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Medical student effect on emergency department length of stay

ANNALS OF EMERGENCY MEDICINE 2001年第3期37卷 275-278页

作者： Gerbeaux, P Ledoray, V Liauthaud, H Torro, D Takun, K Thirree, R Nelh, P Jean, P Hop Concept Serv Accueil & Traitement Urgences F-13385 Marseille France Hop Concept Dept Med Informat F-13385 Marseille France

Study objective: Taking advantage of a medical student strike. the authors evaluated the effect of medical students on emergency department length of slay (LOS). Methods: ED LOS and patient characteristics were compared for the 4-day strike period and the same days the week before. Proportions were compared by using the Mann-Whitney U test and the chi (2) test (P<.05). Results: Eight hundred thirty-one patients were studied. There was no significant difference between the study and control periods for the general patient characteristics or laboratory or radiologic investigations. Median LOS decreased by 24% (31 minutes, 95% confidence interval [CI] 24 to 38) during the strike (110 minutes [95% CI 65 to 178] to 79 minutes [95% CI 40 to 135], P<10(-4)). Conclusion: Medical students lengthen ED FOS. This should be explained to patients and should be considered as one justification for increasing medical staff in the teaching ED.

关键词：效率急诊室医院/统计学和数值数据法国医院大学住院时间/统计学和数值数据学生医科/统计学和数值数据时间和运动研究成年人女(雌)性人类男(雄)性

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Comparison of the objective structured clinical examination with the performance of third year medical students in surgery

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AMERICAN JOURNAL OF SURGERY 2000年第4期179卷 286-288页

作者： Merrick, HW Nowacek, G Boyer, J Robertson, J Med Coll Ohio Dept Surg Toledo OH 43699 USA Med Coll Ohio Off Educ Resources & Res Toledo OH 43699 USA

BACKGROUND: The purpose of this study was to investigate the validity of the Objective Structured Clinical Examination (OSCE) as an evaluation technique by comparing medical student performance on the OSCE with traditional forms of evaluation. SUBJECTS AND METHODS: We analyzed the performance of 129 third-year medical students in the 1997-1998 academic year on clinical evaluations, oral examinations, and NBME subject examinations, and on OSCE, which was not included in the final grade. RESULTS: The OSCE showed high correlation with the final grades received for the clerkship. Seventy-one percent of students receiving High Pass or Honors had high OSCE scores whereas 67% of students with low OSCE scores received poor or Defer grades. Pearson product-moment correlations demonstrated significant bivariate correlations with the other test parameters. CONCLUSIONS: This study demonstrates that the OSCE is similar to the traditional methods in evaluating general ability and is also able to evaluate clinical ability in a standardized manner. Am J Surg. 2000;179:286-288. (C) 2000 by Excerpta Medica, Inc.

关键词：方差分析教育考核/方法教育考核/标准教育考核/统计学和数值数据实习医师和住院医师职务/方法实习医师和住院医师职务/统计学和数值数据学生医科/统计学和数值数据外科学/教育外科学/统计学和数值数据人类

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Are physicians aware of which of their patients have indwelling urinary catheters?

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AMERICAN JOURNAL OF MEDICINE 2000年第6期109卷 476-480页

作者： Saint, S Wiese, J Amory, JK Bernstein, ML Patel, UD Zemencuk, JK Bernstein, SJ Lipsky, BA Hofer, TP Univ Michigan Sch Med Dept Internal Med Ann Arbor MI USA Univ Calif San Francisco Sch Med Dept Med San Francisco CA 94143 USA Univ Washington Sch Med Dept Med Seattle WA 98195 USA Vet Affairs Ann Arbor Healthcare Syst Vet Affairs Ctr Practice Management & Outcomes Ann Arbor MI USA Vet Affairs Puget Sound Hlth Care Syst Primary & Specialty Med Care Seattle WA USA

PURPOSE: Although infections associated with indwelling urinary catheters are common, costly, and morbid, the use of these catheters is unnecessary in more than one-third of patients. We sought to assess whether attending physicians, medical residents, and medical students are aware if their hospitalized patients have an indwelling urinary catheter, and whether physician awareness is associated with appropriate use of these catheters. METHODS: The physicians and medical students responsible for patients admitted to the medical services at four university-affiliated hospitals were given a list of the patients on their service. For each patient, the provider was asked: "As of yesterday afternoon, did this patient have an indwelling urethral catheter?" Respondents' answers were compared with the results of examining the patient. RESULTS: Among 288 physicians and students on 56 medical teams, 256 (89%) completed the survey. Of 469 patients, 117 (25%) had an indwelling catheter. There were a total of 319 provider-patient observations among these 117 patients. Over all, providers were unaware of catheterization for 88 (28%) of the 319 provider-patient observations. Unawareness rates by level of training were 21% for students, 22% for interns, 27% for residents, and 38% for attending physicians (P = 0.06). Catheter use was inappropriate in 36 (31%) of the 117 patients with a catheter. Providers were unaware of catheter use for 44 (41%) of the 108 provider-patient observations of patients who were inappropriately catheterized. Catheterization was more Likely to be appropriate if respondents were aware of the catheter (odds ratio = 3.7;95% confidence interval, 2.1 to 6.7, P<0.001). CONCLUSION: Physicians are commonly unaware that their patients have an indwelling urinary catheter. Inappropriate catheters are more often "forgotten" than appropriate ones. System-wide interventions aimed at discontinuing unnecessary catheterization seem warranted. Am J Med. 2000;109: 476-480. (

关键词：觉知导管留置临床工作能力卫生设施管理人员/统计学和数值数据医院大学/统计学和数值数据医院退伍军人/统计学和数值数据感染控制实习医师和住院医师职务/统计学和数值数据医学审核医师/统计学和数值数据前瞻性研究学生医科/统计学和数值数据导尿管插入术/方法导尿管插入术/利用老年人女(雌)性人类男(雄)性中年人

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The effects of patient sex and race on medical students' ratings of quality of life

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AMERICAN JOURNAL OF MEDICINE 2000年第7期108卷 561-566页

作者： Rathore, SS Lenert, LA Weinfurt, KP Tinoco, A Taleghani, CK Harless, W Schulman, KA Duke Univ Med Ctr Duke Clin Res Inst Ctr Clin & Genet Econ Durham NC 27715 USA Univ Calif San Diego Dept Med San Diego CA 92103 USA Georgetown Univ Sch Med Washington DC USA Georgetown Univ Med Ctr Dept Neurosurg Washington DC 20007 USA Interact Drama Bethesda MD USA

PURPOSE: Although previous studies have examined race and sex differences in health care, few studies have investigated the possible role of physician bias. We evaluated the influence of race and sex on medical students' perceptions of patients' symptoms to determine if there are differences in these perceptions early in medical training. SUBJECTS AND METHODS: One-hundred sixty-four medical students were randomly assigned to view a video of a black female or white male actor portraying patients with identical symptoms of angina. We evaluated students' perceptions of the actors' health state (based on their assessment of quality of life) using a visual analog scale and a standard rating technique, as well as the type of chest pain diagnosis. RESULTS: Students assigned a lower value (indicating a less desirable health state) to the black woman than to the white man with identical symptoms [visual scale (mean +/- SD): 72 +/- 13 vs 67 +/- 12, P <0.02;standard gamble: 87 +/- 10 vs 80 +/- 15, P < 0.001). Nonminority students reported higher mean values for the white male patient (standard gamble: 89 +/- 8 vs 81 +/- 14 for the black female patient), whereas minority students' assessments did not differ by patient. Male students assigned a slightly lower value to the black female patient (standard gamble: 76 +/- 16 vs 87 +/- 10 for the white male patient). Students were less likely to characterize the black female patient's symptoms as angina (46% vs 74% for the white male patient, P = 0.001). CONCLUSIONS: The way that medical students perceive patient symptoms appears to be affected by nonmedical factors. (C) 2000 by Excerpta Medica, Inc.

关键词：非洲大陆世系人群方差分析欧洲大陆世系人群健康状况生活质量问卷调查性别因素学生医科/统计学和数值数据美国成年人女(雌)性人类男(雄)性

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Measurement of expired carbon monoxide among medical students to assess smoking behaviour

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SOZIAL-UND PRAVENTIVMEDIZIN 1998年第6期43卷 322-324页

作者： Groman, E Kunze, U Schmeiser-Rieder, A Schoberberger, R Univ Vienna Inst Sozialmed A-1080 Vienna Austria

CO-Measurement of medical students was taken during a compulsary public health training at the University of Vienna. The students were not informed previously so a non-response bias was excluded. Measurements were done with Bedfont EC50-MICRO Carbon monoxide monitor. The cut off point was set at 11 ppM. One hundred and seventy-three students were measured. Define indication of active smoking was found in 9%. With exception of one student all the others with carbon monoxide over 10 ppM called themselves active smokers. CO measurement will replace at some stage the usual question regarding the number of cigarettes consumed. Students also had the opportunity to learn a new diagnostic technique.

关键词：奥地利呼吸试验一氧化碳/分析敏感性与特异性吸烟/流行病学学生医科/统计学和数值数据成年人女(雌)性人类男(雄)性

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Assessing sexual health behaviors of resident physicians and graduate students

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ACADEMIC PSYCHIATRY 2003年第1期27卷 44-49页

作者： Williams, JK Goebert, D Univ Hawaii Dept Psychiat John A Burns Sch Med Honolulu HI 96822 USA

Objective: To compare the sexual practices of 44 resident physicians with those of 88 non-medical graduate students, including law students and master's-level social work students, by using the Safe Sex Behavioral Questionnaire (SSBQ). Methods: In a cross-sectional survey, the SSBQ, used to assess the sexual practices of these two groups, was distributed to participants at a state university via their campus mailboxes, along with a return address envelope, to help ensure anonymity. Results: The educational cohorts did not differ. Overall, participants reported engaging in high-risk sexual behaviors. Women with multiple partners were more likely to engage in increased risky behaviors, whereas men with multiple partners were more likely to use condoms. Conclusions: Physicians, although educated about healthy sexual behaviors, are still engaging in unsafe safe. The reasons for the discrepancy between knowledge and practice need to be explored. (Academic Psychiatry 2003;27:44-49).

关键词：态度避孕套/统计学和数值数据横断面研究教育医学研究生实习医师和住院医师职务冒险性别因素性行为/心理学学生医科/心理学学生医科/统计学和数值数据成年人女(雌)性人类男(雄)性

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Part 1 behavioral science scores: After a summer psychiatric research clerkship: Failure to replicate

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PERCEPTUAL AND MOTOR SKILLS 1999年第2期88卷 622-624页

作者： Holmes, GR Thornhill, JT Univ S Carolina William S Hall Psychiat Inst Dept Neuropsychiat & Behav Sci Columbia SC 29208 USA

The present study did not replicate Holmes,' ef al.'s (1987) findings that medical students who participated ina summer psychiatric research clerkship scored statistically significantly higher than matched controls on the Behavioral Science portion of the National Board of Medical Examiners' Pare I Exam. Group ns in this replication were 39 each.

关键词：成就行为科学/教育临床实习临床工作能力教育考核/统计学和数值数据精神病学/教育学生医科/统计学和数值数据女(雌)性人类男(雄)性

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Influence of a rural primary care clerkship on medical students' intentions to practice in a rural community

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JOURNAL OF RURAL HEALTH 2000年第2期16卷 155-161页

作者： Jones, AR Oster, RA Pederson, LL Davis, MK Blumenthal, DS Morehouse Sch Med Dept Community Hlth & Prevent Med Atlanta GA 30310 USA Morehouse Sch Med Rural Primary Care Clerkship Atlanta GA 30310 USA Morehouse Sch Med Clin Res Ctr Atlanta GA 30310 USA

The purpose of this study is to examine the relationship of a rural clerkship to medical students' interest in establishing careers in rural communities. The Association of American Medical Colleges Medical School Graduation Questionnaire (GQ) for years 1988 through 1997 was examined to compare the career plans of students graduating from Morehouse School of Medicine (MSM) with those of all students graduating from United States medical schools before the period 1988 through 1992 and after the period 1993 through 1997, after inception of the rural clerkship at MSM. Select GQ data items examined include student demographics, medical school experiences, and career plans. Statistical analyses were used to compare pre- and post-clerkship responses for MSM students and to compare their responses with the national trends. Results indicate that, following a transition period, MSM students showed an increased preference for a future career in a rural community. A smaller upward trend in the national data was observed. There appears to be an association between the rural clerkship experience at MSM and the stated preferred career choices of the students.

关键词：亚拉巴马职业选择临床实习佐治亚初级卫生保健专业场所乡村卫生服务/人力学生医科/统计学和数值数据美国成年人女(雌)性人类男(雄)性

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Social background of minority ethnic applicants to medicine and dentistry

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BRITISH DENTAL JOURNAL 2000年第3期189卷 152-154页

作者： Bedi, R Gilthorpe, MS UCL Eastman Dent Inst Natl Transcultural Oral Hlth WHO Collaborating Ctr Disabil Culture & Oral Hlth London WC1X 8LD England

Aim To explore ethnic variations in social background of successful applicants to undergraduate United Kingdom medical and dental schools. Method Retrospective analyses of University and College Admissions Services data on all students to commence study in pre-clinical medicine and dentistry, during the academic years 1994/5, 1995/6 and 1996/7. Analyses were undertaken for two categories of social class, namely higher (professional and intermediate) and lower (skilled non-manual, skilled manual, partly skilled, and unskilled) social class. Results Over 15 thousand students were accepted to study medicine and dentistry during the three-year study period, of which 80% were from high social class backgrounds. More medical (80.9%) students were from high social class backgrounds than dental (73.3%) students (OR=1.54, 95% CI=1.39, 1.70). Social class differences were observed, with a greater proportion of higher social class students amongst the white students than amongst the minority ethnic students (OR=1.42, 95% CI=1.30, 1.55). This was more marked in dentistry (OR=1.48, 95% CI=1.22, 1.79) than in medicine (OR=1.35, 95% CI=1.22, 1.49). More students from higher social class backgrounds were observed in medicine than in dentistry amongst the black (OR=1.55, 95% CI=0.59, 4.00), Indian (OR=2.04, 95% CI=1.58, 2.62) and white (OR=1.44, 95% CI=1.26, 1.64) groups. Conclusions Significant inter-ethnic differences are observed in the social background of students entering medicine and dentistry. Dentistry accepted a greater proportion of students from lower social class backgrounds and from black and minority ethnic groups.

关键词：非洲裔美国人非洲大陆世系人群亚洲/人种学人种群/统计学和数值数据欧洲大陆世系人群少数民族/统计学和数值数据比值比回顾性研究社会阶级学生牙科/统计学和数值数据学生医科/统计学和数值数据人类

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Ethnic and gender variations in university applicants to United Kingdom medical and dental schools

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BRITISH DENTAL JOURNAL 2000年第4期189卷 212-215页

作者： Bedi, R Gilthorpe, MS UCL Eastman Dent Inst WHO Collaborating Ctr Disabil Culture & Oral Hlth London WC1 8LD England

Aim To explore ethnic and gender variations amongst applicants to undergraduate United Kingdom medical and dental schools. Method Retrospective analyses of University and College Admissions Services (UCAS) data on all students applying to study pre-clinical medicine and dentistry, during the academic years 1994/5, 1995/6 and 1996/7. Information for each medical and dental applicant included age, gender, social class and ethnic group. Results Of all applicants, just over half (50.2%) were male, though a greater proportion of applicants to dentistry were male (54.1%) than for medicine (49.3%) (OR=1.21, 95% CI=1.15, 1.28). Over one third (36.4%) of all students were from minority ethnic groups, a larger proportion of which were dental students (48.3%) than were medical students (33.8%) (OR=1.83, 95% CI=1.73,1.94). There were also marked differences between medicine and dentistry when the ethnic groups were examined separately. The largest number of applicants from minority ethnic groups came from the Indian community, and this group increased in size annually by 4.1% (P<0.05) for medicine, and 29% (P<0.05) for dentistry. Conclusions Significant inter-ethnic and gender differences are observed amongst applicants to medicine and dentistry. Dentistry appears to be relatively more attractive to minority ethnic applicants.

关键词：非洲裔美国人/统计学和数值数据非洲大陆世系人群孟加拉国/人种学中国/人种学人种群/教育人种群/统计学和数值数据印度/人种学巴基斯坦/人种学回顾性研究入学标准性别因素社会阶级学生牙科/统计学和数值数据学生医科/统计学和数值数据妇女/教育女(雌)性人类男(雄)性

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