Objective Because psychoeducational primary prevention programs for eating disorders have met with little success, this preliminary experiment tested a dissonance‐based targeted preventive intervention. Method Female undergraduates (N = 30) with elevated body image concerns were assigned to a three‐session intervention, wherein they voluntarily argued against the thin ideal, or a delayed‐intervention control condition. Participants completed a baseline, termination, and a 1‐month follow‐up survey. Results The intervention resulted in a subsequent decrease in thin‐ideal internalization, body dissatisfaction, dieting, negative affect, and bulimic symptomatology, with most changes remaining at the 1‐month follow‐up. Discussion These preliminary results suggest that this dissonance‐based targeted prevention intervention reduces bulimic pathology and known risk factors for eating disturbances, and provide experimental support for the claim that thin‐ideal internalization contributes to body dissatisfaction, dieting, negative affect, and bulimic symptoms. © 2000 by John Wiley & Sons, Inc. Int J Eat Disord 27: 206–217, 2000.

In 2005, medical educators at the University of California, San Francisco (UCSF), began developing the Parnassus Integrated Student Clinical Experiences (PISCES) program, a year-long longitudinal integrated clerkship at its academic medical center. The principles guiding this new clerkship were continuity with faculty preceptors, patients, and peers; a developmentally progressive curriculum with an emphasis on interdisciplinary teaching; and exposure to undiagnosed illness in acute and chronic care settings. Innovative elements included quarterly student evaluation sessions with all preceptors together, peer-to-peer evaluation, and oversight advising with an assigned faculty member. PISCES launched with eight medical students for the 2007/2008 academic year and expanded to 15 students for 2008/2009. Compared to UCSF's traditional core clerkships, evaluations from PISCES indicated significantly higher student satisfaction with faculty teaching, formal didactics, direct observation of clinical skills, and feedback. Student performance on discipline-specific examinations and United States Medical Licensing Examination step 2 CK was equivalent to and on standardized patient examinations was slightly superior to that of traditional peers. Participants' career interests ranged from primary care to surgical subspecialties. These results demonstrate that a longitudinal integrated clerkship can be implemented successfully at a tertiary care academic medical center.

Research suggests that dieting is a risk factor for bulimia nervosa, yet little is known about the predictors of dieting. Accordingly, this study examined the correlates and prospective predictors of dieting in a community sample of adolescent girls (N = 320). Results indicated that body mass, pressure to be thin, thin-ideal internalization, body dissatisfaction, and binge eating were positively correlated with dieting. Moreover, body mass, pressure to be thin, body dissatisfaction, and binge eating prospectively predicted increased dieting over a 9-month period. Multivariate analyses revealed that this set of predictors accounted for significant variance in concurrent and subsequent dieting, although only some of the unique effects were significant in the full models. Not only do these findings identify several risk factors for dieting, but they also suggest that dieting may be a response to bulimic pathology.Mounting evidence suggests that dieting represents a key risk factor for the development of bulimic pathology (Heatherton & Polivy, 1992;Striegel-Moore, 1993). Dieting is defined as intentional efforts to achieve or maintain a desired weight through reduced caloric intake (Brownell & Rodin, 1994;Laessle, Tuschl, Kotthaus, & Pirke, 1989). According to restraint theory (Polivy & Herman, 1985), dieting leads to disinhibited eating because of both physiological (e.g., altered hormonal reflexes) and psychological mechanisms (cognitively produced disin-

Preceptors and students perceived evaluation in an LIC more favourably than evaluation on block clerkships. For educators working to improve student evaluation, further examination of the LIC structure and evaluation processes that seem to enhance both formative assessment and summative evaluation may be useful to improve the quality of evaluation and feedback.