Journal of general internal medicine
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Multicenter Study
Tobacco cessation and prevention practices reported by second and fourth year students at US medical schools.
Tobacco dependence counseling is recommended to be included as core curriculum for US medical students. To date, there has been little information on students' self-reported skills and practice opportunities to provide 5A's (Ask, Advise, Assess, Assist, and Arrange) counseling for tobacco cessation. ⋯ By the beginning of their fourth year, most students in this group of medical schools reported multiple opportunities for training and practicing basic 5A counseling, although clear deficits for assisting patients with a quit plan and arranging follow-up care exist. Addressing these deficits and integrating tobacco teaching through tailored specific instruction across all clerkships, particularly in Surgery, Pediatrics, and Obstetrics/Gynecology is a challenge for medical school education.
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Categorical internal medicine (IM) residency training has historically effectively prepared graduates to manage the medical needs of acutely ill adults. The development of the field of hospital medicine, however, has resulted in hospitalists filling clinical niches that have been traditionally ignored or underemphasized in categorical IM training. ⋯ Taken in this context, many graduating IM residents are under-prepared to practice as effective hospitalists. In this paper, we outline the rationale for targeted training in hospital medicine and discuss the content and methods for delivering this training.
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Standard curricula to teach Internal Medicine residents about quality assessment and improvement, important components of the Accreditation Council for Graduate Medical Education core competencies practiced-based learning and improvement (PBLI) and systems-based practice (SBP), have not been easily accessible. ⋯ The ABIM CPS PIM can be used by Internal Medicine residency programs to introduce QI concepts into their residents' outpatient practice through encouraging practice-based learning and improvement and systems-based practice.
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Randomized Controlled Trial
Automatic capture of student notes to augment mentor feedback and student performance on patient write-ups.
To determine whether the integration of an automated electronic clinical portfolio into clinical clerkships can improve the quality of feedback given to students on their patient write-ups and the quality of students' write-ups. ⋯ An electronic clinical portfolio that automatically collects students' clinical notes is associated with improved teacher feedback on write-ups and similar quality of write-ups.
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Ward attending rounds are fundamental for internal medicine residency training. An improved understanding of interns' and residents' perceptions of attending rounds should inform training programs and attending physicians. ⋯ Although there was some overlap in interns' and residents' perceptions of attending rounds, interns identified interpersonal factors as the most important factors; whereas residents viewed structural factors as most important. These findings should assist attending physicians improve the way they conduct rounds targeting both interns and residents needs.