title: Clinical learning experiences of Israeli medical students in health promotion and prevention of cancer and cardiovascular diseases.
abstract: BACKGROUND
  The importance of health promotion and disease prevention in health policy and clinical practice is widely accepted in many countries. However, a large number of medical schools do not dedicate a significant part of their curriculum to these aspects. In Israel, there are no reports on the training of the future physician towards his or her role as health promoter in general, or in the areas of cardiovascular and cancer diseases specifically.
  
  
  OBJECTIVE
  To examine the preparation of Israeli medical students for the role of health promoter in cancer and cardiovascular diseases.
  
  
  METHODS
  The study was carried out over 2 years in two of the four medical schools in Israel: the Sackler Faculty of Medicine at Tel Aviv University and the Faculty of Health Sciences at Ben-Gurion University in Beer Sheva. The students (n = 172, 70% response rate) were surveyed during 1999-2000 by means of a questionnaire, which included assessment of their training towards the role of health promoter, their clinical experiences and exposure to patients at different stages of illnesses at various medical sites, and the specific skills and relevant knowledge they acquired.
  
  
  RESULTS
  Most of the students' learning experiences occurred in hospitals with patients at the treatment stage and little time was dedicated to prevention, especially in the community. They demonstrated better knowledge, skills and satisfaction with their learning experiences in CVD than in cancer; and reported having insufficient exposure to several common cancer diseases and lacking examining skills for early detection of cancer. The students in Beer Sheva had significantly more interaction with patients at different stages of CVD and acquired more examination skills than the Tel Aviv students.
  
  
  CONCLUSIONS
  A change in the curriculum is urgently needed: namely training medical students in community settings and preparing them to promote the well-being of their patients, including prevention. Attention should be given to launching new learning modes in the pre-clinical and clinical curriculum. We propose that: a) pre-clinical courses include prevention techniques in CVD and cancer, problems of cancer patients, and some examining skills; and b) the clinical phase should integrate oncology concepts and total cancer and CVD care into existing clerkships in the hospitals and in the community.
authors.affiliation: Unit of Medical Education, Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Israel. mededu@post.tau.ac.il
authors.forename: Netta
authors.initials: N
authors.lastname: Notzer
authors.forename: Ruth
authors.initials: R
authors.lastname: Abramovitz
mesh_terms: D000328:Adult; D002309:Cardiology / Q000193:education*; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000517:prevention & control* / Q000628:therapy; D002983:Clinical Competence; D004504:Education, Medical, Undergraduate; D005260:Female; D006293:Health Promotion; D006801:Humans; D007557:Israel; D008297:Male; D008495:Medical Oncology / Q000193:education*; D009369:Neoplasms / Q000175:diagnosis / Q000517:prevention & control* / Q000628:therapy; D010819:Physician's Role; D013337:Students, Medical; D011795:Surveys and Questionnaires