Wai-Ching Leung has some practical advice on questionnaires
Aims and MethodFactors leading to success in the MRCPsych Part I and Part II examinations, including age, gender and original medical school of training, were examined in the 1999 MRCPsych examination entrants to determine how far they are associated with the results. The ethnic breakdown of examiners of the MRCPsych examinations was also determined and compared with the origin of all consultant psychiatrists.ResultsYounger age at taking the examination and training at a British or Irish medical school were found to be highly significant predictors of success in the MRCPsych examinations. When allowance was made for confounding variables, the gender of candidates did not contribute to success. There was no difference in ethnic background of examiners compared with consultant psychiatrists overall.Clinical ImplicationsFactors affecting trainees wishing to undertake a psychiatric career need to be more closely examined. To ensure fairness and transparency in future examinations the ethnicity of candidates taking the examination needs to be addressed.
While the need for evidence-based medical education is widely acknowledged, it is often assumed that the 'gold standard' used in evidence-based medicine is sufficient evidence for practising evidence-based medical education. Using the introduction of a problem-based learning (PBL) curriculum as an example, this paper argues that evidence from ethnography can provide valuable insight into medical education, although few such studies have been carried out. Ethnography attempts to capture the true nature of human social behaviour by going beyond what individuals say to what they actually do, and explores social and educational phenomena beyond mere mechanical products of our purported educational interventions. Applied to problem-based learning, ethnographic accounts would be valuable to help us understand the PBL process and improve our educational practice.
Patients who are subject to compulsory care constitute a substantial proportion of the work-load of mental health professionals, particularly psychiatric nurses. This article examines the traditional 'beneficence-autonomy' approach to ethics in compulsory psychiatric care and evaluates it against the reality of daily practice. Risk to the public has always been an important but often unacknowledged consideration. Inequalities exist among ethnic and socio-economic groups and there is a lack of agreement on what constitutes mental disorder. Two major changes in compulsory psychiatric care--community orders and care for patients with untreatable severe personality disorders--further challenge the traditional ethical approach. There are also important human rights implications. The simple patient-health professional relationship no longer provides an adequate framework for mental health professionals on which to base their ethical decisions. The public and organizations may have different perspectives and their interests are becoming increasingly important. Mental health professionals, particularly psychiatric nurses, may face ethical dilemmas because of these different perspectives.
style attributes or a combination of both. Numerous studies in the disciplines of epidemiology, work physiology, psychology, and biochemistry have all pointed towards a beneficial effect of physical activity on health, but the optimal intensity, frequency, and duration of physical activity has yet to be established.Although our study was observational, the men were randomly selected from a general population. The estimated effect of jogging did not depend on the inclusion of intermediate variables, supporting the association of jogging with lower mortality.Whether light, moderate, or vigorous exercise should be recommended to the public has changed through the years. Although light exercise has some value, moderate and vigorous exercise is now considered more favourable for health.3 4 Our study supports this by showing that even a vigorous activity such as jogging is associated with a beneficial effect on mortality.Contributors: PS initiated and conducted the study and contributed to the writing of the manuscript with PL. JP was responsible for the statistical analysis of the data and contributed to the writing. PS will act as guarantor for the paper.Funding: Danish Heart Foundation.Competing interests: None declared.1 Appleyard M, Hansen AT, Schnohr P, Jensen G, Nyboe J. The Copenhagen City heart study. A book of tables with data from the first examination (1976-78) and a five-year follow-up (1981-83 This report examines the level of skills in evidence based medicine that are formally assessed by the royal colleges in the United Kingdom, through a review of the colleges' syllabuses for postgraduate examinations that are compulsory for specialist training. Methods and resultsWe reviewed all syllabuses in effect on 20 October 1999 that were held by 16 faculties or royal colleges in the United Kingdom, representing 15 major specialties. Surgical examinations (held by three royal colleges) were reviewed separately. Subspecialties in surgery and pathology were grouped as a single specialty. Radiology and oncology, which are both examined by the Royal College of Radiologists, were analysed separately.We reviewed each syllabus to determine whether the skills required for the four steps in evidence based medicine were assessed. The authors initially reviewed the syllabuses independently, and any disagreements (of which there were very few) were resolved by discussion. Where it was clear from the syllabus that a specific section of the examination is dedicated to examining skills in evidence based medicine, we obtained sample or past papers if available.These skills were not substantially assessed in seven of a total of 17 syllabuses, for five out of 15 major specialties represented: general medicine, surgery, paediatrics, ophthalmology, and radiology. (We did not regard assessment of basic statistics alone as adequate for step three.) A dedicated section of the examination explicitly assesses these skills in five syllabuses (table). Most of these five syllabuses focus on the candidates' ability to evaluate the evidence...
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