Expert Consensus Statement on Proficiency Standards for Dermoscopy Education in Primary Care.

Background: Primary care providers (PCPs) frequently address dermatologic concerns and perform skin examinations during clinical encounters. For PCPs who evaluate concerning skin lesions, dermoscopy (a noninvasive skin visualization technique) has been shown to increase the sensitivity for skin cancer diagnosis compared with unassisted clinical examinations. Because no formal consensus existed on the fundamental knowledge and skills that PCPs should have with respect to dermoscopy for skin cancer detection, the objective of this study was to develop an expert consensus statement on proficiency standards for PCPs learning or using dermoscopy.

Envisioning nutrition teaching as a three-course meal: a blended approach to knowledge, application and assessment.

Medical students receive inadequate training in nutrition counselling, but the best way to teach this topic is unknown. To address this research gap, we developed a longitudinal blended programme - combining physical classroom experiences with online education - to teach nutrition counselling in a primary care clinical course. The learning experience comprised a pre-class online module to convey knowledge; a formative, ungraded standardised patient exercise on dietary modification to practise skills; and a written exam on nutrition knowledge and an Objective Structured Clinical Exam assessing nutrition counselling skills.

The Relationship Between Medical School Clerkships and Primary Care Specialty Choice: A Narrative Review.

Background And Objectives: There is a persistent shortage of primary care physicians in the United States. Medical schools can help meet societal primary care health needs by graduating more students who select family medicine and other primary care careers. The objective of this narrative review was to evaluate the relationship between clerkships and primary care specialty choice.

Medical School Characteristics, Policies, and Practices That Support Primary Care Specialty Choice: A Scoping Review of 5 Decades of Research.

Background And Objectives: The United States, like many other nations, faces a chronic shortage of primary care physicians. The purpose of this scoping review was to synthesize literature describing evidence-based institutional practices and interventions that support medical students' choices of primary care specialties, published in the United States, Canada, Australia, and New Zealand.

Methods: We surveyed peer-reviewed, published research.

The science of education: using learning theory to solve teaching problems in medical education.

Although theories do not play a major role in clinical medicine, the application of established theories of education can improve medical teaching. By understanding and harnessing learning theories, clinician educators can solve common teaching problems, thoughtfully craft their teaching sessions, determine whether learners or residents have achieved the intended learning objectives, and even earn higher course ratings. Key theories to be aware of include cognitive load theory, social learning theory, experiential learning, constructivism, humanism, behaviourism and connectivism.

Developing a Clinician Friendly Tool to Identify Useful Clinical Practice Guidelines: G-TRUST.

Background: Clinicians are faced with a plethora of guidelines. To rate guidelines, they can select from a number of evaluation tools, most of which are long and difficult to apply. The goal of this project was to develop a simple, easy-to-use checklist for clinicians to use to identify trustworthy, relevant, and useful practice guidelines, the Guideline Trustworthiness, Relevance, and Utility Scoring Tool (G-TRUST).

Student-teacher education programme (STEP) by step: transforming medical students into competent, confident teachers.

Background: While most medical schools have students teach other students, few offer formal education in teaching skills, and fewer provide teaching theory together with experiential teaching practice. Furthermore, curriculum evaluation of teaching education is lacking.

Aim: This study aimed to examine effects of a novel didactic teaching curriculum for students embedded in a practical teaching experience.

Conflicts of interest and the quality of recommendations in clinical guidelines.

Background: There is increasing concern that conflicts of interest affect the development process of clinical practice guidelines. We evaluated The American Psychiatric Association's Practice Guideline for the Treatment of Patients with Major Depressive Disorder to determine the existence of financial and intellectual conflicts of interest and examine their possible effects. We selected this guideline because of its influence on clinical practice and because this guideline recommends pharmacotherapy for all levels of depression, despite controversies over the evidence base.

Diabetes update: population management.

To optimally care for diabetes patients, physicians must adopt a systematic approach to managing the entire panel. At the heart of excellent care is a multidisciplinary health care team working in a patient-centered environment. Options to supplement traditional office visits include shared medical appointments (ie, group visits), patient self-management education, and social media for patient support and education.

Diabetes update: new drugs to manage type 2 diabetes.

Metformin is the first-line treatment for patients with diabetes because it reduces mortality rates. If metformin is contraindicated or is not tolerated, any one of the other available antihyperglycemic drugs may be used as monotherapy. These drugs are equally effective for glucose control, lowering A1c by approximately 1%.

Diabetes update: long-term treatment of adults.

Current evidence supports a less interventional, less aggressive, and more patient-oriented approach to the care of patients with diabetes than is commonly followed. When treating an adult patient with type 2 diabetes, the physician must focus on the following (in order of importance): smoking cessation and other lifestyle interventions, blood pressure control, metformin use, lipid control, and glycemic control. Patients also should receive influenza and pneumococcal vaccinations.

Diabetes update: screening and diagnosis.

Busy primary care physicians who want their patients with type 2 diabetes to live longer and better should, as much as possible, base screening and management decisions on patient-oriented evidence that affects morbidity and mortality. Because patients with dual diagnoses of diabetes and hypertension have a high risk of cardiovascular mortality, asymptomatic patients with hypertension should be screened for type 2 diabetes. Screening is conducted using a fasting plasma glucose test, a random A1c test, or a 2-hour oral glucose tolerance test.