The effect of a 12-month longitudinal long-term care rotation on knowledge and attitudes of internal medicine residents about geriatrics.
*Attitude of Health Personnel; Aged; Attitudes; Clinical Competence/*standards; Cost-Benefit Analysis; Curriculum; Education; Educational Measurement; Efficiency; Geriatric Assessment; Geriatrics/*education; Graduate/organization & administration; Guidelines as Topic; Health Knowledge; Health Services Needs and Demand; Humans; Internal Medicine/*education; Internship and Residency/*organization & administration; Long-Term Care/*organization & administration; Longitudinal Studies; Medical; Nursing Homes; Ohio; Organizational; Practice; Program Evaluation; Self Efficacy; Surveys and Questionnaires
OBJECTIVE: To determine if participation in a 12-month longitudinal long-term care (LTC) rotation resulted in improved knowledge and attitudes about geriatrics. DESIGN: Longitudinal study with paired measurements. SETTING: A community LTC facility and a university-affiliated, community-based internal medicine residency program. PARTICIPANTS: Sixty-seven internal medicine residents who participated in the rotation from 1997 through 2004. INTERVENTION: The internal medicine residents attended nursing home (NH) rounds one half day per month for 1 year, during which time they participated in a case-based interactive lecture on a core geriatric topic and rounded on their assigned patients. MEASUREMENTS: Knowledge was assessed using a 70-item test. Attitudes were evaluated with a 28-item, 5-point Likert scale (1 = least positive, 5 = most positive). RESULTS: The percent correct responses on geriatric knowledge pretest was 47% (95% CI = 45.2% to 48.8%) and on the posttest it was 57.5% (95% CI = 55.3% to 59.6%) (t = 8.180, df = 67, P \textless .001). The pretest total attitude score was 3.6 (95% CI = 3.6 to 3.7), with a posttest score of 3.7 (95% CI = 3.7 to 3.8) (P \textless .001). The difference in this total was accounted for mainly by the significant changes in the attitude subscales in educational preparation (pretest 3.6 [95% CI = 3.5 to 3.8]; posttest 3.8 [95% CI = 3.7 to 3.9] [P \textless .001]), general attitudes (pretest 4.0 [95% CI = 3.9 to 4.1]; posttest 4.2 [95% CI = 4.0 to 4.3] [P = .006]), and therapeutic potential (pretest 3.7 [95% CI = 3.5 to 3.8]; posttest 3.8 [95% CI = 3.7 to 3.9] [P = .048]). CONCLUSION: A longitudinal LTC rotation is an efficient and effective way to systematically provide internal medicine residents their core knowledge and experience in geriatrics.
Baum Elizabeth E; Nelson Karl M
Journal of the American Medical Directors Association
2007
2007-02
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1016/j.jamda.2006.05.009" target="_blank" rel="noreferrer noopener">10.1016/j.jamda.2006.05.009</a>
The art of office triage. Seven steps to improve productivity and efficiency.
Humans; *Electronic Health Records; Time Management/economics/methods/*organization & administration; Efficiency; Practice Management; Medical/economics/*organization & administration; Organizational/economics
Ellis George G Jr
Medical economics
2012
2012-03
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
The Morphology Of The Masticatory Apparatus Facilitates Muscle Force Production At Wide Jaw Gapes In Tree-gouging Common Marmosets (callithrix Jacchus)
3-dimensional mathematical-model; bite forces; biting; common marmosets; cross-sectional area; efficiency; fiber architecture; fiber length; jaw gape; Life Sciences & Biomedicine - Other Topics; masseter; masseter muscle; masticatory mechanics; muscle architecture; opening index; physiological; range; rhesus-monkey; sarcomere length operating; sarcomere-length; skeletal-muscle; superficial masseter; temporalis; tree gouging
Eng C M; Ward S R; Vinyard C J; Taylor A B
Journal of Experimental Biology
2009
2009-12
Journal Article or Conference Abstract Publication
<a href="http://doi.org/10.1242/jeb.029983" target="_blank" rel="noreferrer noopener">10.1242/jeb.029983</a>
Estimating The Cost Of Primary Care Training In Ambulatory Settings
Business & Economics; care; cost and cost analysis; efficiency; Health Care Sciences & Services; medical education; medical-care; primary; selection models; variables
The Balanced Budget Act of 1997 legislated the idea of reimbursing ambulatory sites for training medical professionals. However, very little is known about the costs of training in such settings. This paper assesses the cost of primary care training in ambulatory settings. Selection models were used to separate the cost of teaching from the cost of infrastructural differences between teaching and non-teaching sites. A probit equation modelled the likelihood of an ambulatory site having a teaching programme and a cost function related total medical practice costs to clinical output, the presence of a health professions educational programme, the price of resources used, characteristics of the medical practice and location. Data on 184 community health centres (CHCs), group practices, health maintenance organizations (HMOs) and outpatient clinics were used. Teaching sites were found to have 36% higher operating costs than their non-teaching counterparts: 38% of these higher costs were due to infrastructural differences and 62% were the 'pure' costs of teaching, i.e. the costs of teaching the net of infrastructural effects. Copyright (C) 2000 John Wiley & Sons, Ltd.
Hogan A J; Franzini L; Boex J R
Health Economics
2000
2000-12
Journal Article or Conference Abstract Publication
<a href="http://doi.org/10.1002/1099-1050(200012)9:8%3C715::aid-hec573%3E3.3.co;2-j" target="_blank" rel="noreferrer noopener">10.1002/1099-1050(200012)9:8%3C715::aid-hec573%3E3.3.co;2-j</a>
Locomotor evolution in the earliest cetaceans: functional model, modern analogues, and paleontological evidence
aquatic locomotion; Biodiversity & Conservation; efficiency; Environmental Sciences & Ecology; eocene; Evolutionary Biology; origin; otters; Paleontology; power output
We discuss a model for the origin of cetacean swimming that is based on hydrodynamic and kinematic data of modern mammalian swimmers. The model suggests that modern otters (Mustelidae: Lutrinae) display several of the locomotor modes that early cetaceans used at different stages in the transition from land to water. We use mustelids and other amphibious mammals to analyze the morphology of the Eocene cetacean Ambulocetus natans, and we conclude that Ambulocetus may have locomoted by a combination of pelvic paddling and dorsoventral undulations of the tail, and that its locomotor mode in water resembled that of the modern otter Lutra most closely. We also suggest that cetacean locomotion may have resembled that of the freshwater otter Pteronura at a stage beyond Ambulocetus.
Thewissen J G M; Fish F E
Paleobiology
1997
1997
Journal Article
<a href="http://doi.org/10.1017/s0094837300019850" target="_blank" rel="noreferrer noopener">10.1017/s0094837300019850</a>