Showing papers on "Annotation published in 1986"

Annotation Undergraduate teaching in hospitals

Abstract: Medical undergraduates have been taught mainly in major teaching hospitals, which seem ideally suited for the purpose. They are staffed by academics or visiting specialists and offer a wide selection of patients. A large number of bright students arrive each year having completed their basic medical sciences.' They have finally the opportunity to follow their vocation and train as doctors. Their eagerness may soon be replaced by a realization that their considerable scientific knowledge does not equip them to care for patients. How does their extensive study of human function and anatomy relate to patients' symptoms? How do they begin to interview a patient and confidently elicit physical signs? What is involved in the process of arriving at a diagnosis to make correct clinical decisions? Are hospitals with their bias of patients and specialist staff the best place to acquire such skills? Elstein et a/.' have observed that \"With increasing frequency medical educators were told that their objective was to produce problem-solvers, enquirers, individuals skilled in gathering and interpreting information for the purpose of rendering judgments, making decisions and taking actions.\" Traditional medical schools have been critized for lack of integration, both vertically (between the year of the course) and horizontally (between the subjects taught by the various department^).^ Sheldrake et a/.' describing the Australian scene, have commented on the lack of continuity between the preclinical and clinical years. Gale has suggested that \"The academic sciences of the pre-clinical years, set outside the clinical problem-solving context of the clinical curriculum, may well require considerable cognitive restructuring or reorganisation before they assist the diagnostic thinking process in an efficient and effective manner, for disease does not differentiate between separate scientific territories or levels of enquiry in bodily structure and f ~ n c t i o n \" . ~ There has been concern that the usual subject-orientated education in medical schools does not require actively practised reasoning skills as the students learn. There is concern that the traditional approach to medical education may actually diminish the natural problem solving skills possessed by students before they enter medical school. Arising from this concern a number of universities, both oversea^^.^ and in Australia,' have tried improving student problem solving skills not only by greater integration within the course but by using problem-based learning as propounded by the McMaster Medical School. Attempts have been made at \"greater inte-