Teaching public health: an innovative method using computer-based project work

What biomedical science should be included in undergraduate medical courses and how is this decided?

This review aimed to determine the availability of core curricula for the biomedical sciences in the published literature and the approach taken to determining learning objectives. A systematic review was conducted searching three databases for articles containing the terms 'core curriculum', 'undergraduate' and 'medic*'. Fifty seven papers were read in full, of which 40 listed learning objectives. The authors used a consensus process to categorize the learning objectives according to the level of detail (high / medium / low) and the approach taken (either a top down approach using experts or a bottom up approach using key stakeholders). This paper directs the reader to publications that describe core curricula for the biomedical sciences. The review revealed that topic coverage was patchy and there was a variable level of detail of learning outcomes presented. Documents published by professional bodies tended to provide more detailed learning outcomes than those derived by experts associated with medical schools. Two thirds of the 40 publications used a top down approach and there was a temporal trend towards involving non-expert groups in some stage of the process of defining the learning objectives, regardless of whether a top down or bottom up approach was taken.

What matters most? Predictors of student satisfaction in public health educational courses

The development of primary care trusts, the health protection agency, and non-medical public health (PH) specialists' pathways requires a competent PH workforce to be in place. Hence, the quality of education and training of PH workers is increasingly critical. With the diversity of courses and programmes that contribute to building a competent PH workforce, few studies have examined the satisfaction of students (and reasons for it) on educational PH programmes. The present study investigated the influences that four demographic variables (gender, disability, ethnicity and age bracket) and seven education-related variables (mode of study, academic term, academic level, pre-/postregistration status, entry qualification, qualification aim and class size) have on PH students' perceptions of satisfaction with 18 aspects of their learning. After controlling for the effects of the other variables, five variables explained 32% of the reported satisfaction levels. These were class size, study mode, qualification aim, pre-/postregistration status and academic level. Part-time students on postgraduate programmes are a particularly vulnerable group who may need extra support from PH educators and trainers. For these students, smaller class sizes could be beneficial, and if larger classes are inevitable, smaller group work sessions within the classes is advocated. Equally important is the availability of library resources required for learning, and course materials, handbooks and briefs need to be clear, informative, user friendly and available early in the course. Satisfied students achieved better final grades, reflecting an increased amount of transferable knowledge. The implications of the study findings for research and practice are discussed.

Teaching and learning population and preventive health: challenges for modern medical curricula

OBJECTIVES

This study aimed to formally identify medical students' attitudes towards population and preventive health issues addressed in the University of Queensland's Bachelor of Medicine, Bachelor of Surgery (MBBS) programme, in response to informal student reports that population and preventive health issues were largely just matters of "common sense".

METHODS

Year 2 medical students were surveyed in 1999 and 2000 using a custom-designed instrument incorporating Likert scales and requests for qualitative responses. A sample of students participated in semistructured interviews.

RESULTS

A total of 341 students (71%) responded to the survey. Students' attitudes towards general population health issues were overwhelmingly positive, and more than 60% of students reported having a more positive attitude towards psychosocial and preventive health issues than they had when they commenced the MBBS programme. Just over half of the students, however, considered population and preventive health issues to be matters of common sense. Students reported poor role modelling by the faculty in relation to population and preventive health issues, with only 41% of students indicating they perceived a positive attitude towards psychosocial and preventive health issues in the School of Medicine. Qualitative data indicated that some students fear that the opportunity cost of dedicating study time to population and preventive health issues might endanger their future clinical knowledge, skills and management of patients.

CONCLUSIONS

These findings have important implications for modern medical curricula. The challenge in teaching population health issues is to balance students' needs to understand and apply the principles of population and preventive health and the biopsychosocial model of patient care, with the need for them to be confident they will be able to practise safely if they do so.

Paradigm shifts in medical and dental education: behavioural sciences and behavioural medicine

Psychosomatic and behavioural medicine have a long tradition in Hungary. In this paper, we highlight the possibilities of teaching behavioural medicine and behavioural science in the medical and dental curricula, particularly in the field of health promotion and prevention. There are a number of possibilities for dentists in the fields of behavioural science in both research and health policy. There is a need for closer integration of teaching, research and health policy in both general medicine and dentistry, and both doctors and dentists must approach their patients in a holistic way.

Behavioral medicine in Hungary: past, present, and future

During the socialist period before 1989, training in behavioral medicine and behavioral science was not a priority in Hungary's medical schools despite the nation's long tradition of psychosomatic and behavioral medicine. In this article, the authors review the development of behavioral medicine and behavioral science in Hungarian medical schools and outline some of the problems and future challenges these departments face. The resistance of faculty members has influenced the acceptance of behavioral medicine and behavioral science courses, attitudes toward the acceptance of departments of behavioral science, and evaluations of the staff's scientific research. Although research is emphasized in these departments of behavioral medicine, closer integration of teaching, research, and health policy is necessary. The primary message of this approach is that modern physicians should see beyond molecular substances and perceive humans from a total biopsychosocial perspective.

'Not too much, not too little, but just enough?': observations on continuing professional development in Public Health in the north of England

Three inquiries about Public Health continuing professional development were undertaken in the Northern and Yorkshire Region of the National Health Service during 1995-96. Public Health Physicians were asked about their experience of continuing education and for their views on a regional policy for continuing professional development. Health Authority Chief Executives were asked about their reactions to Public Health Physicians continuing educational needs. The overall response rates for the Public Health Physicians were very disappointing. Most of the Chief Executives (a much smaller group) responded to the inquiry. A large minority of Public Health Physicians believed that their continuing education in the preceding two years had been adequate. Most wished their future continuing education activities to be multi-disciplinary. One finding with considerable significance for those managing Public Health education, both specialist and continuing, was that many of those with teaching responsibilities had not been trained to teach. Despite apparent concordance between the views of Chief Executives and those of Public Health Physicians; on some important points there were inconsistencies in the comments of Chief Executives, which suggested lack of understanding of both the roles of their professional colleagues and the need for their continuing education. The inquiries gave rise to a sense of apathy and under-confidence, manifested in some reluctance to accept policing of continuing education. There is a need to experiment with learning and teaching approaches in order to progress from the current traditional educational methods.