Keats’ Medical Milieu

2020 ◽  
pp. 150-172
Author(s):  
Hrileena Ghosh
Keyword(s):  
Intellectual Capital ◽  
Medical Training ◽  
Teaching Hospitals ◽  
Privileged Access

This chapter offers an account of the London teaching hospitals to show that Keats had privileged access to intellectual capital. London was a hotbed of intellectual ferment, as embodied by professional bodies like the Guy’s Hospital Physical Society and which found expression in the Vitalism Debates. The milieu within which Keats lived and worked is explored, focusing particularly upon characteristic aspects of Romantic medical training that are now obsolete, such as dissection of corpses freshly exhumed by ‘resurrection men’. The only known account of Keats in action as a surgeon is discussed, revealing that Keats was not fully persuaded by the prevailing Brunonian hypothesis of physiology. The chapter draws upon unpublished contemporary manuscripts in dating Keats’ medical notes, thus resolving an important and hitherto uncertain issue.

scholarly journals Intellectual Capital at Two Levels of Organizational Excellence in Teaching Hospitals of Tehran University of Medical Sciences

2018 ◽  
Vol 9 (2) ◽  
pp. 215-224
Author(s):  
M Jafari ◽  
A* Dargahi ◽  
A Pourtaleb ◽  
B Delgoshaee ◽  
M Salehi ◽  
...  
Keyword(s):  
Intellectual Capital ◽  
Teaching Hospitals ◽  
Medical Sciences ◽  
Organizational Excellence ◽  
Excellence In Teaching

scholarly journals Competency assessment of the medical interns and nurses and prevailing practices to provide family planning services in teaching hospitals in three states of India

2019 ◽  
Author(s):  
Madhu Gupta ◽  
Madhur Verma ◽  
Kiranjit Kaur ◽  
Kirti Iyengar ◽  
Tarundeep Singh ◽  
...  
Keyword(s):  
Family Planning ◽  
Medical Training ◽  
Universal Access ◽  
Teaching Hospitals ◽  
Competency Assessment ◽  
Contraceptive Device ◽  
Family Planning Services ◽  
Cross Sectional ◽  
Knowledge And Skills ◽  
Medical Interns

AbstractObjectivesThe objectives of the study was to assess the knowledge and skills of medical interns and nurses regarding family planning (FP) services, and document the prevailing FP practices in the teaching hospitals in India.Study DesignA cross-sectional study was conducted in three states (Delhi, Rajasthan, and Maharashtra) of India, among randomly selected 163 participants, including medical interns (n=81) and in-service nurses (n=82), during 2017. Semi-structured, pre-tested interview schedule, was used to assess the knowledge and status of training received; and objective structured clinical examination (OSCE) based checklist was used to assess the skills.ResultsAbout 60% of the interns and 48% of the nurses knew more than five contraceptives that could be offered to the clients. About 22% (11.1% interns and 33.3% nurses) respondents believed that contraceptives should not be given to a married woman coming alone, and 31.9% (17.3% interns and 46.3% nurses) respondents reported that it was illegal to provide contraceptives to unmarried people. Nearly 43.3% interns and 69.5% nurses refused to demonstrate intrauterine contraceptive device (IUCD) insertion in the dummy uterus as per OSCE, and among those who did, 12.3% interns and 18.3% nurses had failed. About 63% interns and 63.4% of nurses had observed IUCD insertion, and 12.3% interns and 17.1% had performed IUCD insertion, during their training.ConclusionsKnowledge and skills of interns and nurses regarding FP services were only partial. The medical training during graduation or internship, and during the job, was found to be inadequate to provide quality FP services.ImplicationsThe partial knowledge and skills of medical interns and nurses regarding family planning services indicated inadequate training received, and substandard quality of services rendered by them, which may put the universal access to sexual and reproductive health care services and rights in the developing countries at risk.

scholarly journals Who owns responsibility? An administrator’s take on implementing time-variable medical training in teaching hospitals

2019 ◽  
Vol 41 (8) ◽  
pp. 905-911
Author(s):  
Tiuri R. van Rossum ◽  
Fedde Scheele ◽  
Lindsay Bank ◽  
Henk E. Sluiter ◽  
Ide C. Heyligers
Keyword(s):  
Medical Training ◽  
Time Variable ◽  
Teaching Hospitals

scholarly journals Exploring How Evidence is Used in Care Through an Organizational Ethnography of Two Teaching Hospitals (Preprint)

2018 ◽  
Author(s):  
Bryn Lander ◽  
Ellen Balka
Keyword(s):  
Clinical Practice ◽  
Evidence Based Medicine ◽  
New Technologies ◽  
Medical Training ◽  
Advisory Council ◽  
Teaching Hospitals ◽  
Evidence Based ◽  
Sources Of Information ◽  
Web Based ◽  
Based Medicine

BACKGROUND Numerous published articles show that clinicians do not follow clinical practice guidelines (CPGs). However, a few studies explore what clinicians consider evidence and how they use different forms of evidence in their care decisions. Many of these existing studies occurred before the advent of smartphones and advanced Web-based information retrieval technologies. It is important to understand how these new technologies influence the ways clinicians use evidence in their clinical practice. Mindlines are a concept that explores how clinicians draw on different sources of information (including context, experience, medical training, and evidence) to develop collectively reinforced, internalized tacit guidelines. OBJECTIVE The aim of this paper was to explore how evidence is integrated into mindline development and the everyday use of mindlines and evidence in care. METHODS We draw on ethnographic data collected by shadowing internal medicine teams at 2 teaching hospitals. Fieldnotes were tagged by evidence category, teaching and care, and role of the person referencing evidence. Counts of these tags were integrated with fieldnote vignettes and memos. The findings were verified with an advisory council and through member checks. RESULTS CPGs represent just one of several sources of evidence used when making care decisions. Some forms of evidence were predominately invoked from mindlines, whereas other forms were read to supplement mindlines. The majority of scientific evidence was accessed on the Web, often through smartphones. How evidence was used varied by role. As team members gained experience, they increasingly incorporated evidence into their mindlines. Evidence was often blended together to arrive at shared understandings and approaches to patient care that included ways to filter evidence. CONCLUSIONS This paper outlines one way through which the ethos of evidence-based medicine has been incorporated into the daily work of care. Here, multiple Web-based forms of evidence were mixed with other information. This is different from the way that is often articulated by health administrators and policy makers whereby clinical practice guideline adherence is equated with practicing evidence-based medicine.

scholarly journals LO37: Barriers and enablers to direct observation of clinical performance a qualitative study using the theoretical domains framework

CJEM ◽  
2018 ◽  
Vol 20 (S1) ◽  
pp. S19-S20
Author(s):  
W. J. Cheung ◽  
A. M. Patey ◽  
J. R. Frank ◽  
M. Mackay ◽  
S. Boet
Keyword(s):  
Residency Training ◽  
Direct Observation ◽  
Medical Training ◽  
Tertiary Care ◽  
Theoretical Domains Framework ◽  
Teaching Hospitals ◽  
Pedagogical Practice ◽  
Structured Interviews ◽  
Barriers And Enablers ◽  
Social Expectation

Introduction: Direct observation is essential to assess medical trainees and provide them with feedback to support their progression from novice to competent physicians. However, learners consistently report infrequent observations, and calls to increase direct observation in medical training abound. In this study, a theory-driven approach using the Theoretical Domains Framework (TDF) was applied to systematically investigate factors that serve as barriers and enablers to direct observation in residency training. Methods: Semi-structured interviews of faculty and residents from various specialties at two large tertiary-care teaching hospitals were conducted. An interview guide based on the TDF was used to capture 14 theoretical domains that may influence direct observation. Interview transcripts were independently coded using direct content analysis by two researchers, and specific beliefs were generated by grouping similar responses. Relevant domains were identified based on the frequencies of beliefs reported, presence of conflicting beliefs, and perceived influence on direct observation practices. Results: Data saturation was achieved after 12 resident and 13 faculty interviews, with a total of 10 different specialties represented. Median postgraduate year among residents was 4 (range 1-6), and mean years of independent practice among faculty was 10.3 (SD=8.6). Ten TDF domains were identified as influencing direct observation: knowledge, skills, beliefs about consequences, social professional role and identity, intention, goals, memory/attention/decision-making, environmental context and resources, social influences, and behavioural regulation. Discord between faculty and resident intentions to engage in direct observation, coupled with the social expectation that residents should be responsible for ensuring observations occur, was identified as a key barrier. Additionally, competing demands identified across multiple TDF domains emerged as an important and pervasive theme. Conclusion: This study identified key barriers and enablers to direct observation. The influencing factors identified in this study provide a basis for the development of potential strategies aimed at embedding direct observation as a routine pedagogical practice in residency training.

scholarly journals Dialectics of a medical provision policy in priority areas in Brazil

2017 ◽  
Vol 63 (3) ◽  
pp. 268-277
Author(s):  
César Augusto Trinta Weber
Keyword(s):  
Medical Training ◽  
Treatment Plan ◽  
Quality Education ◽  
Teaching Hospitals ◽  
Quality Of Services ◽  
Technical Quality ◽  
The People ◽  
Network Maintenance ◽  
The Government

Summary Introduction: The people living in vulnerable areas that are difficult to access in Brazil represent a portion of the population that has proven very sensitive to lack of medical and health services. The government, seeking to solve the situation urgently, implemented the More Doctors Program [Programa Mais Médicos, in the Portuguese original] in 2013. Objective: To discuss the More Doctors Program, with the purpose of contributing to the debate on the provision of medical policies in Brazil. Method: Study based on the review of official documents: Programa Mais Médicos - dois anos: mais saúde para os brasileiros, 2015 [More Doctors Program - two years: more health for Brazilians, 2015]; Operational Audit Report, TC Nº 005391/2014-8, the Court of Auditors of Brazil; and Medical Demography in Brazil 2015. Results: The import of exchange physicians without diploma revalidation has cast a shadow on the technical quality of services offered to the population. In terms of infrastructure, the reduction of resources paralyzed works and made the care network maintenance projects impossible. The creation of new medical schools has created uncertainty about the possibility of quality education being offered, with minimum and sufficient structure including laboratories, clinics and teaching hospitals indispensable to medical training. Conclusion: The regional inequalities of concentration and dispersion of physicians, showed by studies on medical demography in Brazil, stem from several factors, including the lack of a career path and working conditions. There is no point in having physicians if they do not have safe and ethical conditions to establish the diagnosis and a treatment plan, as well as to monitor the rehabilitation of the patient.

The Royal Medico-Psychological Association's Second Memorandum on the Report of the Royal Commission on Medical Education

1969 ◽  
Vol 115 (521) ◽  
pp. 483-485
Keyword(s):  
Medical Education ◽  
Professional Training ◽  
Medical Training ◽  
Postgraduate Education ◽  
Teaching Hospitals ◽  
Royal Commission ◽  
Clinical Teachers ◽  
University Departments ◽  
Postgraduate Medical Training ◽  
The University

It is appreciated that the National Health Service already makes substantial contributions towards the training of doctors. Nevertheless, the view expressed in the Royal Commission Report (paragraph 195) that the N.H.S. should accept a broad responsibility for the cost of postgraduate medical training is endorsed. Moreover, a distinction between ‘academic’ and ‘vocational’ training is somewhat artificial as far as medical education is concerned: both are important, and it seems inevitable that much of the postgraduate training as psychiatrists will fall upon the universities, whose staff, on the whole, are more experienced in teaching. More teachers will be needed to implement the proposals of the Royal Commission, and their training will be largely the responsibility of the universities. At present, very few of the university departments of psychiatry are equipped for the increasing demands made for postgraduate education, nor do they receive any grant for this purpose. The future training of psychiatrists must be more intensive and better organized. While it is agreed that much of this training will be provided by the ‘non-teaching’ hospitals and by tutors at the periphery, the university departments will need to be actively involved in these teaching programmes. Moreover, there will have to be an increase in the courses organized by university departments for general practitioners, medical officers of health, school medical officers, etc. Such an expansion of university departments does not run counter to the principle of the N.H.S. financing the professional training of doctors. Finally, consideration should be given to establishing parity in the salaries of university clinical teachers and N.H.S. consultants, whose responsibilities are usually very similar.

Perceptions of intellectual capital held by the supervisors of nursing divisions in hospitals in Taiwan

2014 ◽  
Vol 52 (6) ◽  
pp. 1101-1115 ◽  
Author(s):  
Hsin-Yuan Chang ◽  
Ming-Yu Wu ◽  
Dwan-Fang Sheu
Keyword(s):  
Intellectual Capital ◽  
Delphi Method ◽  
Design Methodology ◽  
Large Scale ◽  
Teaching Hospitals ◽  
Content Type ◽  
Hospital Nursing ◽  
Structural Capital ◽  
Fuzzy Delphi ◽  
Medical Institutions

Purpose – The purpose of this paper is to explore how the nursing division supervisors at hospitals perceive intellectual capital (IC) and identify the relative importance of IC factors. Design/methodology/approach – Using literature review combined with experts’ viewpoints, IC is divided into four main structures and adopted them as the measurement criteria. A set of criteria that measure the hospital nursing division's IC was established using the Fuzzy Delphi Method, by the expert questionnaire given out to nursing division supervisors at large-scale teaching hospitals. Findings – The research results will hopefully help the management of medical institutions make decisions and input more resources in the “structural capital” perspective of their respective nursing divisions. Originality/value – Hospitals in Taiwan may improve in performance and medical services quality.

Status of Behavioral Medicine in American and Canadian Medical Training

1988 ◽  
Vol 17 (3) ◽  
pp. 249-260 ◽  
Author(s):  
Ronald B. Margolis ◽  
Paul N. Duckro ◽  
Lindbergh S. Sata ◽  
William T. Merkel
Keyword(s):  
Behavioral Medicine ◽  
Medical Training ◽  
Training Programs ◽  
Teaching Hospitals ◽  
Liaison Psychiatry ◽  
Clinical Specialty ◽  
Specialty Area ◽  
Canadian Medical School ◽  
Training And Research ◽  
Consultation Liaison Psychiatry

This article reports a survey of attitudes and current practices regarding behavioral medicine in American and Canadian medical school departments of psychiatry. Participants were eighty-two chairpersons of departments of psychiatry. Five major areas were addressed concerning the existence, location, and composition of behavioral medicine faculty and their contribution to training and research programs. Results indicate that behavioral medicine is represented in the majority of medical schools and teaching hospitals. Faculty tended to be located in psychiatry. A majority of the respondents did not think that behavioral medicine should be considered a separate clinical specialty area, but in actual practice behavioral medicine was distinct from consultation/liaison psychiatry as often as integrated with it. The analysis of subjects and methods taught in residency training programs suggested a meaningful trend in the data. The implications of these results for models underpinning traditional medical education and psychosomatic medicine are discussed.

Sign in / Sign up

Export Citation Format

Share Document