Perceptions of medical school graduates and students regarding their academic preparation to teach.

PURPOSE: How medical students learn and develop the characteristics associated with good teaching in medicine is not well known. Information about this process can improve the academic preparation of medical students for teaching responsibilities. The purpose of this study was to determine how different experiences contributed to the knowledge, skills, and attitudes of medical school graduates and students regarding medical teaching. METHODS: A questionnaire was developed, addressing reliability and validity considerations, and given to first year residents and third year medical students (taught by those residents). Completed questionnaires were collected from 76 residents and 110 students (81% of the sample group). Item responses were analysed using descriptive and inferential statistics. RESULTS: Most residents (n = 54; 71%) positively viewed opportunities they had to practice teaching when they were seniors. Residents rated three activities for learning to teach highest: (1) observing teachers as they teach; (2) reviewing the material to be taught; and (3) directly teaching students; representing both individual and participatory ways of learning. Residents' self ratings of teaching behaviours improved over time and this self assessment by the residents was validated by the students' responses. Comparison between residents' self ratings and students' views of typical resident teaching behaviours showed agreement on levels of competence, confidence, and motivation. The students rated characteristics of enthusiasm, organisation, and fulfilment lower (p<0.002) than residents rated themselves. CONCLUSIONS: The residents and students in this study viewed academic preparation for teaching responsibilities positively and showed agreement on characteristics of good teaching that may be helpful indicators in the process of developing medical teachers.

Patterns of symptom change in anxious depressed outpatients treated with different drugs.

Patients with mixtures of anxiety and depressive mood of rather modest degree constitute a majority in the psychiatric outpatient population. Drug treatments are employed to produce symptomatic relief. In this study, thirteen commonly used psychotherapeutic drugs were compared for efficacy in producing change in symptoms of anxiety, depressive mood, and psychomotor activation level in this most common type of psychiatric clinic patient. The drugs were found to differ in relative effect on anxiety and depressive mood. Paradoxically, the major and minor tranquilizers produced greater effect on depressive mood than anxiety, while the more sedative of the tricyclic antidepressants produced relatively greater effect on anxiety. Within each of the three major drug classes, the more sedative members of the class tended to have relatively greater effect on anxiety and the less sedative tended to have relatively greater effect on depressive mood components of the symptom picture.

Prospective management of a child with neonatal citrullinemia.

A patient with neonatal citrullinemia caused by severe deficiency of argininosuccinate synthetase was treated prospectively according to the currently accepted protocol. We gradually reduced the doses and then discontinued treatment with sodium benzoate and phenylacetate; blood glutamine levels were maintained in the normal range, but ammonia was mildly elevated. Growth and development progressed normally through 31 months of age. Some patients with citrullinemia can be successfully managed without daily sodium benzoate and phenylacetate therapy.