Search

Background: Completing a master thesis (MT) is mandatory in many undergraduate curricula in medicine but a specific educational model to guide the supervisor-student relationship during the MT has not been published. An attractive model for this purpose is the ‘Educational Alliance’ (EA), which focusses on the ‘clarity and agreement on goals, tasks, relationship and roles’. This study investigated factors and supervisory approaches that can either facilitate or hinder the process of MTs, and related these to the components of the EA. Methods: We conducted separate, semi-structured interviews with students and their corresponding supervisors, after the MT had been accepted. The interviews included open and Likert-type scale questions on factors facilitating or hindering the success of the MT. The authors analyzed the anonymized transcripts using inductive thematic analysis. Results: From 40 interviews related to 20 MTs, we extracted 469 comments and categorized these into four main categories a) ‘Preparation’ b) ‘Process’ c) ‘Atmosphere’ d) ‘Value of the MT’. Overall, interviewees highlighted the importance of clear expectations, a clear research plan, thorough and timely feedback, mutual agreement on timelines, and a positive working atmosphere. These factors appeared well in line with the EA concept. In addition, however, the interviews also showed that careful preparation of the project was regarded as essential. Based on the findings, we provide recommendations for students, supervisors, and the university. Conclusion: In summary, we propose this extended EA model as useful in guiding students, supervisors, and the university towards conducting successful MTs in medicine.

This manuscript investigates clinical decisions and the management of ‘intersex’ children at the University Children’s Hospital Zurich between 1945 and 1970. This was an era of rapid change in paediatric medicine, something that was mirrored in Zurich. Andrea Prader, the principal figure in this paper, started his career during the late 1940s and was instrumental in moving the hospital towards focusing more on expertise in chronic diseases. Starting in 1950, he helped the Zurich hospital to become the premier centre for the treatment of so-called ‘intersex’ children. It is this treatment, and, in particular, the clinical decision-making that is the centre of our article. This field of medicine was itself not stable. Rapid development of diagnostic tools led to the emergence of new diagnostic categories, the availability of new drugs changed the management of the children’s bodies and an increased number of medical experts became involved in decision-making, a particular focus lay with the role of the children themselves and of course with their families. How involved were children or their families in an era widely known as the golden age of medicine?

In the second half of the twentieth century, the Zurich Children’s Hospital (Kispi) developed into an internationally renowned treatment center for »intersexuality.« Children with ambiguous body-sexual characteristics were given there a clearly male or female identification by means of surgical interventions and/or hormone therapies. This study examines the question of how medical and family communication shaped the (narrated) experience of »intersex« treatments. Our analysis is based on nine oral history interviews with former Kispi patients. We show that communication in connection with the treatments was semi-tabooing and directive. We discuss the mode of communication in its social and medical-historical conditions (tabooing of the clitoris and »intersex,« paternalistic relationship between doctors and patients, concealment of »intersex« diagnoses as a doctrine), examine its biographical effects (ignorance of one’s own body, feelings of shame, stigmatization) and address individual processing strategies (breaking taboos, acquisition of knowledge).

Zusammenfassung. Dieser Aufsatz untersucht die Geschichte von Krankenhausinfektionen, die Einführung von Antibiotika und die Entdeckung der Antibiotikaresistenzen in englischen Krankenhäusern zwischen 1930 und 1960. Infektion erwies sich als fast konstantes Problem für das moderne, kurative Krankenhaus. Die Einführung von Sulfonamiden und später von Antibiotika bot eine kosten-effektive, gut verfügbare Gegenmassnahme, die zumindest kurzfristig sehr erfolgreich war. Die längerfristigen Konsequenzen waren allerdings weniger günstig, da schon früh resistente Keime im Krankenhaus auftraten. Rufe nach einem rationalen Umgang mit Antibiotika verhallten ungehört, stattdessen eskalierte das Problem. Der Schock von Staph 80/81, ein gegen alle damals verfügbaren Antibiotika resistenter Keim, sowie die Grippepandemie von 1957/58 beschleunigte die Entwicklung von Methicillin sowie die Durchsetzung strengerer Infektionsprophylaxe im Krankenhaus. Das Problem der Krankenhausinfektionen verschwand dann vorläufig von der Bildfläche.