A medical humanities program emphasizing clinically oriented training is described. The four-year required curriculum, in which students accompany attending physicians on rounds, is taught by faculty representing a wide range of medical and non-medical disciplines. The approach is seen to challenge good teachers and evoke humanities themes from…

Computer-based clinical simulations used in medical education are designed according to decisions about which elements of reality to explicitly include, which to leave to imagination, and when to intervene for educational purposes. Programs offer many options for structuring the simulations, such as varying levels of volunteered information about…

The strategy used by one health maintenance organization (HMO) for balancing residents' training needs and patient health problems, often limited and routine in an HMO, is to allocate patients to residents by matching them with curriculum content. A process for handling patient resistance to such an arrangement was also instituted. (MSE)

The Working Group on the Pre-Clinical Years of the 1997 National Consensus Conference on Medical Education for Care Near the End of Life identifies promising settings and suggests how they might be used for maximum benefit in end-of-life education. Basic-care competencies are in five domains: psychological/social/cultural/spiritual issues;…

A review of the literature on medical school curriculum and primary care specialty choice suggests that three types of curricular experiences may increase interest in primary care: third-year required family medicine clerkships, especially longer clerkships; continuity experiences in primary care settings; and primary care tracks. (Author/MSE)

In the University of South Dakota's medical school clerkship program, students may choose one of three ambulatory-care settings. In one, the curriculum is problem based and student centered to enhance student interest in primary care. The new program has been successful and well received and is being further developed. (MSE)

The process used by the Society of Teachers of Family Medicine to develop core curriculum guidelines for third-year family medicine clerkships is described, the guidelines are presented, and dissemination, implementation, and further development activities are outlined. The work was supported by a Department of Health and Human Services grant.…

A study systematically reviewed published literature on graduate medical-education curricula in clinical epidemiology, critical appraisal, and evidence-based medicine (EBM). The 18 reports found in the search provide useful guidelines for medical educators but many suffer from incomplete descriptions and inadequate curriculum evaluations.…

What is needed in graduate medical education is a curriculum built around learning experiences and valued activities, not performance objectives. The example of a curriculum for an ambulatory care block rotation illustrates the development of such a curriculum and how it can be used to frame the rotation experience. (MSE)

A popular required family medicine clerkship at Jefferson Medical College (Pennsylvania) suggests that ambulatory care can be taught as a core component of the clinical curriculum. Success requires strong institutional support, structured curriculum, adequate patients, dedicated faculty, sufficient training sites, an appropriate evaluation…

A study of 217 Stanford University (California) Medical School graduates found clerkship experience lengths from 12 to 23 months; the median was 18 months. A highly significant correlation was found between longer clinical training and higher scores on Step 2 of the United States Medical Licensing Examination. Results suggest that decreasing…

A study compared scores on identical tests in internal medicine for two groups of graduating University of Toronto (Canada) medical students: those in a traditional, lecture-based curriculum (TC) and those in a redesigned curriculum with less didactic instruction and more clinical experience (NC). All comparisons showed a significantly higher…

A review of 85 articles published 1984-93 on the effects of medical school curricula, faculty role models, and federal biomedical research support on the specialty choices of medical students suggests effective strategies to enlarge the proportion of medical students choosing generalist careers including institutional reform to emphasize…

Reports on strategies being developed by medical schools to carry out education in the ambulatory care setting, based on studies of 38 institutions. Highlights three main strategies: longitudinal preceptorships; multi-specialty clerkships; and community-oriented and population-based activities that provide relevant educational experiences for…

Identifies and characterizes five major curricular-reform movements in North American medical education since 1765: the apprenticeship-based model; a discipline-based model; the organ-system-based model; the problem-based model; and a clinical-presentation model. Discusses principles and practices and disadvantages and advantages of each. (MSE)