Secondary peer reviewed medical journal articles[edit | edit source]
Paving the way for evidence-based medicine in Pakistan[edit | edit source]
by Zaidi Z, Hashim J, Iqbal M, Quadri KM.
Shifa College of Medicine, Islamabad, Pakistan.
J Pak Med Assoc. 2007 Nov;57(11):556-60.
Evidence-based Medicine (EBM) is the process of systematically reviewing, appraising and using clinical research findings to aid the delivery of optimal clinical care to patients. EBM has become popular due to: the need for valid information about diagnosis, prognosis, therapy and prevention during patient care; traditional sources such as textbooks and expert opinion being frequently out-of-date; and knowledge of current best evidence declining with time from graduation from medical college. EBM has become feasible for practicing clinicians due to: new strategies for appraising studies; availability of systematic reviews (summaries) of current best evidence; and information technology (computers with Internet access). In a resource-limited country such as Pakistan, an evidence-based approach can be cost-effective by reducing clinical practices that have no proven benefit. Commonly perceived obstacles to EBM include limited access to computers, the Internet and online resources. Reliable resources of EBM are available (such as The Cochrane Database of Systematic Reviews http://www.cochrane.org ) although many of these require paid subscriptions. Another difficulty is the issue of applicability of data from other countries to patients in our setting with different socio-economic factors. Other barriers to EBM in developing countries include: inexperience in small-group learning, limited time to attend workshops, and the lack of role models for practicing EBM. We have also tried to address the common fallacies related to EBM in the hope of greater use of these skills by busy clinicians as well as academic researchers.
Facilitating the development of moral insight in practice: teaching ethics and teaching virtue[edit | edit source]
by Begley, AM.
School of Nursing and Midwifery, The Queen's University of Belfast, 50 Elmwood Avenue, Belfast, UK. a.begley -at- qub dot ac dot uk
Nurs Philos. 2006 Oct;7(4):257-65.
The teaching of ethics is discussed within the context of insights gleaned from ancient Greek ethics, particularly Aristotle and Plato and their conceptions of virtue (arete, meaning excellence). The virtues of excellence of character (moral virtue) and excellence of intelligence (intellectual virtue), particularly practical wisdom and theoretical wisdom, are considered. In Aristotelian ethics, a distinction is drawn between these intellectual virtues: experience and maturity is needed for practical wisdom, but not for theoretical wisdom. In addition to this, excellence of character is acquired through habitual practice, not instruction. This suggests that there is a need to teach more than theoretical ethics and that the ethics teacher must also facilitate the acquisition of practical wisdom and excellence of character. This distinction highlights a need for various educational approaches in cultivating these excellences which are required for a moral life. It also raises the question: is it possible to teach practical wisdom and excellence of character? It is suggested that virtue, conceived of as a type of knowledge, or skill, can be taught, and people can, with appropriate experience, habitual practice, and good role models, develop excellence of character and become moral experts. These students are the next generation of exemplars and they will educate others by example and sustain the practice of nursing. They need an education which includes theoretical ethics and the nurturing of practical wisdom and excellence of character. For this purpose, a humanities approach is suggested.
Teaching professionalism: theory, principles and practices[edit | edit source]
by Cruess, RL.
Centre for Medical Education, McGill University, Montreal, Quebec, Canada. richard.cruess -at- mcgill dot ca
Clin Orthop Relat Res. 2006 Aug;449:177-85.
Professionalism as a subject must be taught explicitly. This requires an institutionally accepted definition which then must be learned by both students and faculty. This directs what will be taught, expected, and evaluated. Of equal importance, and more difficult to achieve, is the incorporation of the values and attitudes of professionalism into the tacit knowledge base of physicians in training and in practice. This requires learning experiences which encourage self-reflection on professionalism throughout the continuum of medical education. Because of the great influence of role models and because most physicians do not fully understand professionalism and the obligations required to sustain it, faculty development is essential to the success of any program on professionalism. Also important are strong institutional support including adequate resources, the presence of a longitudinal program which ensures repeated exposure throughout the educational process, a supportive environment, and a system of evaluation which reinforces teaching.
Role of parents in the determination of the food preferences of children and the development of obesity[edit | edit source]
by Benton, D.
Department of Psychology, University of Wales Swansea, Swansea, Wales, UK. d.benton -at- swansea dot ac dot uk
Int J Obes Relat Metab Disord. 2004 Jul;28(7):858-69.
The role of parental behaviour in the development of food preferences is considered. Food preferences develop from genetically determined predispositions to like sweet and salty flavours and to dislike bitter and sour tastes. Particularly towards the second year of life, there is a tendency to avoid novel foods (neophobia). Food aversions can be learnt in one trial if consumption is followed by discomfort. There is a predisposition to learn to like foods with high-energy density. However, from birth genetic predispositions are modified by experience and in this context during the early years parents play a particularly important role. Parental style is a critical factor in the development of food preferences. Children are more likely to eat in emotionally positive atmospheres. Siblings, peers and parents can act as role models to encourage the tasting of novel foods. Repeated exposure to initially disliked foods can breakdown resistance. The offering of low-energy-dense foods allows the child to balance energy intake. Restricting access to particular foods increases rather than decreases preference. Forcing a child to eat a food will decrease the liking for that food. Traditionally, educational strategies have typically involved attempts to impart basic nutritional information. Given the limited ability of information to induce changes in behaviour, an alternative strategy would be to teach parents about child development in the hope that an understanding of the characteristic innate tendencies and developmental stages can be used to teach healthy food preferences.
Suggested sources[edit | edit source]
- http://lib.rus.ec/b/163295/read (Russian; fiction)
From Andreas Kolbe[edit | edit source]