Objective: To assess whether the clinical experience of undergraduate medical students relates to their performance in final examinations and whether learning styles relate either to final examination performance or to the extent of clinical experience. Design: Prospective, longitudinal study of two cohorts of medical students assessed by questionnaire at time of application to medical school and by questionnaire and university examination at the end of their final clinical year. Subjects: Two cohorts of students who had applied to St Mary's Hospital Medical School during 1980 (n=1478) and 1985 (n=2399) for admission in 1981 and 1986 respectively. Students in these cohorts who entered any medical school in the United Kingdom were followed up in their final clinical year in 1986–7 and 1991-2. Main outcome measures: Students' clinical experience of a range of acute medical conditions, surgical operations, and practical procedures as assessed by questionnaire in the final year, and final examination results for the students taking their examinations at the University of London. Results: Success in the final examination was not related to a student's clinical experiences. The amount of knowledge gained from clinical experience was, however, related to strategic and deep learning styles both in the final year and also at the time of application, five or six years earlier. Grades in A level examinations did not relate either to study habits or to clinical experience. Success in the final examination was also related to a strategic or deep learning style in the final year (although not at time of entry to medical school). Conclusions: The lack of correlation between examination performance and clinical experience calls into question the validity of final examinations. How much knowledge is gained from clinical experience as a student is able to be predicted from measures of study habits made at the time of application to medical school, some six years earlier, although not from results of A level examinations. Medical schools wishing to select students who will gain the most knowledge from clinical experience cannot use the results of A level examinations alone but could assess a student's learning style. Medical students with the most clinical experience do not perform best in final undergraduate examinations, throwing some doubt on the validity of the examinations The amount of knowledge a student gains from clinical experience correlates positively with deep and strategic learning styles as measured not only in the final year but also at the time of selection, five or six years earlier If it is important for students to obtain as much clinical experience as possible then final examinations require restructuring to assess and reward clinical experience, and selection should emphasise deep learning which cannot be assessed from grades at A level The use of deep and strategic learning styles in the final year of medical school predicts better performance in the final examination, but the same measures at the time of selection for admission to medical school do not predict examination performance

Research evidence demonstrates that sex offender treatment programmes (SOTPs) can reduce the number of sex offenders who are reconvicted. However, there has been much less empirical research exploring the experiences and perspectives of the prison environment within which treatment takes place. This is important, particularly for sexual offenders, as they often face multiple stigmas in prison. This study used a mixed-methods approach to explore the experiences of prisoners and staff at a therapeutically orientated sexual offenders’ prison to understand whether the prison environment was conducive to rehabilitation. The quantitative strand of the research sampled prisoners (n = 112) and staff (n = 48) from a therapeutically orientated sex offenders prison. This strand highlighted that both prisoners and staff had positive attitudes toward offenders and high beliefs that offenders could change. Importantly, the climate was rated positively and, in particular, participants had very high ratings of “experienced safety.” The qualitative strand of the research consisted of semistructured interviews with prisoners (n = 15) and a range of prison staff (n = 16). The qualitative analysis revealed positive prisoner views toward staff relationships, with most participants articulating that the prison and its staff had contributed to positive change in prisoners. Crucially, the environment was perceived as safe and allowed prisoners “headspace” to work through problems and contemplate change. This research offers some support to the notion that context is important for sex offender rehabilitation.

Objectives: To assess the effects of taking an intercalated degree (BSc) on the study habits and learning styles of medical students and on their interest in a career in medical research Design: Longitudinal questionnaire study of medical students at application to medical school and in their final year. Setting: All UK medical schools Participants: 6901 medical school applicants for admission in 1991 were studied in the autumn of 1990. 3333 entered medical school in 1991 or 1992 and 2695 who were due to qualify in 1996 or 1997 were studied 3 months before the end of their clinical course. Response rates were 92% for applicants and 56% for final year students. Main outcome measures: Study habits (surface, deep, and strategic learning style) and interest in different medical careers, including medical research. Identical questions were used at time of application and in final year. Results: Students who had taken an intercalated degree had higher deep and strategic learning scores than at application to medical school Those with highest degree classes had higher strategic and deep learning scores and lower surface learning scores. Students taking intercalated degrees showed greater interest in careers in medical research and laboratory medicine and less interest in general practice than their peers. The effects of the course on interest in medical research and learning styles were independent. The effect of the intercalated degree was greatest in schools where relatively few students took intercalated degrees. Conclusions: Intercalated degrees result in a greater interest in research careers and higher deep and strategic learning scores. However, the effects are much reduced in schools where most students intercalate a degree Introduction of intercalated degrees for all medical students without sufficient resources may not therefore achieve its expected effects. Although intercalated degrees are well established, little is known about their effect on medical students In this longitudinal study final year students who had taken intercalated degree were more interested in medical research, and had higher deep and strategic learning style scores than other students The effects of the intercalated degree were dose dependent, being greatest in those gaining a first class degree The effects of the intercalated degree were greatest in medical schools where a relatively small proportion of medical students took the degree Differences between medical schools are most easily explained by resource dilution

The high prevalence rates and numerous consequences associated with child sexual abuse makes preventing these offences a societal priority. Prevention strategies have traditionally involved only tertiary interventions, implemented by the criminal justice system after an offence has occurred. More recently, some have argued for a public health approach to preventing child sexual abuse, which includes interventions at the primary and secondary levels. Secondary prevention aims to provide treatment and support to those at-risk of sexually offending before any involvement with the legal system. Increased demand for secondary prevention services and early results from current initiatives demonstrate that at-risk individuals are willing to seek treatment without external pressure from the legal system, and often report numerous treatment-related benefits. These findings support the need for widespread implementation of primary and secondary prevention initiatives. The safety of children requires that society stops merely reacting to sexual offences, and instead begins implementing proactive evidence-based strategies that can prevent even initial incidents of child sexual abuse. This article explores some of the many benefits and barriers associated with primary and secondary prevention, as well as strategies for overcoming these barriers. Recommendations for the development and implementation of prevention initiatives are also included.

Objective : To assess whether people from ethnic minority groups are less likely to be accepted at British medical schools, and to explore the mechanisms of disadvantage. Design : Prospective study of a national cohort of medical school applicants. Setting : All 28 medical schools in the United Kingdom. Subjects : 6901 subjects who had applied through the Universities' Central Council on Admissions in 1990 to study medicine. Main outcome measures : Offers and acceptance at medical school by ethnic group. Results : Applicants from ethnic minority groups constituted 26.3% of those applying to medical school. They were less likely to be accepted, partly because they were less well qualified and applied later. Nevertheless, taking educational and some other predictors into account, applicants from ethnic minority groups were 1.46 times (95% confidence interval 1.19 to 1.74) less likely to be accepted. Having a European surname predicted acceptance better than ethnic origin itself, implying direct discrimination rather than disadvantage secondary to other possible differences between white and non-white applicants. Applicants from ethnic minority groups fared significantly less well in 12 of the 28 British medical schools. Analysis of the selection process suggests that medical schools make fewer offers to such applicants than to others with equivalent estimated A level grades. Conclusions : People from ethnic minority groups applying to medical school are disadvantaged, principally because ethnic origin is assessed from a candidate's surname; the disadvantage has diminished since 1986. For subjects applying before A level the mechanism is that less credit is given to referees' estimates of A level grades. Selection would be fairer if (a) application forms were anonymous; (b) forms did not include estimates of A level grades; and (c) selection took place after A level results are known. Key messages: Key messages Applicants from ethnic minority groups continue to fare less well in being selected for medical school, although the extent of disadvantage is reduced in comparison with previous studies Since surname is a better predictor of disadvantage than ethnic origin as such, discrimination could be reduced by making application forms anonymous The locus of disadvantage in applicants is principally that estimated A level grades on application forms are given less weight in ethnic minority applicants—the problem could be circumvented by selecting medical students after they have their A level results No disadvantage was experienced by female applicants, mature applicants, or those from public sector schools, and no advantage was shown for those from medical families