Medical College of Georgia at Augusta University Thomas, Andria M; Page, Renee; Gillies, Ralph ...
Academic medicine,
2020-September, Letnik:
95, Številka:
9S A Snapshot of Medical Student Education in the United States and Canada: Reports From 145 Schools
Journal Article
A number of disorders cause dysphagia, which is the perception of an obstruction during swallowing. The purpose of this study was to determine the prevalence of dysphagia in primary care patients.
...Adults 18 years old and older were the subjects of an anonymous survey that was collected in the clinic waiting room before patients were seen by a physician. Twelve family medicine offices in HamesNet, a research network in Georgia, participated.
Of the 947 study participants, 214 (22.6%) reported dysphagia occurring several times per month or more frequently. Those reporting dysphagia were more likely to be women (80.8% women vs 19.2% men, P = .002) and older (mean age of 48.1 in patients with dysphagia vs mean age of 45.7 in patients without dysphagia, P = .001). Sixty-four percent of patients with dysphagia indicated that they were concerned about their symptoms, but 46.3% had not spoken with their doctor about their symptoms. Logistic regression analyses showed that increased frequency odds ratio (OR) = 2.15, 95% CI 1.41-3.30, duration (OR = 1.91, CI 1.24-2.94), and concern (OR = 2.64, CI 1.36-5.12) of swallowing problems as well as increased problems eating out (OR = 1.72, CI 1.19-2.49) were associated with increased odds of having talked to a physician.
This is the first report of the prevalence of dysphagia in an unselected adult primary care population. Dysphagia occurs commonly in primary care patients but often is not discussed with a physician.
Abstract Purpose There is currently too few endoscopists to enact a national colorectal cancer screening program with colonoscopy. Primary care physicians could play an important role in filling this ...shortage by offering screening colonoscopy in their practice. The purpose of this study was to examine the safety and effectiveness of colonoscopies performed by primary care physicians. Methods We identified relevant articles through searches of MEDLINE and EMBASE bibliographic databases to December 2007 and through manual searches of bibliographies of each citation. We found 590 articles, 12 of which met inclusion criteria. Two authors independently abstracted data on study and patient characteristics. Descriptive statistics were performed. For each outcome measure, a random effects model was used to determine estimated means and confidence intervals. Results We analyzed 12 studies of colonoscopies performed by primary care physicians, which included 18,292 patients (mean age 59 years, 50.5% women). The mean estimated adenoma and adenocarcinoma detection rates were 28.9% (95% confidence interval CI, 20.4%-39.3%) and 1.7% (95% CI, 0.9%-3.0%), respectively. The mean estimated reach-the-cecum rate was 89.2% (95% CI, 80.1%-94.4%). The major complication rate was 0.04% (95% CI, 0.01%-0.07%); no deaths were reported. Conclusions Colonoscopies performed by primary care physicians have quality, safety, and efficacy indicators that are comparable to those recommended by the American Society of Gastrointestinal Endoscopy, the American College of Gastroenterology, and the Society of American Gastrointestinal Endoscopic Surgeons. Based on these results, colonoscopy screening by primary care physicians appears to be safe and effective.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
Survey of Student Education in Surgery Lind, D. Scott, MD, FACS; Deladisma, Adeline M., MD, MPH; Cue, Jorge I., MD, FACS ...
Journal of the American College of Surgeons,
05/2007, Letnik:
204, Številka:
5
Journal Article
Recenzirano
Background Few data exist comparing medical student surgical education programs across the US and Canada. We conducted a 30-question, Web-based survey of 142 medical schools in the US and Canada ...about the administration of undergraduate surgical education programs at their institutions. Study Design From October 2005 to January 2006, 142 Association of American Medical Colleges (AAMC) medical schools in the US and Canada were asked to complete a 30-item, Web-based questionnaire. Descriptive statistics were compiled for all responses and data were analyzed using Student’s t- test. Results One hundred two medical schools responded to the survey (90 of 125 US and 12 of 17 Canadian schools, overall response rate, = 72%). The majority of surgical clerkships have between 16 and 30 students rotating at a time through 2 to 4 teaching sites. The most frequent overall clerkship duration was 8 weeks, divided most frequently between a 4- to 6-week general surgery rotation and a 4-week subspecialty rotation. There was no consensus about what services constitute general surgery rotations, although the most common subspecialty rotations were urology (68%) and orthopaedics (66%). American medical schools were more likely to use the National Board of Medical Examiners (NBME) subject examination for student assessment (90.9% US versus 50.0% Canadian, p < 0.05); Canadian medical schools were more likely to use an Objective Structured Clinical Examination (69.2% Canadian versus 37.7% US, p < 0.05) and other written examinations (69.2% Canadian versus 37.7% US, p < 0.05). Conclusions There is wide variation in the structure and administration of medical student surgical education programs in the US and Canada. These findings underscore the need for a clerkship directors committee and a national dialog about a core student curriculum to ensure consistency in the quality of student education in surgery.
Abstract Introduction This resource contains four video problem-based learning (PBL) cases and accompanying scripts. These cases address the following clinical issues: child abuse, sexually ...transmitted diseases, diabetes, and Alzheimer's disease. Additionally, there are multiple psychosocial issues addressed in each including drug abuse, confidentiality, patient-physician communication, and access to care. Methods The child abuse, sexually transmitted diseases, and diabetes cases have a video and corresponding script, as well as a facilitator guide. The Alzheimer's case has a video and corresponding script. Results These video cases have been implemented for 4 months and initial feedback has been positive. No formal evaluation of effectiveness has been conducted at this time. Discussion Given the fact that a majority of medical schools utilize PBLs in their preclinical curricula, these cases are easily implemented in an educational setting. Further, the use of video components in this resource provides additional case-conceptualization by students.
To better understand similarities and differences in Black and White women's perceptions about obesity, we conducted race-matched focus groups with thirty physician-referred, obese women. ...Participants completed demographic questionnaires and body image assessments. Analysis yielded some common themes. Unique themes for Black women included disagreement with the thin ideal and their own and family members' satisfaction with their weight; dislike of physical activity because of perspiration and appearance; program access barriers; and difficulties with clothing. White women desired support during weight loss from other obese individuals. Results support education and intervention programs that respond to specific needs of each group.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, OILJ, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK, VSZLJ
Manage uncomplicated cases following guidelines on medical therapy and with adjunctive psychotherapy. Refer complicated and severe cases to Psychiatry.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Depression is one of the leading causes of premature death and disability. However, both unipolar and bipolar depression are underdiagnosed and undertreated. The aims of this study were to assess ...medical students' level of confidence in and knowledge of diagnosing and treating depression before and after completing a psychiatry clerkship, and their knowledge of differentiating unipolar vs bipolar depression.
Third-year medical students at Augusta University (Georgia, USA) completed an online questionnaire to assess confidence in and knowledge of diagnosing and treating unipolar and bipolar depression.
Students who completed a psychiatry clerkship were statistically significantly more comfortable/confident with diagnosing (P < .0001) and treating (P < .0001) unipolar depression. Regarding bipolar depression, 73% of students who completed a psychiatry clerkship correctly diagnosed bipolar disorder, vs 59% of students who did not complete a psychiatry clerkship. This difference was not statistically significant (P = .181).
Students who completed a psychiatry clerkship were more confident in diagnosing and treating unipolar depression compared with those who did not complete a psychiatry clerkship. However, there was no statistically significant difference between students who had completed a psychiatry clerkship and those who had not completed a psychiatry clerkship in making the correct diagnosis of bipolar depression. Neither group had a very high rate of correct diagnosis.
Background: Medical schools are increasingly using community practice sites (CPS) for clerkship training.
Purposes: We compared the test performance of all students assigned to CPS with all students ...trained at an academic medical center (AMC) for their pediatric clerkship for the past 5 years.
Methods: Baseline comparability of both groups was established by the group mean scores on 1st and 2nd year medical school grade point average (GPA) and the United States Medical Licensing Examination (USMLE) Step 1 and Step 2. Performance outcome was compared by group mean scores on a written clerkship exam and the National Board of Medical Examiners Pediatric Subject Examination.
Results: There was no statistical difference between the two groups with regard to GPA or USMLE scores. Standardized test performance results:
N
Written Exam
p-Value
NBME score
p-Value
CPS
173
87.1%
.003
74.2
.382
AMC
698
85.1%
74.8
Conclusion: The CPS-trained students performed as well or better on standardized written tests compared with AMC-trained students. Community pediatric practices can provide a quality clerkship experience for junior medical students.
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