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      Comparison of Two Methods of Teaching Hypertension in Under Graduate Medical Students: “Planned Lecture” Versus “Cooperative Learning”

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          Abstract

          Background

          The direct and indirect negative impacts of hypertension on mortality and morbidity and the deficiencies in physicians’ knowledge on its management prompted us to search for new methods of training this item.

          Objectives

          In this study, 2 methods of teaching—planned lecture and cooperation—were compared in instructing hypertension to medical students.

          Materials and Methods

          This study was designed to be a prospective analysis of the efficacy of 2 models of cooperation and planned lecture teaching of hypertension. The medical students, in the second term of the 2010 academic year who were introduced to the nephrology ward for their internal medicine course, were randomly assigned to 2 groups to be taught hypertension by 2 models of cooperation and planned lecture to compare their advantages and disadvantages. In their final exam 2 questions concerning the management of hypertension were asked with regard to evaluating the long-term impact of the models on learning. Data were analyzed by paired t-test to compare pre- and post-test in each group, and independent t-test was used to compare the average and standard deviation scores between groups.

          Results

          Fifty-one students participated in the study. The total number of students in the lecture (group 1) and cooperation (group 2) methods was 28 and 23, respectively. By independent t-test, differences in test scores indicated a similar achievement of the 2 methods for the endpoint of basic knowledge (P = 0.253). But, the cooperation method was more successful in transferring abilities, primarily in the areas of workup and treatment (P < 0.05).

          Conclusions

          The study findings show that both methods can set in the optimal training for hypertension to students but that the cooperative method is more effective for deduction analysis.

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          Most cited references 20

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          National study of physician awareness and adherence to cardiovascular disease prevention guidelines.

          Few data have evaluated physician adherence to cardiovascular disease (CVD) prevention guidelines according to physician specialty or patient characteristics, particularly gender. An online study of 500 randomly selected physicians (300 primary care physicians, 100 obstetricians/gynecologists, and 100 cardiologists) used a standardized questionnaire to assess awareness of, adoption of, and barriers to national CVD prevention guidelines by specialty. An experimental case study design tested physician accuracy and determinants of CVD risk level assignment and application of guidelines among high-, intermediate-, or low-risk patients. Intermediate-risk women, as assessed by the Framingham risk score, were significantly more likely to be assigned to a lower-risk category by primary care physicians than men with identical risk profiles (P<0.0001), and trends were similar for obstetricians/gynecologists and cardiologists. Assignment of risk level significantly predicted recommendations for lifestyle and preventive pharmacotherapy. After adjustment for risk assignment, the impact of patient gender on preventive care was not significant except for less aspirin (P<0.01) and more weight management recommended (P<0.04) for intermediate-risk women. Physicians did not rate themselves as very effective in their ability to help patients prevent CVD. Fewer than 1 in 5 physicians knew that more women than men die each year from CVD. Perception of risk was the primary factor associated with CVD preventive recommendations. Gender disparities in recommendations for preventive therapy were explained largely by the lower perceived risk despite similar calculated risk for women versus men. Educational interventions for physicians are needed to improve the quality of CVD preventive care and lower morbidity and mortality from CVD for men and women.
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            Trends in hypertension prevalence, awareness, treatment, and control in older U.S. adults: data from the National Health and Nutrition Examination Survey 1988 to 2004.

            To describe hypertension trends in U.S. adults aged 60 and older using National Health and Nutrition Examination Survey (NHANES) data. NHANES III (1988-1994) and NHANES 1999 to 2004. Cross-sectional nationally representative health examination survey. Participants in NHANES III (n=5,093) and NHANES 1999 to 2004 (n=4,710). Blood pressure (BP). In 1999 to 2004, 67% of U.S. adults aged 60 and older years were hypertensive, an increase of 10% from NHANES III. Between 1988 to 1994 and 1999 to 2004, hypertension control increased for men from 39% to 51% (P .05). Non-Hispanic black men and women had higher prevalences of hypertension than non-Hispanic whites (odds ratio (OR)=2.54, 95% confidence interval (CI)=1.90-3.40 and OR=2.07, 95% CI=1.31-3.26, respectively), but men were less likely to have controlled BP (OR=0.60, 95% CI=0.41-0.86). Mexican-American men and women were less likely than non-Hispanic whites to have controlled BP (OR=0.55, 95% CI=0.33-0.91 and OR=0.63, 95% CI=0.40-0.98, respectively). Women and men aged 70 and older were significantly less likely to control their hypertension than those aged 60 to 69. In addition, women aged 70 and older were significantly less aware and treated. Having BP measured within 6 months was significantly associated with greater awareness, greater treatment in men and women, and greater control in women. A history of diabetes mellitus or chronic kidney disease (CKD) was significantly associated with less hypertension control. There was a significant increase in hypertension prevalence from 1988 to 2004. Hypertension control continues to be problematic for women, persons aged 70 and older, non-Hispanic blacks and Mexican Americans, and individuals with diabetes mellitus and CKD.
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              Promoting early adolescents' achievement and peer relationships: the effects of cooperative, competitive, and individualistic goal structures.

              Emphasizing the developmental need for positive peer relationships, in this study the authors tested a social-contextual view of the mechanisms and processes by which early adolescents' achievement and peer relationships may be promoted simultaneously. Meta-analysis was used to review 148 independent studies comparing the relative effectiveness of cooperative, competitive, and individualistic goal structures in promoting early adolescents' achievement and positive peer relationships. These studies represented over 8 decades of research on over 17,000 early adolescents from 11 countries and 4 multinational samples. As predicted by social interdependence theory, results indicate that higher achievement and more positive peer relationships were associated with cooperative rather than competitive or individualistic goal structures. Also as predicted, results show that cooperative goal structures were associated with a positive relation between achievement and positive peer relationships. Implications for theory and application are discussed. (c) 2008 APA, all rights reserved.
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                Author and article information

                Journal
                Nephrourol Mon
                Nephrourol Mon
                10.5812/numonthly
                Kowsar
                Nephro-urology monthly
                Kowsar
                2251-7006
                2251-7014
                01 March 2012
                Spring 2012
                : 4
                : 2
                : 478-481
                Affiliations
                [1 ]Iranian Tissue Bank, Tehran University of Medical Sciences, Tehran, IR Iran
                [2 ]Nephrology Research Center, Tehran University of Medical Sciences, Tehran, IR Iran
                [3 ]Educational Research in Medical Sciences (CERMS), Tehran University of Medical Sciences, Tehran, IR Iran
                [4 ]Department of Social Medicine, Tehran University of Medical Sciences, Tehran, IR Iran
                [5 ]Urology and Nephrology Research Center (UNRC), Shahid Beheshti University of Medical Sciences, Tehran, IR Iran
                [6 ]Hamedan University of Medical Sciences, Hamedan, IR Iran
                Author notes
                [* ]Corresponding author: Khadijeh Eslami, Hamedan University of Medical Sciences, Hamedan, IR Iran. Tel.: +98-9123636331, Fax: +98-2166581568, E-mail: eslami.khadijeh@ 123456yahoo.com
                Article
                10.5812/numonthly.4103
                3614271
                23573471
                Copyright © 2012 Kowsar M. P. Co.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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