Teaching conceptions and approaches to teaching of medical school faculty: the difference between how medical school teachers think about teaching and how they say that they do teach.

BACKGROUND: It is often assumed that the way teachers approach their teaching is determined by the way they think about learning. This study explores how teachers of an undergraduate medical programme (UMP) think about learning, how they approach teaching and whether their conceptions of learning relate to their teaching approaches. METHODS: Quantitative data of academic teachers involved in the undergraduate programme in medicine were collected and analysed. We used a questionnaire designed to measure teachers' conceptions of their own learning (COL) and of student learning as well as teachers' approaches to teaching (AT). RESULTS: Teachers of the medical undergraduate programme hold a variety of COL, of how students learn and their AT. No significant correlations were found between teachers' conceptions of learning and their AT. CONCLUSIONS: Although UMP teachers' ideas on learning and teaching are very diverse, some of their conceptions are interrelated. Teachers' ideas on their own learning is sometimes - but not always - related to how they think about student learning. But most importantly, the way UMP teachers think about learning is not automatically converted into the way they approach teaching.

Clinical skills training in a skills lab compared with skills training in internships: comparison of skills development curricula.

CONTEXT: The necessity of learning skills through "integrated skills training" at an undergraduate level has been supported by several studies. The University of Antwerp implemented undergraduate skills training in its renewed curriculum in 1998, after it was demonstrated that Flemish students did not master their medical skills as well as Dutch students who received "integrated skills training" as part of their undergraduate medical course. AIM: The aim of this study was to compare the skill outcome levels of two different student populations: students who had been trained in basic clinical skills mainly through clinical internships in year 7 with students who had learned these skills through an integrated longitudinal programme in a special learning environment in years 1-5 prior to their internship experience. STUDY SAMPLE: Students of the traditional curriculum learned skills through a 75 hour programme in years 4 and 5, through plenary sessions followed by a 12 month period of internships during which skills could be further practiced. We tested this group right after completion of their internships. Students from the renewed curriculum followed a 200 hour intensive small group skills training programme offered in years 1-5. This group was tested before starting their internships. RESULTS: On global OSCE-scores, renewed curriculum students had significantly higher overall scores (p<0.001) and they scored significantly higher at 6 of 15 stations. There was no significant difference at 8 stations, while traditional curriculum students scored better at station 1. DISCUSSION: 5 years and 200 hours of integrated undergraduate skills training is more effective as a method of learning basic clinical skills, compared to learning these skills through 75 hours of traditional skill training and reinforcement of these skills in 12 month clinical internships, when measured by means of an OSCE.

Revision of shoulder replacement with a reversed shoulder prosthesis (Delta III): report of five cases.

The authors report on their experience in revision total shoulder arthroplasty using the Delta III shoulder prosthesis, a reversed constrained prosthesis which is known to give good functional results in the rotator cuff-deficient shoulder. It was implanted in patients with a failed total or hemishoulder prosthesis. The Constant-Murley score was used to assess the functional outcome. The preliminary results achieved in four patients (one bilaterally) are discussed and compared with the results of other treatments. After two years follow-up, the Constant-Murley score has improved from 14/100 preoperatively to 62/100 postoperatively. Although these initially good functional results may be temporary and loosening may occur over the longer term, the authors recommend the Delta III shoulder prosthesis as an alternative solution for revision shoulder arthroplasty.