Journal of general internal medicine
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Comparative Study
Teaching feedback to first-year medical students: long-term skill retention and accuracy of student self-assessment.
Giving and receiving feedback are critical skills and should be taught early in the process of medical education, yet few studies discuss the effect of feedback curricula for first-year medical students. ⋯ Teaching feedback to early medical students resulted in improved skills of delivering corrective specific feedback and enhanced comfort with feedback. However, students' overall ability to deliver specific feedback decreased over time.
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Comparative Study
Dual use of veterans health administration and Indian Health Service: healthcare provider and patient perspectives.
Many American Indian and Alaska Native veterans are eligible for healthcare from Veterans Health Administration (VHA) and from Indian Health Service (IHS). These organizations executed a Memorandum of Understanding in 2003 to share resources, but little was known about how they collaborated to deliver healthcare. ⋯ Fostering closer alignment between VHA and IHS would reduce care fragmentation and improve accountability for patient care.
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Review
Genetic testing before anticoagulation? A systematic review of pharmacogenetic dosing of warfarin.
Genotype-guided initial warfarin dosing may reduce over-anticoagulation and serious bleeding compared to a one-dose-fits-all dosing method. ⋯ We did not find sufficient evidence to support the use of pharmacogenetics to guide warfarin therapy. Additional clinical trials are needed to define the optimal approach to use warfarin pharmacogenetics in clinical practice.
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Decision analysis is a tool that clinicians can use to choose an option that maximizes the overall net benefit to a patient. It is an explicit, quantitative, and systematic approach to decision making under conditions of uncertainty. In this article, we present two teaching tips aimed at helping clinical learners understand the use and relevance of decision analysis. ⋯ Learners identified the importance of incorporating values into the decision-making process as well as the role of uncertainty. The educational objectives appeared to be reached. These teaching tips introduce clinical learners to decision analysis in a fashion aimed to illustrate principles of clinical reasoning and how patient values can be actively incorporated into complex decision making.
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Multicenter Study Comparative Study
Symptom burden, depression, and spiritual well-being: a comparison of heart failure and advanced cancer patients.
A lower proportion of patients with chronic heart failure receive palliative care compared to patients with advanced cancer. ⋯ Patients with symptomatic heart failure and advanced cancer have similar needs for palliative care as assessed by symptom burden, depression, and spiritual well-being. This implies that heart failure patients, particularly those with more severe heart failure, need the option of palliative care just as cancer patients do.