Treatment of breast cancer.

Understanding breast cancer treatment options can help family physicians care for their patients during and after cancer treatment. This article reviews typical treatments based on stage, histology, and biomarkers. Lobular carcinoma in situ does not require treatment.

Sharpening the eye of the OSCE with critical action analysis.

Purpose: When interpreting performance scores on an objective structured clinical examination (OSCE), are all checklist items created equal? Although assigning priority through checklist item weighting is often used to emphasize the clinical importance of selected checklist items, the authors propose the use of critical action analysis as an additional method for analyzing and discriminating clinical performance in clinical skill assessment exercises. A critical action is defined as an OSCE checklist item whose performance is critical to ensure an optimal patient outcome and avoid medical error. In this study, the authors analyzed a set of clerkship OSCE performance outcome data and compared the results of critical action analysis versus traditional checklist item performance scores.

Foreign bodies in the ear, nose, and throat.

Foreign bodies in the ear, nose, and throat are occasionally seen in family medicine, usually in children. The most common foreign bodies are food, plastic toys, and small household items. Diagnosis is often delayed because the causative event is usually unobserved, the symptoms are nonspecific, and patients often are misdiagnosed initially.

Enhancing clinical skills education: University of Virginia School of Medicine's Clerkship Clinical Skills Workshop Program.

In 1993, the University of Virginia School of Medicine began a clinical skills workshop program in an effort to improve the preparation of all clerkship students to participate in clinical care. This program involved the teaching of selected basic clinical skills by interested faculty to small groups of third-year medical students. Over the past 14 years, the number of workshops has increased from 11 to 31, and they now involve clerkship faculty from family medicine, internal medicine, and pediatrics.

Preventing postpartum hemorrhage: managing the third stage of labor.

Postpartum hemorrhage is a significant cause of maternal morbidity and mortality. Most postpartum hemorrhages are caused by uterine atony and occur in the immediate postpartum period. Expectant or physiologic management of the third stage of labor has been compared with active management in several studies.