The Maternal Infant Health Outreach Worker program in low-income families.

Vanderbilt University Medical Center's Maternal Infant Health Outreach Worker program (MIHOW) is a community-based intervention dedicated to enhancing birth outcomes and healthy child development. Trained neighborhood women provide home and group services to underserved families in rural and inner city communities. This report describes MIHOW's history and work in Tennessee, Kentucky, West Virginia, Mississippi, and Louisiana.

The Emphasis Program: a scholarly concentrations program at Vanderbilt University School of Medicine.

In 1999, a faculty committee at Vanderbilt University School of Medicine reviewed the mission and goals of the school and determined that graduates should receive initial preparation to develop scholarly careers in medicine. The authors describe the design of a scholarly projects course, the Emphasis Program, which is required of all students in the first two years of medical school. Each student undertakes a mentored project in one of nine areas of scholarship related to medicine.

A program to enhance competence in clinical transaction skills.

The ability to take a comprehensive and accurate clinical history, perform a thorough and nuanced physical examination, engage in sequential clinical reasoning using all relevant clinical and laboratory data, and communicate clearly and compassionately with patients and other providers--the skills of the clinical transaction--are critical to a successful therapeutic outcome. Yet few medical schools' curricula include an explicit focus on developing these skills beyond the introductory level. Vanderbilt Medical School has developed a structured curriculum, integrated into the traditional clerkships of the third and fourth years, that ensures that each student receives specific instruction in clinical transaction skills.

The relationship between academic performance and severity of depressed mood during medical school.

We employ a structural equation model to examine the relationship between academic performance and depressed mood over 4 years for a single medical school class. Academic performance measures included undergraduate gradepoint average, first- and second-year medical school gradepoint average, full Medical College Admissions Test (MCAT) and total National Boards Part I (NB) scores. Severity of depressed mood was assessed by administering the Beck Depression Inventory two times per year during the first 2 years, and once per year during the last 2 years.