Using motivational interviewing for smoking cessation in primary care.

Objectives: To compare the effects of resident physician motivational interviewing (MI), resident physician MI plus registered nurse (RN), and the standard of care counseling approach--ask, advise, assess, assist, and arrange follow-up (5 As)--on current smokers' behaviors (readiness to quit, cigarettes smoked per day, current smoking rates), self-efficacy to quit smoking, and nicotine dependence.

Methods: The study design was quasi-experimental pretest/posttest with a comparison group. Pencil/paper measures were completed in the clinic setting at baseline and via telephone approximately 1 and 2 months after the clinic visit.

The responsible use of online social networking: who should mentor medical students.

Background: As medical students become more active in online social networking (OSN), there are increasing concerns regarding violations of patient privacy and a lack of professionalism.

Purpose: Students need to be mentored, but who is best suited to the task? We hypothesized that residents are closer to students in usage and attitudes toward online communication than are faculty. If so, they would be more credible as mentors.

What residents know about health care reform and what we should teach them.

Purpose: We surveyed residents and fellows at the University of Louisville School of Medicine (N  =  600) to (1) explore their perceptions and knowledge of issues related to health care business and health care reforms, and (2) seek their input on what instructional content concerning health care business and health care reform they would like to receive and what instruction venue they would prefer. We will use the findings to make decisions about curriculum content and delivery.

Methods: All residents were invited to complete a 4-part, web-based survey that included questions on demographics, attitudes, and perceptions; a baseline-knowledge quiz about health care costs; and 2 open-ended questions about what they wanted to learn and how they preferred to be taught.

Improving residents' teaching skills: a program evaluation of residents as teachers course.

Background: The role of residents as teachers is recognized as an important part of medical education. However, residents may not possess the practical skills needed to teach medical students effectively.

Aim: In response to a Liaison Committee on Medical Education citation concerning surgery residents' teaching skills, the University of Louisville School of Medicine instituted a campus-wide residents as teachers program based on the bringing education and service together curriculum.

Community-acquired pneumonia in infants and children.

Community-acquired pneumonia is one of the most common serious infections in children, with an annual incidence of 34 to 40 cases per 1,000 children in Europe and North America. When diagnosing community-acquired pneumonia, physicians should rely mainly on the patient's history and physical examination, supplemented by judicious use of chest radiographs and laboratory tests as needed. The child's age is important in making the diagnosis.

Infantile colic.

Infantile colic can be distressing to parents whose infant is inconsolable during crying episodes. Colic is often defined by the "rule of three": crying for more than three hours per day, for more than three days per week, and for longer than three weeks in an infant who is well-fed and otherwise healthy. The physician's role is to ensure that there is no organic cause for the crying, offer balanced advice on treatments, and provide support to the family.

Introducing practice-based learning and improvement ACGME core competencies into a family medicine residency curriculum.

Background: The Accreditation Council for Graduate Medical Education (ACGME) recommends integrating improvement activities into residency training. A curricular change was designed at the Department of Family and Community Medicine, University of Louisville, to address selected ACGME competencies by incorporating practice-based improvement activities into the routine clinical work of family medicine residents.

Methods: Teams of residents, faculty, and office staff completed clinical improvement projects at three ambulatory care training sites.

Overview of histoplasmosis.

Histoplasmosis is an endemic infection in most of the United States and can be found worldwide. The spectrum of this illness ranges from asymptomatic infection to severe disseminated disease. Life-threatening illness is usually associated with an immunocompromised state; however, 20 percent of severe illnesses result from a heavy inoculum in healthy persons.