The Journal of family practice
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Although there is little evidence that evaluation actually helps improve teaching, some conditions increase the likelihood of evaluation leading to improvement, including a combination of student ratings with educational consultation, comparison of student ratings to self-ratings, feedback early enough to provide time for improvement, and linkage of faculty development to the promotion-retention-tenure process. These conditions were built into a family practice faculty development program. ⋯ The evaluator collected "laboratory" data regarding the instructor's teaching and made a "diagnosis." He provided "treatment" in terms of educational consultation and "assessed" the changes in the instructor's teaching. A repetition of the data collection and consultative process demonstrated improvement in clinical teaching, particularly with regard to the skill of leading a collaborative group discussion during resident teaching rounds.
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After analyzing its first year of operation, a homecare hospice staff describes its patient statistics (n = 70), its evaluations received from the patients' families, its inability to accept many referrals (n = 150), and its cost analysis. The mean patient longevity in the program was 42 days for a cost of $65 per patient day. ⋯ Many referrals were not accepted into the caseload because contact came so late that the patient died before processing could be completed. The data indicate that the hospice program was urgently sought by the public and that the hospice reported in this study will be able to provide homecare services at a cost which is competitive with skilled nursing home care.
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Coronary arterial spasm has been postulated to be a cause of myocardial ischemia for over 100 years. It was not until the work of Prinzmetal et al in 1959, however, that major clinical attention and research began to be addressed to the role of vasospasm in the manifestations of ischemic heart disease. ⋯ Symptomatic arrhythmias, including sinus bradycardia, heart block, and ventricular tachyarrhythmias, have been documented to complicate coronary vasospasm. Given the potential importance of coronary arterial spasm in so many different ischemic heart disease syndromes, the development of therapeutic agents that may prevent spasm has obvious clinical importance.