Sound Medicine -- March 29, 2003

Challenges for stepfamilies

Trends in medical education

Challenges for stepfamilies

Therapist Susan Wisdom is a leading authority on stepfamilies, in part because of her personal experience. She says the long-term success of the stepfamily hinges on the maturity of the couple and the strength of their relationship. A licensed counselor, Wisdom has been in private practice for 14 years and has advised many families. She is author of the book Stepcoupling: Creating and Sustaining a Strong Marriage in Today's Blended Family.

Divorce is more prevalent in blended-family couples; as many as 6 in 10 marriages involving two families end in divorce, Wisdom says. She emphasizes the importance of a successful divorce before plunging into a new marriage and stepfamily. Stress factors for couples include the lack of time spent together, management of stepchildren, and the sheer unpredictability of the new arrangement. Expect it to take two to seven years for blended families to adjust, she says.

Wisdom's tips for couples include talking about the new family during courtship, spending time with your stepchildren, leaving discipline to the biological parent, relaxing the bond with your biological children, and adopting a "we" attitude within the stepfamily.

Resources:

Read excerpts of Susan Wisdom's book, Stepcoupling, at Amazon.com.

Find information for kids on blended families from the KidsHealth and TeensHealth Web sites.

The Stepfamily Association of America is a good starting place for stepfamilies and for couples preparing to create one.

Trends in medical education

Gone are the days when medical students studied only scientific subjects. Today's medical graduates are expected to possess clinical expertise in basic interpersonal skills such as history-taking and physical diagnosis, communication, and ethical reasoning. Most medical curricula now include tests in which students engage actor-patients playing out prepared scenarios. To learn more about this new aspect of medical training, we meet with educators Susan Ballinger, MD, and Stephen Leapman, MD. Dr. Leapman is executive associate dean for educational affairs and director of the Clinical Skills Education Center at the Indiana University School of Medicine.

Dr. Leapman explains that at the beginning of the 20th century, medical schools were like apprenticeships, with students receiving little scientific training. Enlightened educators at the time developed a more exacting curricula with a scientific basis, he says; but now, modern medical educators are infusing scientific training with social and ethical skills. Students appreciate the new emphasis, Dr. Leapman explains, because it gives them practical experience in things like delivering bad news to patient families and admitting mistakes. It also pinpoints and assists students who perform well academically but who have poor interpersonal skills. He discusses the history and reasoning behind the Objective Standardized Clinical Exams, or OSCEs, live practice exams for assessing these skills in students.

Dr. Ballinger details the OSCE method and experience. Medical faculty write test cases to serve as open-ended patient-doctor scenarios. Students are tested by enacting these scenes with actors playing patients; the 15-minute interaction is videotaped. The "patients" and a panel of faculty rate the performance. Dr. Leapman says that starting in 2004, an OSCE will be included in national physician licensing exams.

Drs. Leapman and Ballinger also discuss the competency-based medical curriculum at Indiana University. What is happening, Dr. Leapman says, is that medical education is shaping the future of medical practice.

Resources:

"A Day at the OSCEs" offers a fun visual overview of the testing process.

Read more about the IUSM Clinical Skills Education Center, where the school's OSCEs are taken.

Find out more about United States Medical Licensing Exam (USMLE) and the new clinical skills component of it.

Visit the site for The Office of Medical Education and Curriculum at IUSM and get a quick look at the School's curriculum.

Is there a medical topic you'd like us to cover? Reach us by email: soundmed@iu.edu
or by phone:
(317) 274-4848.

Spring is officially here, so golfing can't be far behind. And for all you golf addicts looking for another excuse to hit the links, you can thank a group of Finnish researchers who studied the health benefits related to golfing. Which of the following did the researchers report offers the most benefit to golfers?

A. Playing golf weekly
B. Walking the course
C. Carrying your own clubs

Find out!

Eyebrows are one of our most noticeable facial features and certainly play important roles as symbols of beauty and ways of expressing emotion. But do eyebrows have any physiological function to perform? You may be surprised at the answer.

Find out!

Dietary supplements carrying USP (United States Pharmacopeia) certification labels began appearing on store shelves in December 2002. The label assures consumers that a product has been tested and verified in terms of its ingredients and manufacturing process. According to the USP Web site, the label certifies that:

• The product contains the ingredients stated on the label.
• It has the declared amount of ingredients.
• It will dissolve effectively to release nutrients for absorption into your body.
• It has been screened for harmful contaminants such as pesticides, bacteria and heavy metals.
• It has been manufactured using safe, sanitary and well-controlled procedures.

Manufacturers voluntarily submit their products for testing and earn the USP mark only after passing through a comprehensive testing and evaluation process.

The certification does not certify health benefits, however, or other health claims made on product labels. Some critics allege this misleads consumers looking for safety assurances.