Journal of general internal medicine
-
Meta Analysis
Postponement of Death by Statin Use: a Systematic Review and Meta-analysis of Randomized Clinical Trials.
The average postponement of the outcome (gain in time to event) has been proposed as a measure to convey the effect of preventive medications. Among its advantages over number needed to treat and relative risk reduction is a better intuitive understanding among lay persons. ⋯ The systematic review was registered in PROSPERO [CRD42016037507] .
-
Clinical reasoning is a core component of clinical competency that is used in all patient encounters from simple to complex presentations. It involves synthesis of myriad clinical and investigative data, to generate and prioritize an appropriate differential diagnosis and inform safe and targeted management plans. The literature is rich with proposed methods to teach this critical skill to trainees of all levels. ⋯ In this perspective, we first introduce the concepts of illness scripts and dual-process theory that describe the roles of analytic system 1 and non-analytic system 2 reasoning in clinical decision making. Thereafter, we draw upon existing evidence and expert opinion to review a range of methods that allow for effective assessment of clinical reasoning, contextualized within Miller's pyramid of learner assessment. Key assessment strategies that allow teachers to evaluate their learners' clinical reasoning ability are described from the level of knowledge acquisition, through to real-world demonstration in the clinical workplace.
-
Disseminating scholarly work as a clinician educator is critical to furthering new knowledge in medical education, creating an evidence base for new practices, and increasing the likelihood of promotion. Knowing how to initiate scholarship and develop habits to support it, however, may not be clear. This perspective is designed to help readers choose and narrow their focus of scholarly interest, garner mentors, find potential project funding, and identify outside support through involvement with national organizations, collaborators, and faculty development programs. By incorporating these suggestions into their daily work, educators can find ways to connect their clinical and educational interests and make their daily work count toward scholarship.
-
Women physicians are paid less than their male peers across medical specialties and geographies. While the medical literature to date has focused on documenting the existence of a wage gap, less attention has been paid to fixing this gap. We focus on interventions around auditing, salary transparency, family leave, and childcare that can be implemented to advance gender wage parity.