Journal of general internal medicine
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Randomized Controlled Trial
Evaluation of a women's safe shelter experience to teach internal medicine residents about intimate partner violence. A randomized controlled trial.
Although intimate partner violence (IPV) remains a major public health problem, physicians often fail to screen female patients. Reported IPV training approaches suffer from weak study designs and limited outcome assessments. We hypothesized that an educational experience for residents at a women's safe shelter would have significantly greater impact on IPV competencies, screening, and care for victims than a workshop seminar alone. ⋯ There were no significant differences between cases and controls in the subscales of skills, attitudes, or resource awareness. Cases increased their self-reported screening frequency but this did not differ significantly from the controls. Enhancing traditional IPV curriculum with a women's safe shelter educational experience may result in small improvements in residents' knowledge about IPV.
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The Institute of Medicine calls for physicians to engage patients in making clinical decisions, but not every patient may want the same level of participation. ⋯ This population-based study demonstrates that people vary substantially in their preferences for participation in decision making. Physicians and health care organizations should not assume that patients wish to participate in clinical decision making, but must assess individual patient preferences and tailor care accordingly.
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To determine whether phlebotomy contributes to changes in hemoglobin and hematocrit levels in hospitalized general internal medicine patients. ⋯ Phlebotomy is highly associated with changes in hemoglobin and hematocrit levels for patients admitted to an internal medicine service and can contribute to anemia. This anemia, in turn, may have significant consequences, especially for patients with cardiorespiratory diseases. Knowing the expected changes in hemoglobin and hematocrit due to diagnostic phlebotomy will help guide when to investigate anemia in hospitalized patients.
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To determine how well a single question of self-reported erectile dysfunction compares to a gold standard clinical urologic examination. ⋯ Our single-question self-report accurately identifies men with clinically diagnosed ED, and may be useful as a referral screening tool in both research studies and general practice settings.
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To compare the utilization of health care resources and patterns of chronic disease care by patients of medical residents and patients of their attending physicians. ⋯ Our results indicate that residents' patients had higher costs than attendings' patients, but the differences would have been seriously overestimated without adjustment. We conclude that it costs about 7% more for residents to manage patients than for attendings. On the ambulatory side, the larger number of procedures and consults ordered for residents' patients appears to drive the higher costs.