulatory care teaching.

The authors interviewed faculty members to determine their perceptions of what constitutes effective teaching in the ambulatory setting. They conducted semistructured interviews with experienced clinician-tutors who supervise residents in two internal medicine clinics. Tutors identified similarities as well as important differences between inpatient teaching and outpatient teaching. Questioning, role modeling, and emphasizing general principles and concept comprehension can be used effectively in both settings. On the other hand, the two settings differ strikingly in teaching of problem solving, bedside teaching, and provision of feedback. Many characteristics of the setting influence outpatient teaching, but the tutors offered differing viewpoints about whether these characteristics are beneficial or detrimental.