Friday, October 15, 1976
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University Daily Kansan
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Med Center furthers elimination of classroom, clinical difficulties
Midwives and doctors driving horse-drawn buggies have almost been laid to rest with the advent of hospitals' ultra-modern ambulance and helicopter ambulse service.
That evolution occurs daily at the KU Medical Center.
Changes are obvious when they occur over long spans of time, but there are also more subtle changes in the evolution of medicine and its application.
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Alan Thompson, Med Center physiologist, said instructors try to predict where the practice of medicine is going and don't just teach students for today.
"FOR EXAMPLE," he said, "it's very obvious that we're heading in the direction of more use of instrumentation to diagnose, and so we think it's important for medical students to understand some of the instrumentation.
"We have to try to teach them stuff they stuff
be handling in 15 or 20 years instead of only
the first."
Besides adjusting the training to fit the future, training is also updated when it's shown to be behind the times. Complaints and suggestions of the students in the health care programs are a big part of the impetus to change.
"There were some kids in my class that had never seen a patient while training." Cheryl Raupp Smith, a 1972 physical therapy graduate, said.
The students' first contacts with patients was during their semester of affiliation with a hospital, she said. The physical therapy department at that time required one semester of training at the Med center and one semester at an affiliated hospital.
NOW, SHE SAID, the requirement has been expanded to two years at the Med Center.
Changes in physical therapy training also extend beyond the educational realm.
"As a student, you couldn't measure me as rebellious," Smith said, "but there was one person who didn't."
She said there were very strict clothing regulations which required girls in physical therapy to wear white cotton uniforms and other protective clothing at a time when the mini-skirt was in style.
"If you could get away with it at mid-knee, knew you were lucky," she said. Clothing regulations have been relaxed since then.
Stephen Roth, the only male nursing student in the December 1973 graduating class, said he had seen a lot of room for his students and that nurses in nursing training at the Med Center.
In his clinical training, a nursing student would have only one or two patients to look after and would be heavily supervised by an instructor, he said.
"AT THAT TIME the nursing program was dwellingly heavy on theoretical aspects and kind of soft-pedaling clinical aspects, such as floor experience." he said.
"That's not very realistic."
The experience that he received outside of school training—working as a nursing assistant at the Med Center—made him competent as a registered nurse, he said.
A blend of theory and more real-life experience, he said, would be the best precept.
Besides criticizing a lack of realistic patient care experience, Roth also said he had been disappointed in classroom instruction.
"THE TEACHING was horrible," he said.
Instructors weren't the only problem, he said. Conditions such as little desks and cramped lecture halls weren't conducive to learning.
Beth said he probably hadn't been optimistic about the program because he'd had a chip on his shoulder during his training. As the only male in his class, he said, he had felt some pressure because of personal conflicts.
He started work at Trinity Lutheran Hospital after graduation and was in the
By Barbara Rosewicz
Staff Writer
graduate nursing program at the Med Center for two months before dropping out.
"I SAID TO myself, 'I'm not going to do this all over again.' It was the same atmosphere I'd been in for two years—the people teaching me the real razzmatzz.
Similar charges by students have caused a change in the nursing curriculum, Jean Watson, new director of the Undergraduate School of Nursing, said.
Roth is now in his second year of a graduate program in public administration.
Clinical contact work has been increased by 38 per cent over the former curriculum, she said. The first products of the new training will graduate in May. Therefore, no evaluation results of the new program have been collected yet, she said.
WATSON, WHO came to the Med Center this year, said she hadn't seen a faculty work together so well and so productively in a long time.
The problem of cramped, improvised classrooms has been eased for all students this fall by added classroom space in the new Orn-Major building on the Med Center campus, Mary Ann Kasper, a maternal health nursing instructor, said.
Recognizing both the advantages and limitations of programs aids the evolution process and puts KU's program in per- sonance with health education in other schools.
Robert Parker, a Leavenworth general practitioner who graduated from KU in 1971, said he thought KU was one of the best medical schools in his country. KU is ranked among the top academic aspects compared to graduates from other medical schools, he said.
FOR EXAMPLE, schools on the East Coast emphasize academics and don't emphasize the practical experience he thinks is valuable, he said.
He would like to see more attention given to individual students through smaller lecture classes and better faculty-student relationships, he said.
However, Parker said, he saw limitations and room for improvement at the Med.
Also, the family practices need to be emphasized so that doctors will be better prepared to handle the common cases, he said. Because the Med Center handles more of the exceptional cases, he said, it is kind of an artificial environment.
THE NEED FOR more experience in dealing with common problems was also recognized by Doma Vaughan, a Newton doctor and 1871 KU graduate.
It's important to teach students about the rare diseases, she said, and the emphasis
Private practice is different from work with hospital patients at the Med Center, she said. For example, she said, Med Center students order all types of tests for a patient and never think of the test's expense because they never see the bill.
should be shifted to the more common problems that doctors face in private
AFTER SHE started her practice, she had to be more aware of the test's expense and tell the patient in advance, Vaughan told me. The patient was unexpected $10 bill for tests, she said.
Vaughan said KU had a stronger clinical orientation than many other medical
Timothy Burch, a 1972 graduate in residence at St. Luke's Hospital in Kansas City, Mo., said he had worked with some of the students in the faculty of Missouri at Kansas City (UMKC).
He wasn't too impressed with UMKC's system, he said, because it involves very little basic science background, compared to the work in the sciences during the first half of the training.
"Oddly enough, I don't wish I'd gone to a different school," he said. "I feel most of my competence in nursing came in working at the Med Center. That was very valuable. I'm still enthusiastic when I remember my work experience."
Marie Homberger, a 1974 nursing graduate who now works on the Med Center's surgical floor, also said her working experience has made the most valuable practical preparation.
DESPITE CRITICISMS of the KU nursing department, Roth said he had some doubts about her.
"For my particular area of interest, the preparation was adequate," she said, "but I felt that I needed more preparation so I got more."
HOMBERGER SAID she took a six week cardio-coronary class on the Med Center before she started her job on the surgery floor.
Lynn Jeffries, an August 1976 nursing graduate who works in the Med Center's neo-natal care unit, said the Med Center could prepare a nurse as well as any other
"It depends on what you want to put into it," she said.
A BACHELOR'S degree and four years of medical school prepare a doctor for at least three more years of training in a residency before he privately practices medicine.
Med Center training has the ultimate objective of preparing students to step into leadership roles.
KU's nursing program involves students' last two years of undergraduate study and prepares them to step immediately into a job as registered nurses.
There are also 15 fields of allied health care training offered at the Med Center. These programs for ferr students degrees or certificates in such areas of study as medicine, emergency medical technology, and emergency medical intensive care technology.
"We give them the science background they need before they learn medicine and surgery. We try to give them as broad and thorough of a background as possible." he
Lawrence Sullivan, a physiology professor, said medical students study the basic sciences for 18 months and then do clinical training for 18 months.
NURSING TRAINING is two-fold,
Watson said. Nurses are trained to be practitioners and are also qualified for leadership positions after some practical work experience.
An emergency medical intensive care program, an example of one of the allied health sciences, prepares individuals to give advanced life support therapy to patients before they reach the hospital. Mary Beth Skelton, associate director for emergency mobile intensive care training, said.
Students who complete the 12-month program and obtain the program's certificate can work as paramedics, like in the KARE emergency units, she said.
Placement of health care professionals isn't as difficult as placing graduates of many other schools. The great demand for doctors, nurses and allied health workers has resulted in communities searching out professionals when they graduate.
DAVID WAXMAN, vice chancellor for student affairs, said medical school graduates are matched with hospitals offering residency programs.
Nursing students find jobs through advertisements in nursing journals, lists that are posted outside the nursing office or on a bulletin board at agency agencies in other cities. Walson said.
Jack Madkoff, a placement officer for the Kansas chapter of the American Physical Therapy Association, said a clearing house program was implemented by employers and physical therapy students.
"they all find jobs," he said. "It's just a matter of finding one they like in a com-
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