The following abstracts have been accepted for presentation at this meeting in Poster format in the category of Instructional Methods.  Those selected for Oral Poster Presentations are so designated in the far right column.
 
 

IM1	PSYCHOCOMMUNITY: AN INTEGRAL MEDICAL EDUCATION PROCESS Jesus Alveano*, Universidad Michoacana de San Nicolas de Hidalgo Morelia, 58000, Michoacan  Mexico Nowadays, medical education in Mexico is confronting difficult times. We have too many students; they could not see enough patients during their training; there are no courses on interviewing techniques. Research is far of the needs of the population; the issues in training sometimes are different than the frequent diseases we see in external consult; there are almost any spaces for reflection on the attitudes to the patients.  Psychocommunity was designed to fight these aspects.  The method of Psychocommunity consists in a) a typical course (six months or annual). b) Series of student’s visits to a community. c) Series of psychotherapy-like group sessions after the visits to the community. In this paper, an evaluation of the model of psychocommunity is showed by a group of first grade medical apprentices who participated in a Medical Psychology course. The integration between teaching, research and services to the community is presented with the reports and the fantasies of the disciples. Also, the psychocommunity process encourages the technical, scientific, human and ethical development of the pupils.
IM2	TRIGGER FILMS (VIDEO-TRIGGERS) FOR TEACHING PATIENT-PHYSICIAN RELATIONSHIP, PROFESSIONALISM, MULTICULTURALISM AND CLINICAL REASONING Rosalie Ber* and Gideon Alroy,  Department of Medical Education, B.Rappaport Faculty of Medicine, Technion – Israel Institute of Technology, Haifa 31096  Israel For the past 22 years we have supplemented the teaching of students in the Introduction to Clinical Medicine  course by small group discussions, triggered by viewing a series of short (3-9 minutes) home-made videos – trigger films (TFs). At this point of their studies the students are in transition between their preclinical and  clinical studies. The TFs, depicting documented physician – patient encounters, are filmed in surroundings familiar to the students,  with our fellow physician colleagues and friends and relatives following our script and “acting” respectively in the physician and patient roles. This non-threatening situation enables the students to feel free to discuss all aspects of the encounter – and us , the tutors, to raise all aspects of the patient-physician encounter: physican-patient communication, medical ethics, professionalism, multiculturalism, pathophysiology, clinical reasoning and diagnostic thinking. Our philosophy has been that there is no cookbook recipe on “how to  become a competent physician”. However, while we espouse the biopsychosocial model and believe that there are norms of professional behavior, we are convinced that medicine should be based on strong basic science foundations, and that these need be integrated within the clinical teaching. Initially, each group of 6-10 students with one tutor (one of us) viewed one TF (or part thereof), following which (generally with no further prompting) a lively discussion ensued. We, as tutors, did our best not to interfere, but at times steered the group and initiated “role-playing”. We also integrated discussion on the pathophysiology of the medical condition depicted in the TFs. During the last few years we have written a hand-book for TF tutors and conducted TF tutor-training workshops, thereby  increasing the pool of TF tutors. We have found that it is of greater interest to both students and tutors (inspite of doubling their teaching hours) to conduct the TF sessions with 2 tutors per group. Although our TFs are in Hebrew, we have made a series of TFs with English subtitles, one of which we hope can be viewed at this  IAMSE 2002 conference.  Reference: R.Ber and G.Alroy. Twenty years experience with Trigger Films as a teaching tool. Acad. Med.. 76: 656 – 658, 2001
IM3	THAT REALLY IS CLINICALLY RELEVANT!!!! GW Brumbaugh, DVM*1, A Rodriguez M, MVZ, MS,2 H Sumano L, MVZ, PhD, MC,2 R Armendariz F, MVZ, MSc,4 ML Hoyos de B, MV,3 M Masri D, MVZ, MS,2 S Salinas N, MVZ, 4 LM Forero R, PhD,3 JL Velázquez R, MVZ, MC2 J Plascencia B, VMZ5    1Texas A&M Univ., College of Veterinary Medicine, College Station, Texas, USA 77843; 2Univ. Nacional Aut?noma de México, Facultad de Medicina Veterinaria, México, DF, México; 3Univ. de Ciencias Aplicadas y Ambientales, Depto. Educaci?n Avanzada e Investigaciones, Santafé de Botogá, DC, Columbia; 4Private Practice, 5Univ. de Guadalajara, Facultad de Medicina Veteriaria, Guadalajara, Jalisco México Why are arterial blood-gas tensions different in animals in México City or in Santafé de Bogotá  than those in Monterrey or Guadalajara?  Can one successfully diagnose or treat an animal if limited resources and their own bodily senses are all that are available?  How can an animal in a mountainous area have a tropical disease?  Why are most textbooks written in English if the language of medicine is Latin-based? Since 1991 the authors (and many others) have cooperated in México and Colombia for advanced training of veterinarians and veterinary students.  The scientific basis for clinical or public activities, appropriate to the individual’s discipline, was the core of that training.  With a strong foundation in biochemistry, physiology, anatomy, pharmacology, toxicology, microbiology, and pathology, and with experience, a veterinarian can provide better clinical care, discern animal and public health.  While teaching at the students’ location, one can observe the resources, requirements, possibilities, limitations and complicating factors that they face, as well as learn of folklore, the socio-economic role of animals, veterinary medicine, public and animal health, agricultural practices, governmental regulations and commerce.  That insight can help one see under the façade, more effectively explain why a scientific foundation is applicable, and help those individuals succeed in their environment.  Lack of high-tech equipment is not always an excuse.  Teaching on- sight can defuse sensations of isolation, can reinforce similarities of the profession or of life and can provide international contacts for future interaction with governmental agencies, educational institutions or industry. While concentrating on “distance learning” and computers we must not forget the recipient of our training – the patient/client.  For some, it is a long distance to the teaching hospital but reinforcement of basic science in that setting is the greatest opportunity to strengthen veterinary medical training.  A computer can neither smell nor palpate; it cannot shake the hand of the grateful client or console the heartbroken.  The computer can be an unequaled tool, but people must enter real information using language that is officially correct and understood.  The student must assume the responsibility of life-long learning, to progress, to become ethical leaders and experts, and to succeed when they encounter new diseases, diagnostic or therapeutic modalities regardless of the technology of communication.
IM4	DEVELOPMENT OF A HYBRID CURRICULUM IN HISTOLOGY COMBINING DISTANCE LEARNING WITH TRADITIONAL DIDACTIC TEACHING H.A. Barcelo, M.D.,E.M. Kremenchutzky, M.D., H. Pezzi, and C.A. Feldstein, M.D.* Instituto Universitario de Ciencias de la Salud (Fundacion HA Barcelo) School of Medicine, Buenos Aires, Argentina Introduction and Objectives:  Histological concepts were previously taught at Instituto Universitario de Ciencias de la Salud School of Medicine delivering structural concepts within a traditional combination of didactic lectures and laboratory exercises. In recent years, traditional laboratory exercises have come under criticism by educators and having little or no direct application to clinical practice. In addition, students have expressed their dislike for such exercises, not only for the aforementioned reason, but also because they consider them to be tedious as compared to computer-based learning. In response to these factors we have introduced a distance learning methodology to help in teaching quality and enhance student performances. The current study was aimed to examine novel methods to produce distance learning in histology, and to determine the relative impact of this technology compared to the traditional one based only on lectures and microscopic specimen study (light, immunofluorescent, and electron microscopic). Methods:  An eight-month follow-up survey was performed in two groups of voluntarily enrolled 100 students. The first group (n=100) used digital pictures provided by CD ROM, with labeled and captioned images, sound and animation and the whole explanation from the faculties. This system includes connection to a web page with related information about the topics of lectures, an e-mail address as the modes of delivery for both discussion and communication between faculty and students and between the students themselves. This group was compared with a control group (n=100) of students that attended the traditional didactic lectures. Both groups attended seminars and laboratory sessions, and solved case-based problems sets. Results:  At the completion of the study, surveys were administered to students and faculties to determine the relative level of satisfaction with these methods of teaching. Furthermore, the student's performance was evaluated on our basic histological exam. Rather than simply ask students questions in a written format we required them to demonstrate their proficiency with specimen examination. The majority of the students indicated the distance histology teaching aided them in their performances. Students that used this technology showed not only better qualitative responses but also higher test scores. Conclusions:  the present study demonstrated the ability to produce a mixing distance teaching with a face-to-face instruction that encourages and help students to enhance their histological skills.
IM5	MEETING AND DISSECTING THE CADAVER:  A PERSONAL AND PROFESSIONAL OPPORTUNITY TO EXPLORE THE KEY PATIENT-CARE ISSUES OF MORTALITY, DYING AND DEATH  T.R. Olson, Ph.D.*, P. Grossman, Ed.D. (Albert Einstein College of Medicine), C.E. Schwartz, M.D. (Montefiore Medical Center), and M.A. Carling, C.S.W. (Bronx Lebanon Hospital Center); Bronx, NY  U.S.A. Meeting the cadaver and starting dissection are transforming experiences for medical students because they evoke intense feelings that have profound professional implications. They evoke awe, anxiety, grief, awareness of one's own mortality, and wonder about the complexities of the body-mind-personality relationship. Starting anatomy, students are positively excited about studying the body’s structure and intensely involved and struggling with potent emotions and thoughts. This moment is a unique opportunity to help students explore their personal reactions and to relate them to the medically relevant issues of dying, death, and the emotional growth of the physician. For the past two years, a one-hour conference was held at the end of week one. Dissecting teams of four to five students met in small-groups facilitated by non-anatomy faculty. Faculty were selected based upon their appreciation of anatomy as a medically relevant learning resource that extends well beyond the naming and identification of the body’s parts. The thirty facilitators were clinical educators practicing primarily in the fields of family medicine, medicine, geriatrics and palliative care. They were instructed to create a non-judgmental environment and to encourage students to express their feelings about meeting the cadaver and starting dissection. An e-mail survey of anatomy course directors in 2000 revealed that similar cadaver conferences were held at only two other medical schools. The primary objectives of the conference are to help students realize and accept that their various reactions to the cadaver and dissection are normal and to begin to acknowledge and process these feelings rather than repress or deny their importance and relevance to their personal and professional development. The secondary objective is to help them appreciate the necessary balance between responding personally to the cadaver’s qualities as the remains of a person while at the same time acquiring an objective professional comprehension of what is being observed through dissection. Becoming emotionally over involved makes observational-based inquiry extremely difficult whether it is at the dissecting table or bedside. Equally, while extreme detachment makes both dissection and clinical procedures easier to do, it creates greater problems by eliminating empathy and disconnecting the participant from a vital aspect of the total patient-care process. Students evaluated the conference immediately following the event and at the end of the course. 2000 and 2001 quantitative and qualitative results both indicated a very positive and beneficial response to this experience.
IM6	THE USE OF PAIRED CLINICAL AND BASIC SCIENCE FACILITATORS IN AN INTEGRATIVE PROBLEM BASED LEARNING (PBL) CURRICULUM: STUDENT EVALUATION BY FACULTY TYPE Frazier T. Stevenson* and Vijaya Kumari, University of California, Davis, CA 95616  U.S.A. Question:  Do medical students rate paired basic science and clinical PBL facilitators differently? PBL Course Structure:  Application of Medical Principles is a three year course instituted at UC Davis this year. It uses PBL to integrate concurrent core courses, including clinical clerkships, and to integrate basic and clinical science with ethics, social issues in medicine, and other underserved topics. Cases are 6 hours long, spread over 3 to 4 weekly sessions. Currently, 3 cases are offered in each of years 1 and 2 (basic science and pathophysiology curricular emphasis, respectively). Cases grow more clinically advanced in year 2. Group size ranges from 7-9 students. Faculty:  In years 1 and 2, each group has paired facilitators, generally one “basic scientist” (including MD pathologists) and one “clinician”, who can be from any specialty. No attempt is made to match the expertise of faculty to the case. Faculty are trained using undergraduates as model medical students and direct feedback from core PBL faculty. Evaluation: Each case and group is evaluated by students and faculty. Faculty and students evaluate each other using pre-published criteria. Each group is observed by core PBL faculty for peer feedback and quality control. Results:  In year 1, there was no difference in student satisfaction between basic science and clinical preceptors (on a 7 point scale, basic scientists [BS] 5.90 +/- 0.12, clinicians [CL] 6.01 +/- 0.13). In year 2, students evaluated basic scientists  significantly lower than clinicians, (BS 5.63 +/- 0.18 vs. CL 6.04 +/- 0.11, p< 0.05).  In neither year was there a difference between BS and CL faculty perceptions of the case quality or of group performance. Conclusion/Discussion:  Students in year 1 PBL exhibit no preference for basic scientist vs. clinical facilitators, despite the clinical nature of the PBL cases. Students praise facilitators who help “make concepts clear”. Discussions focus more on mechanism and review of normal biology, where the basic scientists play an active role. In contrast, students in year 2 PBL rate the clinicians more highly than basic scientists. Year 2 student subjective comments focus on the clinicians’ ability to “bring the case alive” and “make clinical analysis fun”. Explanations for the year 2 difference could include closer student identification with their mainly clinical faculty in year 2, or the students’	ORAL
IM7	ONLINE TRAINING FOR ONLINE FACILITATORS OF CLINICAL CASE IN MICROBIOLOGY FOR FIRST YEAR MEDICAL STUDENTS M. WaKabongo, Ph.D.*a, S. Andersona M.A., S. Walrod, M.Sa., S. Geletta, Ph.Da. and M. Lufuluabo, Ph.D.b   a) Des Moines University - Osteopathic Medical Center, Des Moines, IA  50312 U.S.A.;  b) Best Practices, Stone Mountain, Georgia U.S.A. Microbiology clinical cases are used in the first year DO/DPM class to bring clinical relevance to the study of Microbiology, to assist the development of critical thinking and to reinforce lecture content.  The class of over 200 students is divided in teams of 4 to 5 students, with about 62 teams in the class.  Faculty or students in advanced classes are facilitators. The purpose of this course was to develop competencies in online facilitating for faculty, 2nd and 3rd year students.  Some of the 3rd year students were on rotations outside of Des Moines.  Online discussion assists student and facilitator interaction even when geographically separated.  Interaction is independent of time and space. General Course Objectives: (1) Navigate easily through Blackboard; (2) Access the group area and participate in a discussion; (3) Keep discussion on track, help members to work together as a team, and create a friendly environment in which learning is promoted; (4) Practice acceptable online behaviors.  Instructional Formats:  short lectures, small group discussion and technology – Blackboard.  Six lectures were offered: (1) Online Behaviors – Netiquette; (2) Use of Discussion Board within a Group – Graphics (3) Use of Discussion Board within a Group – Non-graphic; (4) The Art of Online Facilitating; (5) Introduction to Clinical Case in Medical Microbiology; (6) Clinical Case and Guiding Questions.  The training class was comprised of 30 students (6 faculty members, 21 2nd and 3rd   year students and 3 non- faculty).  The class was divided in 6 teams of 5 members.  Each member played a specific role.  Active participation was a must.  Each student was expected to post a minimum of 3 meaningful contributions to the discussion, and was encouraged to formulate answers to the case before reading postings by other participants.  Participants evaluated each other’s performance and gave feedback. This training: (1) Allowed practice in a real-online environment; (2) Encouraged familiarity with Blackboard; (2) Saved time and assisted in logistics.	ORAL
IM8	KEEPING IT PERSONAL: USING A NEW POOL OF HIGHLY MOTIVATED STUDENT INSTRUCTORS IN MEDICAL EDUCATION S.A. Scoville, Ph.D.*, and George Wettach, M.S.  Department of Pathology and Anatomy, Eastern Virginia Medical School, Norfolk, VA 23501  U.S.A. Under continuing pressures to contain costs, many medical schools are willing to exchange direct faculty contact for computer-based resources.  While access to programs and information on the internet and intranet, as well as commercial and noncommercial CDs may be a helpful adjunct, the impact of the threatened loss of direct, spontaneous classroom or laboratory interaction must be considered carefully.  An increasing number of medical schools now offer graduate degrees for aspiring medical students.  Eastern Virginia Medical School offers one of these programs.  While the use of graduate students to assist in teaching is not a new concept, the special circumstances and motivation of those admitted to medical school from this program present a unique pool of willing and capable teachers. These EVMS students have taken some of the identical courses required in the first year of medical school. While some students choose to retake a course and others choose to exempt from retaking the same course, virtually all returning students have chosen to assist in teaching their classmates.  Histology, a lecture and laboratory course, in which diminished numbers of faculty (compared to previous years) are present, is now successfully augmented with these student teachers. Teaching takes place in the laboratory and in a multiple-headed microscope facility.  Assessment of this program demonstrates mutual benefit to the institution and all students, both those who are teaching and those who are taught.
IM9	BIOMEDICAL DEVICE DESIGN DISCOVERY TEAM APPROACH TO TEACHING PHYSIOLOGY TO UNDERGRADUATE BIOENGINEERING STUDENTS Timothy A. Cudd, D.V.M. Ph.D. and Jeremy S. Wasser, Ph.D.* Department of Veterinary Physiology & Pharmacology, College of Veterinary Medicine, Texas A&M University, College Station, TX  77843 U.S.A. Teaching effectiveness is enhanced by generating student enthusiasm, by using active learning techniques, and by convincing students of the value of acquiring knowledge in the area of study.  We have employed a technique to teach physiology to bioengineering students that couples students’ enthusiasm for their chosen field, bioengineering, with an active learning process in which students are asked to design a biomedical device to enhance, replace, or create a new cellular or organ system function.  Each assignment is designed with specific constraints that serve to direct students’ attention to specific areas of study and that require students to create original designs.  Preventing students from using existing designs spurred student invention and enthusiasm for the projects.  Students were divided into groups or “design discovery teams” as might be done in a biomedical device industry setting.  Students then researched the physiological issues that would need to be addressed to produce an acceptable design.  Groups met with faculty to brainstorm and to obtain approval for their general design concepts before proceeding.  Students then presented their designs to the instructors in a structured, written outline form and to the class as a 10-minute oral presentation. Grades were based on the outline, oral presentation, and peer evaluations (group members anonymously rated contributions of other members of their team).  We believe that this approach succeeded in generating enthusiasm for learning physiology by allowing the students to think creatively in their chosen field of study and that it has resulted in students developing a more thorough understanding of difficult physiological concepts than would have been achieved with a traditional didactic lecture approach.	ORAL
IM10	PROBLEM BASED LEARNING (PBL) A USEFULL INSTRUCTIONAL METHOD IN BASIC AREAS. Lopez-Cabrera M.*, Xaviera García, Hernández M. and Castañeda A. Coord. NUCE, Faculty of Medicine, National Autonomous University of Mexico, 04510, D.F.  México In recent years the Faculty of Medicine used Problem Based Learning (PBL) as educational strategy in which the students confront a clinical problem. PBL promote active learning, team work, self learning and improve a critical attitude. After the traditional education, in the last moth of the year, our students were faced to PBL. We were interested to observed the influence of this strategy in the integration of the knowledge acquired in basic areas. Experts with special training in PBL design the problem and an instrument for its evaluation. Students of the first and second year, 112 and 92 students respectively, resolve a diagnostic test (Dt) and this instrument was applied when PBL has finished (post-test, Pt). We observed that most of our students did not approve the Dt (61.06% and 42.52%). But after the experience of PBL the students improve in their performance and 92.5% approve the Pt. We analysed this data with a Wilcoxon test and we obtained significant differences between the results of both tests (p<0.0001). We can conclude that PBL is important as strategy focused in the student and also can impact the medical education, because the student can improve the knowledge acquired in basic areas.
IM11	PROBLEM-BASED LEARNING AFTER A TRADITIONAL EDUCATION PERIOD PROVIDES SUCCESSFULLY TOOLS FOR THE STUDENT OF MEDICINE IN THE FACULTY OF MEDICINE. Lopez-Cabrera M.*, Lorenzana-Jimenez M., Arredondo-Mendoza G., Gómez-Acevedo, C., and Xaviera García, Coord. NUCE, Faculty of Medicine, National Autonomous University of Mexico, 04510, México, D.F.  México Problem-based learning (PBL)in small groups provides students an opportunity to take great responsibility for their own learning. In PBL, process and content are linked with three cardinal elements: students, tutors and problems. In our medical school, the goals of PBL stated in terms of outcomes for the students are as follows:  1) To identify and define health problems in order to integrate basic subjects coursed during the first two years of their medical education.  2) To develop clinical skills to manage patients’ complains including physical, emotional and social aspects.  3) To be able to construct clinical learning related to patient care, health care delivery and medical research. To accomplish this, our students are faced to a PBL experience during the last month of their school year, after finished their basic courses. They work in small groups (5-6) and a tutor twice a week for four weeks with a problem elaborated to accomplish these goals. To evaluate their performance, students take a content exam at the beginning (diagnostic) and at  the end of the exercise. Additionally, we evaluated the PBL process using different instruments designed for that purpose. This is a new way to approach the PBL in undergraduate students because we used traditional teaching in the first period (30 weeks) of the year and the PBL in the last period (4 weeks). The aim of this strategy is to allow the student to integrate the previous learning acquired with the traditional education in basic areas in a clinical problem and also to construct new knowledge of basic and clinical areas by PBL. Applying this strategy we found that the students:  1) Can integrate basic areas,  2) Acquire clinical knowledge and medical language,  3). Develop an adequate searching of information in a systematic way and  4) Develop capacities to orderly and successfully solve problems.
IM12	STANDARDIZED PATIENTS: THEIR HISTORY AND HOW THEY ARE USED IN THE BASIC SCIENCES M. Cantrell, M.A.*, Association of Standardized Patient Educators, Little Rock, AR  U.S. A. For the past 50 years Standardized Patients (SP) have been used in medical schools for assessment and teaching.  In addition to prevalent use of SPs for teaching, the most frequent use has been for assessing clinical skills of medical students in years 1-4. There is now practical SP exams for licensure in Canada and for International Medical Graduates through the Educational Commission on Foreign Medical Graduates. The National Board of Medical Examiners are forecasting their exam to be up and running with in a few years. With these exams in place SPs are becoming mainstay in most medical schools. For basic science education, SPs have been used in PBL, demonstrations of physical findings and as presentations for clinical correlations.  This paper will review the history of SPs in medical education and look at increasing and enhancing the ways medical schools can use SPs in teaching the basic sciences.
IM13	A MULTIMEDIA APPROACH TO THE TEACHING OF MICROSCOPIC ANATOMY (HISTOLOGY). Ronald P. Jensh, Ph.D*., Department of Pathology, Anatomy, and Cell Biology, Jefferson Medical College of Thomas Jefferson University, Philadelphia, PA  19107-6799  U.S.A. Students learn using a variety of methodologies.  Learners may be grouped into two general categories, graphic learners and textual learners.  At Jefferson Medical College we team-teach a class of 230 first year students.  As course coordinator, I have adapted the course to address the individual needs of students using a combination of traditional teaching techniques and innovative technologies.  I am able to reduce the number of lecture and laboratory hours without compromising the educational goals and objectives of the course.  The five teachers interact with students as facilitators and, therefore, reinforce one of the objectives, namely, creating life-long learners.  However, I also am committed to a traditional “hands-on” approach to histology.  The course consists of 28 one-hour lectures and 23 2.5-hour labs.  Each student has a 200+ glass slide set.  The self-instructional lab manual is bar-coded to a laser disc of images located in four kiosks.  The kiosks contain a laser disc player, a VHA tape player, and a computer containing a program of images.  The labs start with a 25-minute commercially available video of the day’s subject shown on sixteen 27’ monitors.  Students use the lab manual and glass slide set during the remaining time.  Four computer CD programs have been created and are available for student use, each addressing a specific educational need:  “Microscopic Anatomy – A Student’s Guide” (a course tutorial with quizzes), “Histimages” (three libraries; 1500 images), “Q&A” (2300 questions, two formats), and “The Ultimate Microscope” (a simulated microscope with 400 images and two video presentations).  Students can purchase the CD’s; they are also available in the library and learning resource centers.  Thus students can mix-and-match these various media to maximize their learning efficiency.  Students are very enthusiastic about the computer programs but have consistently indicated, through exit surveys over the last 10 years, that they do want continued exposure to laboratories and lectures (>90% of respondents).	ORAL