Telling tales out of school — Portrayals of the medical student experience by physician-novelists

Changes in medical and medical ethics education are being considered with little attention to the experience of the medical students involved. This study attempts to characterize and highlight certain aspects of that experience from a literary perspective. After a brief review of the history of traditional academic studies in the field, eight novels, written by physician-writers and featuring medical student protagonists, are analyzed. Several common themes of the student experience are identified in the novels, and are contrasted with themes found in the medical literature. A plea is made to acknowledge literary as well as scientific interpretations of the medical student experience when considering changes in medical education.     

The role of the clinical psychologist on a burn unit in a general teaching hospital

This paper reviews the core skills that a clinical psychologist brings to a burn unit and suggests a model for optimal psychological management of burn patients, families, and staff. Recovery from a burn injury involves three stages that comprise (a) acute treatment of severe medical complications, (b) adjustment to hospitalization, and (c) long-term rehabilitation. Each stage contains numerous issues that the clinical psychologist should monitor and manage. Assessment of patients at risk, early intervention, and specialist management are highlighted as critical components of effective psychological management of burn injury in a multidisciplinary team context.     

Personality and cognitive functioning among hospitalized sexual offending Roman Catholic priests

A tremendous amount of media attention has been directed towards sexual abuse perpetrated by Roman Catholic priests in recent years. While there are countless research studies on both sexual abuse victims and perpetrators in the professional literature, very few have specifically investigated Roman Catholic priests who sexually abuse minors. The purpose of this study is to investigate the role of personality and cognitive variables among hospitalized sex offending Roman Catholic priests using specific MMPI-2, WAIS-R, and Halstead-Reitan measurements. Specifically, the role of defensive coping styles as measured by the L, K, O-H, and R scales of the MMPI-2 along with IQ scores from the WAIS-R and the Halstead impairment index were investigated. A total of 160 Roman Catholic priests (80 who sexually abused minors and 80 nonabusing control patients) hospitalized in a private psychiatric facility specializing in the diagnosis and treatment of clergy were evaluated. Results suggest that overcontrolled-hostility (O-H) was the most reliable predictor of group membership while Verbal IQ approached statistical significance. Implications for further research are offered.     

Enhancement of experienced sexual arousal in response to erotic stimuli through misattribution of unrelated residual excitation.

In a pretest, three phases of recovery from a standard physical exercise were determined. In Phase 1, subjects experienced high levels of physiological excitation and recognized that their arousal was due to exercise. In Phase 2, subjects maintained substantial excitatory residues from the exercise but felt that their arousal had returned to base level. In Phase 3, subjects' excitatory responses had decayed, and they knew they had recovered from the exercise. Subjects in the main experiment were exposed to an erotic film in the first, second, or third recovery phase after performing the exercise. Subjects viewing the film during the second recovery phase reported being more sexually aroused by the film and evaluated the film more positively than subjects in the other two conditions. Counter to the notion of arousal as a simple energizer of all behavior, these findings were interpreted as supporting excitation-transfer theory, which posits that residual excitation enhances emotional responses to unrelated, immediately present stimuli only when the prevailing arousal cannot be attributed to its actual source.     

The effect of suspense and its resolution on the appreciation of dramatic presentations

In a factorial design, degree of suspense (low, intermediate, high) of an adventure presented audiovisually was varied with resolution of the suspense (resolved, lingering). The variations were accomplished by producing different versions of the same program. Appreciation of the presentation was measured in the viewers' facial displays, in structured interviews, and in ratings. Consistently across measures, it was found that under conditions of resolved suspense, appreciation substantially increased with degree of suspense. Under conditions of lingering suspense, appreciation also increased with degree of suspense but to a significantly smaller extent. Excitatory responses were measured in skin temperature and heart rate. A significant differentiation of heart rate as a function of degree of suspense was observed. In addition, both skin temperature and heart rate disclosed sudden declines in excitation with the effective resolution of suspense.     

Systematic Monitoring of the Implementation of a Case Management Model

A systematic approach for monitoring case management service provision and the results obtained when this approach was applied to a program for community-dwelling elders with severe mental illness are presented. A detailed, closed-ended, daily service log was used to collect data on 713 client-contact days. Participants (N = 24) were predominantly female (71%), were White (63%) or African American (37%), and tended to have diagnoses of either schizophrenia (42%) or major depression (21%). Services were delivered most frequently in the client's home (47%), the program office (35%), or by phone (27%); most frequent activities were monitoring psychiatric symptoms/medications (62 %), and monitoring physical symptoms or medications or both (54%). Service characteristics did not differ with regard to demographics but did vary with living situation and psychiatric diagnosis. The findings point to the need for flexible programs capable of meeting diverse service needs as well as the utility of a daily service log in studying case management.     

Implicit associative responses influence encoding in memory

In list-learning experiments, the orienting question asked of one item may influence the processing of, and memory for, later items in the list. Four experiments demonstrated that words that are not related to their own orienting question, but that are semantically related to the question asked of a previous item, are better recalled than are words that are not related to any question in the list. Factors that influence this memory enhancement include the number of times relevant orienting questions appear during study, as well as the retention interval. Experiment 4 revealed that this effect is contingent upon conscious awareness: Item-category relations do not enhance recall if the subject is not aware of them. The results of the four experiments imply that semantic categories can be primed as implicit associative responses to words, which influence memory.