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Medical Residents (medical + resident)
Selected AbstractsMultidimensional Attitudes of Medical Residents and Geriatrics Fellows Toward Older PeopleJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 3 2005Ming Lee PhD Objectives: To examine dimensions of a validated instrument measuring geriatric attitudes of primary care residents and performances on these dimensions between residents and fellows. Design: Cross-sectional and longitudinal studies. Setting: An academic medical center. Participants: Two hundred thirty-eight primary care residents (n=177) and geriatrics fellows (n=61) participated in the study from 1995 to 2000. Measurements: A 14-item, 5-point Likert scale previously validated for measuring primary care residents' attitudes toward older people and geriatric patient care was used. Results: Factor analysis showed four dimensions of the scale, labeled Social Value, Medical Care (MC), Compassion (CP), and Resource Distribution, which demonstrated acceptable reliability. Both groups of subjects showed significantly (P<.001) positive (mean>3) attitudes across the dimensions and times, except for residents, who had near-neutral (mean=3) attitudes on MC. Residents' mean attitude scores on the overall scale and the MC and CP subscales were significantly (P<.001) lower than those of fellows over time. Residents and fellows showed different change patterns in attitudes over time. Residents' attitudes generally improved during the first 2 years of training, whereas fellows' attitudes declined slightly. Personal experience was a strong predictor of residents' attitudes toward older patients. Ethnicity, academic specialty, professional experience, and career interest in geriatrics were also associated with residents' attitude scores. Conclusion: The multidimensional analysis of the scale contributes to better understanding of medical trainees' attitudes and sheds light on educational interventions. [source] What sticks: How medical residents and academic health care faculty transfer conflict resolution training from the workshop to the workplaceCONFLICT RESOLUTION QUARTERLY, Issue 3 2008Ellen B. Zweibel Workshops in conflict resolution were given to enhance the ability of residents and academic health care faculty to collaborate in multidisciplinary teams, patient care, hospital committees, public health issues, teaching, and research. A qualitative research study on the transfer of learning from the workshops to the workplace reports on the attitude, knowledge, and skills consistently reported both immediately after the workshops and twelve months later. Learners' descriptions of workplace conflict confirmed they gained a positive outlook on conflict and their own ability to solve problems and apply conflict resolution skills, such as interest analysis and communication techniques, to gain perspective, reduce tension, increase mutual understanding, and build relationships in patient care, teaching, research, and administration. [source] A Pilot Study of the Clinical Impact of Hand-Carried Cardiac Ultrasound in the Medical ClinicECHOCARDIOGRAPHY, Issue 6 2006Lori B. Croft M.D. Background: Small, hand-carried ultrasound devices have become widely available, making point-of-care echocardiograms (echos) accessible to all medical personnel as a means to augment and improve the increasingly inefficient physical examination. This study was designed to determine the clinical utility of hand-carried echo by medical residents in clinical decision making. Methods: Nine residents underwent brief, practical echo training to perform and interpret a limited hand-carried echo as an integral component of their office examination. The residents' hand-carried echo consisting of four basic views to define left ventricular (LV) function and wall thickness, valvular disease, and any pericardial effusions was compared to one performed by a level III echocardiographer. Results: Seventy-two consecutive medical clinic patients were enrolled with an average image acquisition time of 4.45 minutes. Residents obtained diagnostic images in 94% of the cases and interpreted them correctly 93% of the time. They correctly identified 92% of the major echo findings and 78% of the minor findings. Their diagnosis of LV dysfunction, valvular disease, and LV hypertrophy improved by 19%, 39%, and 14% with hand-carried echo compared to history and physical alone. Management decisions were reinforced in 76% and changed in 40% of patients with the use of hand-carried echo. Conclusion: This study demonstrates that it is possible to train medical residents to perform an effective and reasonably accurate hand-carried echo during their physical examination, which can impact clinical management. [source] The influence of Patient Age and Alcohol-Relevant Laboratory Values on Physicians' Diagnoses of AlcoholismJOURNAL OF APPLIED BIOBEHAVIORAL RESEARCH, Issue 2 2004Allison Paganelli This study investigated factors that contribute to physicians' diagnoses and ratings of prognosis when reviewing vignettes of hypothetical cases constructed to reflect alcohol dependence. Forty-nine medical residents who read the vignettes were asked to list three probable diagnoses and a prognosis. Patient descriptions in the hypothetical vignettes were identical except for age (35 years vs. 70 years) and inclusion of alcohol-relevant lab values (present vs. absent). Results indicated that the younger patient described in the vignettes was diagnosed with alcoholism more often than was the older patient. The presence of alcohol-relevant lab values was unrelated to a diagnosis of alcoholism. Prognosis, which was on average rated as fair for most patients, was unrelated to the age of the patient. [source] Development of a test to evaluate residents' knowledge of medical procedures,,JOURNAL OF HOSPITAL MEDICINE, Issue 7 2009Shilpa Grover MD Abstract BACKGROUND AND AIM: Knowledge of core medical procedures is required by the American Board of Internal Medicine (ABIM) for certification. Efforts to improve the training of residents in these procedures have been limited by the absence of a validated tool for the assessment of knowledge. In this study we aimed to develop a standardized test of procedural knowledge in 3 medical procedures associated with potentially serious complications. METHODS: Placement of an arterial line, central venous catheter, and thoracentesis were selected for test development. Learning objectives and multiple-choice questions were constructed for each topic. Content evidence was evaluated by critical care subspecialists. Item test characteristics were evaluated by administering the test to students, residents and specialty clinicians. Reliability of the 32-item instrument was established through its administration to 192 medical residents in 4 hospitals. RESULTS: Reliability of the instrument as measured by Cronbach's , was 0.79 and its test-retest reliability was 0.82. Median score was 53% on a test comprising elements deemed important by critical care subspecialists. Increasing number of procedures attempted, higher self-reported confidence, and increasing seniority were predictors of overall test scores. Procedural confidence correlated significantly with increasing seniority and experience. Residents performed few procedures. CONCLUSIONS: We have successfully developed a standardized instrument to assess residents' cognitive competency for 3 common procedures. Residents' overall knowledge about procedures is poor. Experiential learning is the dominant source for knowledge improvement, but these experiences are increasingly rare. Journal of Hospital Medicine 2009;4:430,432. © 2009 Society of Hospital Medicine. [source] Online simulations of ambulatory care for medical residentsMEDICAL EDUCATION, Issue 5 2005Rene W G Wong No abstract is available for this article. [source] Development of 2-hour suicide intervention program among medical residents: First pilot trialPSYCHIATRY AND CLINICAL NEUROSCIENCES, Issue 5 2010Takahiro A. Kato MD Aim:, Suicide is associated not only with primary psychiatric disorders but also with physical disorders. Physicians' education on suicide prevention contributes to reducing suicide. Therefore, medical residents, who contact patients daily and who eventually become primary physicians in each specialty, might be the most appropriate candidates for intervention. In this article, we introduce our newly developed suicide intervention program among medical residents. Methods:, We developed a 2-hour suicide intervention program among medical residents, based on the Mental Health First Aid (MHFA), which had originally been developed for the public. The program contains a 1-hour lecture and a 1-hour role-play session. As the first pilot trial, we conducted the program among 44 first-year medical residents at a university hospital and evaluated its effectiveness. Changes in confidence, attitudes and behavior toward suicidal people were evaluated using self-reported questionnaires before, immediately after, and 6 months after the program. Results:, Participants' confidence and attitudes significantly improved after the program. The total mean score (standard deviation) of the Suicide Intervention Response Inventory improved from 18.4 (2.0) before the intervention to 19.4 (2.0) immediately after the intervention. However, the effectiveness was limited after 6 months. In the course of 6 months, the participants learned to apply the MHFA principles in their daily clinical practice. Conclusion:, Our newly developed brief suicide intervention program demonstrating its effectiveness among medical residents should be modified in order to be more effective in the long term. The next trial with a control group ought to be conducted to evaluate our developed program. [source] | ||||||||||