Faculty from six eastern health science schools, from Florida to Nova Scotia, developed a new series of group-learning units during 1983 and 1984 using a recently developed patient-oriented problem-solving approach. The purpose of the units was to teach problem solving by applying the concepts and principles of pharmacology to therapeutic problems, and to find ways to engage students actively in their learning of this material. The development team envisioned that these goals would be met by means of well-crafted teaching units that could be evaluated and, if acceptable, used by academic pharmacologists in their teaching. The units were developed, edited, reviewed by experts, and field-tested with students at the authors' schools; editing and publication were done by the study's sponsor, the Upjohn Company. The results of the field trials (which indicated no need for revisions of the units) showed that the units were well crafted and that the students had higher scores on tests of their knowledge of pharmacology after they had used the units.
A highly purified preparation of rat thyrocalcitonin (TCT) has been obtained from lyophilized thyroid glands by gel chromatography following acid-acetone extraction. Biological activity of Sephadex G-50 eluates appeared in two peaks. The TCT in the major peak was concentrated, and applied to a Bio-Gel P-6 column, and a major protein peak was eluted which coincided with TCT activity. Potency, estimated by bioassay in rats, increase approximately 3500-fold from 0.075 MRC U/mg lyophilized glands to 250-400 MRC U/mg in the final product. The overall yield of TCT activity was about 36%. The purified product was characterized by chemical procedures and evaluated for its antigenic properties and use for radioimmunoassay. The purified rat TCT was used both labeled with 125I and as unlabeled standard. The following results were obtained: 1) Guinea pig antisera to either human or rat TCT were capable of binding 125I-rat TCT or 125I-human TCT; 2) Using either 125I-human or 125I-rat TCT and antisera to either TCT, pg amounts of rat and human TCT reacted in the assay while ng to mug amounts of salmon calcitonin or porcine TCT failed to react; 3) Using 125I-rat TCT and antisera to human or rat TCT, synthetic C-terminal (10-32 or 22-32) fragments of human TCT reacted well, while N-terminal (1-18) or desamide (1-32) derivatives reacted poorly or not at all; 4) Rat TCT was easily detected in normal thyroid venous plasma (5-10 ng/ml) and thyroid gland extracts (similar to 1 mug/gland) but not in peripheral blood; 5) Bioassay and radioimmunoassay of rat thyroid extracts (N equals 18) showed good agreement (r equals 0.86, p less than 0.001). The results support the idea that rat TCT is closely related to human TCT, indicate that major antigenic determinants reside in the C-terminal portion of the molecule, and show that antisera to either human or rat TCT can be used to measure rat TCT.
We have presented some views on past, present and potential trends for teaching clinical pharmacology in the medical curriculum. Clinical pharmacology as subject matter in the medical curriculum has been operationally defined for our purposes as: (1) the application of fundamental principles of basic pharmacology to rational drug therapy in humans; and (2) the application of appropriate nuances of the human pharmacology of individual drugs to their use in particular disease states. In terms of improving the results of drug therapy, arguments were advanced for the importance of teaching clinical pharmacology at all levels in the medical curriculum and in postgraduate medical education. The introduction of so many new and potent pharmaceuticals over the past 25 years requires well educated and skilled medical practitioners adept and well versed in the fundamental principles of basic and applied pharmacology, so as to achieve the most prudent, effective and economically sound use of these drugs as possible. This creates a challenge to medical educators, particularly those involved in teaching clinical pharmacology, to devise innovative teaching techniques and curricular changes that foster these goals. In an attempt to address these challenges, we have reviewed some innovative teaching approaches and curricular reforms, both published and unpublished, that have already met with success, and we have also discussed some future trends in teaching both undergraduate and graduate physicians the fundamental principles of rational drug therapy. The challenges and issues involved in these future trends have been identified and will be addressed in subsequent articles in this journal. These will be concerned with teaching clinical pharmacology: (1) in basic medical pharmacology courses; (2) to upperclass medical students; and (3) in continuing medical education programs. Subsequent articles will also deal with new and innovative teaching modalities for clinical pharmacology and with the role of the drug industry in these modalities.
The Journal of Clinical Pharmacology is publishing an educational series dealing with Innovative Teaching programs in Clinical Pharmacology. Claire M. Lathers, PhD, FCP, and Alphonse J. Ingenito, PhD, FCP, are coediting this series of articles. Two articles have been published to date. The first is coauthored by AJ Ingenito, CM Lathers, and HJ Burford, and is entitled “Instruction in Clinical Pharmacology: Changes in the Wind” (J Clin Pharmacol 1989;29:7–17) and the second was written by CM Lathers and CM Smith and is entitled “Teaching Clinical Pharmacology: Coordination with Medical Pharmacology Courses” (J Clin Pharmacol 1989;29:581–597). The third article, “Incorporation of Clinical Pharmacology into the Fourth Year of the Medical Curriculum: Teaching Clinical Pharmacology Without a Clinical Pharmacologist,” (J Clin Pharmacol 1990;30:1065–1073) was written by Patricia Williams, PhD at Eastern Virginia Medical School. The fourth article (in press) written by Duncan E. Hutcheon, MD, FCP of UMDNJ in Newark, and Hoda Wadie El‐Gawly, MD, PhD, from the University of Suez, describes a computer‐based problem‐solving system in clinical pharmacology. A system that isn't innovating is a system that is dying. In the long run, the innovators are the ones who rescue all human ventures from death by decay. So value them. You don't have to be one yourself, but you should be a friend of the innovators around you. And if you don't have any around you, you had better import some.
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