Background Infectious diseases kill more than 10 million people worldwide every year. It is therefore vital that doctors receive a good education in this field. Online learning is one way in which doctors can learn new knowledge and skills. We conducted this study to determine whether the infectious diseases interactive online learning packages enabled primary care professionals to increase their knowledge and skills in the area of infectious diseases. Description We built a series of interactive case histories on the following topics: tuberculosis; hepatitis B; hepatitis C; influenza; meningitis; mumps; helicobacter pylori; chlamydia; and genital herpes. The modules involved a pre-test, a number of interactive cases and/or a summary of up-to-date knowledge in that area and a post-test. Results The learning modules were completed by 3,956 users. Wilcoxon's test showed that learners increased their knowledge to a statistically significant degree (p < 0.001) and qualitative data showed that users found the tool useful. Discussion The results appear to demonstrate that online modules are effective in helping health professionals learn more about infectious diseases.

Revisions to existing program evaluation approaches of the Dokuz Eylul University School of Medicine (DEUSM) were made by the Medical Education Department in June 2005. After considering several evaluation models, a mixed evaluation model was developed to meet institutional needs. The general program evaluation plan was structured as areas of inquiry under the three main program evaluation questions: what are the effects of the educational program on students and graduates, what are the effects of the educational program on trainers, and is the educational program being implemented as planned. The School's first report made through its new program evaluation approach was prepared in July 2006, leading to important revisions to the educational program. This article presents DEUSM's project to revise its program evaluation approach and briefly discusses its early implementation.

Context: Physicians face complex public health issues in clinical practice today. We describe an innovative "community-first" model that teaches public health to medical students. Methods: The United Way of Chittenden County Volunteer Center (UWCCVC) in the State of Vermont, U.S.A., was chosen as the focal point for projects because of its documented history, success, and credibility. A simple form, sent to local community agencies, facilitated participation and identified Healthy People 2010 focus areas as the public health framework. Community agencies identified the health needs of populations that were served through this process. Projects were subsequently jointly developed and following student completion, assessed jointly by university faculty and community agency mentors. Results: A total of 41 projects have been completed, spanning 11 different areas of Healthy People 2010. Many different local community agencies have participated. An annual poster session is held at project completion. Assessment includes both faculty mentor and community agency assessment of student groups' progress and project quality. Community agencies are surveyed following project completion. Nearly all community agencies agreed that projects benefited the populations served and anticipated continuing the partnership. Conclusions: Putting community public health needs first, in developing projects, was critical to success. This "community-first" model provides opportunities to teach public health and benefit health in local communities.

Background: The relationship between medicine and public health has a long and complex co-evolution. In developing countries where the health needs are greatest and resources are few, this relationship is of critical importance. Development of medicine and public health at the Aga Khan University: This paper provides a case study of the development of the relationship between medical and public health at the Aga Khan University (AKU), a leading educational institution in Pakistan, which was founded with a vision of reuniting medicine and public health. Rapid growth and development have led to successful medicine and public health programs, but have fallen short in creating the synergies needed to address the population health problems of the country. The way forward: In a twenty-five year history of strong growth and development, the AKU has recreated the schism that marked US institutional development in the 20th century, despite strategic consideration to address population health in the design of the University. We recommend the creation of public health schools that focus on leadership to renew an emphasis on unifying health concepts and actions following successful examples to bring medicine and public health together.

Objective: In recent years, many medical schools have added communication skills training to their curricula, and some studies have measured medical students' attitudes toward learning communication skills. The Communication Skills Attitude Scale (CSAS) was developed in England; however, there is no scale to measure these attitudes in Turkey. This study aims to adapt and examine the psychometric properties of a Turkish translation of the Communication Skills Attitude Scale in a group of Turkish medical students. Methods: One hundred and seventy nine students from years 1 to 5 in Adnan Menderes University Medical School in Turkey voluntarily participated in the study. Mean age was 19.7 years (±3.8). Factor analysis was conducted to assess construct validity, and Cronbach alphas were calculated to evaluate internal consistency. Results: Exploratory factor analysis confirmed the original structure of the scale as positive and negative subscales, with some modifications. After putting items 8 and 13 into the positive subscale and item 22 into the negative subscale, alphas were calculated as 0.92 and 0.71, respectively. For divergent validity, comparisons showed that groups from training years 1 to 5 differed (p<0 .001) in their positive and negative subscale scores. Conclusions: This study substantiates the validity and internal consistency of the Turkish version of the CSAS and demonstrates that it can be used in future studies and educational evaluations to measure medical students' attitudes towards learning communication skills.

Objective: This study investigated the attitudes of medical students towards psychiatry, both as a subject in their medical curriculum and as a career choice. Three separate domains were elicited: (i) merit, competency and status; (ii) perceived attitude and attributes toward psychiatry and psychiatric services and (iii) treatment. Materials and Methods: The 26-item scale Das and Chandrasena Questionnaire was administered prior to and immediately following an 8-week clinical training program. Results: Results indicate that the perception of psychiatry was positive prior to clerkship and became even more so upon completion of the training. However, there was a significant drop in the proportion of students who indicated that they might choose a career in psychiatry. Conclusion: This is consistent with other studies suggesting that perception of psychiatry is enhanced following a clerkship but this does not translate into psychiatry as a career intention. This finding is highlighted in light of the increasing magnitude of the number of people affected with mental disorders in a developing country like Oman but with no parallel development in psychiatric services.

Background: In recent decades, studies that evaluate training programmes have shown that continuing education for physicians is not very effective in improving performance and behavioural changes. One of our goals was to create a Continuing Medical Education Programme (CMEP) that would result in changing the behaviour of health professionals. In early 2005, a new CMEP was offered to emergency medical services and emergency room professionals to introduce an Emergency Critical Pathway (ECP) for the management of acute stroke patients. This paper illustrates the main characteristics of the educational model and the strategies and activities adopted to realize it. Methods: The training programme was planned and organized applying the concepts and tools of experiential learning. It was organised in three successive phases: 1) interviews with health professionals to identify their learning needs; 2) training the ECP coordinators/facilitators in a residential setting; and 3) on-site training in small groups of health professionals (6-8), led by a coordinator/facilitator. Results: The CME involved 324 emergency health professionals. Participants positively evaluated both the educational programme and the clinical indications of the protocols. Over six months of the ECP training, health professionals treated 657 stroke patients: 153 (23.3%) were transferred to the stroke unit where 15 (9.8%) were thrombolysed. In the same period of the previous year, the professionals treated 638 patients: 99 (15.5%) were transferred to the stroke unit and no patients were thrombolysed. Conclusion: The application of the new educational methodology has contributed to improved management of stroke patients in Latium.

Context: Students start their medical study with the opinion that saving lives and preventing deaths are the main goals of medicine. So, what will they do when faced with dying patients? How will they feel; how will they communicate? These are important, but often unspoken and neglected, issues. Objectives: We assessed the attitudes and opinions of first-year medical students regarding doctor-patient communication, chronic diseases, death, and dying patients at Uludag University Medical School in Bursa/Turkey. Our secondary objective was to delineate the educational needs related to this field. Methods: Cross-sectional survey of the first-year students in the class of 2004-2005. Students were evaluated using a questionnaire consisting of six questions and 18 Likert-type statements. Results: Completed questionnaires were received from 253 of the 265 (95.5%) students. According to the students, the most fatal diseases were cancer and AIDS. Students strongly agreed with the importance of talking to patients, where female students agreed more than males with this statement (p<0.05). Most students disagreed that patients should be informed that they are dying. Older students feared less for the death of patients. Female students would like to work in an environment where they can communicate with their patients and where they can be with them for a longer period. Conclusions: The results of this survey indicate that the need of providing palliative care, enhancing communication skills with terminally ill patients, and integrating different teaching strategies are important aspects of the undergraduate medical curriculum.

Context: Adolescence is the age period from 10-19 years when lifestyle patterns of behavior are being formed. These behaviors set the stage for future health problems. Behaviors and lifestyles are determinants of future health, illness, disability, and premature mortality. Objectives: To gain new insight into health behaviors, lifestyles and their context in adolescents in order to assess the determinants and barriers to the improvement of health. Methods: A cross-sectional descriptive study. A random sample of 1200 adolescents within the age group of 10-19 years (53.2% girls and 46.8% boys) were interviewed individually. A self-reported questionnaire was developed for data collection by trained interviewers. Bivariate and logistic regression analyses were conducted. Outcomes: The overall prevalence of smoking among adolescents was 4.9%. More boys (9.1%) than girls (1.3%) reported smoking. Older participants and those with higher levels of education reported higher rates of tobacco use (10.4 % and 7.9%). Consumption of alcohol was significantly more common for boys (2.3%). More boys than girls reported they were actively engaged in sports. Inactivity was significantly higher among older age groups and was associated with lack of education. 58% of girls and 8.7% of boys were physically inactive. More than half of the boys go hungry due to lack of availability of food in the house and this was somewhat less common for girls (43%). Adolescents 16 years and older reported significantly less consumption of both nutritious and non-nutritious foods than other age groups. Conclusion: Our research contributed to greater understanding of current health-related behaviors of Sudanese adolescents. There are a number of implications for potential interventions (e.g. physical inactivity of girls and hunger experiences).