Development of a high-value care subscore on the internal medicine in-training examination.

Background: Although high-value care (HVC) that balances benefits of tests or treatments against potential harms and costs has been a recently emphasized competency for internal medicine (IM) residents, few tools to assess residents' knowledge of HVC are available.

Objective: To describe the development and initial results of an HVC subscore of the Internal Medicine In-Training Examination (IM-ITE).

Design: The HVC concepts were introduced to IM-ITE authors during question development.

In the clinic. Insomnia.

This issue provides a clinical overview of Insomnia focusing on prevention, diagnosis, treatment, practice improvement, and patient information. The content of In the Clinic is drawn from the clinical information and education resources of the American College of Physicians (ACP), including ACP Smart Medicine and MKSAP (Medical Knowledge and Self-Assessment Program). Annals of Internal Medicine editors develop In the Clinic from these primary sources in collaboration with the ACP's Medical Education and Publishing divisions and with the assistance of science writers and physician writers.

Hospitalist career decisions among internal medicine residents.

Background: Hospital medicine is a rapidly growing field of internal medicine. However, little is known about internal medicine residents' decisions to pursue careers in hospital medicine (HM).

Objective: To identify which internal medicine residents choose a career in HM, and describe changes in this career choice over the course of their residency education.

Does medical student knowledge of anticoagulation differ by future intended practice?

Background: The scope of medical student knowledge may differ by the student's future intended specialty.

Aim: To determine whether medical student knowledge of and confidence with anticoagulation differed by perceived likelihood of managing anticoagulation in future practice.

Methods: One hundred and twenty-three third- and fourth-year medical students (41% response rate) participated in a cross-sectional web-based survey.

Medical student documentation in the medical record: is it a liability?

Medical students have routinely documented patient encounters in both inpatient and outpatient care venues. This hands-on experience has provided a way for students to reflect on patient encounters, learn proper documentation skills, and attain a sense of being actively involved in and responsible for the care of patients. Over the last several years, the practice of student note writing has come into question.

Attending rounds and bedside case presentations: medical student and medicine resident experiences and attitudes.

Background: Attending rounds have transitioned away from the patient's bedside toward the hallway and conference rooms. This transition has brought into question how to best teach on medicine services.

Purpose: The purpose is to describe learner experiences and attitudes regarding bedside attending rounds at an academic medical institution.

Trimethoprim-sulfamethoxazole revisited.

During the past 3 decades, the combination of trimethoprim and sulfamethoxazole has occupied a central role in the treatment of various commonly encountered infections and has also been particularly useful for several specific clinical conditions. However, changing resistance patterns and the introduction of newer broad-spectrum antibiotics have led to the need to carefully redefine the appropriate use of this agent in clinical practice. While trimethoprim-sulfamethoxazole's traditional role as empirical therapy for several infections has been modified by increasing resistance, it remains a highly useful alternative to the new generation of expanded-spectrum agents if resistance patterns and other clinical variables are carefully considered.