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"education"

Among the many factors that have altered the practice of obstetrics-gynecology are the following: the numbers of obstetrician-gynecologists, the increasing percentage of women entering the specialty, the expansion of ambulatory services with a simultaneous reduction in hospital admissions, a decrease in gynecologic surgical procedures, a stabilized number of total births with an anticipated increase in those to socially deprived and unmarried women, an increasing number of elderly women, general social and behavioral changes, and increasing outside control of practice. A proposal is presented for improving the education of residents and obstetrician-gynecologists in practice. © 1989 The American College of Obstetricians and Gynecologists.

We compared the schedules and responsibilities of medical interns at an urban university hospital in 1967 with those in 1987. We analyzed admissions, length of stay, diagnostic problems, demographic data on interns, changes in diagnostic and therapeutic options, and number and type of consultations. The intern in 1987 spent less time in the hospital but had more admissions, more interruptions, more clerical responsibilities, and more therapeutic and diagnostic options, and was more dependent on senior colleagues with special expertise. For these reasons the intern in 1987 had less time with individual patients and less autonomy than his 1967 counterpart. Recognition and modification of the negative aspects of medicine interns’ experience will increase the attractiveness of internal medicine residencies. © 1989 Southern Medical Association.

Previous attempts to predict resident clinical performance based solely on measures of cognitive skills have been uniformly unsuccessful. For the past 8 years, a formative residency evaluation system has been used that includes yearly comprehensive oral in-training examinations (OITEs) assessing each resident's performance in the three areas of professional competence: cognitive, psychomotor, and affective. The results of these examinations and scores received on the written in-training examination (WITE) given by the American Board of Pediatrics were compared with faculty ratings received during the subsequent year of residency. No significant correlation was found at any level of training between WITE scores and clinical performance. Analysis based on clinical setting did not improve these results. Oral in-training examination scores, however, were highly correlated with clinical performance ratings. In addition, with oral in-training examination scores, the 'problem' interns - those whose clinical performance rating placed them in the lower 10% of interns - were predicted with a high degree of significance, sensitivity, and specificity. Predictions based on WITEs were not significant. Simultaneous evaluation of all three areas of professional competence should be done when predictions of resident performance are attempted. The OITE is a powerful formative evaluation tool, providing valuable learning experiences as residents are objectively assessed while they perform patient-centered tasks that represent critical skills in the practice of medicine. It allows early detection and possible amelioration of future problems in the clinical performance of a resident.

This paper is addressed to those responsible for determining policy in tertiary vocational education, in particular senior staff in TAFE. It discusses the likely effects of the Government’s recent emphasis on skills formation. The context for a skills formation approach is provided and the growing influence industry is likely to have upon vocational education is discussed. TAFE, as the major provider of tertiary vocational education, is the educational organisation most likely to be affected. The need to maintain a commitment to provide education as well as training, and for concern with equity as well as short term economic success, is stressed. The paper argues that we must learn from the thinking behind the economic successes of countries such as Sweden and Japan and use this to produce solutions which will work in our context, rather than simply copy the processes they have used to achieve that success. © 1989, Taylor & Francis Group, LLC. All rights reserved.

[No abstract available]

This article reviews the practice visiting procedures employed in vocational training. The particular usage examined is that employed in the West Midlands region after a 10-year development period, although most regions employ a similar format. It is hoped that the article will be of particular assistance to practitioners contemplating an application to become a trainer. © 1989 Nature Publishing Group. All rights reserved.

During the 1970s and 1980s, vocational training for general practice developed from experimental beginnings to become established nationwide. Committees were set up nationally and regionally and methods devised for the approval of training practices. Important publications related to the discipline of general practice and to educational methodology appeared. The problems that remain include the absence of a compulsory assessment prior to entering general practice and the low remuneration for course organizers.

Inspired by the coverage that the Vocational Training Scheme has been receiving recently, Josephine Drewett gives BDJ readers a rather different view of the life she chose to follow immediately after graduating from the University of Bristol Dental School. © 1989 Nature Publishing Group. All rights reserved.

[No abstract available]

An orthodontic module for the vocational training scheme has been designed specifically with the needs of trainees in mind. It has the two-fold aim of streaming patients in relation to orthodontic requirement and providing a proper understanding of the very specific nature of interceptive measures so often advocated in relation to orthodontics. Due to its relative geographic isolation, the small area of Northern Ireland is an ideal region for a pilot scheme such as this. It may well be of interest to vocational advisers and those planning orthodontic input. © 1989 Nature Publishing Group. All rights reserved.