RESUMEN
Tularemia is an endemic zoonotic infection caused by Francisella tularensis, which primarily causes infection in humans who have handled contaminated animal tissue or have been bitten by infected arthropods. Because of its ease of dispersion and transmission and its high degree of infectivity, F. tularensis is also considered to be a bioterrorism agent. Consequently, there is renewed interest in the development of safe, effective measures, such as vaccines, to prevent the morbidity and mortality associated with aerosol exposure to F. tularensis. Current efforts, however, are hampered by the lack of an animal model that faithfully reproduces human infection. Employing a model of "induced human infection" with aerosol administration of F. tularensis, Dr. Theodore E. Woodward and colleagues pioneered the clinical studies of tularemia vaccines that form the basis for current tularemia vaccine research.
Asunto(s)
Vacunas Bacterianas/historia , Vacunas Bacterianas/inmunología , Francisella tularensis/inmunología , Tularemia/inmunología , Animales , Antibacterianos/uso terapéutico , Vacunas Bacterianas/administración & dosificación , Ensayos Clínicos como Asunto/ética , Francisella tularensis/patogenicidad , Historia del Siglo XX , Experimentación Humana/historia , Humanos , Maryland , Ohio , Prisioneros , Conejos , Tularemia/tratamiento farmacológico , Tularemia/prevención & controlRESUMEN
PURPOSE: To present an alternative approach to mission-based management (MBM) for assessing the clinical teaching efforts of the faculty in the third and fourth years of medical students' education. METHOD: In fiscal years 2000 and 2001, interviews were conducted with department chairs and faculty members with major responsibilities in education at the University of Maryland School of Medicine. Using a standard worksheet, each rotation was categorized according to the amounts of time students spent in five teaching modes. After each department described its rotation and maximum teaching time, the department team and the MBM team negotiated the final credit received for its course. This final determination of departmental clinical teaching was used in subsequent calculations. Adjustments were made to the department clinical education time based on the teaching mode. Groups of medical students were surveyed to determine the relative value of each teaching mode. These relative values were then used to modify the clinical education times credited to the department. The last step was to distribute the effort of the faculty between clinical and educational missions. RESULTS: The data analysis showed approximately 57,000 credited faculty hours in one year for direct education of medical students in each curriculum year. These hours equal the annual workload of 28 full-time faculty members. CONCLUSIONS: A powerful use of MBM data is to move from thinking about resource allocation to thinking about the effective management of a complex organization with interlaced missions. Reliable data on faculty's contributions to medical students' education across departments enhances other MBM information and contributes to a picture of the dynamic interconnectedness of missions and departments.