Medical Teacher
ISSN: 0142-159X (Print) 1466-187X (Online) Journal homepage: http://www.tandfonline.com/loi/imte20
Continuing Education-Where Does it Begin? Hilliard Jason To cite this article: Hilliard Jason (1979) Continuing Education-Where Does it Begin?, Medical Teacher, 1:6, 277-279 To link to this article: http://dx.doi.org/10.3109/01421597909014336
Published online: 03 Jul 2009.
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Article views: 20
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Full Terms & Conditions of access and use can be found at http://www.tandfonline.com/action/journalInformation?journalCode=imte20 Download by: [University of California, San Diego]
Date: 08 November 2015, At: 16:15
Editorial Director: Dr Abraham Marcus Editor: Dr Katherine Hope Editorial Adviser: Dr Michael A. Simpson Managing Editor: Anne Patterson
Staff Editor: Cathy Peck
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Advertisement Manager: Robert Clarke
Editorial Department: Update Publications Ltd 33/34 Alfred Place London WClE 7DP, England Tel: 01-637 4544 Subscription Department: Update Publications Ltd 33/34 Alfred Place London WClE 7DP, England Tel: 01-637 4544 Subscription Rates: Annual Subscription UK: 213.00 (post free) Overseas: f15.00 (post free) USA and Canada: US $32.00 (post free including air freight to N . America)
Contributions: Contributions are invited in the form of original papers, articles of discussion and comment on all aspects of health sciences education. Prospective contributors should write to the Managing Editor, Medical Teacher, Update Publications Ltd, 33/34 Alfred Place, London WClE 7DP, England, before submitting manuscripts. Medical Teacher is published bi-monthly.
@Update Publications Ltd, 1979 Medical Teacher Vol I No 6 1979
ContinuingEducationWhere Does it Begin? The story is told of a secretary in 1927 who rushed into her boss’s office, full of excitement, exclaiming that she had just heard a news report that a man had flown across the Atlantic Ocean alone. Her boss nodded but didn’t look up. Disbelieving his reaction, she repeated her story and asked, “Mr Smith, aren’t you thrilled by this news?” Mr Smith slowly raised his head, saying, “Miss Jones, a person alone can do anything. If you had told me a committee had managed to fly across the Atlantic I would be jumping for joy!” Over the years the World Health Organization has put far more trust in the capacity of committees than our fictional Mr Smith. When problems of serious consequence are felt to need attention, a committee is brought together to discuss the matter and offer recommendations. Subsequently, reports of these deliberations tend to be published. Such a report, Continuing Education of Health Personnel as a Factor in Career Development (Euro Reports and Studies 6) has recently been released by the WHO Regional Office for Europe in Copenhagen. It is the report of a ‘Working Group’ (WHO’S term for an ad hoc committee), which met in Budapest from 31 October to 2 November, 1978. The publication is a sequel to a 1976 report, Continuing Education of Health Personnel, based on a Working Group which had met in Dublin. The present report, while brief (34pages), manages to summarize many of the important issues affecting the continuing education of health professionals. In its brevity, however, a few fundamental questions are left unasked (and unanswered), and its style is sufficiently telegraphic that some of the most important, but subtle, observations may not be understood by those for whom they are new. Actually, it is not made clear for whom this document is intended, or what its purposes are. Whether intended or not, it can serve as a reasonable ‘primer’ for those who are relatively new to the problems of continuing education. It does provide a useful summary of much of what is now being done in various parts of the world and effectively identifies many of the problems which confound those who are concerned about the quality and impact of continuing education. It also provides a helpful bibliography. The report recommends that continuing education should be controlled and organized by appropriate bodies, as are undergrad uate and postgraduate training. It also maintains that continuing education should be an integral part of employment and that adequate provision should therefore be made in terms of manpower, study leave and financial reimbursement. It follows that an adequate proportion of the health budget should be set aside for this purpose. The WHO report restricts attention to practices and pitfalls within the health fields. Perhaps an important lesson can be learned from experiences in a rather different field. We in the health professions tend to characterize ourselves as distinctive, if not unique, because we are entrusted with the lives of others. There is, however, another field 277
Downloaded by [University of California, San Diego] at 16:15 08 November 2015
in which the lives of those being served are even more clearly in the hands of those in control: commercial aviation. Like us, pilots, in whose hands we travellers regularly place our lives, regard themselves as professionals. Unlike us, they participate in a meticulously organized and demonstrably effective programme of continuing education throughout their careers. The key to their system is a programme of continuing evaluation. On a regular basis, typically every six months, they are directly witnessed in the execution of their duties by a trained examiner. The orientation of this evaluation is not punitive; it is diagnostic and corrective. The intent is to identify deficiencies, for the sake of ensuring that appropriate remedial action is taken, not to withhold privileges -unless that should prove appropriate and unavoidable. We in the health professions have only begun to emerge from the strikingly arrogant posture of asserting that our licences are awarded for life and that we can be fully entrusted to pursue whatever continuing learning we choose, without the need for external monitoring. We still have not acknowledged that the basic education in our profession does nothing to foster a lifetime of continuing growth and development. Indeed, nearly everything that happens during our basic education mitigates against the development of those skills and attitudes most necessary for a life of continuing self-evaluation and productive learning. Our educational experiences tend to foster a distrust of evaluation, a fear of being identified as having any limitations, a dependency on others to identify what we need to learn and how to learn it, and a sense that passing an examination means we are now ‘done’with that subject. Until some fundamental alterations have been made in the basic education of health professionals it is unlikely that we will have the climate in which we can successfully develop the continuing assessment and continuing learning that characterize the world of the airline pilot. Until that time we are likely to continue to be subject to the mockery of education characterized by the system currently dominating continuing education in the United States: the requirement. that hours of attendance at courses be accumulated - without any need for evidence that such attendance did any good. The recently released WHO report draws attention to an area with which we should be far more concerned. If WHO wants, however, to have a significant impact on the quality of continuing education in the health professions, it must turn even more of its prestige and resources to seeking modifications in the fundamental preparation of health professionals. If the education of health professionals is truly to be continuous, it is in their basic training that the necessary skills and attitudes must begin to be developed.
Hilliard Jason, MD, ED.D, Director National Center for Faculty Development University of Miami School of Medicine Miami, Florida 33101, USA.
278
Faculty Development Earlier this year, 24 health professionals met for two weeks at the University of New South Wales to participate in an intercountry workshop on faculty development sponsored by the Western Pacific Regional Office of the World Health Organization. All the participants were involved in the education of health personnel -most of them as teachers of clinical and basic sciences to medical and nursing students. Two representatives attended from each of 12 countries in the Far East and Australasia. The workshop was planned, co-ordinated and administered by the staff of the Centre for Medical Education at the University of New South Wales. The Proceedings have recently been published (Faculty Development Proceedings of the W H O - R T T C Intercountry Workshop, 1979), and very interesting reading they make. These intercountry workshops are designed to raise participants’ awareness of recent developments in the education of the health professions, to provide an opportunity for sharing experiences and expertise across countries, educational systems and professional groups, and to provide opportunities for acquiring skill in various aspects of education. With such broad terms of reference, the widely differing roles of the participants and the diverse needs of the various countries in which they work was probably an advantage rather than a disadvantage. The workshop focussed on the three main areas of faculty development: the educational skills of teachers, the development of teaching programmes, and the effectiveness of the faculty as an organization. On the basis of their interest and experience, the participants selected themselves into three groups covering these areas and then each negotiated and contracted within his or her group a topic for an individual project. The presentations that were based on these projects are included in the Proceedings. All the participants seemed to approach their tasks (project and otherwise) with an uninhibited enthusiasm which would not have been possible under any other circumstances. The opportunity for concentrated thought and discussion, without the pressure of routine day-to-day work and responsibility, must have been entirely new to most of them. Those who are inherently suspicious of terms such as ‘task force’, ‘overview’, ‘role-play (fish bowl)’, and ‘force field analysis’ may be sceptical of the workshop concept, but it does seem to work. A group of people are brought together for an extended period under the direction of expert ‘workshopkeepers’ (the task force), involved in intensive group activity and discussion, and are encouraged actively to participate in the process of learning and communicating. This is a dynamic and exciting experience. In such a situation the participants rapidly come to realize what they are doing, why, and how they are doing it; even more important, they have time to reflect on what they should be doing. Insight is gained: one can perhaps draw an analogy with the religious retreat. Teamwork is stressed, problems are discussed Medical Teacher Vol 1 No 6 1979
Downloaded by [University of California, San Diego] at 16:15 08 November 2015
and sometimes solved (or apparently so). Individual participation and self-expression are also emphasized. There is much to stimulate thought in the proceedings, but perhaps the project reports are the core. These papers are clear, well written and sometimes outspoken. Many would agree that Dr R. L. B. Neame of the University of Newcastle, New South Wales, really gets to the heart of things in his paper on a system for the evaluation and reward of educational endeavour and achievement. As he points out (and the majority of participants at the workshop agreed), one of the major obstacles to any meaningful improvement in teaching technique has been the low importance placed upon teaching in many academic institutions. There is a strong tendency for centres of higher education to place an excessive emphasis on scholarly achievement and research, to the detriment of teaching. Official recognition is largely limited to the areas of research and service, so effectively discouraging many staff from making more than a token effort in the area of education, even though they realize its importance. Although many universities in the UK have, for some time, been aware of this failing and are taking steps to correct it, a good deal still needs to be achieved. As Neame points out, those deeply involved in the planning and implementation of effective teaching and assessment programmes deserve recognition and appropriate ‘reward’. At the end of the workshop the participants must have been mentally and physically exhausted, but they seemed to have had fun and their evaluation of the immediate effects and of the processes used indicated considerable success. However, one would like to know what happened when the participants returned to the ‘real world’, as one of them put it. For 24 people this was a unique opportunity to relax, to discuss and to think about their roles and their plans for the future. One participant welcomed the opportunity that she had been given “to feel totally involved here without any real concern about what may be happening back there”. But “back there” is still there, and one wonders how many participants were able to influence and to alter the behaviour and the attitudes of their colleagues when they returned. How many sank back after a time into the old, frustrating routine? The beauty of a workshop is freedom from pressure and stress-and time to think. Regrettably, life is not a workshop, it is a force field. I wonder whether the participants have thought about a reunion in the future. A report of the proceedings of such a get-together might well be much more rewarding than the Proceedings of the workshop itself. J, Anderson, MB. FRCP Academic Sub Dean and Senior Lecturer in Medicine The Medical School, University of Newcastle upon Tyne Newcastle upon Tyne NEI 7RU UK Reference Faculty Development -Proceedings of the W H O / R T T C Intercountry Workshop, Vniuersity of New South Wales, Sydney, 4 to 16 February 1979, A. Rotem, K . R . Cox and M . J. Bennett (Eds), Clarendon Press, Sydney, for the University of New South Wales, 1979.
Medical Teacher Vol 1 No 6 1979
Appleton books for the medical student: BASIC SURGERY A SYMPTOM-ORIENTED APPROACH Bernard Gardner et al In 600 pages four distinguished U.S. surgeons prepare the student to evaluate and manage the commonest surgical complaints, as they draw on their own clinical experience in a thoughtful presentation of pathophysiology, treatment, repair and recovery. Future practitioners and specialists will find Basic Surgery a model of coherence. 1979 627pp Pa. S13.70 THE HISTORY AND PHYSICAL EXAMINATION Howard P. Lewis A practical guidebook for the medical student which makes history-taking and physical examinations easy to comprehend and master. It begins with a systematic procedure for obtaining the patient’s history, which is paralleled by a photographically illustrated summary of the physical examination. Desi ned to help students think clinically and construct a differential dia nosis, Dr. Lewis’s concise text will promote improve t competence. 1979 160pp Pa S5.80 CUTTING’S HANDBOOK OF PHARMACOLOGY Sixth Edition T. 2. Csaky In a major revision since the 1972 edition, Cutting’s Handbook under its new editorship offers readers a fingertip reference to every important drug in current use. Organised in broad pharmacologic or therapeutic groups, each chemical agent is highlighted for these salient features: history, chemistry, mechanisms, toxicity, dose and use. Structural formulae are given so that molecular similarities can be easily compared. 1979 704pp Pa. S11.OO INTERPRETATION OF ELECTROCARDIOGRAMS Nora and Stuart Laiken and Joel Kariiner Recently published, this self-instructional manual gives the medical student a sophisticated working knowledge of ECG abnormalities as they appear in clinical situations and their probable interpretations. A vector approach introduces readers to newer viewing modalities. 1978 224pp Pa S9.45 Write for our new medical catalogue to Sheila Hillen.
Appleton-Century-Crofts A Division of PrenticeHall Int’l 66 Wood Lane End
Hemel Hempstead Herts. HP2 4RG
@ 279
ISSN: 0142-159X (Print) 1466-187X (Online) Journal homepage: http://www.tandfonline.com/loi/imte20
Continuing Education-Where Does it Begin? Hilliard Jason To cite this article: Hilliard Jason (1979) Continuing Education-Where Does it Begin?, Medical Teacher, 1:6, 277-279 To link to this article: http://dx.doi.org/10.3109/01421597909014336
Published online: 03 Jul 2009.
Submit your article to this journal
Article views: 20
View related articles
Full Terms & Conditions of access and use can be found at http://www.tandfonline.com/action/journalInformation?journalCode=imte20 Download by: [University of California, San Diego]
Date: 08 November 2015, At: 16:15
Editorial Director: Dr Abraham Marcus Editor: Dr Katherine Hope Editorial Adviser: Dr Michael A. Simpson Managing Editor: Anne Patterson
Staff Editor: Cathy Peck
Downloaded by [University of California, San Diego] at 16:15 08 November 2015
Advertisement Manager: Robert Clarke
Editorial Department: Update Publications Ltd 33/34 Alfred Place London WClE 7DP, England Tel: 01-637 4544 Subscription Department: Update Publications Ltd 33/34 Alfred Place London WClE 7DP, England Tel: 01-637 4544 Subscription Rates: Annual Subscription UK: 213.00 (post free) Overseas: f15.00 (post free) USA and Canada: US $32.00 (post free including air freight to N . America)
Contributions: Contributions are invited in the form of original papers, articles of discussion and comment on all aspects of health sciences education. Prospective contributors should write to the Managing Editor, Medical Teacher, Update Publications Ltd, 33/34 Alfred Place, London WClE 7DP, England, before submitting manuscripts. Medical Teacher is published bi-monthly.
@Update Publications Ltd, 1979 Medical Teacher Vol I No 6 1979
ContinuingEducationWhere Does it Begin? The story is told of a secretary in 1927 who rushed into her boss’s office, full of excitement, exclaiming that she had just heard a news report that a man had flown across the Atlantic Ocean alone. Her boss nodded but didn’t look up. Disbelieving his reaction, she repeated her story and asked, “Mr Smith, aren’t you thrilled by this news?” Mr Smith slowly raised his head, saying, “Miss Jones, a person alone can do anything. If you had told me a committee had managed to fly across the Atlantic I would be jumping for joy!” Over the years the World Health Organization has put far more trust in the capacity of committees than our fictional Mr Smith. When problems of serious consequence are felt to need attention, a committee is brought together to discuss the matter and offer recommendations. Subsequently, reports of these deliberations tend to be published. Such a report, Continuing Education of Health Personnel as a Factor in Career Development (Euro Reports and Studies 6) has recently been released by the WHO Regional Office for Europe in Copenhagen. It is the report of a ‘Working Group’ (WHO’S term for an ad hoc committee), which met in Budapest from 31 October to 2 November, 1978. The publication is a sequel to a 1976 report, Continuing Education of Health Personnel, based on a Working Group which had met in Dublin. The present report, while brief (34pages), manages to summarize many of the important issues affecting the continuing education of health professionals. In its brevity, however, a few fundamental questions are left unasked (and unanswered), and its style is sufficiently telegraphic that some of the most important, but subtle, observations may not be understood by those for whom they are new. Actually, it is not made clear for whom this document is intended, or what its purposes are. Whether intended or not, it can serve as a reasonable ‘primer’ for those who are relatively new to the problems of continuing education. It does provide a useful summary of much of what is now being done in various parts of the world and effectively identifies many of the problems which confound those who are concerned about the quality and impact of continuing education. It also provides a helpful bibliography. The report recommends that continuing education should be controlled and organized by appropriate bodies, as are undergrad uate and postgraduate training. It also maintains that continuing education should be an integral part of employment and that adequate provision should therefore be made in terms of manpower, study leave and financial reimbursement. It follows that an adequate proportion of the health budget should be set aside for this purpose. The WHO report restricts attention to practices and pitfalls within the health fields. Perhaps an important lesson can be learned from experiences in a rather different field. We in the health professions tend to characterize ourselves as distinctive, if not unique, because we are entrusted with the lives of others. There is, however, another field 277
Downloaded by [University of California, San Diego] at 16:15 08 November 2015
in which the lives of those being served are even more clearly in the hands of those in control: commercial aviation. Like us, pilots, in whose hands we travellers regularly place our lives, regard themselves as professionals. Unlike us, they participate in a meticulously organized and demonstrably effective programme of continuing education throughout their careers. The key to their system is a programme of continuing evaluation. On a regular basis, typically every six months, they are directly witnessed in the execution of their duties by a trained examiner. The orientation of this evaluation is not punitive; it is diagnostic and corrective. The intent is to identify deficiencies, for the sake of ensuring that appropriate remedial action is taken, not to withhold privileges -unless that should prove appropriate and unavoidable. We in the health professions have only begun to emerge from the strikingly arrogant posture of asserting that our licences are awarded for life and that we can be fully entrusted to pursue whatever continuing learning we choose, without the need for external monitoring. We still have not acknowledged that the basic education in our profession does nothing to foster a lifetime of continuing growth and development. Indeed, nearly everything that happens during our basic education mitigates against the development of those skills and attitudes most necessary for a life of continuing self-evaluation and productive learning. Our educational experiences tend to foster a distrust of evaluation, a fear of being identified as having any limitations, a dependency on others to identify what we need to learn and how to learn it, and a sense that passing an examination means we are now ‘done’with that subject. Until some fundamental alterations have been made in the basic education of health professionals it is unlikely that we will have the climate in which we can successfully develop the continuing assessment and continuing learning that characterize the world of the airline pilot. Until that time we are likely to continue to be subject to the mockery of education characterized by the system currently dominating continuing education in the United States: the requirement. that hours of attendance at courses be accumulated - without any need for evidence that such attendance did any good. The recently released WHO report draws attention to an area with which we should be far more concerned. If WHO wants, however, to have a significant impact on the quality of continuing education in the health professions, it must turn even more of its prestige and resources to seeking modifications in the fundamental preparation of health professionals. If the education of health professionals is truly to be continuous, it is in their basic training that the necessary skills and attitudes must begin to be developed.
Hilliard Jason, MD, ED.D, Director National Center for Faculty Development University of Miami School of Medicine Miami, Florida 33101, USA.
278
Faculty Development Earlier this year, 24 health professionals met for two weeks at the University of New South Wales to participate in an intercountry workshop on faculty development sponsored by the Western Pacific Regional Office of the World Health Organization. All the participants were involved in the education of health personnel -most of them as teachers of clinical and basic sciences to medical and nursing students. Two representatives attended from each of 12 countries in the Far East and Australasia. The workshop was planned, co-ordinated and administered by the staff of the Centre for Medical Education at the University of New South Wales. The Proceedings have recently been published (Faculty Development Proceedings of the W H O - R T T C Intercountry Workshop, 1979), and very interesting reading they make. These intercountry workshops are designed to raise participants’ awareness of recent developments in the education of the health professions, to provide an opportunity for sharing experiences and expertise across countries, educational systems and professional groups, and to provide opportunities for acquiring skill in various aspects of education. With such broad terms of reference, the widely differing roles of the participants and the diverse needs of the various countries in which they work was probably an advantage rather than a disadvantage. The workshop focussed on the three main areas of faculty development: the educational skills of teachers, the development of teaching programmes, and the effectiveness of the faculty as an organization. On the basis of their interest and experience, the participants selected themselves into three groups covering these areas and then each negotiated and contracted within his or her group a topic for an individual project. The presentations that were based on these projects are included in the Proceedings. All the participants seemed to approach their tasks (project and otherwise) with an uninhibited enthusiasm which would not have been possible under any other circumstances. The opportunity for concentrated thought and discussion, without the pressure of routine day-to-day work and responsibility, must have been entirely new to most of them. Those who are inherently suspicious of terms such as ‘task force’, ‘overview’, ‘role-play (fish bowl)’, and ‘force field analysis’ may be sceptical of the workshop concept, but it does seem to work. A group of people are brought together for an extended period under the direction of expert ‘workshopkeepers’ (the task force), involved in intensive group activity and discussion, and are encouraged actively to participate in the process of learning and communicating. This is a dynamic and exciting experience. In such a situation the participants rapidly come to realize what they are doing, why, and how they are doing it; even more important, they have time to reflect on what they should be doing. Insight is gained: one can perhaps draw an analogy with the religious retreat. Teamwork is stressed, problems are discussed Medical Teacher Vol 1 No 6 1979
Downloaded by [University of California, San Diego] at 16:15 08 November 2015
and sometimes solved (or apparently so). Individual participation and self-expression are also emphasized. There is much to stimulate thought in the proceedings, but perhaps the project reports are the core. These papers are clear, well written and sometimes outspoken. Many would agree that Dr R. L. B. Neame of the University of Newcastle, New South Wales, really gets to the heart of things in his paper on a system for the evaluation and reward of educational endeavour and achievement. As he points out (and the majority of participants at the workshop agreed), one of the major obstacles to any meaningful improvement in teaching technique has been the low importance placed upon teaching in many academic institutions. There is a strong tendency for centres of higher education to place an excessive emphasis on scholarly achievement and research, to the detriment of teaching. Official recognition is largely limited to the areas of research and service, so effectively discouraging many staff from making more than a token effort in the area of education, even though they realize its importance. Although many universities in the UK have, for some time, been aware of this failing and are taking steps to correct it, a good deal still needs to be achieved. As Neame points out, those deeply involved in the planning and implementation of effective teaching and assessment programmes deserve recognition and appropriate ‘reward’. At the end of the workshop the participants must have been mentally and physically exhausted, but they seemed to have had fun and their evaluation of the immediate effects and of the processes used indicated considerable success. However, one would like to know what happened when the participants returned to the ‘real world’, as one of them put it. For 24 people this was a unique opportunity to relax, to discuss and to think about their roles and their plans for the future. One participant welcomed the opportunity that she had been given “to feel totally involved here without any real concern about what may be happening back there”. But “back there” is still there, and one wonders how many participants were able to influence and to alter the behaviour and the attitudes of their colleagues when they returned. How many sank back after a time into the old, frustrating routine? The beauty of a workshop is freedom from pressure and stress-and time to think. Regrettably, life is not a workshop, it is a force field. I wonder whether the participants have thought about a reunion in the future. A report of the proceedings of such a get-together might well be much more rewarding than the Proceedings of the workshop itself. J, Anderson, MB. FRCP Academic Sub Dean and Senior Lecturer in Medicine The Medical School, University of Newcastle upon Tyne Newcastle upon Tyne NEI 7RU UK Reference Faculty Development -Proceedings of the W H O / R T T C Intercountry Workshop, Vniuersity of New South Wales, Sydney, 4 to 16 February 1979, A. Rotem, K . R . Cox and M . J. Bennett (Eds), Clarendon Press, Sydney, for the University of New South Wales, 1979.
Medical Teacher Vol 1 No 6 1979
Appleton books for the medical student: BASIC SURGERY A SYMPTOM-ORIENTED APPROACH Bernard Gardner et al In 600 pages four distinguished U.S. surgeons prepare the student to evaluate and manage the commonest surgical complaints, as they draw on their own clinical experience in a thoughtful presentation of pathophysiology, treatment, repair and recovery. Future practitioners and specialists will find Basic Surgery a model of coherence. 1979 627pp Pa. S13.70 THE HISTORY AND PHYSICAL EXAMINATION Howard P. Lewis A practical guidebook for the medical student which makes history-taking and physical examinations easy to comprehend and master. It begins with a systematic procedure for obtaining the patient’s history, which is paralleled by a photographically illustrated summary of the physical examination. Desi ned to help students think clinically and construct a differential dia nosis, Dr. Lewis’s concise text will promote improve t competence. 1979 160pp Pa S5.80 CUTTING’S HANDBOOK OF PHARMACOLOGY Sixth Edition T. 2. Csaky In a major revision since the 1972 edition, Cutting’s Handbook under its new editorship offers readers a fingertip reference to every important drug in current use. Organised in broad pharmacologic or therapeutic groups, each chemical agent is highlighted for these salient features: history, chemistry, mechanisms, toxicity, dose and use. Structural formulae are given so that molecular similarities can be easily compared. 1979 704pp Pa. S11.OO INTERPRETATION OF ELECTROCARDIOGRAMS Nora and Stuart Laiken and Joel Kariiner Recently published, this self-instructional manual gives the medical student a sophisticated working knowledge of ECG abnormalities as they appear in clinical situations and their probable interpretations. A vector approach introduces readers to newer viewing modalities. 1978 224pp Pa S9.45 Write for our new medical catalogue to Sheila Hillen.
Appleton-Century-Crofts A Division of PrenticeHall Int’l 66 Wood Lane End
Hemel Hempstead Herts. HP2 4RG
@ 279
