Objective: To identify the learning styles of a group of cardiology residents (R) undergoing a training program at the University of Buenos Aires and to identify correlations of these styles. Methods: Statistical data were obtained through a 120-question survey developed by Vermunt and colleagues, which identified four different learning styles: constructiondirected; reproduction-directed; application-directed; and undirected. Four variables were identified [gender, previous experience as a teaching assistant (TA) in medical school, university final average (FA) and the public or private institution/centre of origin] in order to analyse level of correlation with learning styles (LS). Between April 2001 and April 2002, 149 residents (R) completed the survey. Average age was 29 (+2.7) years old; with 63% being men. Findings: The predominant LS were oriented toward knowledge application. In terms of variables, no differences regarding gender were detected; the R with TA showed undirected LS characteristics; those with a low FA registered a tendency towards reproduction-directed LS; and those residents at public/state medical centres indicated construction-directed LS tendencies. Conclusion: An application-directed learning style predominates in this group of residents. Information regarding learning styles can provide foundations upon which arguments can be made for changes in education that are traditionally not evidencebased.

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Purpose: The study aims to identify the career preferences of the final year medical student as well as to determine gender differences in career choices. Participants: The participants were 232 final year MMBS students of the first five classes of Ziauddin Medical University. Method: A questionnaire was designed that identified student's choice of specialty, location preferences, and reasons influencing career preferences. Percentages and chisquare were used to determine differences in career preferences of students. Results: Students chose internal medicine, surgery, and pediatrics as their first three career choices. Clinical specialties were highly rated as compared to family medicine. Personal interest was ranked as the most influencing factor that contributed to choice of specialty. Most respondents preferred working in Pakistan as compared to overseas, and for practice selected, private setup was more favored compared to other settings. Gender differences were found in career preferences. Conclusion: The impact of the innovative community education programme is not clearly evident in the study, indicating that several other factors contribute towards decisions regarding career. A critical review by the university is required to strengthen the fields that are being overlooked by the students. A follow-up study would be beneficial to determine the changing trends in career preferences.

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Problem: Curricula are developed to educate health professions students to provide efficient and effective health services. In addition to learning their disciplinary perspective, today's students must master the concepts of multidisciplinary team care. Traditionally, curriculum was developed based primarily on the perspectives of the discipline faculty, administration and accrediting agencies. However, now there are multiple groups (other academic educators, consumers and employers of health care providers) who may hold differing perspectives about outcomes expected from these programs. Purpose: The purpose of this investigation was to use an innovative methodology to generate and validate a curriculum for health professions students from multiple disciplines. Method: A multi-phased method using focus groups, surveys, dissemination and affirmation was presented to identify the concepts and best practices that should be included. Results: Several performance-based themes evolved during the interviews and a questionnaire was generated. Academic educators, consumers and employers of health care providers indicated agreement that the components on the survey were realistic and important for health professions students to achieve. Thus, outcomes for a curriculum were validated. The faculty rated several components of the curriculum as less realistic for students to achieve than did the consumers and employers. This investigation suggests it may be necessary for faculty to assist providers and parents in developing more realistic expectations about what students can achieve during their educational program. The approach used in this current project moves the field of the health professions curriculum development to a different level when compared with the traditional curriculum development approaches and should be used by others concerned with multi-professional education to assure the validity of the curricula.

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Context: The World Health Organization developed the Towards Unity for Health (TUFH) strategy in 2000 for the improvement of health system performance. Twelve projects worldwide were supported to put this strategy into practice. A standard evaluation and monitoring framework was developed on the basis of which project coordinators prepared technical progress reports. Objectives: To review the utility and effectiveness of the evaluation criteria recommended by TUFH and their application in four of the original twelve projects. Methods: We reviewed status reports provided by European project coordinators and developed a standardized reporting template to extract information using original TUFH evaluation criteria. Results: The original TUFH evaluation framework is very comprehensive and has only partly been followed by the field projects. The evaluation strategies employed by the projects were insufficient to demonstrate the connections between the intervention and the desired process improvements, and few of the evaluation measures address outcomes. Discussion: The evaluation strategies employed by the projects are limited in allowing us to associate the intervention with the desired process improvements. Few measures address outcomes. The evaluation of complex community interventions poses many challenges, however, tools are available to assess impact on structures and process, and selected outcome indicators may be identified to monitor progress in future projects. Conclusion: Based on the review of evaluation status of the TUFH projects and resources available we recommend moving away from uniform evaluation and towards monitoring minimal, context-specific performance indicators criteria.

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Context: Teaching nutrition to medical students is constrained by limitations in curricular time and competition with other topics. Objectives: To identify time slots and teaching methods for incorporating nutrition into the medical school curriculum, determine students' nutritional knowledge following the program, and their perception of the effectiveness of the program. Methods: A nutritional workshop was added to the clinical experience weeks of secondyear medical students. The first class included 66 students and the second class included 56 students. In order to fully acquaint the students with nutrition, four topics were included: nutritional policy, dietary assessment, nutritional recommendations, and obesity. Students were encouraged to actively participate in the program which included dietary intake interviews, debates regarding nutritional treatments, and actual practice in class. The main outcome measures were nutritional knowledge and evaluation of the program by the students. Findings: Over 90% of the students answered the knowledge questions correctly. The effectiveness of the training was graded (on a scale of 1-7) between 3.7-5.4 in the first year and 3.4-5.7 in the second year. Conclusions: The ten-hour nutritional workshops within the clinical weeks were wellreceived by second-year medical students. Using cases relevant to the students' age seems to enhance their interest in the program.

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Background and Objectives: In 1998 Ben-Gurion University, in collaboration with Columbia University, inaugurated the first medical school with the express purpose of training students in International Health and Medicine (IHM). The highlight of the program is the two-month clerkship in IHM. The purpose of this paper is to describe the IHM clerkship and report the preliminary results of an evaluation. Methods: To evaluate the impact of the clerkship on the students' attitudes and knowledge of IHM, the students were asked to complete a previously validated selfassessment questionnaire before and after the clerkship. Results: Ninety-six students participated in the IHMclerkship in the first 3 years. The mean age of the students was 29.4±4 and 53%were female. Comparison of the student's answers before their departure and after their return showed a significant difference in 5 of 64 items on the questionnaire. There was also a significant increase in the overall scores of the female students but no change in the scores of the male students pre- and post-clerkship. Discussion and Conclusions: Our results show that students who completed the clerkship modestly increased their knowledge of some aspects of IHM as measured by the survey. Further studies on the long-term impact of IHM experiences are needed in parallel with efforts to increase medical students' exposure to IHM.

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