Academic medicine : journal of the Association of American Medical Colleges
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To examine physicians' attitudes toward 16 competencies deemed essential to the effective practice of medicine in the changing health care system. ⋯ The physicians validated the traditional strengths of medical schools, but revealed curricular weaknesses in the teaching of competencies proposed as important for the emerging health care system, especially in the managed care environment.
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Comparative Study
Use of an objective structured clinical examination to determine clinical competence.
To describe the performance of second-year internal medicine residents on an objective structured clinical examination (OSCE) and to analyze the role of the OSCE in the evaluation of clinical competence. ⋯ The OSCE's moderate correlation with the ITE and CRS suggests that the OSCE, which consists largely of physical diagnosis stations, may test a component of clinical skills not evaluated by the other measures. Thus, the OSCE is an important addition to the assessment of clinical competence.
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To use issues identified by students in order to establish an experience- and evidence-based approach to medical ethics education. ⋯ The differences between the responses of the sophomores and seniors tend to support other research suggesting a retardation of moral sensitivity in the course of medical education. It may be that clinical teaching and faculty behavior model values at odds with what is taught in the classroom. Ethics education should focus on issues relevant to students' experience.
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The author describes in detail the successful education initiatives on domestic violence, especially violence against adult women, that have been implemented for family medicine residents at the St. Paul-Ramsey Medical Center in St. Paul, Minnesota, and for medical students at each of the three Minnesota medical schools. ⋯ The author describes some important types of resistance to having instruction about domestic violence in the medical curriculum. To move forward, faculty must overcome their discomfort with the topic yet acknowledge that teaching about it is difficult and requires personal stamina and empathy with colleagues. Faculty must also agree to collaborate with those who have sensitivity and expertise in the area, and must make a long-term commitment to prepare physicians to recognize problems of domestic violence and work effectively with its victims and perpetrators.