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According to the Bureau of Labor Statistics (cf. Crispell, 1990), the medical clerical field is one of the faster growing areas of employment. This paper reports on long‐term employment of trainees involved in nontraditional medical clerical programs. These programs were funded by the Job Training Partnership Act (JTPA) and filled both the needs of the local rural health care facilities and the employment needs of unskilled youths and adults. These nontraditional students of low socioeconomic background and poor work history were successfully mainstreamed into university courses and consequently obtained productive employment. A follow‐up study was conducted of 64 individuals who completed three different, one‐year JTPA programs. The study investigated the following questions: Was the trainee currently employed? If so, was employment related to the training program, and were the quarterly salaries higher than minimum wage and previous salaries? How many different jobs were reported since training? Did the individual retain employment in a rural setting? The JTPA programs at Southern Illinois University included some innovative yet practical components that resulted in very high program completion rates, high initial placement, and a continuing pattern of long‐term employment. These components included: emphasis on training for the most needed positions/jobs that matched university capabilities; the pursuit of higher starting salaries; informing participants of support services; training in job hunting and work readiness; using some individualized, competency‐based instruction; establishing internship arrangements with prospective employers; and careful matching of the trainee to initial placement site with consideration of personality as well as skills. Copyright © 1992, Wiley Blackwell. All rights reserved

In Britain, the National Council for Vocational Qualifications is developing a new framework of vocational qualifications (NVQs). This paper presents an analysis of the place of this emerging system within the broader context of 16-19 education. The needs for reform of 16-19 provision are identified, and the potential contribution of NVQs to meeting them is analysed. Firstly, it is suggested that NVQs may not contribute sufficiently to student/trainee empowerment, because of employer control of the system. Secondly, while NVQs may be well suited to the training of adults in employment, it is suggested that they are ill-equipped to meet the needs of students on full-time vocational courses. Based on this analysis, three alternative future scenarios for 16-19 education and training are presented, and the strengths and weaknesses of each identified. It is concluded that the extensive use of NVQs within 16-19 education and training is likely to be counterproductive. © 1991, Taylor & Francis Group, LLC. All rights reserved.

The Technical and Vocational Education Initiative (TVEI) is a four year programme of study for 14-18 year olds which aims to provide vocational and general education broadly related to employment trends. It was announced by the Prime Minister in 1982 and in 1986 the government signalled its intention to extend TVEI to all local education authorities (LEAs) in England and Wales. Although it is not yet clear how much of TVEI will be retained within or alongside the National Curriculum, elements of the Initiative will undoubtedly affect the future education of school students. The central curricular feature of TVEI has been work-experience and in 1988 the Department of Education and Science (DES) announced that this activity was to be extended to all secondary students in England and Wales. This paper analyses the recent development of work-experience, locates it within broader shifts which have taken place in the school-society relationship and uses data from eight LEAs to examine its organization and effects on participating students. © 1991, BSA Publications Limited. All rights reserved.

Although a few surgical residents do leave the surgical field, little research has been done into the eventual whereabouts of all surgical residents. We undertook this follow-up to find out what proportion of them enter the surgical field and to identify changing patterns over the past 15 years. We compared 593 medical schoool graduates on demographics, academic credentials, and surgery program directors' rating of their performance in the first postgraduate year (PGY-1). Sixty percent remained in general surgery, and about 26% moved to another specialty within the surgical field. During the mid-1970s, those who remained within the surgical field had better academic credentials on average than those who switched out of the surgical field. However, more recently, the trend has reversed. There were no differences between the groups on age or sex. These results suggest that some good students are being recruited into surgical programs but are later lost in major career switches. Perhaps these changes are related to residents' preferences for specialties that offer more controllable lifestyles than the surgical field. © 1991.

Recent research points to an association between participation in certain kinds of secondary vocational programs and the development of improved attitudes (e.g. toward self, school, work, and others). There is considerable disagreement, however, over the meaning of these findings. Supporters of vocational education suggest they reflect the capacity of vocational programs to enhance the work skills and opportunity of disadvantaged participants; critics, on the other hand argue they reveal the process by which vocational education actually inhibits the opportunity of such youth by fostering compliant work attitudes and an acceptance on their part of low status employment. The study here is an attempt to address this debate through ethnographic investigation. It suggests that while most of the students found their programs enjoyable and rewarding, this response was, generally, the product of a complex assemblage of personal, social, economic, family, and educational factors which worked against the goal of increasing the students' ooportunity. Although the vocational education experience was only one part of this network, it did tend to reinforce class-related inequalities. © 1990, Taylor and Francis Group, LLC. All rights reserved.

A questionnaire was designed and distributed to students in 12 randomly selected physiotherapy schools. The questionnaire sought information on the students' evaluation of nursing experience. The majority of students were very satisfied both with the time spent on this placement and with the quality of experience gained, but felt an improvement could be made in the actual organisation of the placement. © 1990, The Chartered Society of Physiotherapy. All rights reserved.

A randomized controlled trial was performed to study the effect on various teaching techniques on students performing sacroiliac motion palpation tests. This trial assessed the interexaminer reliability of interns in their final year at a chiropractic college, and compared their results prior to and following 1 year of clinical experience. The study also compared the intra- and interexaminer reliability of experienced clinicians. The results were analyzed via the Kappa coefficient. Kappa values for interns ranged from 0.00 to 0.30, with no significant differences noted at the end of 1 year of clinical experience. The interexaminer reliability of experienced clinicians was 0.00 to 0.167, whereas their intraexaminer reliability ranged from 0.15 to 1.00. These results question the role of experience in improving clinical accuracy between examiners performing sacroiliac motion palpation. Results analyzed for intraexaminer agreement were moderate to almost perfect. We conclude that experience does not play a significant role in the diagnostic test analyzed, but rather that clinicians may establish their own criteria by which to determine the standards of a given test.

This article may be of interest to physical therapy educators who are responsible for structuring station or practical examinations used to evaluate physical therapy students. The global intent of the article is to provide information that may be useful in selecting test items. Specifically, the purposes of this study were 1) to examine how two item-sampling strategies (one based on different diagnostic concepts, or diagnostic probes, and the other based on different anatomical sites) influenced the generalizability of a station examination, 2) to determine the interrater reliability during the station examination, and 3) to determine whether the status of the rater (that of observer or simulated patient) influenced the rating. Using a nested study design, 24 physical therapy students were assessed by eight raters. The raters were randomly and equally assigned to four teams. Each team assessed six students. One rater acted as the simulated patient for the first three students in each group, and the other rater acted as observer. This order was reversed for the last three students. Each student performed nine mini-diagnostic patient cases consisting of three diagnostic probes reproduced at three different anatomical sites. The results demonstrate that 1) similar diagnostic concepts can be generalized across anatomical sites, although different concepts or skills cannot be generalized at a given anatomical site or across sites; 2) interrater reliability was excellent; and 3) the status of the raters (ie, simulated patient or observer) did not bias the ratings. These findings suggest that increasing the number of diagnostic probes is a better strategy than increasing the number of anatomical sites for improving the overall test generalizability. Furthermore, costs (ie, expenditures of faculty time and funds) can be reduced by using a single rater acting as both the simulated patient and the rater.

Developmental pediatricians are being consulted by medical school promotion committees with regard to the course of action to be taken with learning-disabled medical students experiencing academic difficulties. Faculty attitude, a difficulty understanding the nature of learning disabilities, appears to be a major contributor to poor medical school performance on the part of learning-disabled adults. Utilizing the sequential-simultaneous information processing model as a simplified introduction to learning disability patterns, the authors argue that recommending intensive remediation of rote spelling and writing skills in students engaged in graduate education represents both a waste of time and a further emotional trauma to these young professionals. © 1989 by Williams & Wilkins Co.

This paper reviews the integration of an active teaching program into a busy treatment facility. All first and second year medical students at the University of California, San Diego take part in a series of didactic lectures and small group discussions, while third and fourth year students have the opportunity of joining a treatment team for 4 to 6 weeks. All psychiatric residents spend a minimum of 8 weeks working on the unit, and one fourth year resident is chosen to work with the staff for a year. The interactions between treatment teams and students in various stages of development help maximize enthusiasm and the commitment to the best patient care possible. Copyright © 1989, Wiley Blackwell. All rights reserved