Monday, December 13, 2010

Appalling medical school teaching

Even something as basic as anatomy stumps medical students -- but you can be sure that they are well up on "cultural sensitivity" and the like

Anatomy teaching has been cut back so much that medical students have been unable to identify important body parts. In some cases, students who volunteered for a catch-up crash course in anatomy could not answer when asked to identify specific anatomical structures, such as major blood vessels, in partially dissected human specimens. In a few cases, students responded with fictitious names of body parts that did not exist.

The seven-week course in full-body dissection, run earlier this year at the University of Sydney, proved wildly popular with the students who completed it -- and had a dramatic effect on their anatomical knowledge. The students were tested again halfway through and at the conclusion of the course, and both times the 29 students achieved almost perfect scores.

The findings, by a team led by George Ramsey-Stewart, professor of surgical anatomy at the University of Sydney, promise to rekindle controversy over the scaling back of anatomy tuition nationwide.

Detailing the results in today's edition of the Medical Journal of Australia, Professor Ramsey-Stewart called for a standard national curriculum for anatomy -- something resisted by most medical school deans -- that included dissection. He also called for "barrier" assessments, requiring students to gain a pass mark before being able to progress in their degree course.

Structures some students failed to identify correctly included the abdominal aorta -- the biggest artery in the abdomen -- and the sciatic nerve, the longest and widest nerve in humans that runs from the lower back into the leg.

Professor Ramsey-Stewart said while it would be wrong to make too much of the students' poor results in the first tests, it was nevertheless "of concern" that one-quarter of all the answers given by the students betrayed worrying gaps in their knowledge. "It's a problem for most universities . . . I hear from my anatomical and surgical colleagues that it's across the board," he said.

However, he said the students involved were too advanced in their course to have benefited from curriculum changes introduced by the University of Sydney in 2007, when anatomy teaching hours were trebled.

Doctor and researcher Steven Craig, who in March published a study that found teaching hours for anatomy varied from as few as 56 hours in one medical school to 560 hours -- said improvements in anatomy teaching to date were mostly "a patch-up job". "These sorts of (voluntary dissection) courses are fantastic -- for the students who get to do them," Dr Craig said. "But if they can only accept 30 of the 250 students (it needs expanding)."

Australian Medical Students Association president Robert Marshall rejected the call for a national curriculum, and said such studies ignored the fact that much anatomy tuition was incorporated into other activities.


Bank changes pointless and possibly harmful

WAYNE Swan has produced a "McBank Package" - seemingly tasty but with all the nutritional value of cardboard. He has managed a rare double: a package that is both pointless and potentially damaging and harmful.

It is also a formal statement that this Government has embarked on populist feel-good measures that will unwind the tough Hawke-Keating Labor government reforms that delivered 20 years of growth and prosperity.

This is captured in the package's signature so-called reform: the abolition of exit fees. It's pointless, because the big banks were already abolishing them. The two Melbourne banks, the ANZ and NAB, have abolished them. Westpac and CBA haven't yet, but almost certainly would have followed.

In any event they aren't that large - $500-$700. That's so far as the big banks are concerned. It's the small banks and building societies that charge up to $7000.

They do so, because they have to, in order to compete with the big banks. So the number one thing that Swan and wannabe-PM Bill Shorten do, is directly and seriously attack the very institutions that they purportedly want to compete against the big banks! Pointless and harmful.

Their major complaint is that there's not enough competition. So what do they do? Seek to force all financial institutions, big banks and the rest to offer exactly the same sort of home loans, with inevitably exactly the same interest rate, charges and terms.

The reason we had exit fees was to deliver lower charges to the vast majority of borrowers who didn't seek to get out of their home loans in the first few years. Now those benefits vanish, courtesy of Swan and Shorten.

Sure, there are some good things in the package. The "lettuce" so to speak. Correction, one: the simplified, understandable facts sheet.

The rest are deceptive, dangerous and plain silly. The competition czar is going to be given the power to stamp down on "price-signalling". Oh yeah? So is the ACCC going to ban the most blatant price-signalling of all banks publishing what rates they charge and what rates they pay on deposits?

Like when the CBA announced immediately on Cup Day it would raise its home loan rate by 40 points. That was certainly a very big "signal", which all the other banks followed to varying degrees.

Oh dear, we have a Treasurer who's made a complete goose of himself.


Another government computer bungle

Queensland's OneSchool program hits a snag. When will they learn to buy "off the shelf"?

THE launch of a new $100 million software program for Queensland schools has suffered a major delay over concerns staff don't know how to operate it.

In the latest information technology bungle to hit the Bligh Government, The Sunday Mail can reveal the third and final phase of the controversial OneSchool program has been delayed for up to 12 months or more.

The rollout of the third phase, which has already cost $30.1 million, involves financial account keeping of receipts and invoices for hundreds of primary and high schools. However, Education Queensland has aborted the January 4 launch date because staff are complaining they don't know how to use the system.

The revelations come as the Government is still scrambling to fix the Queensland Health payroll debacle that has cost hundreds of millions of dollars and exposed major problems with the state's IT service delivery.

The OneSchool program, created by Education Queensland, first struck controversy when the initial phase, involving published student profiles to 1.5 million users, came under fire over concerns for children's privacy. The Auditor-General criticised the program last year because it was estimated to cost $45 million but had already cost $97 million.

Education Minister Geoff Wilson failed to answer questions directed to his office. But in a written statement, Education Queensland deputy director-general of corporate services Richard Eden said the software was ready to launch but staff required more training to use it.

"After feedback from school administration staff, who will be the ones using the program to run school accounts, the rollout will now happen progressively throughout 2011 instead of from 4 January," he said. "It's acknowledged that the start of the school year is a very busy time and it is more suitable to do a progressive rollout throughout next year as schools are ready for the transition."

But Opposition IT spokesman Scott Emerson said he had been told the department was concerned about going live after the embarrassment of the health payroll bungle. "Clearly this is another botched project by the long-term Labor Government," Mr Emerson said. "What we have here is the warning signs of another health payroll."


$20 million compensation payments for birth bungles in Victorian public hospitals

SECRET payouts totalling almost $20 million have been made to families whose babies suffered bungled births in Victoria's public hospitals. Hospitals were forced to pay compensation in 25 botched obstetric and newborn cases in just one year - totalling half of all medical payouts in the past 12 months - but authorities will not reveal details of what went wrong.

Victorian Health Minister David Davis and Health Services Commissioner Beth Wilson have called for a culture of greater transparency.

And the Herald Sun can reveal further lawsuits over allegations of bungled births have been launched, including a Melbourne mum who says mistakes by the Monash Medical Centre left her baby severely brain-damaged. Janelle Smythe says she was sent home believing she had a healthy baby. It was only months later that she discovered her baby, Maddison, was profoundly disabled. Maddison is now aged three but still cannot laugh, talk, eat or sit after suffering brain damage when she was starved of oxygen at birth.

Ms Smythe claims doctors "stuffed around" for hours instead of delivering Maddison by emergency caesarean.

Figures obtained under the Freedom of Information Act reveal more than $41.7 million was paid secretly to 128 Victorians by public hospitals for medical botch-ups in 2009.

The highest payout by the Victorian Managed Insurance Authority - the insurer for state government departments - was $5 million awarded to a newborn or child last year, while the second and third-highest sums, of $4.5 million and $3 million, went to obstetrics cases.

Other high-claim categories were emergency medicine, where 23 patients were awarded more than $4 million, 15 general surgery patients got $2.5 million and 11 anaesthetics patients shared $2 million. Two GP patients received more than $2 million, as did three radiology and three paramedical patients.

More than $372 million has been paid in compensation to patients in the past decade.

Leading medical negligence lawyer Paula Shelton, of Slater & Gordon, said: "As a human being it really frustrates me to see the same things happening over and over again, when these injuries are avoidable."

Obstetrics and newborn cases attracted high payouts if they were very badly disabled and needed care for life.

Mr Davis said: "Data identifying individual patients would be quite inappropriate, but more data and information on quality and safety is important in the long term."

Health Services Commissioner Beth Wilson said hospitals were more open about mistakes than they used to be, but still had some way to go. "Hospitals deal with risky cases. Any misadventure is one too many and, of course, we'd like to see none at all. However, I think that's probably an unrealistic expectation," Ms Wilson said. "It's extremely important we learn from those mistakes so they are not repeated."


1 comment:

Paul said...

Trust me, they aren't up with any cultural sensitivity, in fact the privilidged little swots coming through these days, not to mention the third worlders who are only there to make their parents proud and tell white people what to do, are not up with any sensitivity at all.