Monday, May 01, 2006

Teaching medical students clinical neurology: an old codger's view

By Charles Warlow, The University of Edinburgh

From The Clinical TeacherVolume 2 Page 111 - December 2005

Curtain rises on an outpatient clinic, two 4th year students are sitting rather tensely with the professor who is in shirt sleeves, and a patient

Professor (seeing a patient who has had a stroke some years ago and now complains of brief attacks in which the affected arm stiffens and rises in the air out of his control): What do you think is going on here?

Student (nervous, almost terrified): is it, er…a …stroke?

Professor (astonished): during a stroke do you think the arm goes up in the air or flops to the side? What do you think happens in an epileptic attack?

Student: um………

An hour or so later…………

Professor (after seeing a man with tricky epilepsy, and hoping to strike one of those vertical themes): do you know the difference between compliance, adherence and concordance?

Student (visibly cheering up): oh yes, concordance is when you and the patient agree together with a course of action…

Professor smiling as lights fade, curtain.

I am frustrated; the students seem to know so very little about neurology and how to sort out what is wrong with patients and yet they know so much about how to be nice to them. What on earth has gone wrong?

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Staff development for clinical teachers

From The Clinical TeacherVolume 2 Page 104 - December 2005

It goes without saying that no man can teach successfully who is not at the same time a student. Sir William Osler

The word 'doctor' is derived from the Latin, docere, which means 'to teach'.1 Interestingly, however, although all doctors are prepared for their roles as clinicians, very few are trained for their roles as teachers: 'the one task that is distinctively related to being a faculty member is teaching; all other tasks can be pursued in other settings; and yet, paradoxically, the central responsibility of faculty members is typically the one for which they are least prepared.'2

Professional development can help doctors to prepare for their roles as teachers, and is fundamental to career development and growth. Although the majority of doctors participate in continuing medical education activities, not all of them take part in staff development. My goal is to discuss staff development from the following perspectives:
•What is staff development?
•Why is staff development important?
•What are common goals and content areas?
•What are common formats?
•What is the evidence?
•How can clinical teachers devise a plan for staff development?


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