What are the implications of implementation science for medical education?

Background: Derived from multiple disciplines and established in industries outside of medicine, Implementation Science (IS) seeks to move evidence-based approaches into widespread use to enable improved outcomes to be realized as quickly as possible by as many as possible.

Methods: This review highlights selected IS theories and models, chosen based on the experience of the authors, that could be used to plan and deliver medical education activities to help learners better implement and sustain new knowledge and skills in their work settings.

Results: IS models, theories and approaches can help medical educators promote and determine their success in achieving desired learner outcomes.

Recurrent urinary tract infections in women: diagnosis and management.

Recurrent urinary tract infections, presenting as dysuria or irritative voiding symptoms, are most commonly caused by reinfection with the original bacterial isolate in young, otherwise healthy women with no anatomic or functional abnormalities of the urinary tract. Frequency of sexual intercourse is the strongest predictor of recurrent urinary tract infections in patients presenting with recurrent dysuria. In those who have comorbid conditions or other predisposing factors, recurrent complicated urinary tract infections represent a risk for ascending infection or urosepsis.

Health risks and benefits of bottled water.

Health and safety concerns have dramatically increased the consumption of bottled water in developed countries, including the United States. The economic and environmental impact of the many different bottled water products on the market is considerable, and the role and impact of bottled water for routine use is unclear, outside the setting of emergencies or natural disasters, when routine water sources may be unsafe. Evidence for routine health risks or benefits from using bottled water is limited.

Management of genital warts.

Genital warts caused by human papillomavirus infection are encountered commonly in primary care. Evidence guiding treatment selection is limited, but treatment guidelines recently have changed. Biopsy, viral typing, acetowhite staining, and other diagnostic measures are not routinely required.

Diagnosis and management of acute interstitial nephritis.

Acute interstitial nephritis is an important cause of acute renal failure resulting from immune-mediated tubulointerstitial injury, initiated by medications, infection, and other causes. Acute interstitial nephritis may be implicated in up to 15 percent of patients hospitalized for acute renal failure. Clinical features are essentially those of acute renal failure from any cause, and apart from a history of new illness or medication exposure, there are no specific history, physical examination, or laboratory findings that distinguish acute interstitial nephritis from other causes of acute renal failure.