Thursday, February 21, 2002 TODAY
- Medical pioneer calls for equality in health care
- Study of approaches to learning histology published
in professional journal
Medical pioneer calls for equality in health care
Richard Allen Williams, MD, presented the first annual Dr. Martin Luther
King Jr. Memorial Lecture for the School of Medicine in celebration of
Dr. King's national holiday.
The presentation and his professional accomplishments reflect his dedication
to procuring health-care access for everyone.
In an effort to review medical practice patterns of the previous century
in the United States in regards to minority patients, with the objective
of teaching the history of deficient health-care delivery, Dr. Williams
painted a picture seldom seen.
“One should keep in mind the diverse nature of our country and how
this diversity impacts upon the way in which medicine should be taught
and practiced,” Dr. Williams said. “They [doctors of African
descent] have been left out of the textbooks of medical history, leaving
us with the perception that dark-skinned people have done little to advance
their own cause of improving health care conditions. This is certainly
not true.”
And Dr. Williams proved this in his presentation, naming 12 individuals
(several slaves) who added significant contributions to medical progress.
Traveling back to 3000 B.C., Dr. Williams introduced Imhotep, chief physician
for the third dynasty of Egypt. Imhotep, of sub-Saharan origin, was renowned
for his knowledge of the heart and circulation of the blood.
Other little-known African descendants mentioned were Onesimus, a slave
who initiated the practice of smallpox vaccination. Papan, a Virginia
slave, earned his freedom with his skill for treating skin and venereal
diseases. Primus was a “slave-doctor,” pioneering in the treatment
of rabies and snakebites. David John Peck, MD, became the first Black
graduate of an American medical school in 1847.
Charles R. Drew, MD, headed the British blood plasma project and conceived
the idea of the blood bank in 1941. John Beauregard Johnson, MD, chair
of medicine at Howard University College of Medicine, called attention
to the serious problem of hypertension in Blacks.
To this list can be added Dr. Williams, who in 1974 founded the Association
of Black Cardiologists. This was one way he decided to focus attention
on what he calls the “death gap,” wrote Deborah Schneider in
a profile of Dr. Williams' life and career in the March/April, 2001 issue
of Harvard Magazine.
The death gap refers to the fact that Blacks in the United States have
a shorter life expectancy than Whites by about seven years.
A year later, Dr. Williams became an author. “As a young postgraduate
cardiology trainee at Harvard in the late 1960s, I became interested in
the medical predicament of my people,” he said during the presentation.
“I decided that the first thing to do was to research, analyze, and
investigate the situation. The results of my efforts were produced in
1975 in the Textbook of Black-related Diseases, which was the first and
only textbook of medicine written by a Black person about illnesses which
predominantly affect Blacks.”
Coining the terms “Black-related diseases” and “ethnic
medicine,” his 1975 book still stands as the pre-eminent authority
on the subject of diseases affecting the Black population.
Dr. Williams has done much to reverse the undercurrent of medical care
started centuries ago, raising awareness of those “who regulated
Blacks to an inferior sub-human species” such as Dr. Samuel George
Morton, who wrote the book Crania Americana in 1839. The book published
Dr. Morton's claim that measurements of the human skull demonstrated marked
differences between racial types, with Caucasians having larger skulls
(and therefore larger brains) than Blacks. This was the basis of the pseudoscience
of phrenology, which was taught in medical schools and discussed and accepted
by the premier physicians and scientists of the day.”
In 1987, Dr. Williams founded the Minority Health Institute, of which
he is president and CEO. The group aims to promote the concept of humane
medicine through symposia, similar to the one Dr. Williams presented at
the School of Medicine.
“We need to have full-fledged departments of diversity in all of
the 125 medical schools in the nation,” he said. Currently less than
10 percent have such a department. “Humane medicine should be the
core of the curriculum, which teaches students the tenets of cultural
diversity, sensitivity, understanding, and compassion. Attendance at a
course in humane medicine would be required of all students.”
Dr. Williams presented a review of statistics of health-care disparities
between minorities and the majority populations, with the objective of
determining causes of the difference, in order to eliminate those causes.
“I want to ask you…to try to leave this room with something
of value you can utilize to treat your patients better and to improve
medical education in the classroom,” he said.
Now a professor at UCLA School of Medicine, Dr. Williams has spent his
career focused on the particular health-care needs of minority populations.
His immediate goal is to “assure the minorities of this country that
the low standard of medical treatment they receive is not America's final
answer.”
And with doctors like Dr. Williams, change is only a matter of time.
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Study of approaches to learning histology published in professional journal
An opinion survey of histology learning resources by dentistry students,
developed by the School of Medicine department of anatomy, was published
in the fall, 2001, issue of The Anatomical Record (New Anatomist) 265:
222-227.
Written by Paul J. McMillan, PhD, professor of anatomy, and titled “Exhibits
Facilitate Histology Laboratory Instruction: Student Evaluation of Learning
Resources,” the article describes the student opinion survey and
its findings.
“A thorough understanding of histology requires the development of
three-dimensional mental images of arrangements of cells that form the
component parts
of organs,” Dr. McMillan says in the article. “Because these
images must be derived from two-dimensional sections, it is imperative
that the student has clear instruction on the interpretation or the sections.”
Traditional microscope laboratories are typically difficult to maintain.
Dr. McMillan continues, “Increasingly, the cost of maintaining such
facilities and the pressure to reduce the time dedicated to the study
of histology have led faculty to look more favorably on alternative modes
of laboratory instruction.”
While digital slide review is far more efficient, students lose the opportunity
to develop necessary skills needed for using a microscope for study and
diagnosis.
The anatomy department, according to Dr. McMillan, has chosen to integrate
aspects of both the traditional and more recent digital approaches into
its learning resource exhibits.
Six components make up the system: weekly exhibits, black and white copies
of atlas materials, a CD atlas with annotated color images, printed color
atlas materials (prepared by many of the students), exhibit demonstration
videos, and pre-exam review videos.
The exhibits are set up in advance of the corresponding lecture to provide
students with an introduction to the material. Exhibit materials are based
entirely on the corresponding slide sets.
The microscopes and slide sets are accessible by the students for 70 hours
a week. During specified times, a laboratory instructor is available to
answer any questions the students might have.
“During the eighth week of the quarter,” Dr. McMillan explains,
“the students were asked to complete an anonymous survey evaluating
the six components of the course.”
Virtually full participation was achieved by offering students an additional
five percentage points on the weekly written quiz. Of the 92 students
in the course, 89 returned their surveys.
The review videos received the highest rating, while the CD atlas received
the lowest. However, all of the components received relatively favorable
ratings by the students.
“It is a hallmark of success that, in this study, nothing was valued
significantly more highly than the microscope exhibit,” Dr. McMillan
emphasizes.
Naturally, individual students gave the highest rating to the components
with which they spent the greatest amount of time.
Dr. McMillan points out, “One can only speculate that, as students
become more comfortable by using the computer as a study resource—as
opposed to hard copies—and as more interactive software become available,
computers will be increasingly valued in histology education.”
The transition from traditional laboratory experience to one based solely
on exhibits has been gradual.
“The first step in that transition began in 1995 with the assembly
of 20 study sets each with its own unique ‘low power atlas,'”
Dr. McMillan clarifies. “During the next two years, these sets went
through two major revisions.”
Others involved in the project have included Robert Schultz, professor
of anatomy, who reviewed all of the atlas pages and provide many helpful
suggestions; David Henderson, PhD, assistant professor of anatomy, for
review of the article; Ann Gallion-Ingram, who provided secretarial support;
and high school students David Jung, Candra Malone, Redee Yosef, Michael
Jung, Daniel Lee, and Sannon Oh, as well as high school teacher Thomas
Quinn.
|Top| [February 21, 2002 TODAY]
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