Evaluating curriculum changes in undergraduate cancer education

Background. Previous studies have indicated that Australian medical schools have not adequately prepared our graduating doctors to care for patients with cancer. The University of Western Australia (UWA) introduced a two-week clinical attachment in cancer medicine for fifth-year students in 2000 and a four-day clinical attachment in palliative care for sixth-year students in 2001. This article evaluates the introduction of these dedicated clinical attachments in cancer and palliative care. Method. The Australian Cancer Society's Cancer Education Survey was administered to the UWA graduates starting their intern year in teaching hospitals in Perth, Western Australia, in 2002. Their responses were compared with data collected in a similar national survey of Australian and New Zealand interns in 2001. Results. The response rate was 56% (n = 70). When compared with the national data for 2001, more UWA interns (2002) would refer a newly diagnosed breast cancer patient to a multidisciplinary breast clinic (97% vs. 74%, P<.001). Fewer UWA 2002 interns rated their training as poor or very poor in the management of patients with incurable cancer (19% vs. 35%, P=.008) and the management of symptoms in patients dying from cancer (10% vs. 37%, P<.001), but they were more likely to rate their training in assisting a patient to stop smoking as poor or very poor (54% vs. 21%, P<.001). Only a quarter of the UWA 2002 interns had examined a patient with a cancer of the mouth or tongue (25% vs. 49%, P<.001), and only two thirds had examined a patient with lymphoma (64% vs. 83%, P<.001). Conclusions. Our data reflect changes in the final two years of the medical course at UWA and suggest that the introduction of dedicated attachments in cancer and palliative care has better prepared graduating doctors to care for patients with cancer.

The Australian Universities Teaching Committee project in 'Learning Outcomes and Curriculum Development in Psychology'

The Australian Universities Teaching Committee (AUTC) funds projects intended to improve the quality of teaching and learning in specific disciplinary areas. The project brief for 'Learning Outcomes and Curriculum Development in Psychology' for 2004/2005 was to 'produce an evaluative overview of courses ... with a focus on the specification and assessment of learning outcomes and ... identify strategic directions for universities to enhance teaching and learning'. This project was awarded to a consortium from The University of Queensland, University of Tasmania, and Southern Cross University. The starting point for this project is an analysis of the scientist-practitioner model and its role in curriculum design, a review of current challenges at a conceptual level, and consideration of the implications of recent changes to universities relating to such things as intemationalisation of programs and technological advances. The project will seek to bring together stakeholders from around the country in order to survey the widest possible range of perspectives on the project brief requirements. It is hoped also to establish mechanisms for fiiture scholarly discussion of these issues, including the establishment of an Australian Society for the Teaching of Psychology and an annual conference.

The neurosurgical training curriculum in Australia and New Zealand is changing. Why?

The Neurosurgical Advanced Training curriculum of the Royal Australasian College of Surgeons (RACS) is currently undergoing change. Given the high standard of neurosurgery in Australia and New Zealand, it may be questioned why such change is necessary. However, the curriculum has not kept pace with developments in professional practice, educational practice or educational theory, particularly in the assessment of medical competence and performance. The curriculum must also adapt to the changing training environment, particularly the effects of reduced working hours, reducing caseloads due to shorter inpatient hospital stays and restricted access to public hospital beds and operating theatres, and the effects of subspecialisation. A formal review of the curriculum is timely. (c) 2004 Elsevier Ltd. All rights reserved.

Taxonomic revision of Gripopteryx (Pictet, 1841) (Plecoptera: Gripopterygidae)

The genus Gripopteryx is revised and two new species are described, G. japi n. sp. from southeastern Brazil, and G. clemira n. sp. from northeastern Brazil. The male of G. brasiliensis Samal, 1921 and the female of G. flinti Froehlich, 1993 are described. New figures for G. maculosa Jewett, 1960, for the male of G. reticulata Brauer, 1866, and for the female of G. brasiliensis are provided. Keys to adult males and to nymphs are provided.

A revision of Gasteruption Latreille (Hymenoptera: Gasteruptiidae) in the Neotropical Region

The Neotropical species of Gasteruption Latreille are revised, described, diagnosed, and illustrated; a key for females is provided. Twenty six valid species are recognized, thirteen of which are described as new: G. amputatum Townes, G. barnstoni (Westwood), G. bertae n. sp., G. bispinosum Kieffer, G. brachychaetum Schrottky, G. brandaoi n. sp., G. brasiliense (Blanchard), G. floridanum (Bradley), G. glauciae n. sp., G. guildingi (Westwood), G. hansoni n. sp., G. helenae n. sp., G. huberi n. sp., G. kaweahense (Bradley), G. lianae n. sp., G. loiaconoae n. sp., G. masneri n. sp., G. oliveirai n. sp., G. parvum Schrottky, G. rafaeli n. sp., G. sartor Schletterer, G. smithi n. sp., G. tenue Kieffer, G. townesi (Alayo), G. visaliae (Bradley), and G. wahli n. sp. The following new synonymies are proposed: G. maculicorne Cameron, G. macroderum Schletterer, and G. zapotecum Schletterer with G. barnstoni; G. bihamatum Kieffer, G. fallens Kieffer, G. fiebrigi Schrottky, G. leptodomum Kieffer, G. montivagum Kieffer, and G. strandi Kieffer with G. bispinosum; G. annulitarse Schrottky, G. brasiliae Kieffer, G. gracillimum (Schletterer), G. longicauda Kieffer, G. petroselini Schrottky, G. subtropicale Schrottky and G. torridum (Bradley) with G. brasiliense; G. rufipectus (Westwood) with G. guildingi; G. angustatum (Kieffer) with G. kaweahense; G. horni Brethes with G. parvum. The following taxa are considered as species inquirendae: G. albitarse Schletterer, G. austini Jennings and Smith, G. subcoriaceum Kieffer n. stat., and G. tenuicolle Schletterer. As well, G rubrum Taschenberg is synonymized with Pseudofoenus infumatus (Schletterer). In addition, G. tenue Pasteels, 1957a from Australia is a junior homonym of G. tenue Kieffer, 1922 and is renamed G. pasteelsi n. name.

Revision of the South American species of Hagenulopsis Ulmer and Askola Peters (Ephemeroptera: Leptophlebiidae) with description of six new species

The South American species of the genera Askola and Hagenulopsis are revised. Three new species of Askola from Brazil are described based on male imagos. Askola emmerichi sp. nov. and A. paprockii sp. nov. present spotted wings, but differ in general coloration and details of genitalia; Askola cipoensis sp. nov. is easily distinguished because the male eyes being widely separated on meson of head. Three new species of Hagenulopsis are also described: H. lipeo (from Argentina and Bolivia) and H. zunigae (from Colombia), both described from imagos and nymphs, can be recognized by details of coloration and male genitalia. H. esmeralda sp. nov. from Ecuador, described from imagos, shows a distinct male genitalia and translucent male abdomen. A key to species for the the male and female imagos of Askola and Hagenulopsis species is provided.

A revision of the genus Lycomorphon (Coleoptera: Lycidae)

The Neotropical genus Lycomorphon Pic, 1922 is revised. Eleven species are classified in the genus, six of them are redescribed, five species (Lycomorphon brasiliense sp. n., L. amazonicum sp. n., L. bimaculatum sp. n. L. bolivianum sp. n., L. fulvohumeralis sp. n.) are proposed as new to science. Lycomorphon elongaticolle v. diversicolle Pic, 1926 is raised to species status, and Idiopteron irregularis is transferred to the genus Lycomorphon. The new subgenus Spinolycus sg. n. is proposed within Lycomorphon.

Teaching of medical ethics: Implications for an integrated curriculum

This paper reports on an investigation into the teaching of medical ethics and related areas in the medical undergraduate course at the University of Queensland. The project was designed in the context of a major curriculum change to replace the current 6 year course by an integrated, problem-based, 4 year graduate medical course, which began in 1997. A survey of clinical students, observations of clinical teaching sessions, and interviews with clinical teachers were conducted. Data obtained have contributed to curriculum development and will provide a baseline for comparison and evaluation of the graduate course in this field. A view of integrated ethics teaching is advanced in the light of the data obtained.

Post-craniotomy headache: A proposed revision of IHS diagnostic criteria

Seventy-nine patients with intracranial aneurysms were evaluated in the presurgical period, and followed up to 6 months after surgery. We compare patients who fulfilled with those that did not post-craniotomy headache (PCH) diagnostic criteria, according to the International Classification of Headache Disorders. Semistructured interviews, headache diaries, Short Form-36 and McGill Pain Questionnaire were used. Seventy-two patients (91%) had headaches during the follow-up period. The incidence of PCH according to the International Headache Society diagnostic criteria was 40%. Age, sex, type of surgery, temporomandibular disorder, vasospasm, presence and type of previous headaches, and subarachnoid haemorrhage were not related to headache classification. There were no differences in the quality of life, headache frequency and characteristics or pain intensity between patients with headache that fulfilled or not PCH criteria. We proposed a revision of the diagnostic criteria for PCH, extending the headache outset after surgery from 7 to 30 days, and including the presence of headaches after surgery in patients with no past history of headaches, or an increase in headache frequency during the first 30 days of the postsurgical period followed by a decrease over time. Using these criteria we would classify 65% of our patients as having PCH.

One-Stage Revision of Infected Total Hip Arthroplasty with Bone Graft

There are many different opinions in the literature regarding the best procedure for revision of infected hip arthroplasty and hence in achieving long-term stabilization of a new implant. Thirty-two patients with 32 loose and infected total hip arthroplasties underwent revision with a bone graft in a 1-stage procedure. The bone graft was used in the acetabulum and femure in 25 patients, in the acetabulum alone in 4 patients and in the femur alone in 3 patients. A metal mesh was necessary in 15 patients to contain the morselized bone graft. At the time of surgical revision, 9 patients had a draining sinus, 6 had a closed sinus, and 17 had never had sinuses in the surgical wound. Antibiotic therapy was administered intravenously and orally for 6 months. Mean follow-up was 103 months (range, 63-183 months), and infection recurred in 2 (6.2%) cases. Further studies are necessary, and continuation of this method is justified.