Evaluation of a Tailored Patient Navigation Program for Improving Multitarget Stool DNA Test Adherence.

Background: Multitarget stool DNA (mt-sDNA) is an increasingly utilized noninvasive option for colorectal cancer screening; however, its impact is limited by imperfect test adherence. Tailored patient navigation (TPN) improves adherence for other cancer screening tests, but its role in mt-sDNA is not known.

Aim: Determine whether TPN improves mt-sDNA completion and reduces sample could not be processed (SCNBP) result rates.

Separate But Not Equal? A Cross-Sectional Study of Segregation by Payor Mix in Academic Primary Care Clinics.

Background: At some US Academic Health Centers (AHCs), patients with predominantly Medicaid insurance are seen in one clinic and patients with other insurance are seen in another. The extent of this practice and implications are unknown.

Objective: To estimate the proportion of AHCs that have at least two primary care internal medicine clinics that differ substantially in proportion of patients with Medicaid and to compare patient demographic, staffing, and operational features.

Advance care planning clinic: A structured clinical experience for internal medicine residents.

Background: Advance care planning (ACP) is an important step to provide medical care consistent with patients' preferences and values. Nationally, rates of ACP completion are low, and internal medicine residency clinics face additional barriers. To address this need, we implemented an ACP clinic for internal medicine residents.

Residency Practice Transformation: Implementation of Team-Based Care in an Academic Continuity Clinic.

Background: Team-based primary care has the potential to improve care delivery. However, residency scheduling and precepting models make creating functional ambulatory teams challenging.

Objective: We describe the team-based care transformation at a large academic internal medicine residency practice.

Empanelment in a Resident Teaching Practice: A Cornerstone to Improving Resident Outpatient Education and Patient Care.

Background: Improving continuity is challenging in residency training practices. Studies have shown that empanelment enables high-performing primary care and is foundational to improve accountability and continuity.

Objective: An empanelment process was created in a large, urban, residency training practice as an effective approach to enhancing continuity among residents and their patients.

Resident duty hours in the outpatient electronic health record era: inaccuracies and implications.

Background: The Accreditation Council for Graduate Medical Education expects resident duty hours to be monitored, yet no previous studies have examined the effect of after-hours electronic health record (EHR) use on resident hours or burnout.

Objective: We assessed internal medicine residents' perceived and actual time spent on after-hours outpatient EHR use and calculated increased duty hours if after-hours EHR use were included; we also assessed its effect on resident burnout.

Methods: We retrospectively aggregated time spent logged on to the outpatient EHR for residents in a general internal medicine clinic for 13 weeks in 2011.

Decision making in prostate cancer screening using decision aids vs usual care: a randomized clinical trial.

Importance: The conflicting recommendations for prostate cancer (PCa) screening and the mixed messages communicated to the public about screening effectiveness make it critical to assist men in making informed decisions.

Objective: To assess the effectiveness of 2 decision aids in helping men make informed PCa screening decisions.

Design, Setting, And Participants: A racially diverse group of male outpatients aged 45 to 70 years from 3 sites were interviewed by telephone at baseline, 1 month, and 13 months, from 2007 through 2011.

Behavioral and psychosocial responses to genomic testing for colorectal cancer risk.

We conducted a translational genomic pilot study to evaluate the impact of genomic information related to colorectal cancer (CRC) risk on psychosocial, behavioral and communication outcomes. In 47 primary care participants, 96% opted for testing of three single nucleotide polymorphisms (SNPs) related to CRC risk. Participants averaged 2.

"Is it really worth it to get tested?": primary care patients' impressions of predictive SNP testing for colon cancer.

Despite significant progress in genomics research over the past decade, we remain years away from the integration of genomics into routine clinical care. As an initial step toward the implementation of genomic-based medicine, we explored primary care patients' ideas about genomic testing for common complex diseases to help develop future patient education materials and interventions to communicate genomic risk information. We conducted a mixed-methods study with participants from a large primary care clinic.

Men's use of an Internet-based decision aid for prostate cancer screening.

Most medical organizations recommend informed decision making before undergoing prostate cancer screening. The authors conducted a detailed evaluation of men's use of an interactive, Web-based prostate cancer screening decision aid. Participants (N = 531) were 57 years old (SD = 6.

The development of a web- and a print-based decision aid for prostate cancer screening.

Background: Whether early detection and treatment of prostate cancer (PCa) will reduce disease-related mortality remains uncertain. As a result, tools are needed to facilitate informed decision making. While there have been several decision aids (DAs) developed and tested, very few have included an exercise to help men clarify their values and preferences about PCa screening.

How well do second-year students learn physical diagnosis? Observational study of an Objective Structured Clinical Examination (OSCE).

Background: Little is known about using the Objective Structured Clinical Examination (OSCE) in physical diagnosis courses. The purpose of this study was to describe student performance on an OSCE in a physical diagnosis course.

Methods: Cross-sectional study at Harvard Medical School, 1997-1999, for 489 second-year students.