The Routine School Medical Inspection: A Study of the Efficiency of the Present Form of Examination

Laurie, Alexander (1961) The Routine School Medical Inspection: A Study of the Efficiency of the Present Form of Examination. MD thesis, University of Glasgow.

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The present system of school health administration places most emphasis on health supervision: the present basis of health supervision is the routine medical inspection. The routine medical inspection is used primarily for the detection of defects and its efficiency in this role requires assessment. The effectiveness of the inspection has frequently been criticised but there is little factual evidence from within the school health service that the inspection is seriously inaccurate. The purpose of the present study is to demonstrate this inaccuracy. A further purpose is to demonstrate the presence of certain restricting factors in the circumstances of the inspection which may be in part responsible for the inaccuracy. The parents of 580 children about to leave school were invited to submit their children for special medical examination under school health service arrangements. 562 children attended and were examined. The examinations were conducted in circumstances which were the best the school health service could provide. Ample time was given, satisfactory accommodation provided, special efforts made to obtain attendance of parents and full use made of all special diagnostic and screening techniques, including the use of questionnaires, which could be made available by the service. Physicians of consultant status carried out examinations. The examinations revealed 497 defects in the 562 children. The findings were compared with the contents of the school health service medical records of the children. 189 of the defects found at the special medical examination had been recorded by the school health service but 13 of these had been recorded under a different diagnosis. The service had no record of 308 of the defects found at the special medical examination. The findings demonstrate the importance of close co-operation with parent and teacher, and the importance of the screening techniques of audiometry and colour vision testing. The study suggests the inadequacy of time and of medical examination rooms as possible causes of inaccurate inspection, and the unsatisfactory form of medical record card at present in use as a cause of inadequate recording. The findings lead to the recommendation that further study is required of the value of urine testing and blood pressure estimation as screening procedures for routine use by the service. The true role of the routine medical inspection should be decided. If its purpose is the discovery of defects then it should be planned either as a diagnostic exercise or a screening procedure. In its present form, it is neither of these.

Item Type: Thesis (MD)
Qualification Level: Doctoral
Keywords: Public health, Educational administration
Date of Award: 1961
Depositing User: Enlighten Team
Unique ID: glathesis:1961-79380
Copyright: Copyright of this thesis is held by the author.
Date Deposited: 05 Mar 2020 10:30
Last Modified: 05 Mar 2020 10:30

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