Objective: To determine whether interns' performances of technical, preventive, and communication aspects of patient care improve during the intern year.
Design: A descriptive study. At the beginning and end of the intern year, interns' consultations with three simulated (standardized) patients were videotaped and scored according to explicit criteria set by an expert panel. Problems simulated were urinary tract infection, bronchitis, and tension headache.
Setting: The casualty outpatient department in a general teaching hospital in New South Wales, Australia.
Participants: Twenty-eight interns rotated to the casualty department.
Results: Little improvement over the intern year in technical competence or preventive care was observed, even though initial levels of compliance with criteria were quite low for some items. Greater improvement was apparent in the area of communication skills.
Conclusions: The results suggest that the internship should be restructured to more adequately teach the skills required for primary care.
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http://dx.doi.org/10.1007/BF02599104 | DOI Listing |
J Gen Intern Med
January 2025
General Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA.
Purpose: Physicians are estimated to be responsible for more than 50% of national healthcare costs and hold the greatest potential to improve value by orchestrating quality-driven programs to reduce unnecessary practices and variability. A physician's ability to practice cost-conscious care has been linked to their training, underscoring the importance of integrating cost-conscious practice into training.
Methods: The High Value Practice Academic Alliance was formed to help advance the value-improvement work of individual institutions through a national organization.
Intern Emerg Med
January 2025
The Toxikon Consortium, 1950 West Polk St, 7th Floor, Chicago, IL, 60612, USA.
Carbon monoxide (CO) poisoning continues to result in hospitalization and mortality. We sought to analyze risk factors associated with inpatient admission for CO poisoning. Retrospective study of the US National Inpatient Sample (NIS) database.
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January 2025
Dermatology department, Unidade Local de Saúde de Santa Maria, Avenida Professor Egas Moniz MB, Lisboa, Portugal; Universidade de Lisboa Faculdade de Medicina, Dermatology University Clinic, Portugal.
Intern Med
January 2025
Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Japan.
We herein report the first case of dyspnea with hemidiaphragm elevation in a 68-year-old woman with active giant cell arteritis (GCA), including successful treatment. Contrast-enhanced computed tomography showed a reduced density of the left ophthalmic artery and the left superficial temporal artery with increased soft tissue compared to the other side, indicating that the GCA had flared up and suggesting that the hemidiaphragm elevation might be caused by vasculitis-associated ischemia of the right phrenic nerve. Hemidiaphragm paralysis due to vasculitis-associated ischemia in patients with GCA needs to be distinguished from local infection, tumors, and hepatomegaly, which are the major causes of hemidiaphragm elevation.
View Article and Find Full Text PDFIntern Med
January 2025
Department of Gastroenterology, Kanazawa University Hospital, Japan.
Whether or not pancreaticobiliary maljunction (PBM) is a risk factor for pancreatic cancer (PC) is unclear. We present a case of metachronous PC with PBM diagnosed after cholecystectomy for gallbladder cancer, in which follow-up imaging was possible until PC onset. A 63-year-old man who had been diagnosed with gallbladder cancer and had undergone cholecystectomy 5 years earlier developed pancreatitis.
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