The paradox of professionalism education: the context of one U.S. medical school's curricular reform

In the past fifty years the medical profession in the United States has been transformed by federal and commercial forces. At teaching hospitals, clinical faculty were pressured to cut costs, treat more patients, and spend less time training students. Evidence emerged that medical students became increasingly cynical and detached throughout their training, and medical educators grew concerned that the for-profit priorities of clinical environments were damaging to the professional identities and values of trainees. Consequently, American medical schools reformed their curricula, adding coursework in bioethics and doctor-patient communication. These measures would not, however, counteract the stubborn effects of the so-called hidden curriculum in medical school. Associated with the unintended and implicit lessons that undermine espoused institutional principles, this “curriculum” was thought to be exacerbated by the challenges of contemporary clinical settings. In the late 1990s the “professionalism movement” arose to further the cause of medical ethics education and to promote more accountability in practice; by 2003 the accrediting body of North American medical schools mandated the explicit teaching of professionalism. Professionalism curricula differed from ethics in that it emphasized observable virtuous attitudes and behaviors rather than cognitive reasoning. The reforms at Tufts University School of Medicine (TUSM) in Boston illustrate one approach to the teaching and assessment of professionalism. Archival materials show that TUSM responded to the accreditation mandates by implementing coursework, special programs, performance-based assessment, and the medical school induction rite, the White Coat Ceremony. Professionalism education was complicated for medical schools like TUSM by a lack of clear curricular and institutional goals. Furthermore, the practice of medicine did not necessarily coincide with the ideals of the profession, and senior physicians were inconsistent role models of such ideals – contradictions not lost on students. In 2013 the medical school accreditation agency revised its standards regarding professionalism, shifting its focus to the context for developing professionalism, the learning environment. Recommendations to medical schools for advancing professionalism education include faculty development programming and preparing students to face the ideological conflicts inherent in the current healthcare system

Ortsnamen und Wanderungen der Völker

People who leave their home, take their names with them. That is the reason why place names in new settlements can contain remembrances of the language spoken in the former home area. This essay will among others deal with the German emigration overseas; the German settlement in the East; the spreading of the East-Slavic settlement area; the occupation and settlement of England through Western Germanic tribes, and the home and dispersal of Germanic tribes. For this purpose, place names are important, maybe even the most important witnesses of migration

Balkanska postojbina Slavena i Hrvata u svjetlu imena mjesta Donje Saske

Die Aufarbeitung niedersächsischer Ortsnamen bietet in zweierlei Hinsicht Hinweise für die Frühgeschichte der Slaven. 1. Die slavische Ortsnamen des Hannoverschen Wendlandes zeigen im Einvernehmen mit archäologischen Ergebnissen, daß dieser Bereich von zwei Richtungen aus von Slaven besiedelt wurde: neben einer mehr aus Osten kommenden Siedlungsbewegung steht eine aus Süden und elbabwärts gerichtete Zuwanderung. Das erweisen Ortsnamen, deren Etymologie und Verbreitung Verbindungen mit dem Cechischen, Slovakischen und Südslavischen erkennen lassen. 2. In eine weitaus ältere Periode sind niedersächsische Ortsnamen zu datieren, die zwar aus germanischen Elementen heraus zu erklären sind, die aber allseits bekannte und auf für die Beziehungen zum Osten wichtige Anhaltspunkte hin weisen. Dazu zählen: a) die Tatsache, daß das Slavische als indogermanische Sprache in vielfältiger Weise mit den übrigen indogermanischen Sprachen verbunden ist; b) die besonders engen Beziehungen des Slavischen zum Baltischen und Germanischen; c) der Anteil des Slavischen und Germanischen an der alteuropäischen Hydronymie; d) die unstrittige These, daß jede sprachliche Erforschung einer Region von den Fluß- und Ortsnamen auszugehen hat.Obrada imena mjesta donje Saske upućuje za ranu povijest Slavena u dva smjera. 1. Slavenska imena mjesta luzičkih Slavena na području Hannovera pokazuju podudarnosti s rezultatima arheoloških nalaza. Oni svjedoče daje to područje bilo naseljavano Slavenima iz dvaju smjerova: uz val naseljavanja koji je dolazio pretežito s istoka, očituje se drugi val koji se doseljavao nizvodno uz Labu. To dokazuju imena mjesta čija etimologija i raširenost stoje u vezi s češkim, slovačkim i južnoslavenskim vodnim i mjesnim imenima. 2. Imena mjesta donje Saske treba smjestiti u kudikamo starije razdoblje, i premda ih treba tumačiti germanskim jezičnim sredstvima, ona su posvemašnje poznata, i upozoravaju na važna uporišta za veze s Istokom. To podrazumijeva: a) činjenicu da je slavenski kao indoeuropski jezik na različite načine povezan s ostalim Indoeuropskim jezicima; b) naročito bliske veze slavenskog s baltičkim I germanskim; c) udio slavenskog i germanskog u staroeuropskoj hidronimiji; d) neprijepornu tezu da svako jezično istraživanje neke regije počinje od imena rijeka i imena mjesta