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ing them to a new religion. I expected something similar in this book-and, indeed, I believe I was not disappointed. A scan over the terms the author uses is enough to convince one that this book is very particular: “moral”, “profane”, “religious”, “seven deadly sins of teaching”, “style” and “character”. I am generally unsympathetic towards evangelical styles of argument, so I would not have read much further than the Preface, had I not been asked to review this book. But I am rather glad that I did: it is entertaining (not one of its main aims, I suspect), full of surprises (yes, the chapter entitled “The Joys of Teaching” does draw an analogy between teaching and sex), and it does introduce a variety of novel perspectives (such as the seven deadly sins of teaching) and unexpected arguments (such as the corruption associated with college athletics in America).

The central themes of the book I found difficult to identify: the critique is wideranging. However, the first two chapters concern the development and importance of a teaching style and the associated importance of character as “the necessary foundation of an exemplary teaching style” in the scholar-teacher. Chapter Three explores in depth the analogy between sex and teaching in an effort to uncover “the inescapable place of person in teaching”. Chapter Four considers whether teaching is an art or craft or science. Ebel considers, not unreasonably, that it is a craft. Chapter Five presents an interesting discussion of the conflicts between scholarship and teaching, which is well worth making. Chapter Six extends this discussion to question the place that knowledge has in modern society. This ends with a theological metaphor which extends itself

into the next chapter of seven deadly sins of teaching (arrogance, dullness, rigidity, insensitivity, vanity, self-indulgence, hypocrisy). This chapter also is worth reading: it certainly strikes a number of bells. The remaining chapters are concerned with learning to be a teacher, “teaching’s highest aims’’ (civic responsibility, practical and cultural ends, and moral responsibility) and a comparison between the present and the 1960s in terms of college teaching. Eble has some interesting thoughts: he makes original, important and provocative points about the separation of scholarly work and teaching, about the adverse effects of narrow specialization, and about the personal development of both teacher and student. But, for me, they were lost in a sea of strange metaphors and strongly value-laden argument. Janet Gale

I LEIT’ERS

Programme Evaluation Madam, The article How To Plan and Conduct Programme Evaluation (Med Tsoth 1983; 5 : 127-131) by Rotem and Bandaranayake is a timely and important overview of a vital aspect of medical education. May we add one or two thoughts which may be of interest to your readers? Evaluation should address itself to acceptability, effectivenessand efficiency. If we were to regard students as we do patients,’ a number of questions would emerge as self-evident. Are students progressing satisfactorily towards achieving their optimal potential? Have they achieved an expected level of competence? Have they maintained this level or surpassed it in the long term? Is the educational intervention acceptable to providers and recipients? How costly is the educational intervention of providers and recipients in terms of resources, time and effort?

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As we have indicated,’ programme evaluation can concern itself with ‘monitoring’ the on-going course, including student progress and achievement, with the follow-up of graduates in their subsequent careers. The monitoring of an on-going course may include purposes additional to providing data for deciding on change. For example, regular opportunities for identifying aspects of satisfaction and aspects of concern can help to maintain morale for both staff and students. This, of course, requires that staff and student comments are seen to be noted and acted upon. Little attention has yet been paid to the “Third Curriculum”-how students perceive their educational experiences and how they use (or do not use) what is offered to them during the course. Educational planning and implementation, the First and Second Curricula respectively, build on thin ice, as it were, without closer knowledge of.student perception and reaction. Outcome evaluation of a course in higher professional education would be incomplete if it were limited to evaluation within and at the end of the course. It will be important to seek answers to further questions, such as: ‘Has the course prepared the graduates for their immediate postgraduate responsibilities?’ and ‘To what extent have the competences to be achieved through the course been maintained, extended or lowered-as demonstrated by the performance and behaviour of graduates during their postgraduate career?’ Just as the monitoring aspects of evaluation can play an influential role in maintaining morale within a medical school,

outcome evaluation can be decisive in keeping a medical faculty responsive to the changing needs of health care and thus the changing demands on medical education. Charles E. Engel, Grahame I. Feletti Faculty of Medicine, University of Newcastle, New South Woks 2308 Referencei ’Engel CE, Clarke RM, Feletti GI. The evolution and impact of programme evaluation in a new medical school. Assess Emf Higher Educ 1982; 7: 257-268. ’Fleisher DS. Medical education: A clinical pathologic Conference. Mad Clin N Am 1970; 54: 591-602.

The Way We Teach Community Medicine Madam, The paper by Alkafajei, Antony and Joseph (Med Teach, 1983, 5 , 137) gave a most interesting account of a syllabus in primary care for medical students. However, it is not a syllabus in Community Medicine and should not have been so entitled. Alwyn Smith, PH.D, FRCP, FRCCP, PFCM, President Profasor J. A. D. Anderson, MA, MD,FFCM, MRCCP, Actrdrk Dean Faculty of Community Medicine of the Royal Colkges of Physicians of the United Kingdom, 28 Portlond &e, London WIN 4DE

Medical Teacher VoI 6 No 3 1984

Programme evaluation.

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