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This Week in JAMA
September 1, 1999

This Week in JAMA

JAMA. 1999;282(9):811. doi:10.1001/jama.282.9.811
MEDICAL EDUCATION

Edited by Charlene Breedlove, MA

The ratio of the total number of full-time medical school faculty members to the total number of medical students has increased markedly since the beginning of this century.

Tobacco Dependence Curricula in US Medical Schools

Despite the substantial morbidity and mortality associated with tobacco use and 1992 national recommendations for mandatory inclusion of smoking cessation and intervention techniques in US undergraduate medical education, Ferry and coworkers report that in a survey conducted between 1996 and 1998, 83 (69.2%) of 120 schools did not require clinical training in smoking cessation techniques. In the basic science curriculum, 63 (54.8%) of 115 schools included all of 6 content areas derived from the Agency for Health Care Policy and Research and the National Cancer Institute, but only 5 (4.4%) of 115 schools reported covering all 6 clinical science topics.

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Becoming Professional

How professionalization of medical students is addressed by undergraduate medical schools varies widely. In a survey of US medical schools conducted in academic year 1998-1999, Swick and colleagues foundArticle that 104 of 116 responding schools reported offering some formal curriculum content related to professionalization of medical students. Most responding schools reported that professionalism was addressed during orientation or a white-coat ceremony. Fewer than one third of schools reported that professionalism was taught as a single course or as an integrated sequence of courses. Epstein, in another article Article , asserts that becoming a mindful practitioner, ethically and technically self-aware, is a process that requires more than formal courses; it requires explicit modeling by clinician-mentors. In an editorialArticle, Ludmerer emphasizes that the internal culture of the academic medical center, including formal teaching and faculty mentoring, is the dominant influence on the professionalization process of medical students.

Use of Clinical Simulators in Medical Education

Clinical simulators provide self-learning opportunities for mastering diagnostic and therapeutic skills that complement didactic and beside teaching as well as a method for skill evaluation. Issenberg and coworkers describe simulation technologies that have been used in surgery, cardiology, and anesthesia and review studies of the effectiveness of these techniques.

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Performance and Health Care Outcomes of Formal CME

In a systematic review of 14 randomized controlled trials on the effect of formal continuing medical education (CME) activities on physician performance and patient outcomes, Davis and colleagues found that more than half of the didactic, interactive, and mixed CME interventions were associated with changes in 1 or more measures of professional behavior, and 3 of 4 interactive and mixed interventions were associated with effects on health care outcomes. None of the interventions that used didactic measures alone were associated with a change in physician performance. In a meta-analysis of the results of 7 of the trials included in the review, the overall benefit of formal CME was not significant, although a significant positive effect was associated with CME sessions that included an interactive element.

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Preparation for Medical Practice in Diverse Societies

Information on multicultural education in medical school curricula is limited. In a search of several English-language databases of biomedical literature published since 1993 and of online data sets, Loudon and coworkers identified only 17 studies that described specific educational programs for medical students on racial and ethnic diversity. Thirteen of the 17 programs were conducted in North America and most occurred during the first 2 years of medical school.

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MSJAMA

Dimensions of the patient-physician relationship and the winning poems of the 17th Annual William Carlos Williams Poetry Competition.

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US Medical Schools

Educational Programs and Finances Analysis of the results of the 1998-1999 Annual Medical School Questionnaire of the Liaison Committee on Medical Education Part II on medical students, faculty, and programs, and of Part I-A on financial data, from the 1997-1998 survey.

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GME, 1998-1999

Report of the 1998-1999 American Medical Association Annual Survey of Graduate Medical Education (GME) Programs on resident physicians, residency programs, and specialty and subspecialty enrollment.

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JAMA Patient Page

For your patients: A primer on smoking cessation.

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