The introduction of a clinical skills examination (CSE) to Step 2 of the U.S. Medical Licensing Examination (USMLE) has focused attention on the design and delivery of large-scale standardized tests of clinical skills and raised the question of the appropriateness of evaluation of these competencies across the span of a physician's career. This…

The recurrent failure to adequately conceptualize the medical meaning of "disease" is explained as a function of the way this is taught in the curriculum, since it is transmitted within the internal structure relationships of the medical course. Curriculum reform therefore must stress educational structure as well as content change. (Author/LBH)

A study to determine whether affective skills could be taught to residents in a family practice center without placing arduous constraints on their schedules is described. Residents at the University of Louisville Department of Family Practice were videotaped during a regular patient visit and then scheduled for review sessions. (MLW)

The effectiveness of using gynecology teaching associates is compared with training by gynecology residents on clinic patients for teaching the gynecologic examination. Sophomore medical students at the University of Iowa participated in the instruction and an evaluation session with a simulated patient trained to rate the students' examination…

Students enrolled in a behavioral science course at Washington State University were given the option of completing the behavior change project by functioning as the manager for a weight control patient. The weight control project is described and evaluation measures are discussed. (MLW)

A study describing demographic, residential, health, and utilization characteristics of patients over 70 years of age followed in a hospital-based teaching group practice is presented. It is concluded that physicians' training should include management--for an extended period of time--a cohort of elderly, independent, ambulatory patients.…

The Clinical Learning Center of Queen's University in Ontario uses volunteer patients with documented illnesses in a purely education setting--no health services are provided--to facilitate the development of medical student's clinical skills. Significant educational benefits are achieved and a large number of patients are available and…

Medical schools (N=136) were surveyed concerning their use of standardized patients (lay persons trained to replicate a clinical encounter consistently and realistically). Among 16 specific topics covered are breast and pelvic examination, male genitourinary examination, interviewing skills, administration of program, start-up concerns, and…

A study with about 280 Southern Illinois University senior medical students found that standardized patients felt male and female examinees generally performed equally well with respect to interpersonal and communication skills, except for female examinees' higher performance in personal manner. Patient gender was not an influence. (Author/MSE)

The ECFMG[R] Clinical Skills Assessment (CSA[R]) was developed to evaluate whether graduates of international medical schools (IMGs) are ready to enter graduate training programs in the United States. The patient note (PN) exercise, conducted after a 15-minute interview with a standardized patient (SP), is specifically used to assess a candidate's…

The implementation of a psychiatric outpatient experience for a first class of junior medical students in a nonmedical model community mental health clinic is presented. Advantages and disadvantages of exposing students to a community-oriented, rather than a medical center-oriented, treatment system are detailed, including differences in patient…

Simulated patients can standardize the presentation of a patient problem, and, if the patients are employed in an assessment, the assessment can have an objectivity similar to that of written tests. The results and feasibility of using simulated patients in an assessment are described. (Author/MLW)

The impact of the present changing environment on medical education is considered. Four major components of medical education are influenced by environmental change: the setting (hospital inpatient floors), the patients, the teachers, and way teaching is conducted. Educational goals are defined and recommendations for improving teaching are…

The use of trained gynecologic teaching associates (GTAs) in providing instruction on the gynecologic examination is discussed. GTAs work in pairs; while one provides instruction, the other serves as a model. A study to measure student anxiety and confidence during the examination is described. (MLW)

In order to better prepare medical students for care of alcoholic patients, arguments are presented for understanding the negative perceptions of alcoholics, which are ingrained in the general culture, and how they merge with the students' developing professional identities. (Author/MLW)