Academic medicine : journal of the Association of American Medical Colleges
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Medical schools have been slow to include meaningful end-of-life (EOL) educational experiences in their curricula. As an area of inquiry and focused clinical experience, death is "conspicuous" by its absence, reflecting a medical culture that defines death as failure. The author asked fourth-year medical students at one institution to describe their experiences with dying patients and their families, the skills and attitudes they brought to these encounters, the support they received from attendings and residents while caring for dying patients, and suggestions for the medical curriculum that would help prepare them for care of the dying. ⋯ However, while they did wish for more support and role modeling from residents and attendings, they generally believed that care of the dying can be learned only through direct clinical experience. These beliefs call into question curricular issues of placement of EOL inquiry--most often in the preclinical curriculum--and the teaching of its content, currently overwhelmingly by lectures. The author concludes with recommendations for thoughtful, integrative, interdisciplinary curriculum changes in EOL education.
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Although the communication that occurs within health care teams is important to both team function and the socialization of novices, the nature of team communication and its educational influence are not well documented. This study explored the nature of communications among operating room (OR) team members from surgery, nursing, and anesthesia to identify common communicative patterns, sites of tension, and their impact on novices. ⋯ Team communications in the OR follow observable patterns and are influenced by recurrent themes that suggest sites of team tension. Tension in team communication affects novices, who respond with behaviors that may intensify rather than resolve interprofessional conflict.
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To examine academic rankings and educational backgrounds of underrepresented minority (URM) family medicine faculty and compare their academic ranks with national trends. The authors also determined the extent to which international and historically black educational institutions contributed URM faculty to family medicine. ⋯ URM family medicine faculty appear to experience a double disadvantage: being minority and working for family medicine departments. Their academic ranks remain far below those of both minority medical school faculty and family medicine faculty, a discouraging finding considering the current shortage of URM faculty in family medicine departments. Historically black medical schools cannot address the shortage alone, so non-historically-black medical schools need to both recruit URM faculty and follow up with appropriate mentoring of those faculty.
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To design and evaluate an objective structured clinical examination (OSCE) station on dictating a consult letter as part of a formative OSCE for internal medicine residents. ⋯ An OSCE station is a feasible way to examine written communication skills. Letter-writing skills appear to be distinct from knowledge (physical exam station), but somewhat linked to verbal communication skills.
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To identify benchmarks of financial and staff support in internal medicine residency training programs and their correlation with indicators of quality. ⋯ These results identify benchmarks of financial and staff support provided to internal medicine residency programs. Some of these benchmarks are correlated with board pass rate, an accepted indicator of quality in residency training. Program directors and chairs can use this information to identify areas that may benefit from enhanced financial and administrative support.