Journal of general internal medicine
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To describe how and why attending physicians respond to learner behaviors that indicate negative attitudes toward patients. ⋯ Because of uncertainty about appropriateness and effectiveness, attending physicians were reluctant to respond to perceived disrespect, uncaring, or hostility toward patients by members of their medical team. They tended to avoid, rationalize, or medicalize these behaviors, and to respond in ways that avoided moral language, did not address underlying attitudes, and left room for face-saving reinterpretations. Although these oblique techniques are sympathetically motivated, learners in stressful clinical environments may misinterpret, undervalue, or entirely fail to notice such subtle feedback.
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Randomized Controlled Trial Comparative Study Clinical Trial
Practical methods to increase use of advance medical directives.
To compare the effectiveness of two means for increasing the use of advance medical directives: written materials only versus written materials and an educational videotape. ⋯ In an elderly population with a substantial baseline placement rate, mailing of written materials substantially increased placement of an advance directive in the medical record, but the addition of a videotape did not. Mailing the video did increase the use of treatment trials and made patients more aware of reasons not to use advance directives.