Nothing more can be done' may be shortsighted view.
Physicians; Professional Role; Health Knowledge; Multidisciplinary Care Team; Eye Diseases; Private Practice Management
The article suggests that ophthalmologists should avoid saying "nothing more can be done" to their patients. Topics covered include referral of patients to specialists, willingness of ophthalmologists to engage colleagues in determining the appropriate treatment for their patients and the need for ophthalmologists to provide assistance to patients referred to other physicians.
Weinstock Frank J
Ophthalmology Times
2015
2015-10-15
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
Border crossings in medical education.
Physician-Patient Relations; Curriculum; Literature; *Humanities; Health Knowledge; Practice; Undergraduate; Medical; Attitudes; *Education
Wear D
The Pharos of Alpha Omega Alpha-Honor Medical Society. Alpha Omega Alpha
1997
1905-06
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
Pimping: perspectives of 4th year medical students.
*Clinical Clerkship; *Education; *Students; Attitudes; Clinical Competence; Health Knowledge; Humans; Internship and Residency; Interprofessional Relations; Medical; Practice; Undergraduate; United States
BACKGROUND: A well-known phenomenon among U.S. medical students known as pimping, or the pedagogical device of questioning students in the clinical setting, receives virtually no attention in medical literature. PURPOSE: Identifying 4th-year medical students' relevant knowledge and attitudes about pimping may help educators understand the range of beliefs about pimping and the role it plays in the socialization process into the medical community. METHODS: Over a
Wear Delese; Kokinova Margarita; Keck-McNulty Cynthia; Aultman Julie
Teaching and learning in medicine
2005
2005
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/10.1207/s15328015tlm1702_14" target="_blank" rel="noreferrer noopener">10.1207/s15328015tlm1702_14</a>
Medical Students for Choice: origins, current orientations, and potential impact.
*Physician's Role; Abortion; Attitudes; Curriculum/standards; Dissent and Disputes; Education; Empirical Approach; Female; Genetics and Reproduction; Health Knowledge; Health Services Accessibility/ethics; Humans; Induced/*education/*ethics; Life Change Events; Medical; Medical/*psychology; Motivation; Practice; Pregnancy; Students; Undergraduate/standards; United States; Voluntary Health Agencies/*organization & administration
BACKGROUND: Medical Students for Choice is a U.S.-based organization concerned with the shortage of abortion providers, the lack of abortion education in medical schools, and violence against abortion providers. Created in 1993, MSFC has 110 chapters in North America with 7,000 student affiliates. DESCRIPTION: The rapid spread of MSFC chapters since its creation prompted the Northeastern Ohio Universities College of Medicine's chapter to undertake group interviews of 40 medical students affiliated with 7 MSFC chapters in 4 midwestern states in the United States. EVALUATION: Interview questions were developed to identify students' motivations for affiliation with MSFC, how abortion was currently addressed in the medical curriculum and where it should be, how students think abortion providers are perceived by the medical community, and how they plan to integrate their commitment to reproductive choice in their future practice. CONCLUSIONS: Not all students affiliated with MSFC will become abortion providers, but they are politically enthusiastic and committed to the inclusion of abortion in medical training and to legitimizing and normalizing its provision. More research tracking this group across time and geography will add much to understanding abortion services in the United States and what part the medical curriculum plays in educating students to provide comprehensive reproductive health services for women.
Wear Delese; Keck-McNulty Cynthia
Teaching and learning in medicine
2003
2003
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/10.1207/S15328015TLM1501_10" target="_blank" rel="noreferrer noopener">10.1207/S15328015TLM1501_10</a>
Development of a Scale to Assess Physician Advance Care Planning Self-Efficacy.
*Self Efficacy; Adult; advance care planning; Advance Care Planning; Advance Care Planning/*organization & administration; Attitude of Health Personnel; Attitudes; Chronic Disease; Communication; Cross Sectional Studies; Cross-Sectional Studies; end-of-life care; Exploratory Research; family medicine; Family/*psychology; Female; Health Knowledge; Human; Humans; Instrument Construction; Instrument Validation; Male; Middle Aged; Physician-Patient Relations; Physicians; Physicians – Psychosocial Factors; Practice; Reliability and Validity; scale development; Scales; self-efficacy; Self-Efficacy – Evaluation; Surveys and Questionnaires/*standards; Terminal Care/psychology; Validation Studies
BACKGROUND: Although patients prefer that physicians initiate advance care planning (ACP) conversations, few physicians regularly do so. Physicians may be reluctant to initiate ACP conversations because they lack self-efficacy in their skills. Yet, no validated scale on self-efficacy for ACP exists. Our objective was to develop a scale that measures physicians' ACP self-efficacy (ACP-SE) and to investigate the validity of the tool. METHODS: Electronic questionnaires were administered to a random sample of family medicine physicians (n = 188). Exploratory factor analysis was performed to determine whether the scale was multidimensional. An initial assessment of the scale's validity was also conducted. RESULTS: The exploratory factor analysis indicated that a single factor was appropriate using all 17 items. A single, unidimensional scale was created by averaging the 17 items, yielding good internal consistency (Cronbach alpha = 0.95). The average scale score was 3.94 (standard deviation = 0.71) on a scale from 1 to 5. The scale was moderately correlated with a global single-item measure of self-efficacy for ACP ( r = .79, P \textless .001), and the scale differentiated between physician groups based on how much ACP they were doing, how recently they had an ACP conversation, formal training on ACP, and knowledge of ACP. In a multivariate analysis, the ACP-SE scale was a strong predictor of the percentage of patients with chronic life-limiting diseases with whom the physician discussed ACP. CONCLUSION: The final ACP-SE scale included 17 items and demonstrated high internal consistency.
Baughman Kristin R; Ludwick Ruth; Fischbein Rebecca; McCormick Kenelm; Meeker James; Hewit Mike; Drost Jennifer; Kropp Denise
The American journal of hospice & palliative care
2017
2017-06
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/10.1177/1049909115625612" target="_blank" rel="noreferrer noopener">10.1177/1049909115625612</a>
Specialty milestones and the next accreditation system: an opportunity for the simulation community.
*Clinical Competence; *Patient Simulation; Accreditation/*organization & administration/standards; Attitudes; Communication; Education; Graduate/*standards; Health Knowledge; Humans; Internship and Residency/*standards; Medical; Medicine/standards; Patient Care; Physician's Role; Practice
The Accreditation for Graduate Medical Education has developed a new process of accreditation, the Next Accreditation System (NAS), which focuses on outcomes. A key component of the NAS is specialty milestones-specific behavior, attributes, or outcomes within the general competency domains. Milestones will mark a level of proficiency of a resident within a competency domain. Each specialty has developed its own set of milestones, with semiannual reporting to begin July 2013, for 7 specialties, and the rest in July 2014.Milestone assessment must be based on objective data. Each specialty will determine optimal methods of measuring milestones, based on ease, cost, validity, and reliability. The simulation community has focused many graduate medical education efforts at training and formative assessment. Milestone assessment represents an opportunity for simulation modalities to offer summative assessment of milestone proficiencies, adding to the potential methods that residency programs will likely use or adapt. This article discusses the NAS, milestone assessment, and the opportunity to the simulation community to become involved in this next stage of graduate medical education assessment.
Beeson Michael S; Vozenilek John A
Simulation in healthcare : journal of the Society for Simulation in Healthcare
2014
2014-06
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/10.1097/SIH.0000000000000006" target="_blank" rel="noreferrer noopener">10.1097/SIH.0000000000000006</a>
Perspective: medical students' perceptions of the poor: what impact can medical education have?
*Attitude of Health Personnel; *Education; *Empathy; *Prejudice; *Social Perception; Attitudes; Graduate; Health Knowledge; Humans; Medical; Medical/*psychology; Poverty/*psychology; Practice; Social Class; Socioeconomic Factors; Students; Undergraduate; United States
There is currently little knowledge or understanding of medical students' knowledge and attitudes toward the poor. Teaching hospitals bring students face-to-face with poor and uninsured patients on a regular basis. However, an overview of the research available suggests that this contact does not result in students' greater understanding and empathy for the plight of the poor and may, in fact, lead to an erosion of positive attitudes toward the poor. A basic understanding of justice suggests that as the poor are disproportionately the subjects of medical training, this population should enjoy a proportionate benefit for this service. Furthermore, medicine's social contract with the public is often thought to include an ideal of service to the underserved and a duty to help educate the general public regarding the health needs of our nation. In their discussion, the authors situate medical students' attitudes toward the poor within larger cultural perspectives, including attitudes toward the poor and attributions for poverty. They provide three suggestions for improving trainees' knowledge of and attitudes toward the poor-namely, increasing the socioeconomic diversity of students, promoting empathy through curricular efforts, and focusing more directly on role modeling. The authors argue that service learning, especially efforts that include gaining detailed knowledge of a particular person or persons, coupled with critical reflection, presents a very promising direction toward achieving these goals. Finally, they posit an agenda for future educational research that might contribute to the increased efficacy of medical education in this important formative domain.
Wear Delese; Kuczewski Mark G
Academic medicine : journal of the Association of American Medical Colleges
2008
2008-07
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/10.1097/ACM.0b013e3181782d67" target="_blank" rel="noreferrer noopener">10.1097/ACM.0b013e3181782d67</a>
Testicular health awareness in pubertal males.
*Health Education; Adolescent; Attitudes; Awareness; Data Collection; Health Knowledge; Humans; Internet; Male; Ohio; Practice; Schools; Sports; Testicular Diseases/*diagnosis
PURPOSE: We examined the knowledge and understanding of male teenagers of the necessity for genital examination, and signs and symptoms of serious testicular pathology. Furthermore, current national guidelines for health education were reviewed to understand better the curriculum used by the educational system and to assess its effectiveness. MATERIALS AND METHODS: In 1998, a 5-question survey was administered privately and confidentially to male athletes before a sports physical examination. The athletes were 12 to 18 years old, attended middle or high school, and were sampled randomly. The National Health Education Standards benchmark for grades 9 through 11 was examined with specific attention to male self-health education standards. RESULTS: A total of 318 athletes responded revealing that 54% did not know why the genitals were examined on a sports physical examination, 45% did not use appropriate testicular protection and the majority did not respond appropriately to symptoms of serious testicular pathology. Despite the fact that 46% of respondents answered that checking for a hernia is reason for a genital examination there was no mention of tumor, infection or varicocele. Review of the benchmarks revealed no standards referring to a minimum understanding of anatomy or physiology. Generalized guidelines for high risk behaviors were provided without specific mention of testicular torsion, cancer, varicocele or sexually transmitted diseases. CONCLUSIONS: Young males are at higher risk for testicular torsion, cancer and varicocele than other age groups, and yet our population was universally unaware of these as a reason for genital examination. Furthermore, the majority did not respond appropriately to questions regarding serious testicular pathology. Review of national guidelines reveals poorly defined, nonspecific provisions for male self-health care. Therefore, we have developed a curriculum for male self-health to address this problem.
Nasrallah P; Nair G; Congeni J; Bennett C L; McMahon D
The Journal of urology
2000
2000-09
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/10.1097/00005392-200009020-00049" target="_blank" rel="noreferrer noopener">10.1097/00005392-200009020-00049</a>
Insurgent multiculturalism: rethinking how and why we teach culture in medical education.
*Attitude of Health Personnel; *Cultural Diversity; Attitudes; Curriculum; Education; Health Knowledge; Humans; Medical/*organization & administration; Physician-Patient Relations; Physician's Role; Practice; Professional Competence/standards; Teaching/methods; United States
The author proposes a theoretical orientation for cultural competency that reorganizes common curricular responses to the study of culture in medical education. What has come to be known in medical education as cultural competency is theoretically truncated and may actually work against what educators hope to achieve. Using Giroux's concept of insurgent multiculturalism, she suggests that the critical study of culture might be a bridge to certain aspects of professional development. Insurgent multiculturalism moves inquiry away from a focus on nondominant groups to a study of how unequal distributions of power allow some groups but not others to acquire and keep resources, including the rituals, policies, attitudes, and protocols of medical institutions. This approach includes not only the doctor-patient relationship but also the social causes of inequalities and dominance. Linked to professional development efforts, insurgent multiculturalism can provide students with more opportunities to look at their biases, challenge their assumptions, know people beyond labels, confront the effects of power and privilege, and develop a far greater capacity for compassion and respect.
Wear Delese
Academic medicine : journal of the Association of American Medical Colleges
2003
2003-06
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/10.1097/00001888-200306000-00002" target="_blank" rel="noreferrer noopener">10.1097/00001888-200306000-00002</a>
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>