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A method of teaching clinical research in a community hospital residency program

AMERICAN JOURNAL OF SURGERY 1999年第1期177卷 83-85页

作者： Chung, R Diaz, J Li, P Meridia Huron Hosp Cleveland Clin Hlth Syst Dept Surg E Cleveland OH 44112 USA

BACKGROUND: TO provide clinical research experience in community hospital programs, we integrated research training with the daily work of surgical residency. METHODS: Teaching conferences and daily care of patients served as a source of projects. Emphasizing team work, high-yield projects are assigned to principal resident investigators, who lead a project team. Regular meetings with the faculty provides guidance and supervision, working to meet an abstract deadline. RESULTS: Over a 3-year period, 10 of 16 trainees participated in at least one project. Thirteen projects were presented at national meetings and 13 articles (including 6 from presentations) were published. Three projects were abandoned for lack of progress, and 5 manuscripts have been rejected. CONCLUSION: The integrated program trains multiple residents/projects with low requirements in space and funding, but high demands of organization and faculty time. Am J Surg. 1999;177: 83-85. (C) 1999 by Excerpta Medica, Inc.

关键词：课程医院社区实习医师和住院医师职务出版研究/教育外科学/教育人类

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Do surgical residents rated as better teachers perform better on in-training examinations?

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AMERICAN JOURNAL OF SURGERY 1999年第1期177卷 33-37页

作者： Seely, AJE Pelletier, MP Snell, LS Trudel, JL McGill Univ Dept Gen Surg Div Gen Surg Montreal PQ Canada McGill Univ Dept Cardiothorac Surg Div Gen Surg Montreal PQ Canada McGill Univ Dept Internal Med Div Gen Surg Montreal PQ Canada McGill Univ Dept Gen Surg & Oncol Div Gen Surg Montreal PQ Canada

BACKGROUND: There have been no attempts to objectively compare resident teaching ability with resident knowledge level. METHODS: Resident teaching ability, as rated by medical students and junior surgical residents, was compared with resident knowledge level, estimated by in-training examination results, for 18 PGY5 and PGY4 surgical residents at McGill University (September 1996 to July 1997). RESULTS: There was a trend to suggest that greater teaching ability is associated with higher in-training examination scores;this did not achieve statistical significance. PGY4 residents were rated as better teachers than PGY4 residents. Resident self-evaluation revealed a high degree of interest in teaching;inadequate time was the principal deterrent to resident teaching;enjoyment and learning during teaching were found to be the most common incentives. CONCLUSIONS: Our results suggest an association between resident level of knowledge and teaching ability. The principal deterrent to teaching-inadequate time-must be addressed to effectively assist surgical resident teaching. Am J Surg. 1999;177:33-37. (C) 1999 by Excerpta Medica, Inc.

关键词：成就加拿大职业选择教育考核实习医师和住院医师职务职业满意外科学/教育成年人女(雌)性人类男(雄)性

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Safety and efficacy of total thyroidectomy in hands of endocrine surgery trainees

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AMERICAN JOURNAL OF SURGERY 1999年第5期178卷 377-380页

作者： Mishra, A Agarwal, G Agarwal, A Mishra, SK Sanjay Gandhi Postgrad Inst Med Sci Dept Endocrine Surg Lucknow 226014 Uttar Pradesh India

BACKGROUND: Fear of a high complication rate of total thyroidectomy, especially in the hands of less experienced surgeons, limits its routine use. The results of total thyroidectomy in the hands of endocrine surgery trainees and consultants were compared to know whether this procedure can be performed effectively and safely by trainees. METHODS: Medical records of 232 patients who underwent total thyroidectomy from 1990 to 1997 were reviewed. Patients were put into groups A (operated by consultants) and B (trainees). Safety (postoperative hypoparathyroidism, recurrent laryngeal nerve palsy, and hemorrhage) and efficacy (postoperative radioactive iodine uptake) in the two groups were compared. RESULTS: There were 127 patients in group A and 105 in group B. Rates of occurrence of permanent hypoparathyroidism and recurrent laryngeal nerve palsy were comparable in the two groups. Postoperative radioactive iodine uptake in the two groups was not significantly different. CONCLUSIONS: Total thyroidectomy can be safely and effectively performed by endocrine surgical trainees. (C) 1999 by Excerpta Medica, Inc.

关键词：甲状旁腺功能减退症/流行病学甲状旁腺功能减退症/病因学发病率实习医师和住院医师职务喉神经/损伤手术后并发症/流行病学专业能力回顾性研究外科学/教育甲状腺疾病/外科学甲状腺切除术/方法甲状腺切除术/标准治疗结果成年人女(雌)性人类男(雄)性中年人

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The changing status of inpatient dermatology at American academic dermatology programs

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JOURNAL OF THE AMERICAN ACADEMY OF DERMATOLOGY 1999年第5期40卷 755-757页

作者： Kirsner, RS Yang, DG Kerdel, FA Univ Miami Sch Med Dept Dermatol & Cutaneous Surg Miami FL USA Univ Miami Sch Med Dept Epidemiol & Publ Hlth Miami FL USA

Background: Changes in health care delivery financing such as the adoption of the diagnosis-related groups (DRG) in 1983 has affected inpatient services of dermatology programs across the United States. Objective: The purpose of this study was to define the present status of inpatient dermatology at academic medical centers compared with 1982. Methods: Questionnaires inquiring about the state of inpatient service were sent to the chairpersons of each dermatology residency program in the United States. Results: Of the 71 programs responding, 79% reported a reduction in inpatient activity. Nearly half of the dermatology programs with dedicated dermatology beds in 1982 reported not continuing to have these in 1997 (41 to 24). The average number of patients admitted for skin disease decreased from 119 in 1982 to 36.5 in 1997, and the average daily census decreased from 8.9 to 2.2. Conclusion: There has been a decline in the number of patients hospitalized by academic dermatology departments and a shift of some patients hospitalized to beds where the attending is other than a dermatologist.

关键词：医学科学研究中心/统计学和数值数据门诊医疗/统计学和数值数据皮肤病学/教育皮肤病学/统计学和数值数据诊断相关患者组/统计学和数值数据医院病床数/统计学和数值数据住院/统计学和数值数据保险健康/统计学和数值数据实习医师和住院医师职务病人入院/统计学和数值数据皮肤疾病/流行病学皮肤疾病/治疗美国/流行病学人类

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Neonatal care during a residents' strike

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TROPICAL DOCTOR 1999年第2期29卷 73-75页

作者： Daga, SR Shende, SR JJ Hosp Bombay 400008 Maharashtra India

Medical officers from a primary health centre and rural hospital were posted at our neonatal care unit during the residents' strike that lasted 69 days. They were trained in labour room care and in special care of high-risk babies. Four weeks later they were to be first-on-call. During the pre-strike, strike and post-strike period, there was no significant difference in the number of high-risk deliveries and admissions and deaths at the special carl unit (SCU). The low-tech neonatal care that we followed, can be practised at the first referral centre in rural areas of developing countries by the team led by a medical officer.

关键词：医院乡村印度实习医师和住院医师职务医务人员医院围生医学/人力初级卫生保健罢工雇员/人力人类婴儿新生

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Assessment of technical skills transfer from the bench training model to the human model

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AMERICAN JOURNAL OF SURGERY 1999年第2期177卷 167-170页

作者： Anastakis, DJ Regehr, G Reznick, RK Cusimano, M Murnaghan, J Brown, M Hutchison, C Univ Toronto Fac Med Dept Surg Toronto ON M5S 1A1 Canada Univ Toronto Fac Med Ctr Res Educ Toronto ON M5S 1A1 Canada

BACKGROUND: This study examines whether technical skills learned on a bench model are transferable to the human cadaver model. METHODS: Twenty-three first-year residents were randomly assigned to three groups receiving teaching on six procedures. For each procedure, one group received training on a cadaver model, one received training on a bench model, and one learned independently from a prepared text. Following training, all residents were assessed on their ability to perform the six procedures. RESULTS: Repeated measures analysis of variance revealed a significant effect of training modality for both checklist scores (F-2,F-44 = 3.49, P <0.05) and global scores (F-2,F-44, = 7.48, P <0.01). Post-hoc tests indicated that both bench and cadaver training were superior to text learning and that bench and cadaver training were equivalent. CONCLUSIONS: Training on a bench model transfers well to the human model, suggesting strong potential for transfer to the operating room. (C) 1999 by Excerpta Medica, Inc.

关键词：尸体临床工作能力教育医学/方法实习医师和住院医师职务模型解剖学随机分配外科学/教育人类

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Teaching evidence-based medicine skills to medical students and residents

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INTERNATIONAL JOURNAL OF DERMATOLOGY 1999年第12期38卷 893-894页

作者： Barnett, SH Smith, LG Swartz, MH CUNY Mt Sinai Sch Med Dept Pediat New York NY 10029 USA CUNY Mt Sinai Sch Med Dept Med New York NY 10029 USA

Comments on issues pertaining to the teaching of evidence-based medicine (EBM) skills to medical students and residents. Barriers and solutions; Mount Sinai approach.

关键词：教育医学本科循证医学/教育实习医师和住院医师职务

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ACADEMIC RADIOLOGY 1999年第3期6卷 185-186页

作者： Kihiczak, D Amorosa, JK Siegel, RL Univ Med & Dent New Jersey Robert Wood Johnson Med Sch Dept Radiol New Brunswick NJ 08911 USA

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Psychopharmacologist as family doctor: Complications in the joint treatment of a husband and wife

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HARVARD REVIEW OF PSYCHIATRY 1999年第4期7卷 222-229页

作者： Lindley, CR Coyle, JT Brigham & Womens Hosp Boston MA 02115 USA W Roxbury Vet Adm Hosp Boston MA USA Harvard Univ Sch Med Consolidated Dept Psychiat Boston MA USA

Describes the complexities of simultaneously treating husband and wife. Role of spouse in the treatment of the partner with impairment; Advantages and disadvantages of seeing multiple family members for psychopharmaco... 详细信息

关键词：双相情感障碍/药物疗法双相情感障碍/心理学利害冲突逆移情(心理学) 药物疗法联合实习医师和住院医师职务医生病人关系医师家庭/教育精神药理学/教育心理疗法/教育精神治疗药物/投药和剂量精神分裂症偏执型/药物疗法精神分裂症偏执型/心理学配偶/心理学移情(心理学) 成年人女(雌)性人类男(雄)性中年人

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Vision rehabilitation for physiatry residents: A model curriculum

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AMERICAN JOURNAL OF PHYSICAL MEDICINE & REHABILITATION 1999年第4期78卷 389-391页

作者： McCabe, CP Bergman, SB Harvard Univ Massachusetts Eye & Ear Infirm Sch Med Dept OphthalmolVis Rehabil Ctr Boston MA 02114 USA Boston Univ Dept Phys Med & Rehabil Boston MA 02215 USA

The need for community rehabilitation exposure across the continuum of care is addressed. A variety of settings are presented to prepare residents for situations common in rehabilitation practice. Further, a model curriculum of vision rehabilitation for residents at the Massachusetts Eye & Ear Infirmary's Vision Rehabilitation Center is described.

关键词： Blindness Curriculum Internship and Residency Physical Medicine Vision Subnormal 盲课程实习医师和住院医师职务物理医学视力次正常

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