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Internal medicine residency

Shruti Gupta, Jehan Alladina, Kevin Heaton, Eli Miloslavsky
BACKGROUND: Subspecialty fellows can serve as a tremendous educational resource to residents; however, there are multiple barriers to an effective resident-fellow teaching interaction in the setting of inpatient consultation. We designed and evaluated a resident-directed intervention to enhance communication and teaching during consultation on the general medicine wards. METHODS: Five medical teams were randomized to receive the intervention over a 3 month period (3 control, 2 intervention teams)...
October 20, 2016: BMC Medical Education
Outi Laatikainen, Sami Sneck, Risto Bloigu, Minna Lahtinen, Timo Lauri, Miia Turpeinen
Adverse drug events (ADEs) are more likely to affect geriatric patients due to physiological changes occurring with aging. Even though this is an internationally recognized problem, similar research data in Finland is still lacking. The aim of this study was to determine the number of geriatric medication-related hospitalizations in the Finnish patient population and to discover the potential means of recognizing patients particularly at risk of ADEs. The study was conducted retrospectively from the 2014 emergency department patient records in Oulu University Hospital...
2016: Frontiers in Pharmacology
Juliessa M Pavon, Sandro O Pinheiro, Gwendolen T Buhr
OBJECTIVE: We developed a Transitions of Care (TOC) curriculum to teach and measure learner competence in performing TOC tasks for older adults. DESIGN: Internal medicine interns at an academic residency program received the curriculum, which consisted of experiential learning, self-study, and small group discussion. Interns completed retrospective pre/post surveys rating their confidence in performing five TOC tasks, qualitative open-ended survey questions, and a self-reflection essay...
October 18, 2016: Gerontology & Geriatrics Education
Hiromi Rakugi
European guidelines (ESH-ESC2013) for the elderly have discussed well about treatment blood pressure (BP) levels and targeting BP levels. In general, elderly patients with systolic BP (SBP) ≥160 mmHg including individuals older than 80 years in good physical and mental conditions are recommended reducing SBP to between 150 and 140 mmHg. Furthermore, fit elderly patients <80 years old are recommended to consider antihypertensive treatment at SBP values ≥140 mmHg with a target SBP <140 mmHg. On the other hand, frail elderly patients are recommended to leave decisions on antihypertensive therapy to the treating physician, and based on monitoring of the clinical effects of treatment...
September 2016: Journal of Hypertension
E Chapman, A Eastman, A Gilmore-Bykovskyi, B Vogelman, A J Kind
Older adults often face poor outcomes when transitioning from hospital to home. Although physicians play a key role in overseeing transitions, there is a lack of practice-based educational programs that prepare resident physicians to manage care transitions of older adults. An educational intervention to provide residents with real-life transitional care practice was therefore developed-Resident-coordinated Transitional Care (RC-TraC). RC-TraC adapted the evidence-based Coordinated-Transitional Care (C-TraC) nurse role for residents, providing opportunities to follow patients during the peri-hospital period without additional costs to the residency program...
October 17, 2016: Gerontology & Geriatrics Education
Hong-Bo Yang, Meng-Qi Zhang, Hui Pan, Hui-Juan Zhu
<strong>Objective</strong> To evaluate physicians' attitude and knowledge about the management of adult growth hormone deficiency (AGHD) at Peking Union Medical College Hospital and impact factors associated with better decision-making.<strong>Methods</strong> A 21-question anonymous survey was distributed and collected at Peking Union Medical College Hospital, a major teaching hospital in Chinese Academy of Medical Sciences. Data of physicians' educational background, clinical training, patient workload per year and continuing medical education in AGHD were collected...
September 20, 2016: Chinese Medical Sciences Journal, Chung-kuo i Hsüeh K'o Hsüeh Tsa Chih
Amy H Farkas, Sarah Tilstra, Sonya Borrero, Melissa McNeil
BACKGROUND: Internal medicine residents are expected to be able to provide gender-specific care. The objective of this study was to develop a consensus list of core topics and procedural skills in women's health to allow residency program directors to prioritize and standardize educational efforts in women's health. METHODS: We conducted a two-round Delphi of women's health experts. Participants were given a list of topics and asked to: (1) rank each topic based on how important they felt each topic was for internal medicine residents to be proficient in upon graduation, and (2) identify which topics were critical for a women's health curriculum...
October 12, 2016: Journal of Women's Health
Brielle M Spataro, Sarah A Tilstra, Doris M Rubio, Melissa A McNeil
BACKGROUND: Burnout is a significant problem facing internal medicine residents contributing to increased risk of depression and suicidal ideation. Coping mechanisms and burnout may differ based on sex. METHODS: The study was a retrospective cross-sectional study of reported burnout and coping mechanisms used by internal medicine residents in June 2014 at a large academic center and its community affiliate. Two hundred eighty-five postgraduate year (PGY)-1, 2, 3, and 4 and incoming PGY-1 residents were surveyed...
October 12, 2016: Journal of Women's Health
Tanu S Pandey, Kamajit Singh, German Giese
No abstract text is available yet for this article.
January 2016: Journal of the Association of Physicians of India
J M Porcel, E Cases-Viedma, S Bielsa
OBJECTIVE: Pleural fluid aspiration is a routine procedure for pulmonologists and internists. Our aim was to evaluate technical and methodological aspects of diagnostic and therapeutic thoracenteses performed by last two-year residents of Pulmonology and Internal Medicine. METHODS: An online 24-item questionnaire was sent to participants, and responses were evaluated according to the medical specialty. RESULTS: The survey was completed by 139 (17...
October 4, 2016: Revista Clínica Española
David A Fessler, Grace C Huang, Jennifer Potter, Joseph J Baker, Howard Libman
BACKGROUND: Declining mortality has led to a rising number of persons living with HIV (PLWH) and concerns about a future shortage of HIV practitioners. AIM: To develop an HIV Primary Care Track for internal medicine residents. SETTING: Academic hospital and community health center with a history of caring for PLWH and lesbian, gay, bisexual, and transgender (LGBT) patients. PARTICIPANTS: Internal medicine residents. PROGRAM DESCRIPTION: We enrolled four residents annually in a 3-year track with the goal of having each provide continuity care to at least 20 PLWH...
October 4, 2016: Journal of General Internal Medicine
Debra Pugh, Samantha Halman, Isabelle Desjardins, Susan Humphrey-Murto, Timothy J Wood
: Construct: The impact of using nonbinary checklists for scoring residents from different levels of training participating in objective structured clinical examination (OSCE) progress tests was explored. BACKGROUND: OSCE progress tests typically employ similar rating instruments as traditional OSCEs. However, progress tests differ from other assessment modalities because learners from different stages of training participate in the same examination, which can pose challenges when deciding how to assign scores...
October 2016: Teaching and Learning in Medicine
Onur Asan, Jeanne Tyszka, Kathlyn E Fletcher
OBJECTIVES: To understand (1) the perceptions of patients regarding use of EHR during clinic visits, (2) the impact of the presence of EHR on patient interactions with physicians, and (3) the ways in which EHR usage might increase patient engagement. METHODS: We conducted semi-structured interviews of a convenience sample of patients of internal medicine resident doctors from three primary care clinics. Interviews were audio-recorded and transcribed verbatim. We used thematic analysis to identify themes from the transcripts...
November 2016: International Journal of Medical Informatics
Brandon G Coleman, Thomas M Johnson, Kenneth J Erley, Richard Topolski, Michael Rethman, Douglas D Lancaster
In recent years, evidence-based dentistry has become the ideal for research, academia, and clinical practice. However, barriers to implementation are many, including the complexity of interpreting conflicting evidence as well as difficulties in accessing it. Furthermore, many proponents of evidence-based care seem to assume that good evidence consistently exists and that clinicians can and will objectively evaluate data so as to apply the best evidence to individual patients' needs. The authors argue that these shortcomings may mislead many clinicians and that students should be adequately prepared to cope with some of the more complex issues surrounding evidence-based practice...
October 2016: Journal of Dental Education
Nils Myszkowski, Barbara Villoing, Franck Zenasni, Philippe Jaury, Emilie Boujut
Residents experience severely high levels of stress, depression and burnout, leading to perceived medical errors, as well as to symptoms of impairment, such as chronic anger, cognitive impairment, suicidal behavior and substance abuse. Because research has not yet provided a psychometrically robust population-specific tool to measure the level of stress of medicine residents, we aimed at building and validating such a measure. Using an inductive scale development approach, a short, pragmatic measure was built, based on the interviews of 17 medicine residents...
August 12, 2016: Psychology, Health & Medicine
Sara L Bonnes, John T Ratelle, Andrew J Halvorsen, Kimberly J Carter, Luke T Hafdahl, Amy T Wang, Jayawant N Mandrekar, Amy S Oxentenko, Thomas J Beckman, Christopher M Wittich
PURPOSE: The flipped classroom (FC), in which instructional content is delivered before class with class time devoted to knowledge application, has the potential to engage residents. A Mayo Clinic Internal Medicine Residency Program study was conducted to validate an FC perception instrument (FCPI); determine whether participation improved FC perceptions; and determine associations between resident characteristics, change in quality improvement (QI) knowledge, and FC perception scores...
September 27, 2016: Academic Medicine: Journal of the Association of American Medical Colleges
Sejal H Patel, Sunju Park, Jamie B Rosenberg
PURPOSE: The purpose of this study was to compare pediatric and adult ophthalmology consultations in an urban academic center. METHODS: A retrospective chart review of patients evaluated by the ophthalmology consultation service from January through June 2014 was conducted. RESULTS: A total of 751 inpatients and emergency department patients were evaluated by the ophthalmology consultation service, of whom 152 (20.4%) were children and 598 (79...
September 26, 2016: Journal of Pediatric Ophthalmology and Strabismus
Jennifer M Oshimura, Benjamin D Bauer, Neha Shah, Eugene Nguyen, Jennifer Maniscalco
OBJECTIVES: Pediatric hospitalists report the need for additional training in clinical and nonclinical domains. Pediatric hospital medicine (PHM) fellowships seek to provide this training and produce leaders in the field. Our objective is to describe current roles and perceived training needs of PHM fellowship graduates. METHODS: In 2014, all PHM fellowship graduates were asked to complete a Web-based survey. Survey questions addressed demographics, past training, current roles, and training needs in clinical care, research, education, and administration...
October 2016: Hospital Pediatrics
Abigail Ford Winkel, Nathalie Feldman, Haley Moss, Holli Jakalow, Julia Simon, Stephanie Blank
OBJECTIVE: To determine whether a workshop Narrative Medicine curriculum can improve burnout among obstetrics and gynecology residents. METHODS: A Narrative Medicine curriculum was conducted at three obstetrics and gynecology training programs. An explanatory research design examined correlation between Narrative Medicine attendance and changes in survey responses. Residents completed a pretest and 1-year posttest survey that included validated measures of burnout and empathy...
October 2016: Obstetrics and Gynecology
Martin Sievert, Igor Zwir, Kevin M Cloninger, Nigel Lester, Sandor Rozsa, C Robert Cloninger
BACKGROUND: Multiple factors influence the decision to enter a career in medicine and choose a specialty. Previous studies have looked at personality differences in medicine but often were unable to describe the heterogeneity that exists within each specialty. Our study used a person-centered approach to characterize the complex relations between the personality profiles of resident physicians and their choice of specialty. METHODS: 169 resident physicians at a large Midwestern US training hospital completed the Temperament and Character Inventory (TCI) and the Satisfaction with Life Scale (SWLS)...
2016: PeerJ
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