Home About us Contact
|
Home About us Contact | ||
|
|
||
Year Residents (year + resident)
Selected AbstractsUse of an innovative video feedback technique to enhance communication skills trainingMEDICAL EDUCATION, Issue 2 2004Debra L Roter Context, Despite growing interest in medical communication by certification bodies, significant methodological and logistic challenges are evident in experiential methods of instruction. Objective, There were three study objectives: 1) to explore the acceptability of an innovative video feedback programme to residents and faculty; 2) to evaluate a brief teaching intervention comprising the video feedback innovation when linked to a one-hour didactic and role-play teaching session on paediatric residents' communication with a simulated patient; and 3) to explore the impact of resident gender on communication change. Design, Pre/post comparison of residents' performance in videotaped interviews with simulated patients before and after the teaching intervention. Individually tailored feedback on targeted communication skills was facilitated by embedding the Roter Interaction Analysis System (RIAS) within a software platform that presents a fully coded interview with instant search and review features. Setting/participants, 28 first year residents in a large, urban, paediatric residency programme. Results, Communication changes following the teaching intervention were demonstrated through significant improvements in residents' performance with simulated patients pre and post teaching and feedback. Using paired t -tests, differences include: reduced verbal dominance; increased use of open-ended questions; increased use of empathy; and increased partnership building and problem solving for therapeutic regimen adherence. Female residents demonstrated greater communication change than males. Conclusions, The RIAS embedded CD-ROM provides a flexible structure for individually tailoring feedback of targeted communication skills that is effective in facilitating communication change as part of a very brief teaching intervention. [source] 18 Graduate Medical Education and Knowledge Translation: One Problem-Specific Approach in ResidencyACADEMIC EMERGENCY MEDICINE, Issue 2008Christopher Carpenter Traditional graduate medical education approaches to improving clinical performance based upon the latest research have included Journal Club and didactic lectures. Unfortunately, these educational interventions have rarely been demonstrated to change practice behavior or improve patient-important outcomes. Using a structured approach to identifying a gap between best-evidence knowledge and clinical practice, an illustrative one-year residency-wide translational research project was developed in a four year emergency medicine training program. Step one (assigned to the second year residents): identify and quantitatively justify a Knowledge Translation (KT) deficit within our institution. They identified steroids in adult bacterial meningitis as an unequivocal therapeutic option. Based upon a structured one-year chart review, they next demonstrated that only 7% of meningitis patients received pre-antimicrobial steroids. The next step (assigned to the first year residents): identify and quantify the physician "leaks" within the pipeline of information from publication to bedside utilization via an online survey. The third year residents hypothesized plugs for these information leaks, including examples of other specialties or institutions which have successfully navigated this specific clinical scenario. Finally, at an end-of-year Journal Club, the fourth year residents formulated a protocol for the appropriate use of steroids in suspected adult meningitis and brought together individuals from within the institution contributing to the best-practice leak. Knowledge Translation involves multiple stages beyond simple evidence awareness and usually involves continuation beyond the emergency department. The Washington University KT project offers a structured, multidisciplinary example of moving beyond contemplation to implementation of an unequivocal therapy. [source] Cannabis Use and Sexual HealthTHE JOURNAL OF SEXUAL MEDICINE, Issue 2pt1 2010Anthony M.A. Smith PhD ABSTRACT Introduction., Cannabis is the most commonly used illicit substance worldwide. Despite this, its impact on sexual health is largely unknown. Aim., The aim of this article is to examine the association between cannabis use and a range of sexual health outcomes. Main Outcome Measures., The main outcome measures include the number of sexual partners in the past year, condom use at most recent vaginal or anal intercourse, diagnosis with a sexually transmissible infection in the previous year, and the occurrence of sexual problems. Methods., Method used in this article includes a computer-assisted telephone survey of 8,656 Australians aged 16,64 years resident in Australian households with a fixed telephone line. Results., Of the 8,650 who answered the questions about cannabis use, 754 (8.7%) reported cannabis use in the previous year with 126 (1.5%) reporting daily use, 126 reported (1.5%) weekly use, and 502 (5.8%) reported use less often than weekly. After adjusting for demographic factors, daily cannabis use compared with no use was associated with an increased likelihood of reporting two or more sexual partners in the previous year in both men (adjusted odds ratio 2.08, 95% confidence interval 1.11,3.89; P = 0.02) and women (2.58, 1.08,6.18; P = 0.03). Daily cannabis use was associated with reporting a diagnosis of a sexually transmissible infection in women but not men (7.19, 1.28,40.31; P = 0.02 and 1.45, 0.17,12.42; P = 0.74, respectively). Frequency of cannabis use was unrelated to sexual problems in women but daily use vs. no use was associated with increased reporting among men of an inability to reach orgasm (3.94, 1.71,9.07; P < 0.01), reaching orgasm too quickly (2.68, 1.41,5.08; P < 0.01), and too slowly (2.05, 1.02,4.12; P = 0.04). Conclusions., Frequent cannabis use is associated with higher numbers of sexual partners for both men and women, and difficulties in men's ability to orgasm as desired. Smith AMA, Ferris JA, Simpson JM, Shelley J, Pitts M, and Richters J. Cannabis use and sexual health. J Sex Med 2010;7:787,793. [source] Developmental, behavioural and somatic factors in pervasive developmental disorders: preliminary analysisCHILD: CARE, HEALTH AND DEVELOPMENT, Issue 1 2004P. Whiteley Abstract Objectives To ascertain the frequency of parental reporting of selected variables related to development, behaviour and physiology in subgroups diagnosed with pervasive developmental disorders (PDDs) and identify any significant intragroup differences. Design Retrospective cross-sectional analysis of records of patients (n = 512) held on a computerized database with a chronological age between 3 and 11 years resident in the UK/Republic of Ireland and with a formal diagnosis of autism, Asperger syndrome (AS) or autism spectrum disorder (ASD). Methods Non-parametric analysis (P > 0.01) of the frequency of specific variables for PDD subgroups reported by parents/primary caregiver. Variables included timing of symptom onset, presence of skills acquired prior to symptom onset, indications of regression and regression events, current language, history of viral infections, history of ear problems, achievement of continence, current skin complaints, current bowel habits and adverse events at parturition. Results Preliminary results showed general agreement with the principle diagnostic differences between the PDD subgroups with patients diagnosed with AS showing an increased frequency of skills acquired before symptom onset (two- to three-word phrase speech, toileting skills) and a decreased frequency of regression in acquired skills when compared with other PDD subgroups. Developmental milestones such as the achievement of bowel and bladder continence were also more frequently reported for the AS group. Infantile feeding problems defined as vomiting, reflux, colic and failure to feed were more frequently reported for the AS group as was a reported history of the bacterial skin infection impetigo. Results are discussed with reference to relationships between behavioural and somatic factors in PDD. [source] | ||||||||||