This study investigates the clinical problem-solving among Western-trained and traditionally trained acupuncturists. Fifty-six subjects with varying clinical experience were divided into four groups: physicians without acupuncture training (control), physician-acupuncturists, non-licensed physician-acupuncturists, and traditionally trained acupuncturists. Three clinical cases (two routine and one non-routine), were given to the subjects to provide diagnostic and treatment plans. The data were quantitatively and qualitatively analyzed. Subjects' diagnostic and treatment plans were evaluated against reference models for Western medicine and traditional Chinese medicine (TCM). / The results indicate that acupuncturists were influenced by their initial medical training. Physician-acupuncturists and non-licensed physician-acupuncturists' practices were greatly influenced by the training in Western medicine, regardless of their exposure to traditional Chinese medicine. The traditionally trained practitioners outperformed the other groups of subjects in the non-routine case. Accuracy in diagnoses and treatments for the non-routine case was also positively related to the length of clinical experience. The findings support theories of expertise that experts use forward reasoning when coping with familiar cases, and backward reasoning when encountering difficult cases.

Remediation of pre-clerkship students for deficits in basic science knowledge should help them overcome their learning deficiencies prior to clerkship. However, very little is known about remediation in basic science knowledge during pre-clerkship. This study utilized the program theory framework to collect and organize mixed methods data of the remediation plan for pre-clerkship students who failed their basic science cognitive examinations in a Canadian medical school. This plan was analyzed using a logic model narrative approach and compared to literature on the learning theories. The analysis showed a remediation plan that was strong on governance and verification of scores, but lacked: clarity and transparency of communication, qualified remedial tutors, individualized diagnosis of learner’s deficits, and student centered learning. Participants admitted uncertainty about the efficacy of the remediation process. A remediation framework is proposed that includes student-centered participation, individualized learning plan and activities, deliberate practice, feedback, reflection, and rigorous reassessment

Remediation of pre-clerkship students for deficits in basic science knowledge should help them overcome their learning deficiencies prior to clerkship. However, very little is known about remediation in basic science knowledge during pre-clerkship. This study utilized the program theory framework to collect and organize mixed methods data of the remediation plan for pre-clerkship students who failed their basic science cognitive examinations in a Canadian medical school. This plan was analyzed using a logic model narrative approach and compared to literature on the learning theories. The analysis showed a remediation plan that was strong on governance and verification of scores, but lacked: clarity and transparency of communication, qualified remedial tutors, individualized diagnosis of learner’s deficits, and student centered learning. Participants admitted uncertainty about the efficacy of the remediation process. A remediation framework is proposed that includes student-centered participation, individualized learning plan and activities, deliberate practice, feedback, reflection, and rigorous reassessment

This thesis sets out the way in which histology became established in the curriculum of the London medical schools between 1826 and 1886. The text provides a very large number of references to original material, some of it previously unreported. Histology had its origins in continental Europe in the early years of the nineteenth century, in the work of Bichat. The introductory chapter examines how this was translated both as to language and as to practical experience into England. The role of the developing achromatic microscope is also briefly considered. The changes in medical education in London which fostered the teaching of 'general anatomy' (histology) are then described from primary sources in some detail, and with extensive necessary quotation. The establishment and development of medical departments and the appointment of key teachers was pivotal and is fully investigated, while the role of the medical press in infuencing change is also assessed. The teaching programme of each college is explored using evidence from surviving lecture notes, texts, diaries, calendars and correspondence. The changing requirements for qualification, and their influence on the examination system, which accompanied the growth of histological teaching, are discussed. In order to trace the incorporation of the cell theory, the growing understanding of the tissue concept, and the relationship between structure and function, into the teaching of histology, a case study of the histology of the liver has been pursued throughout the thesis. The development of knowledge of the histology of the liver has been traced through the large number of textbooks which were produced to support courses in histology. Throughout the period, steadily increasing specialisms from virtually all other aspects of the curriculum vied for inclusion, with more and more time being given over to new and diverse subjects. In this competition for time and resources histology eventually found a permanent place. The events leading to a formal requirement to teach practical histology are examined, and key people in these changes are identified. The effects of the legislation on texts, equipment, specialist accommodation, teaching skills, and time are assessed.

Thesis (Ed.D.)--University of Tulsa, 1987. / Bibliography: leaves 74-78.

Thesis (Ed.D.)--University of Tulsa, 1987. / Bibliography: leaves 74-78.

Thesis (Ph. D.)--University of Virginia, 1990. / Includes bibliographical references (leaves [194]-200). Also available online through Digital Dissertations.

Thesis (Ph. D.)--University of Washington, 2000. / Vita. Includes bibliographical references (leaves 179-188).

Thesis (M.Ed.St.) - University of Queensland, 2005. / Includes bibliography.

The diagnosis and management of patients requires professional know-how or medical craft knowledge. To explain how this knowledge is acquired, this research asked 'How do medical experts pass on their craft?' Other questions arose through successive data collections and progressive focusing on what medical experts did well in their work and teaching. The programme comprised: pilot interviews with three expert physicians; a case study in a hospital medical unit; and paired consultant/SHO interviews. Participant observation, interviews, and expert-novice comparisons explored clinical work, teaching, and learning in apprenticeship. Data analysis of participants' responses and ward round discussions allowed identified categories to cluster within three inter-related constructs instrumental to the acquisition of medical knowledge: gaining experience in the experiential process of clinical practice (1); and the products of experience which manifest as experts' clinical expertise (2) and teaching/learning expertise (3). These constructs can be located within a model of apprenticeship based on Spady's (1973) analysis of authority in effective teaching containing two frames of reference: the social, 'traditional-legal'; and the individual, 'expert-charismatic'. The medical apprenticeship is associated with similar perspectives: the 'traditional-experiential' represents the professional process of learning through patient care with its infrastructure of clinical methods in presentation, discourse, and commentary; and the 'expert-charismatic' represents clinical and teaching expertise coupled with vocational enthusiasm. Experienced experts synthesised two repertoires of knowledge and skills derived from the craft knowledge of medicine and pedagogy, respectively. Both crafts are required for effective clinical education. While apprenticeship accommodates a range of teaching/learning experiences, in postgraduate education experts pass on knowledge through the deliberate engagement of junior doctors in diagnosis and management. The skills involved in this process were largely unrecognised by most senior and junior doctors and were not perceived as 'clinical teaching' although learning was structured through service-based work.