Exploring the future: a counseling/curriculum project

This article proposes the establishment of a curriculum that will engage students in a study of the future. The goals of this curriculum are: to help students examine their views, assumptions, and values regarding the future; to help them develop a sense of personal agency toward their futures; and to help them acquire the skills involved in planning and decision making. Described in the article are several activities—including brainstorming, futures windowing, and scenario writing—designed to help achieve these learning goals. The author indicates that leading this learning process of exploring the future should be an inherent function of counselors, in their role as persons who help students make plans and decisions for their futures.     

Medical Ethics Education: A Survey of Opinion of Medical Students in a Nigerian University

In Nigeria, medical education remains focused on the traditional clinical and basic medical science components, leaving students to develop moral attitudes passively through observation and intuition. In order to ascertain the adequacy of this method of moral formations, we studied the opinions of medical students in a Nigerian university towards medical ethics training. Self administered semi-structured questionnaires were completed by final year medical students of the College of Medicine, University of Ibadan, Nigeria. There were 82 (64.1%) male and 44 (34.4%) female respondents. The median age was 26 years. Most students (80.5%) responded that they did not receive enough training in medical ethics. The ethics instructions they received did not sufficiently prepare them for the ethical challenges they came across as medical students. Though inadequate, the few hours of lecture and discussion on human values and professional etiquette which they received positively influenced their moral reasoning. They identified end-of-life issues, dealing with financial issues and handling socio-cultural beliefs of patients and relations as some challenges that medical doctors are ill-prepared for by their current training. Most, 85.9% believed that formal medical ethics education would be worthwhile as it would enhance the making of complete and better doctors. They recommended incorporating bioethics as a course in the medical school curriculum. Nigerian medical students encounter ethical challenges for which they have not been adequately trained to resolve. They recommended formal medical ethics training in their curriculum and a uniform bioethics programme in the country.     

The "model minority" and their discontent: examining peer discrimination and harassment of Chinese American immigrant youth

Using an ecological framework, the authors explore the reasons for peer discrimination and harassment reported by many Chinese American youth. They draw on longitudinal data collected on 120 first- and second-generation Chinese American students from two studies conducted in Boston and New York. Our analyses suggested that reasons for these experiences of harassment lay with the beliefs about academic ability, the students' immigrant status and language barriers, within-group conflicts, and their physical appearance that made them different from other ethnic minority or majority students. Implications and future research are also discussed.     

Cutting Deep: The Transformative Power of Art in the Anatomy Lab

On Tuesday evenings at New York University School of Medicine (NYUSoM), the anatomy lab is transformed into an art studio. Medical students gather with a spirit of creative enterprise and a unique goal: to turn anatomy into art. They are participants in Art & Anatomy, an innovative drawing course within the Master Scholars Program in Humanistic Medicine (MSPHM)—a component of NYUSoM, which offers elective courses across a range of interdisciplinary topics in medical humanities. Art & Anatomy has had approximately four hundred fifty participants since its inception in 2009. The educational intention of the course is to use drawing as an active mode of learning that enhances visual-perceptual ability and three-dimensional (3D) spatial understanding of the body's interior; however, the course also opens a creative space for participants to process the emotional complexities of cadaver dissection and the anatomy lab experience. The anatomy lab can be the training ground for clinical detachment, but many U.S. medical schools are beginning to attend more closely to the emotional aspects of dissection. The authors maintain that the inherently expressive nature of drawing makes the Art & Anatomy course a novel and effective approach to this endeavor. Select student artwork and a curriculum overview are provided.     

Constance “Connie” Hanf (1917–2002): The Mentor and the Model

This article provides an account of the impact of Constance Hanf, Ph.D., developer of the well-known two-stage parent training model that bears her name. Past colleagues, interns, postdoctoral students, and undergraduate trainees reflect on their experiences with Dr. Hanf and comment on her influence on their careers, as well as the impact of the model on child behavior therapy. The paper first briefly describes child therapy as it existed before the advent of behavioral parent training, and subsequently describes Dr. Hanf's parent training model and career. Finally, we attempt to elucidate the personal side and professional impact of this very important figure in contemporary empirically based work with families.     

Reflective Writing about Near-Peer Blogs: A Novel Method for Introducing the Medical Humanities in Premedical Education

Narrative analysis, creative writing, and interactive reflective writing have been identified as valuable for professional identity formation and resilience among medical and premedical students alike. This study proposes that medical student blogs are novel pedagogical tools for fostering peer-to-peer learning in academic medicine and are currently underutilized as a near-peer resource for premedical students to learn about the medical profession. To evaluate the pedagogical utility of medical student blogs for introducing core themes in the medical humanities, the authors conducted qualitative analysis of one hundred seventy-six reflective essays by baccalaureate premedical students written in response to medical student-authored narrative blog posts. Using an iterative thematic approach, the authors identified common patterns in the reflective essays, distilled major themes, coded the essays, and conducted narrative analysis through close reading. Qualitative analysis identified three core themes (empathic conflict, bias in healthcare, and the humanity of medicine) and one overarching theme (near-peer affinities). The premedical students’ essays demonstrated significant self-reflection in response to near-peer works, discussed their perceptions of medical professionalism, and expressed concerns about their future progress through the medical education system. The essays consistently attributed the impact of the medical student narratives to the authors’ status as near-peers. The authors conclude that reading and engaging in reflective writing about near-peer blog posts encourages premedical students to develop an understanding of core concepts in the medical humanities and promotes their reflection on the profession of medicine. Thus, incorporating online blogs written by medical trainees as narrative works in medical humanities classrooms is a novel pedagogical method for fostering peer-to-peer learning in academic medicine.

     

Prospective Adaptation in the Use of External Representations

An important element of adaptive expertise involves stepping away from a routine to retool one's knowledge or environment. The current study investigated two forms of this adaptive pattern: fault-driven adaptations, which are reactions to a difficulty, and prospective adaptations, which are proactive reformulations. Graduate and undergraduate students with no medical training engaged in a medical diagnosis task that involved complex information management. The graduate students, who were relative experts in information management and data analysis, uniformly made prospective adaptations by taking the time to create external representations of the available information before they diagnosed a single patient. In contrast, the undergraduate students only made representations reactively, when experimental manipulations made their default behaviors impractical. Graduate students tolerated the time lost creating representations in favor of future benefits—well-structured representations led to more optimal diagnostic choices. Overall, the results indicate that long-term educational experiences are correlated with prospective adaptation, even in a novel task domain that is not explicitly a part of those educational experiences. This research provides new metrics for evaluating educational interventions designed to move students along a trajectory toward adaptive expertise.     

Adult Learners’ Informal Learning Experiences in Formal Education Setting

Schools typically ignore an enormous part of students’ learning, i.e. informal learning. Such informal processes include intentional, incidental, and tacit learning and tend to be unnoticed because of their taken-for-granted nature. By conducting in-depth interviews with 15 students, two teachers, and two program coordinators of an adult education program, this study examines informal learning outcomes, processes, and personal informal learning experiences within formal education. The study aimed to reveal the interaction between formal and informal learning as well as the respondents’ experiences in this matter. Respondents report a diverse array of informal learning results. Respondents describe informal learning to occur through self-directed learning projects, daily conversations and experiences, and the program’s informal and hidden curriculum. According to respondents, informal learning has the potential to enrich and complement formal learning. Moreover, the findings point to potential personal, educational, and societal benefits of revealing informal learning within formal education. Implications for practice and future research are discussed.     

Ethical and legal aspects in teaching students of medicine

Due to the rapid advances in medical technology, medical students are now being faced with increasingly complex and unparalleled ethical and practical dilemmas during their training. The new and future challenges of high-tech medicine demand improvements in current medical education, not only by meeting the needs of students through humanized training programs, but also by involving them in finding solutions to the ethical and legal quandaries they encounter. Today’s students of medical universities must acquire knowledge and understanding of the ethical and legal issues relevant to the practice of medicine, and we have to do everything possible to introduce these students to the current discussions on more or less controversial ethical and legal topics. Although final answers may not be found, the very discussion, argumentation, and awakening of students’ interest should become an essential part of the core curriculum of every doctor. An earlier version of this paper was presented at an international conference, “The Ethics of Intellectual Property Rights and Patents,” held in Warsaw, Poland on 23–24 April, 2004. The author is a student and member of the Senate Committee on Teaching.     

Professional,Personal, and Relational: Exploring the Salience of Identity in Academic Careers

This article explores the role of identity in lived experiences within the professoriate. While scholarship has given some attention to professional identity and personal identity, little in the literature has attempted to present a holistic view of identity and the complex ways that it defines and influences academic careers. The authors present findings from their analysis of interview data from 50 participants across career stages, from doctoral students to full professors. These findings suggest that three distinct but related, and potentially synergistic, components of identity are salient in shaping perceptions of and experiences within academic careers. The authors offer future directions for research centered on a rich conceptualization of identity as critical for understanding faculty development, experiences, and needs.     

Experiences of supervising postgraduate community psychology students at Wits university,South Africa

In this article, the authors discuss problems and challenges of supervising postgraduate community psychology students at the University of the Witwatersrand, South Africa. As part of their community work, students developed community projects in schools in Alexandra Township, aimed at dealing with social ills such as HIV/AIDS, gangs, violence, substance abuse and teenage pregnancy. Students found community work to be extremely exhausting, stressful and demanding. Therefore, community psychology supervision became an important space in helping students to reflect on the experiences, anxieties and frustrations. This article discusses key themes that have emerged in community supervision, including gender, race and class issues. In conclusion, recommendations are provided on how to improve community psychology supervision based our experiences. Supervisors need to be proactive in helping students to reflect on their experiences and actively engage with some of the theoretical and practical issues that emerge in community work. Copyright © 2010 John Wiley & Sons, Ltd.     

Depression, anxiety, and perceived hassles among entering medical students

This study investigated depression and anxiety among students who were entering medical school prior to the onset of their medical curriculum. Entering students reported financial, day-to-day, academic, and time hassles as concerns. Interestingly, the population characteristics of gender, marital status, and ethnicity impacted the type of self-reported hassles indicated by the students. Measurements of depression and anxiety indicated that entering medical school students' emotional status resembles that of the general population. The results suggest that it is the rigors of the medical curriculum that may play an important role in the increased prevalence of depression and anxiety for students during their medical education. Further, students who are entering medical field already have concerns about medical school and are in the process of anticipating the necessary adjustment to the challenges ahead of them. Preventative programming efforts should begin early in medical education and address a wide variety of concerns from academic, to interpersonal relationships and financial worries.     

Patients’ Perceptions on Their Involvement in Medical Education: A Qualitative Pilot Study

Patients’ perception with regards to their use in medical teaching is an under-researched area in Pakistan. The objective of this qualitative, pilot study was to determine the perspectives of hospital admitted patients on their being used in the medical education of students in a private medical institution. An attempt to understand the dynamics of interactions between patients, students and doctors was also made and to see how this affected the doctor-patient relationship. A qualitative study with in-depth interviews was conducted in a private medical college of Islamabad, Pakistan with a total of 20 adult patients. The focus was on their experiences with bedside teaching. This pilot study reveals interesting findings about patient-physician interactions in Pakistan. Patients had a traditionally passive role in medical education putting more onuses on the doctor to impart knowledge to the medical students. Patients comforted themselves in the knowledge that they were following Allah’s command when they were involved in the teaching of medical students. The apparent altruism of Pakistani patients in this study was influenced mainly by religious reasons, following the commandments of Allah to help develop future healers for humanity. The culture evident in the medical college where this study was conducted is reflective of the social power ladders that pervade Pakistani society. The positions of doctors and medical teachers in Pakistani society are hardly challenged to debate. Little attention has been paid to the values that influence the cultural and social frameworks within which Pakistani medical teachers, medical students and the patients function.     

Observed Attachment and Self-Report Affect Within Romantic Relationships

Adult attachment provides unique insights that help researchers and clinicians understand the complexities of individuals and relationships. In romantic relationships, individual attachment can explain partners' abilities for closeness and autonomy as well as how they experience affect within the relationship. These affective experiences during couple interactions have been shown to influence both proximal and distal relationship outcomes. Thus, the authors explore the impact of partners' observed attachment behaviors—coded using the AABQ—on continuous reports of their affective experiences during both difficult and positive marital conversations. Variables examining couple affective negativity and flexibility were developed using state space grids, and data were analyzed using GridWare. Results showed that observed female attachment behaviors significantly impacted a couple's affective experiences of negativity and flexibility during conversations, while there were no significant associations between male observed attachment behaviors and the couple affective experience. Clinical implications and suggestions for future research are discussed.     

Creating Greener Citizens: Political Liberalism and a Robust Environmental Education

Proponents of environmentalist views often urge the teaching of such views and the inculcation of ‘green’ values within the educational curriculum of schools as a key component of achieving their ends. It might seem that modern versions of political morality that refuse to take a stance on controversial questions—religious, ethical, philosophical—or eschew appeal to perfectionist doctrines, such as Rawlsian political liberalism, are beset by a particularly acute difficulty in this regard. To the extent that environmentalist views embody claims about ethical matters such as how individuals should live their lives, they fall foul of this version of political morality. This article evaluates the resources available to political liberalism to respond to the challenge of bringing the teaching of green values and virtues within the national curriculum. It argues that environmental concerns differ in morally important ways from other ethical, philosophical, and religious views that are typically off-limits to political liberalism. Much that passes as green ideals are not simply a conception of the good life in the manner that religious views, for example, are. Rather, many environmental goods are crucial to the realisation of socioeconomic justice and therefore escape the requirement of state neutrality on endorsing the truth or importance of their role. A minimal political liberal education includes teaching about justice-based concerns as part of a compulsory national curriculum.     

Academic and clinical education in fluency disorders: an update

This paper presents a survey of the academic and clinical education in fluency disorders provided by American Speech-Language-Hearing Association (ASHA)-accredited training programs. Respondents were 159 programs (out of 256, return rate = 67.4%) that completed a questionnaire seeking information about the courses and clinical experiences they require, the expertise of their faculty and supervisors, changes following the 1993 modification of training requirements for the ASHA certificate of clinical competence (CCC), and preliminary plans for changes in preparation for the 2005 standards. Results, which supplement findings from an earlier survey distributed in 1997 (Yaruss, 1999), indicated that nearly one-quarter of programs allow students to graduate without coursework in fluency disorders, and nearly two-thirds allow students to graduate without clinical practicum experiences. Findings suggest a trend toward fewer required classes taught by less experienced faculty, fewer clinical hours guided by less experienced supervisors, and a greater likelihood that students will graduate without any academic or clinical education in fluency disorders. Given the repeated finding that many speech-language pathologists are uncomfortable working with people who stutter, as well as ASHA's apparent de-emphasis of fluency disorders within the increasing scope of practice in the field of speech-language pathology, these results are a cause for concern about the future of fluency disorders. EDUCATIONAL OBJECTIVES: The reader will learn about (1) the coursework and clinical practicum experiences that are currently required for students in ASHA-accredited training programs; (2) trends indicating a reduction in training requirements for fluency disorders; and (3) ways of improving these requirements.     

From Number Lines to Graphs in the Coordinate Plane: Investigating Problem Solving Across Mathematical Representations

This article reports on students’ problem-solving approaches across three representations—number lines, coordinate planes, and function graphs—the axes of which conventional mathematics treats in terms of consistent geometric and numeric coordinations. I consider these representations to be a part of a hierarchical representational narrative (HRN), a discursive narrative around a set of representations that model conventional mathematics in structurally consistent ways. A paper-and-pencil assessment was administered to students in grades 5 and 8 along with videotaped interviews with a subset of students. Results revealed students’ application of particular meta-rules, which reflect their attempts to find and make use of recurring patterns in mathematics discourse. One such meta-rule, consistent with the HRN, was characterized by students’ coordination of geometric and numeric properties of an axis, whereas alternate meta-rules reflected coordinations inconsistent with conventional mathematics. Detailed analyses of problem-solving strategies are reported, and implications for theory, curriculum, and instruction are discussed.     

“精选、精讲、精练”教学法在临床教学中的应用

临床医学是集多学科知识为一体的专业学科,具有基础知识与临床实践紧密结合的显著特性。为适应新世纪医学教育的系统性转型,配合器官系统为中心课程模式的有效运行,我院采用“精选、精讲、精练”的教学方法,通过系统性整合各专业学科课程,加强学科间的知识联系,实现基础向临床的转化、从而开辟专业课程综合化发展的道路,给学生提供最优化的教学内容,在掌握专业技术的同时,拓宽临床思维,履践医学人文精神,为培养医学生未来临床岗位胜任能力奠定坚实基础。     

Development of a Medical Humanities and Ethics Certificate Program in Texas

Education in the medical humanities and ethics is an integral part of the formation of future physicians. This article reports on an innovative approach to incorporating the medical humanities and ethics into the four-year curriculum in a Certificate Program spanning all four years of the medical school experience. The faculty of the McGovern Center for Humanities and Ethics at the University of Texas Medical School at Houston conceived and implemented this program to teach medical students a range of scholarly topics in the medical humanities and to engage the full human experience into the process of becoming a physician. This study follows six years of experience, and we report student experiences and learning in their own words.