Medical Students' Knowledge About Brain Death: A South African Contribution.

BACKGROUND: Incorporating transplantation into undergraduate medical curricula can improve organ procurement rates. Intricacies related to the assessment of donor suitability, the clinical diagnosis of brain death, and relevant legal processes are key challenges for the newly qualified doctor. The aim of this study was to describe and analyze knowledge of medical students regarding the various aspects dealing with the diagnosis of brain death, with a view to designing an undergraduate training module. METHODS: A previously validated, self-administered, 26-item questionnaire was distributed to all medical students at the University of Cape Town. General data included age, sex, year of study, and career interests. Knowledge-specific questions explored the suitability of potential organ donors (8 items), the clinical diagnosis of brain death (7 items), and legal factors (11 items) thereof. Descriptive statistical methods were then used to analyze the data. RESULTS: There were 346 participants; 217 (63%) were pre-clinical students and 29 (8%) carried an organ donor card. The mean and median scores for the 26 items were both 12 (range, 0-25). Mean scores increased steadily with years of medical education: from 8 in the first year of study, 10 in the second year, and 17 in the final year. Demographics, year of study, organ donor status, and an interest in a surgical career did not influence knowledge levels (P > .05). CONCLUSIONS: Medical students have limited knowledge about brain death and identification of potential organ donors. This confirms the need for an educational intervention early in the medical curriculum.

A progress report of cancer centers and tribal communities. Building a partnership based on trust.

BACKGROUND: Over the past 20 years, considerable progress has been made in the early detection and treatment of cancer. Despite these advances, cancer incidence and mortality rates among Native Americans have not kept pace. Cancer centers are in a unique position to offer technical assistance, resources, and a long term commitment that can help address these concerns within tribal communities. METHODS: The University of Wisconsin Comprehensive Cancer Center developed a proactive plan to build collaborative partnerships with Wisconsin Native Americans. This began with an outreach plan that prioritized intervention strategies. A Native American health professional was hired to serve as liaison and advocate. Resources were committed, and staff was assigned to work with the community to develop intervention strategies that would be culturally competent and able to address the concerns of community members. RESULTS: Various collaborative activities resulted from these efforts. These included participation in Native American cancer work groups, conferences, and seminars. Most importantly, these efforts resulted in a partnership with the Native American community that is based on honor and mutual respect. CONCLUSIONS: Careful planning, prioritization, allocation of resources, and a commitment to Native Americans can result in partnerships with the community and interventions that address their cancer control needs. Building and sustaining these partnerships takes time and thoughtful exploration of issues and concerns to develop mutual trust and respect. Both cancer centers and tribal communities can benefit by recognizing that shared power, as a reciprocal value, can benefit the whole.