Physicians, nurses, and pharmacists often practice in death environments. A questionnaire was mailed to 126 medical schools, 396 baccalaureate nursing schools and 72 pharmacy colleges to determine the extent of death education offerings in their curricula. A response rate of better than 80 percent was received. The majority of professional programs had some emphasis on thanatology which was initiated within the past decade.
Twenty senior teachers were asked to rank, in order of influence, the seven clinical and five personal characteristics used to grade third-year medicine clerks. Seventeen perceived themselves to be more influenced by clinical characteristics when assigning grades. Independently, the actual ratings completed over a 3-year period by these same teachers were analysed to measure the congruency between their perceived and actual grading behaviour. When actually rating students only nine raters were more influenced by clinical characteristics and just one half of the teachers displayed a congruency between their perceived and actual rating behaviour. The implications of these findings are discussed.
The authors studied the abilities of three groups of third-year medical students (a total of 310) at two schools to order appropriate diagnostic tests and procedures for four cases studies. Each student was classified as "organized," "mixed," or "non-organized" based on the degree of organization of the approach the student used to list hypotheses for the two cases he or she was assigned. Analysis of variance revealed that the students in the organized and mixed groups spent significantly fewer dollars for inappropriate diagnostic evaluations than did the students in the non-organized group for three of the four cases (p less than .05). Analyses of the mean expenditures for all cases revealed that the students in the organized and mixed groups spent significantly fewer dollars for inappropriate evaluations than did the students in the non-organized group (p less than .05). The medical school that was teaching its students to organize hypotheses had more students in the organized group than expected for every case. The authors conclude that the ability of students to organize hypotheses is directly related to their ability to avoid increased expenditures for inappropriate diagnostic tests and procedures, and that organized thinking about patients' problems is a skill that can be taught.
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