Abstract
Background: The task of engaging senior medical students in ethical inquiry while on rural clinical placements has received minimal attention in the medical education literature. As there is ...an international trend for medical students to undertake part or all of their clinical training in rural areas, the need to deliver clinically relevant ethics teaching in a sustainable manner has emerged as a challenge for medical schools. Clinicians tend to be hesitant about delivering this kind of teaching.
What we did: We introduced a novel teaching program which involved recruiting, training and supporting experienced rural clinicians to facilitate a series of Rural Ethics Ward Rounds with the senior medical students on extended rural placements.
Evaluation: The clinical facilitators expressed some initial uncertainty with the teaching model, but generally reported a positive experience, including significant professional benefits such as increased ethical awareness and opportunity for self-reflection.
Conclusion: This model enables experienced rural clinicians to facilitate student development in ethical awareness and skill, and requires relatively low demands on academic time and resources.
Australian Rural Clinical School (RCS) programmes have been designed to create experiences that positively influence graduates to choose rural medical careers. Rural career intent is a categorical ...evaluation measure and has been used to assess the Australian RCS model. Predictors for rural medical career intent have been associated with extrinsic values such as students with a rural background. Intrinsic values such as personal interest have not been assessed with respect to rural career intent. In psychology, a predictor of the motivation or emotion for a specific career or career location is the level of interest. Our primary aims are to model over one year of Australian RCS training, change in self-reported interest for future rural career intent. Secondary aims are to model student factors associated with rural career intent while attending an RCS.
The study participants were medical students enrolled in a RCS in the year 2013 at the University of New South Wales (UNSW) and who completed the newly developed self-administered UNSW Undergraduate Destinations Study (UDS) questionnaire. Data were collected at baseline and after one year of RCS training on preferred location for internship, work and intended specialty. Interest for graduate practice location (career intent) was assessed on a five-variable Likert scale at both baseline and at follow-up. A total of 165 students completed the UDS at baseline and 150 students after 1 year of follow-up.
Factors associated with intent to practise in a rural location were rural background (χ2 = 28.4, P < 0.001), two or more previous years at an RCS (χ2 = 9.0, P = 0.003), and preference for a rural internship (χ2 = 17.8, P < 0.001). At follow-up, 41% of participants who originally intended to work in a metropolitan location at baseline changed their preference and indicated a preference for a rural location. The level of interest in intended practice location was significantly higher for those intending to work in a rural area than those with intention to work in a metropolitan (urban area) location (t = -3.1, P = 0.002). Initial rural career location intention was associated with increased interest levels after 1 year of follow-up (paired t = -2.3, P = 0.02).
When evaluating the success of RCS outcomes with respect to rural workforce destination, both rural practice intentions and level of interest are key factors related to projected career destination. RCS experience can positively influence practice intent (toward rural practice) and interest levels (toward greater interest in rural practice).
To understand the influence of the number of years spent at an Australian rural clinical school (RCS) on graduate current, preferred current and intended location for rural workforce practice.
...Retrospective online survey of medical graduates who spent 1-3 years of their undergraduate training in the University of New South Wales (UNSW) Rural Clinical School. Associations with factors (gender, rural versus non-rural entry, conscription versus non-conscript and number of years of RCS attendance) influencing current, preferred current and intended locations were assessed using X2 test. Factors that were considered significant at P 0.1 were entered into a logistic regression model for further analysis.
214 graduates responded to the online survey. Graduates with three years of previous RCS training were more likely to indicate rural areas as their preferred current work location, than their colleagues who spent one year at an RCS campus (OR = 3.0, 95% CI = 1.2-7.4, P = 0.015). Also RCS graduates that spent three years at an RCS were more likely to intend to take up rural medical practice after completion of training compared to the graduates with one year of rural placement (OR = 5.1, 95% CI = 1.8-14.2, P = 0.002). Non-rural medicine entry graduates who spent three years at rural campuses were more likely to take up rural practice compared to those who spent just one year at a rural campus (OR = 8.4, 95% CI = 2.1-33.5, P = 0.002).
Increasing the length of time beyond a year at an Australian RCS campus for undergraduate medical students is associated with current work location, preferred current work location and intended work location in a rural area. Spending three years in a RCS significantly increases the likelihood of rural career intentions of non-rural students.
A comprehensive understanding of the equine circadian clock involves the evaluation of circadian clock gene expression. A non-invasive and effective method for detecting equine clock gene expression ...has yet to be established. Currently, research surrounding this area has relied on collecting tissue biopsies or blood samples that can often be costly, time consuming and uncomfortable for the animal.
Five mares were individually stabled under a light-dark (LD) cycle that mimicked the external environmental photoperiod during a time of year corresponding with the vernal equinox. Hair follicles were collected every 4 h over a 24-h period by plucking hairs from the mane. RNA was extracted and quantitative (q) PCR assays were performed to determine temporal expression patterns for the core clock genes; ARNTL, CRY1, PER1, PER2, NR1D2 and the clock controlled gene, DBP.
Repeated measures ANOVA for the clock gene transcripts PER1 and PER2 and the clock controlled gene, DBP, revealed significant variation in expression over time (p < .05, respectively). Cosinor analysis confirmed a significant 24-h temporal component for PER1 (p = .002) and DBP (p = .0033) and also detected rhythmicity for NR1D2 (p = .0331).
We show that the extraction of RNA from equine hair follicle cells can identify the circadian 24 h oscillations of specific clock genes and a clock-controlled gene and therefore provide a valuable non-invasive method for evaluating the equine peripheral circadian clock. This method will serve as a useful tool for future evaluations of equine circadian rhythms and their response to environmental changes.
Ancestral Healing in Psychotherapy Dennison, Andrea; Powell-Watts, Lisa
Spirituality in clinical practice (Washington, D.C.),
09/2021, Letnik:
8, Številka:
3
Journal Article
Recenzirano
Ancestor worship is part of many world cultures, and healing ancestral trauma has become a nascent interest amongst therapeutic practitioners. This practice case report shares a brief description of ...energy healing as an indigenous tradition, and introduces a rationale for integrating intergenerational trauma healing work in the context of psychotherapy with diverse multicultural clients. One practitioner shares personal and clinical experiences, having worked with clients and students over decades of practice using chakra healing modalities. An example of engaging ancestral energy and imagery in a therapy session is described. Recommendations for research and practice are given.
Higher education institutions are increasingly interested in infusing sustainability content into their curricula. This can be accomplished through general education programs, which the University of ...Vermont recently established. The implementation of this new requirement created a unique opportunity to investigate sustainability-related teaching and learning. The purpose of this study was to explore how instructors structured and taught sustainability learning outcomes and students' perceptions of learning within an assortment of general education courses. The variety of data collection methods (online survey, interviews, focus groups, observation, and document review) enabled the identification and triangulation of strong themes. Findings describe three course design approaches instructors used to incorporate sustainability. Instructors taught sustainability through class discussions, papers, readings, projects, guest speakers, and case studies. Students reported the following teaching practices as particularly helpful: experiencing real-world applications, discussing sustainability issues in class, exploring different perspectives, experiencing agency, and learning from peers and guest speakers. The following are recommended areas for skill development: (1) training instructors to align learning outcomes with assessment strategies to ensure that appropriate evidence is gathered, (2) encouraging instructors to reflect upon which teaching practices effectively supported student learning and consider improvements, and (3) using a variety of teaching practices and assessment strategies.
Background/Purpose: Spermatogenesis in postnatal testes is controlled by the hypothalamic-pituitary-gonadal axis. To determine if pituitary hormones can induce precocious spermatogenesis once primary ...spermatocytes (PS) have formed, prepubertal mice were treated with human chorionic gonadotrophin (hCG). Methods: Day 12 immature mice (n = 10) were injected every third day with hCG (3 or 6 IU) dissolved in 100 μL phosphate-buffered saline (PBS). Control mice (n = 10) were either uninjected or injected with 100 μL PBS alone. On day 20 to 22 the excised testes were examined histologically with tubule counts. Results: HCG-treated mice had fewer tubules at stage I (P <.001) and more at stage III than the PBS-treated group (P <.001). Mean thickness of the round spermatid layer per tubular cross section in the hCG-treated group was significantly increased compared with the PBS-treated group (P <.01). Similarly, the percentage of the tubules at stage III (containing round spermatids) in the hCG-treated group was significantly increased, from 25% to 71%, compared with the PBS-treated group (P <.01). With increasing doses of hCG the testosterone levels were significantly higher than in controls (P <.01), but hCG did not alter testis weight or position. Conclusions: These results show that hCG stimulates the transformation of PS to round spermatids even in immature mouse testes. These findings suggest that hCG treatment of prepubertal cryptorchid boys may initiate premature spermatogenesis. J Pediatr Surg 37:1751-1753. Copyright 2002, Elsevier Science (USA). All rights reserved.
Higher education institutions are increasingly interested in infusing sustainability content into their curricula. This can be accomplished through general education programs, which the University of ...Vermont recently established. The implementation of this new requirement created a unique opportunity to investigate sustainability-related teaching and learning. The purpose of this study was to explore how instructors structured and taught sustainability learning outcomes and students' perceptions of learning within an assortment of general education courses. The variety of data collection methods (online survey, interviews, focus groups, observation, and document review) enabled the identification and triangulation of strong themes. Findings describe three course design approaches instructors used to incorporate sustainability. Instructors taught sustainability through class discussions, papers, readings, projects, guest speakers, and case studies. Students reported the following teaching practices as particularly helpful: experiencing real-world applications, discussing sustainability issues in class, exploring different perspectives, experiencing agency, and learning from peers and guest speakers. The following are recommended areas for skill development: (1) training instructors to align learning outcomes with assessment strategies to ensure that appropriate evidence is gathered, (2) encouraging instructors to reflect upon which teaching practices effectively supported student learning and consider improvements, and (3) using a variety of teaching practices and assessment strategies.
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