Abstract:
BACKGROUND:Medical school and resident training programmes offer different learning opportunities and outcomes. The aim of the study was to assess medical student and intern experience in common clinical procedures. METHODS:Interns employed in a metropolitan teaching hospital from 2000 to 2004 completed a survey of experience and confidence in clinical procedures at the beginning and end of their intern year. Attendance at and the contribution to procedural confidence of a voluntary procedural skill-training programme were examined. RESULTS:For the 314 interns, clinical experience before and during internship varied for each procedure and between year cohorts as did training programme attendance (44-84%). Student procedural confidence was predicted by pre-intern experience either on patients or by simulation (beta = 0.17, 95% confidence interval (CI) 0.02-0.21, P = 0.03) and age >30 years on commencing internship (beta = 8.44, 95%CI 3.03-14.06, P = 0.003. Adjusted R(2) = 0.08, P = 0.002). Intern procedural confidence by year's end was predicted by attendance at the training programme (beta = 0.48, 95%CI 0.34-0.62, P < 0.001), intern experience with patient procedures (beta = 0.34, 95%CI 0.21-0.47, P < 0.001) and a clear decision to enter a postgraduate training programme (beta = 0.13, 95%CI 0.04-0.22, P = 0.007, Adjusted R(2) = 0.50, P < 0.001). CONCLUSION:Interns and students receive variable experience to carry out procedural skills on patients. This makes designing training programmes difficult as training needs vary each year. Both mandatory supervision of key skills and opportunities to supplement limited experience are needed during the intern year to ensure a uniform experience.
journal_name
Intern Med Jjournal_title
Internal medicine journalauthors
Boots RJ,Egerton W,McKeering H,Winter Hdoi
10.1111/j.1445-5994.2009.01699.xsubject
Has Abstractpub_date
2009-04-01 00:00:00pages
222-7issue
4eissn
1444-0903issn
1445-5994pii
IMJ1699journal_volume
39pub_type
杂志文章abstract::Legionella species are a common cause of community-acquired pneumonia, infrequently complicated by cavitary disease. We describe Legionella pneumophila pneumonia and abscess formation in an immunosuppressed patient receiving corticosteroid therapy for metastatic breast carcinoma. The predisposing role of corticosteroi...
journal_title:Internal medicine journal
pub_type: 杂志文章,评审
doi:10.1111/j.1445-5994.2011.02508.x
更新日期:2011-10-01 00:00:00
abstract:BACKGROUND:There is little existing research on the role that secondary care letters have in ensuring patient understanding of chronic health conditions. AIM:To determine whether minimising the use of medical terminology in medical correspondence improved patient understanding and anxiety/depression scores. METHODS:A...
journal_title:Internal medicine journal
pub_type: 杂志文章,随机对照试验
doi:10.1111/imj.13062
更新日期:2016-05-01 00:00:00
abstract:BACKGROUND:Peptic ulcer disease risk factors have changed, as has the impact of treatment on morbidity and mortality. Recent data on clinical presentation and outcome are sparse in Australia. AIM:To determine the characteristics and outcome of patients presenting with a bleeding peptic ulcer to a tertiary referral cen...
journal_title:Internal medicine journal
pub_type: 杂志文章
doi:10.1111/j.1445-5994.2010.02357.x
更新日期:2011-08-01 00:00:00
abstract::We documented temporal changes in the use of lipid-lowering medications and achievement of cholesterol targets in an Australian diabetes clinic. The number of patients using lipid-lowering therapy for primary or secondary cardiovascular prevention increased from 6 to 69% between 1993-1995 and 2014-2016, which correspo...
journal_title:Internal medicine journal
pub_type: 杂志文章
doi:10.1111/imj.13691
更新日期:2018-02-01 00:00:00
abstract:BACKGROUND:Off-label use of rituximab in lupus nephritis is reported to be beneficial. While the optimal dose is unknown, the regimen of four intravenous doses of 375 mg/m(2) is commonly employed, despite expense and potential side-effects. AIM:To investigate the response to single-dose rituximab, added to standard co...
journal_title:Internal medicine journal
pub_type: 杂志文章
doi:10.1111/imj.13136
更新日期:2016-08-01 00:00:00
abstract::Perhexiline is a prophylactic anti-anginal agent that ameliorates the metabolic basis for myocardial ischaemia and is increasingly used in the management of acute coronary syndromes. No intravenous preparation is available and usual oral loading regimens require 2-3 days to achieve therapeutic drug levels. Two patient...
journal_title:Internal medicine journal
pub_type: 杂志文章
doi:10.1111/j.1445-5994.2004.00624.x
更新日期:2004-06-01 00:00:00
abstract:BACKGROUND:The cost of diabetes is high for both the individual and society. Future health-care planning requires patient-level diabetes-attributable health-care cost data that have not previously been available for Australia. AIM:To determine Australian national direct diabetes-attributable health-care costs for know...
journal_title:Internal medicine journal
pub_type: 杂志文章
doi:10.1111/j.1445-5994.2006.01014.x
更新日期:2006-03-01 00:00:00
abstract::The use of tissue-type plasminogen activator (t-PA) in ischaemic stroke outside of experienced stroke centres remains controversial. The aim of this study was to present the initial experience with t-PA in patients with ischaemic stroke at an institution with no prior experience in i.v. stroke thrombolysis and to comp...
journal_title:Internal medicine journal
pub_type: 杂志文章
doi:10.1111/j.1445-5994.2006.01127.x
更新日期:2006-08-01 00:00:00
abstract:BACKGROUND:Advanced physician training in clinical pharmacology lacks a continuing education programme. There is a need for continuing medical education but how to introduce and develop education remains unclear. AIMS:The primary aim was to develop and implement a peer-led, web-based multiple choice question approach ...
journal_title:Internal medicine journal
pub_type: 杂志文章
doi:10.1111/imj.14663
更新日期:2019-12-01 00:00:00
abstract::Systemic AL amyloidosis is a plasma cell dyscrasia with a characteristic clinical phenotype caused by multi-organ deposition of an amyloidogenic monoclonal protein. This condition poses a unique management challenge due to the complexity of the clinical presentation and the narrow therapeutic window of available thera...
journal_title:Internal medicine journal
pub_type: 杂志文章,评审
doi:10.1111/imj.12566
更新日期:2015-04-01 00:00:00
abstract::This article reports the findings of a survey developed to assess the current use of antifungal prophylaxis among haematology and infectious disease clinicians across Australia and New Zealand, and their alignment with existing consensus guidelines for the use of antifungal agents in the haematology/oncology setting (...
journal_title:Internal medicine journal
pub_type: 杂志文章,评审
doi:10.1111/imj.12594
更新日期:2014-12-01 00:00:00
abstract::Medical goddesses and gods invoked in the Hippocratic Oath were called on in times of pandemics along with Greek physicians such as Galen of Pergamum. Ancient Greek and Roman coinage provide insights into the coexisting religious and rational approaches to medicine rooted in Classical Antiquity, portraying medical sym...
journal_title:Internal medicine journal
pub_type: 杂志文章
doi:10.1111/imj.15111
更新日期:2020-12-01 00:00:00
abstract::Multiple myeloma is an incurable malignancy of plasma cells. We retrospectively reviewed the survival outcomes of patients with multiple myeloma in Western Australia (WA) public hospitals over a 10-year period. We did not detect a difference in survival between patients residing the metropolitan Perth and regional are...
journal_title:Internal medicine journal
pub_type: 杂志文章
doi:10.1111/imj.14905
更新日期:2020-07-01 00:00:00
abstract:BACKGROUND:Management of acute ischaemic stroke is time critical. Reducing time to treatment with thrombolysis is strongly associated with improved outcomes in properly selected patients. However, there are barriers to ensuring timely treatment in the hospital setting. AIM:To determine if simple, no-cost protocol chan...
journal_title:Internal medicine journal
pub_type: 杂志文章
doi:10.1111/imj.14290
更新日期:2019-11-01 00:00:00
abstract:INTRODUCTION:In patients with chronic idiopathic thrombocytopenic purpura (cITP), the platelet count tends to be quite variable and, in the majority of cases, specific therapy is not warranted on a regular basis. However, patients with low platelet count (<30 nL) or with bleeding complications would require therapy, su...
journal_title:Internal medicine journal
pub_type: 杂志文章
doi:10.1111/imj.12794
更新日期:2015-07-01 00:00:00
abstract:BACKGROUND:Eosinophilic esophagitis (EoE) is a newly recognised condition that is apparently increasing in prevalence, and the aetiology is poorly understood. The role of aeroallergens in EoE is controversial, given the success of dietary therapy. Massive aeroallergen exposure leading to food bolus obstruction events (...
journal_title:Internal medicine journal
pub_type: 杂志文章,多中心研究
doi:10.1111/imj.12790
更新日期:2015-09-01 00:00:00
abstract:BACKGROUND:Patients with established coronary heart disease (CHD) are at the highest risk of further events. Despite proven therapies, secondary prevention is often suboptimal. General practitioners (GPs) are in an ideal position to improve secondary prevention. AIM:To contrast management of cardiovascular risk factor...
journal_title:Internal medicine journal
pub_type: 杂志文章
doi:10.1111/j.1445-5994.2011.02534.x
更新日期:2011-10-01 00:00:00
abstract:BACKGROUND:There are several treatment modalities available for diabetes; however, the effects of the different medications on coronary artery disease are less understood. The purpose of this study was to evaluate the correlation of insulin-sensitizing therapy with the outcome of stress myocardial perfusion testing and...
journal_title:Internal medicine journal
pub_type: 杂志文章
doi:10.1111/j.1445-5994.2007.01480.x
更新日期:2008-04-01 00:00:00
abstract::A 75-year-old man of Fijian-Indian extraction complained of a 3-year history of progressive right knee pain and stiffness which were limiting his mobility. On examination, multiple hard nodules were palpable in the popliteal fossa and along the path of the quadriceps tendon. The joint line was not tender, knee flexion...
journal_title:Internal medicine journal
pub_type: 杂志文章
doi:10.1046/j.1445-5994.2002.00260.x
更新日期:2002-08-01 00:00:00
abstract:BACKGROUND:Plasma homocysteine is elevated in patients with end-stage renal disease (ESRD) and is a risk factor for cardiovascular disease. Folic acid has been shown to partially reduce homocysteine levels in dialysis patients. It is not known whether vitamin B12 reduces homocysteine independent of folic acid in patien...
journal_title:Internal medicine journal
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1046/j.1445-5994.2003.00420.x
更新日期:2003-11-01 00:00:00
abstract:BACKGROUND:Lung cancer accounts for significant morbidity and mortality worldwide. The effect of recent changes in demographics and management on outcomes in Australia has not been clearly defined. AIMS:To compare three consecutive lung cancer cohorts to evaluate emergent differences in diagnosis, management and morta...
journal_title:Internal medicine journal
pub_type: 杂志文章
doi:10.1111/imj.13132
更新日期:2016-08-01 00:00:00
abstract::More than 177 000 potentially preventable healthcare-associated infections (HAIs) occur per annum in Australia with sizable attributable mortality. Organizational systems to protect against HAI in hospitals in Australia are relatively poorly developed. Awareness and practice of infection control by medical and other h...
journal_title:Internal medicine journal
pub_type: 杂志文章,评审
doi:10.1111/j.1445-5994.2009.02004.x
更新日期:2009-09-01 00:00:00
abstract::The prevalence of Helicobacter pylori in Western societies has rapidly declined, as reflected by the consistent decline in peptic ulcer disease. Nevertheless, there remains a cohort of the elderly population with a high prevalence of H. pylori infection. While the benefits of H. pylori eradication for H. pylori-associ...
journal_title:Internal medicine journal
pub_type: 杂志文章
doi:10.1046/j.1445-5994.2002.00275.x
更新日期:2002-09-01 00:00:00
abstract:BACKGROUND:Population-based studies of the prevalence of all functional gastrointestinal disorders (FGID) using the Rome II criteria are lacking. It is also not certain whether subjects who meet the Rome II criteria for an FGID are different in terms of demographic and psychological characteristics from those subjects ...
journal_title:Internal medicine journal
pub_type: 杂志文章
doi:10.1111/j.1445-5994.2006.01006.x
更新日期:2006-01-01 00:00:00
abstract:AIMS:Our primary aim was to determine the rate of overseas travel in immunocompromised individuals attending appropriate clinics at an Australian tertiary care hospital. We also aimed to characterise health-seeking behaviour prior to travel and investigated sources of pre-travel advice, compared travel patterns and act...
journal_title:Internal medicine journal
pub_type: 杂志文章
doi:10.1111/imj.12753
更新日期:2015-06-01 00:00:00
abstract:BACKGROUND:Neutropenic fever is a frequently encountered complication when caring for cancer patients and can lead to intensive care admission, with high mortality rates in those patients who require invasive mechanical ventilation (IMV). Although hospital survival in this population has improved, long-term outcomes of...
journal_title:Internal medicine journal
pub_type: 杂志文章
doi:10.1111/imj.14721
更新日期:2020-05-01 00:00:00
abstract:AIM:To prospectively evaluate the efficacy and safety of Selective Internal Radiation (SIR) Spheres (Sirtex Medical, Sydney, NSW, Australia) in patients with unresectable primary or secondary hepatic malignancies. METHODS:We report our experience of SIR sphere therapy at three Australian centres. Patients with previou...
journal_title:Internal medicine journal
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1111/j.1445-5994.2005.00789.x
更新日期:2005-04-01 00:00:00
abstract:BACKGROUND:Long-term prognosis of acute coronary syndromes (ACS) in human immunodeficiency virus (HIV)-infected patients is unknown. AIMS:To compare outcomes after ACS in HIV-infected and uninfected patients. METHODS:Retrospective observational study. HIV cases were matched with two HIV-uninfected controls for age, s...
journal_title:Internal medicine journal
pub_type: 杂志文章
doi:10.1111/imj.14744
更新日期:2020-12-01 00:00:00
abstract::Both hip fractures and vitamin D (25-hydroxyvitamin D (25-OHD)) deficiency are more common in winter in regions with temperate climates, but few data exist for a sub-tropical climate. In a South East Queensland tertiary hospital over a 7-year period, there were significantly more hip fractures in winter than the other...
journal_title:Internal medicine journal
pub_type: 杂志文章
doi:10.1111/imj.14391
更新日期:2019-08-01 00:00:00
abstract:BACKGROUND:The altered status of iron metabolism is reported in hereditary haemochromatosis and in non-alcoholic liver fatty disease. We investigated the relation between the H63D HFE mutation gene and non-alcoholic steatohepatitis (NASH). METHODS:We studied as outpatients, 272 Italian persons with NASH and compared t...
journal_title:Internal medicine journal
pub_type: 杂志文章
doi:10.1111/j.1445-5994.2007.01474.x
更新日期:2008-04-01 00:00:00