Academic medicine : journal of the Association of American Medical Colleges
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To promote greater sensitivity to and heightened awareness of the relevance and therapeutic potential of integrating medicine and spirituality in the healing process of patients cared for by our medical residents. Strategies for clear, effective, and empathetic communication are integrated into the curriculum. ⋯ Traditionally, graduate medical education has not emphasized the importance of spirituality as a "target" for routine inquiry, understanding, and sharing in the context of patient care. We are beginning to see that residents need to be aware of the relationship between spirituality and health, as a consequence of this curriculum. Because the curriculum is seamlessly integrated into a preexisting infrastructure (e.g., noon conferences, ambulatory off-site experiences, walk-rounds, etc.), it has been relatively easy to implement. Focusing on the literature has also provided a "scientific door" that has made this more palatable. Over time, we will foster a growing alliance of the medical and faith communities in our rural area. This has potent implications for community health initiatives. Two of our residents have already volunteered to give talks at local congregations. Spirituality and religion are sensitive and personal areas that can be awkward to embrace and openly discuss. By remaining sensitive and respectful of all views, we strive to diminish the obstacles and enable a more provocative, enlightening residency experience. As a consequence, we are forced to reconsider what it is to be a "healer" and what it is to be "healed." Annual verbal and written feedback will allow us to refine our curriculum. I anticipate this to be a permanent aspect of our residents' training.
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New accreditation requirements for residency training programs require residents to have educational experiences that allow them to demonstrate competency in the following areas: (1) patient care, (2) medical knowledge, (3) practice-based learning and improvement, (4) interpersonal and communication skills, (5) professionalism, and (6) systems-based practice. Residents' competence must be assessed with dependable measures. Residency training program directors (PDs) need assistance in complying with these new requirements. ⋯ Results of the survey indicate that PDs require assistance to comply with the new ACGME requirements. Curricular materials and valid and reliable evaluation methods need to be developed. In order to assist PDs, the following activities are under way: (1) PDs are members of a listserve for sharing ideas and examples of curricular and evaluation materials; (2) PDs attend a monthly seminar series that provides practical information for curricular material development and specific evaluation methods, including indications for use and feasibility; (3) educators from our Office of Educational Development provide individual consultations with each PD; (4) PDs participate in an eight hour workshop with practical sessions for developing curricular materials and evaluations; and (5) two institution-wide assessments are being developed: a patient-satisfaction survey and a 360-degree evaluation to assess communication skills and professionalism.
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Comparative Study
The training and career paths of fellows in the National Research Service Award (NRSA) Program for Research in Primary Medical Care.
To describe the training and career paths of fellows in the National Research Service Award (NRSA) Program for Research in Primary Medical Care. ⋯ Only a minority of those completing NRSA programs held positions as faculty researchers. The preponderance of general internists among researchers may indicate problems in the capacity of general pediatrics and family medicine to support primary care research. The amounts of direct research time during these fellowships may need to be increased to enhance the likelihood of subsequent research success.
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Adolescents in the United States have high morbidity rates, which are attributable to injuries, behavioral disorders, sexually transmitted diseases, and unplanned pregnancies. This has led to a call to action for health care educators to better prepare future practitioners to meet adolescent health care needs. Although pediatrics residency programs have required one-month curricula dedicated to adolescent medicine, many internal medicine (IM) residency programs do not have such requirements despite an American College of Physicians position paper recognizing the importance of internists' providing health care to adolescents. Thus, an introductory curriculum in adolescent medicine was developed for a community hospital IM residency program. The curriculum was designed to train IM residents to effectively interview, provide preventive care for, and evaluate common medical problems of older adolescents (ages 16-21) in an outpatient setting. ⋯ Twenty-one of 40 residents participated in the pilot unit. Evaluations were overall very positive. Quiz scores confirmed that the residents achieved the desired learning objectives. Given these results from the pilot unit, the remaining two units of the curriculum have been integrated into the residency curriculum. Additional faculty members have been selected to deliver future sessions and support this important educational activity. The adolescent medicine curriculum can be used as an model by other IM residency programs for teaching adolescent health care, with an emphasis on both the knowledge base of adolescent issues and awareness of the unique skills necessary for the establishment of a physician-patient relationship between internists and older adolescents.
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Comparative Study
Premed survival: understanding the culling process in premedical undergraduate education.
Why undergraduate students pursue or drop a premedical curriculum has received only scant attention. In this study the authors attempted to uncover reasons why students either persevere in their premedical studies or seek alternative careers. ⋯ Although the sampling technique and sample size severely limit the authors' ability to generalize their findings, the data offer a starting point for those interested in the reasons for the drop in medical school applicants. The authors state the fact that most former premed students admitted organic chemistry had played a significant role in the change in their career plans deserves attention, and it may be time to consider whether a single course should contribute to eliminating persons who might otherwise excel as physicians.