Journal of general internal medicine
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Clinical Trial Controlled Clinical Trial
Teaching residents evidence-based medicine skills: a controlled trial of effectiveness and assessment of durability.
To measure the effectiveness of an educational intervention designed to teach residents four essential evidence-based medicine (EBM) skills: question formulation, literature searching, understanding quantitative outcomes, and critical appraisal. ⋯ A brief structured educational intervention produced substantial and durable improvements in residents' cognitive and technical EBM skills.
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The American Board of Internal Medicine (ABIM) has recommended a specific number of procedures be done as a minimum standard for ensuring competence in various medical procedures. These minimum standards were determined by consensus of an expert panel and may not reflect actual procedural comfort or competence. ⋯ Minimum standards for certifying internal medicine residents may need to be reexamined in light of house officer comfort level performing selected procedures.
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To examine the impact of housing status on health service utilization patterns in low-income HIV-infected adults. ⋯ Our study documents differences in health care utilization patterns across stably housed, doubled-up, and homeless HIV-infected persons after controlling for health insurance coverage. These differences, especially those pertaining to outpatient services, suggest that the unstably housed may be receiving less adequate health care than the stably housed, and hence may be more likely to experience adverse clinical outcomes.
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To describe the presentation, resolution of symptoms, processes of care, and outcomes of pneumococcal pneumonia, and to compare features of the bacteremic and nonbacteremic forms of this illness. ⋯ There were few differences in the presentation of bacteremic and nonbacteremic pneumococcal pneumonia. About half of bacteremic pneumococcal pneumonia patients were at low risk for mortality. Symptom resolution frequently was slow.