Nutrition and cancer education: ten years of progress.

The Nutrition Education and Research Program at the University of Nevada School of Medicine was awarded two separate NIH/NCI R25 cancer education grants over a ten-year period. With this support, a four-year longitudinal nutrition curriculum was implemented, including the required 20-hour freshman Medical Nutrition Course, junior and senior nutrition electives, and a senior assignment in nutrition and cancer during the rural rotation with faculty preceptors. Funding has also supported nutrition integration into the basic science courses, patient care courses, and specialty clerkships. A unique nutrition fellowship for medical students who specialize in nutrition during their four years of training and graduate with special Qualifications in Nutrition (SQIN) has also been instituted. The curriculum reflects a longitudinal, interdisciplinary, but flexible, integration of nutrition into an already crowded medical school education.

Effect of a course on students' attitudes toward substance abuse and its treatment.

From 1978 through 1982, pretests and posttests of second-year medical students' attitudes toward substance abuse and its treatment showed that positive attitude change could be achieved during a substance abuse course. When the course was scheduled in competition with demanding basic science courses, however, the students' attitudes did not become as positive as or became more negative than when the course was part of a less demanding schedule. The course used lectures and reading assignments to provide information on substance abuse and used patient contact to change attitudes toward substance abusers and treatment. Emphasis was placed on patient management problems and small-group discussions. The changes in the students' attitudes are assumed by the authors to be positive, but the link between these attitudes and good clinical practice has not been demonstrated.

The substance abuse attitude survey: an instrument for measuring attitudes.

Although attitudinal objectives in medical education about alcohol and drug misuse are important, adequate instruments for measuring the achievement of such objectives have been lacking. The development of a standardized Substance Abuse Attitude Survey (SAAS) is described. Multiple administrations and factor analyses selected and refined the item pool of the final scale. Five factors were derived from tests completed by 324 noncriterion clinicians: Permissiveness, Treatment Intervention, Nonstereotypes, Treatment Optimism and Nonmoralism. The factor structure was found to be internally consistent over repeated administrations. Validation was obtained by scoring surveys completed by 116 criterion clinicians experienced in treating patients who misuse alcohol and other drugs. The criterion clinicians scored significantly higher than the noncriterion clinicians on the Treatment Intervention and Treatment Optimism factors. The SAAS has been well accepted by medical students and practicing physicians. It has proven useful in developing attitudinal objectives, measuring achievement of these objectives and modifying teaching approaches in both undergraduate and continuing medical education.

A Psychological Study of Health, Injury, and Performance in Athletes on the US Alpine Ski Team.

In brief: We assessed life events, depression, and general well-being (health concerns, energy, life satisfaction, cheerfulness, tension, and emotional control) in 73 members of the US Alpine Ski Team. We compared these psychological factors with subsequent surveys of general health, illness, and athletic performance and found that psychological status (especially general well-being) was associated with subsequent health problems, injuries, and performance levels. These findings indicate that coaches and sports medicine specialists must be sensitive to psychological disorders in elite athletes and provide appropriate clinical assessment and treatment.

A collaborative effort to study methods of teaching physical examination skills.

A collaborative study was conducted between two medical schools to evaluate critically the teaching of physical examination skills to first-year medical students, assess the effect of different instructional methods on student performance, and improve teaching programs at both schools. Students at the two schools were videotaped performing a physical examination on a paid model at the completion of their physical diagnosis courses. The videotapes were sent to a third school for independent evaluation based on criteria agreed upon by all three schools. Students participating in a highly structured course and utilizing a very specific behavioral checklist as both a teaching and evaluating instrument tended to perform more complete physical examinations than students from a less structured course and employing a more generalized checklist. Both medical schools benefited from participation in the study.

A preliminary study of student learning in interdisciplinary health teams.

Self-reported learning in a 12-week interdisciplinary health team training experience at the University of Nevada, Reno, was measured. Fourteen students from seven disciplines participated on health teams in three settings. All students were in early stages of their professional training. A self-report inventory with four general areas was administered before and after the experience. Four analyses of covariance were used to compare participant scores with those of a control group in each area using initial scores as the covariate. There was significant learning in the areas of team skills and processes and in knowledge of and abilities in client communication but not in physical assessment.