An Analysis of Trainee Status of the Primary Care Physician and Ambulatory Care Outcomes.

Purpose: Prior studies report disparities in outcomes for patients cared for by trainees versus faculty physicians at academic medical centers. This study examined the effect of having a trainee as the primary care physician versus a faculty member on routine population health outcomes after adjusting for differences in social determinants of health and primary care retention.

Method: This cohort study assessed 38,404 patients receiving primary care at an academic hospital-affiliated practice by 60 faculty and 110 internal medicine trainees during academic year 2019.

Low Rate of Completion of Recommended Tests and Referrals in an Academic Primary Care Practice with Resident Trainees.

Background: A frequent, preventable cause of diagnostic errors involves failure to follow up on diagnostic tests, referrals, and symptoms-termed "failure to close the diagnostic loop." This is particularly challenging in a resident practice where one third of physicians graduate annually, and rates of patient loss due to these transitions may lead to more opportunities for failure to close diagnostic loops. The aim of this study was to determine the prevalence of failure of loop closure in a resident primary care clinic compared to rates in the faculty practice and identify factors contributing to failure.

Unmasking a Vulnerable Patient Care Process: A Qualitative Study Describing the Current State of Resident Continuity Clinic in a Nationwide Cohort of Internal Medicine Residency Programs.

Background: Residents serve as access points to the health care system for the most vulnerable patients in the United States. Two large academic medical centers have identified performance gaps between resident and faculty physicians. Our intent in this study was to measure the scope of resident-faculty performance gaps in a nationwide sample and identify potential targets for intervention.

"Patient Lost to Follow-up": Opportunities and Challenges in Delivering Primary Care in Academic Medical Centers.

Background: Academic health centers (AHCs) face unique challenges in providing continuity to a medically and socially complex patient population. Little is known about what drives patient loss in these settings.

Objective: Determine physician- and patient-based factors associated with patient loss in AHCs.

Effect of an Immersive Primary Care Training Program on Educational and Clinical Outcomes in an Internal Medicine Residency Training Program: Meeting the Training Needs of a Modern-Day Physician Workforce.

Background: Residents planning careers in primary care have unique training needs that are not addressed in traditional internal medicine training programs, where there is a focus on inpatient training. There are no evidence-based approaches for primary care training.

Objectives: Design and test the effect of a novel immersive primary care training program on educational and clinical outcomes.

Defining the Resident Continuity Clinic Panel Along Patient Outcomes: a Health Equity Opportunity.

Background: Continuity clinics are a critical component of outpatient internal medicine training. Little is known about the population of patients cared for by residents and how these physicians perform.

Objectives: To compare resident and faculty performance on standard population health measures.

Effect of a Flipped Classroom on Knowledge Acquisition and Retention in an Internal Medicine Residency Program.

Background: The flipped classroom is a teaching approach with strong evidence for effectiveness in undergraduate medical education. Objective data for its implementation in graduate medical education are limited.

Objective: We assessed the efficacy of the flipped classroom compared with standard approaches on knowledge acquisition and retention in residency education.

Preventability of Early Versus Late Hospital Readmissions in a National Cohort of General Medicine Patients.

Background: Many experts believe that hospitals with more frequent readmissions provide lower-quality care, but little is known about how the preventability of readmissions might change over the postdischarge time frame.

Objective: To determine whether readmissions within 7 days of discharge differ from those between 8 and 30 days after discharge with respect to preventability.

Design: Prospective cohort study.

Preventability of early vs. late readmissions in an academic medical center.

Background: It is unclear if the 30-day unplanned hospital readmission rate is a plausible accountability metric.

Objective: Compare preventability of hospital readmissions, between an early period [0-7 days post-discharge] and a late period [8-30 days post-discharge]. Compare causes of readmission, and frequency of markers of clinical instability 24h prior to discharge between early and late readmissions.

Differences between early and late readmissions among patients: a cohort study.

Background: Early and late readmissions may have different causal factors, requiring different prevention strategies.

Objective: To determine whether predictors of readmission change within 30 days after discharge.

Design: Retrospective cohort study.

Effect of a systems intervention on the quality and safety of patient handoffs in an internal medicine residency program.

Background: Poor quality handoffs have been identified as a major patient safety issue. In residency programs, problematic handoffs may be an unintended consequence of duty-hour restrictions, and key data are frequently omitted from written handoffs because of the lack of standardization of content.

Objective: Determine whether an intervention that facilitates face-to-face communication supported by an electronic template improves the quality and safety of handoffs.

Activation of estrogen receptor-alpha by the anion nitrite.

In this study, the ability of nitrite and nitrate to mimic the effects of estradiol on growth and gene expression was measured in the human breast cancer cell line MCF-7. Similar to estradiol, treatment of MCF-7 cells with either 1 mumol/L nitrite or 1 mumol/L nitrate resulted in approximately 4-fold increase in cell growth and 2.3-fold to 3-fold increase in progesterone receptor (PgR), pS2, and cathepsin D mRNAs that were blocked by the antiestrogen ICI 182,780.