Factors affecting clinician educator encouragement of routine HIV testing among trainees.

Background: Adoption of CDC recommendations for routine, voluntary HIV screening of all Americans age 13–64 years has been slow. One method to increase adherence to clinical practice guidelines is through medical school and residency training.

Objective: To explore the attitudes, barriers, and behaviors of clinician educators (CEs) regarding advocating routine HIV testing to their trainees.

Provider and practice characteristics associated with use of rapid HIV Testing by general internists.

Background: Rapid HIV testing could increase routine HIV testing. Most previous studies of rapid testing were conducted in acute care settings, and few described the primary care providers' perspective.

Objective: To identify characteristics of general internal medicine physicians with access to rapid HIV testing, and to determine whether such access is associated with differences in HIV-testing practices or perceived HIV-testing barriers.

General internists' beliefs, behaviors, and perceived barriers to routine HIV screening in primary care.

The Centers for Disease Control and Prevention (CDC) recommends routine HIV screening in primary care but little is known about general internists' views of this practice. We conducted a national, cross-sectional, Internet-based survey of 446 general internists in 2009 regarding their HIV screening behaviors, beliefs, and perceived barriers to routine HIV screening in outpatient internal medicine practices. Internists' awareness of revised CDC guidelines was high (88%), but only 52% had increased HIV testing, 61% offered HIV screening regardless of risk, and a median 2% (range 0-67%) of their patients were tested in the past month.

Conceptual frameworks in the study of duty hours changes in graduate medical education: a review.

Purpose: Conceptual frameworks are approaches to a research problem that specify key entities and their relationships. The 2009 Institute of Medicine (IOM) report on resident duty hours, subsequent studies, and published responses to the report present a variety of conceptual frameworks for the study of the impact of duty hours regulations. The authors sought to identify and describe these conceptual frameworks and their implications.

Rheumatologists' recommended patient information when prescribing methotrexate for rheumatoid arthritis.

Objectives: Accurate communication of information concerning the risks and benefits of medications is essential for adherence and patient safety. A diverse array of information and sources makes it difficult to know exactly what to tell a patient with rheumatoid arthritis about methotrexate.

Objective: Our objective is to determine what key information patients must know about methotrexate and the key reasons they should call their doctor while they are taking methotrexate.

Outcomes of AIDS Education and Training Center HIV/AIDS skill-building workshops on provider practices.

The Midwest AIDS Training and Education Center (MATEC) implemented a Web-based survey method to measure impact on practitioners of HIV/AIDS skill-building workshops offered in seven midwestern states. Surveys were sent to 2,949 participants from 230 workshops 4-6 weeks after each workshop. Of those surveyed, 631 respondents provided usable data (22.

A randomized trial of pictorial versus prose-based medication information pamphlets.

Objective: The goal of this study was to compare prose and pictorial-based information pamphlets about the medication methotrexate in the domains of free recall, cued recall, comprehension and utility.

Methods: A single blind, randomized trial of picture versus prose-based information pamphlets including 100 participants aged 18-65 years of age, who had not completed high school, could read English, and had no prior knowledge about methotrexate. Superiority of pamphlet type was assessed using immediate free recall, cued recall and comprehension.

Relationship between candidate communication ability and oral certification examination scores.

Context: Structured case-based oral examinations are widely used in medical certifying examinations in the USA. These orals assess the candidate's decision-making skills using real or realistic patient cases. Frequently mentioned but not empirically evaluated is the potential bias introduced by the candidate's communication ability.

Impact of student reflective e-portfolio on medical student advisors.

Background: Little is published about the role of faculty advisors and use of students' e-portfolios.

Purpose: This article reports advisors' observations and understanding about 1st-year students based on information from students' journaling as part of an e-portfolio.

Methods: Data were collected on Blackboard survey module for 8 volunteer advisors at two medical school campuses.

Assessment of faculty perception of content validity of PerioSim, a haptic-3D virtual reality dental training simulator.

Haptic technology (sense of touch) along with 3D-virtual reality (VR) graphics, creating lifelike training simulations, was used to develop a dental training simulator system (PerioSim). This preliminary study was designed to evaluate whether faculty considered PerioSim realistic and useful for training and evaluating basic procedural skills of students. The haptic device employed was a PHANToM and the simulator a Dell Xeon 530 workstation with 3D, VR oral models and instruments viewed on a stereoscopic monitor.

Best practices for assessing competence and performance of the behavioral health workforce.

The need for mechanisms to assess the competence and performance of the behavioral health workforce has received increasing attention. This article reviews strategies used in general medicine and other disciplines for assessing trainees and practitioners. The possibilities and limitations of various approaches are reviewed, and the implications for behavioral health are addressed.

Specialty board certification and clinical outcomes: the missing link.

Purpose: Specialty board certification status is often used as a standard of excellence, but no systematic review has examined the link between certification and clinical outcomes. The authors evaluated published studies tracking clinical outcomes and certification status.

Method: Data sources consisted of studies cited between 1966 and July 1999 in OVID-Medline, psychological abstracts (PsycLit), and the Educational Research Information Clearinghouse (ERIC).

Residency education.

Residency education has an interesting history in the US that speaks clearly about some of the cherished beliefs still perpetuated in today's residency training programs. The history also provides a foundation for considering how the current knowledge of adult education theory and practice can be incorporated into residency education programs. The author presents a brief overview of the history of residency education in the US followed by a recommendation for applying a conception of adult learning to residency education.

Forty year trends in selecting a psychiatric career.

Since 1950, between three and ten percent of American medical school graduates selected psychiatric careers. Until 1989, the direction of the ratio of medical school applicants to acceptance was the best predictor for medical school graduates entering psychiatry; a declining ratio predicts more students become psychiatrists. The decrease in number of graduates selecting psychiatry for 1989, 1990 and 1991 suggest new factors may be influencing career decisions.

A view of the prospective child psychiatrist.

A questionnaire distributed to the 1,033 medical students who matched into postgraduate year 1 psychiatric positions in 1982 and 1983 obtained data on personal characteristics, career plans before entering medical school, future career plans, attitudes toward personal psychotherapy, and plans for psychotherapy or psychoanalysis during residency. The results for the 579 residents (56%) who responded are reported. The authors explore differences and similarities between respondents who planned to go into general or child psychiatry as they began general psychiatric residency training.

The 1982 first-year resident in psychiatry.

A 197-item questionnaire was distributed to the 541 medical students who matched into first-year postgraduate positions in psychiatry in 1982. The questionnaire obtained basic personal data, career plans before entering medical school, experiences in medical school, factors relating to selection of residency program, future plans, and attitude toward personal psychotherapy. The authors report the results for the 274 residents who completed the questionnaire (51% of the students).

Effect of a medical care evaluation program on physician knowledge and performance.

A model program designed to increase the educational value of medical care evaluation committee meetings was studied to determine its effect on the knowledge and clinical performance of participating physicians. The members of hospital committees in which the program was successfully implemented showed a statistically significant gain in knowledge of the topics discussed by their committees. In addition, several members made substantial changes in their patient care practices.