Abstract:
PURPOSE:To determine how students who are referred to a competency committee for concern over performance, and ultimately judged not to require remediation, perform during internship. METHODS:Uniformed Services University of the Health Sciences' students who graduated between 2007 and 2011 were included in this study. We compared the performance during internship of three groups: students who were referred to the internal medicine competency committee for review who met passing criterion, students who were reviewed by the internal medicine competency committee who were determined not to have passed the clerkship and were prescribed remediation, and students who were never reviewed by this competency committee. Program Director survey results and United States Medical Licensing Examination (USMLE) Step 3 examination results were used as the outcomes of interest. RESULTS:The overall survey response rate for this 5-year cohort was 81% (689/853). 102 students were referred to this competency committee for review. 63/102 students were reviewed by this competency committee, given passing grades in the internal medicine clerkship, and were not required to do additional remediation. 39/102 students were given less than passing grades by this competency committee and required to perform additional clinical work in the department of medicine to remediate their performance. 751 students were never presented to this competency committee. Compared to students who were never presented for review, the group of reviewed students who did not require remediation was 5.6 times more likely to receive low internship survey ratings in the realm of professionalism, 8.6 times more likely to receive low ratings in the domain of medical expertise, and had a higher rate of USMLE Step 3 failure (9.4% vs. 2.8%). When comparing the reviewed group to students who were reviewed and also required remediation, the only significant difference between groups regarding professionalism ratings with 50% of the group requiring remediation garnering low ratings compared to 18% of the reviewed group. CONCLUSIONS:Students who are referred to a committee for review following completion of their internal medicine clerkship are more likely to receive poor ratings in internship and fail USMLE Step 3 compared to students whose performance in the medicine clerkship does not trigger a committee review. These findings provide validity evidence for our competency committee review in that the students identified as requiring further clinical work had significantly higher rates of poor ratings in professionalism than students who were reviewed by the competency committee but not required to remediate. Additionally, students reviewed but not required to remediate were nonetheless at risk of low internship ratings, suggesting that these students might need some intervention prior to graduation.
journal_name
Mil Medjournal_title
Military medicineauthors
Hemann BA,Durning SJ,Kelly WF,Dong T,Pangaro LN,Hemmer PAdoi
10.7205/MILMED-D-14-00575subject
Has Abstractpub_date
2015-04-01 00:00:00pages
71-6issue
4 Suppleissn
0026-4075issn
1930-613Xjournal_volume
180pub_type
杂志文章abstract:OBJECTIVE:Examine substance use and mental health issues among U.S. military personnel. METHODS:Data were from the 2008 (and before) population-based Department of Defense Health Related Behavior Surveys. The sample size for the 2008 survey was 28,546 (70.6% response rate). RESULTS:Analyses examined substance use, st...
journal_title:Military medicine
pub_type: 杂志文章
doi:10.7205/milmed-d-09-00132
更新日期:2010-06-01 00:00:00
abstract::Tick bites, associated clinical symptoms, and antibodies against Borrelia burgdorferi were investigated in 77 Finnish army recruits training during summer in an endemic region and 50 control recruits serving outside the habitat of ticks. During a follow-up of 6 months, 26.9% of the study recruits reported tick bites. ...
journal_title:Military medicine
pub_type: 杂志文章
doi:
更新日期:1995-09-01 00:00:00
abstract:OBJECTIVE:The goal was to show the epidemiological characteristics and clinical manifestations of Lyme borreliosis in Croatia. METHODS:Data on registered Lyme borreliosis cases were analyzed and the most common clinical manifestations of the disease, based on meta-analysis of the data collected, are described. RESULT...
journal_title:Military medicine
pub_type: 杂志文章,meta分析
doi:10.7205/milmed.171.11.1105
更新日期:2006-11-01 00:00:00
abstract::A cluster-randomized trial evaluating the effectiveness of chlorhexidine gluconate-impregnated wipes against skin and soft tissue infections (SSTIs) and colonization with methicillin-resistant Staphylococcus aureus (MRSA) was conducted among military recruits attending Officer Candidate School at Marine Corps Base Qua...
journal_title:Military medicine
pub_type: 杂志文章,随机对照试验
doi:10.7205/milmed-d-12-00145
更新日期:2012-11-01 00:00:00
abstract:OBJECTIVES:This was a pilot study to determine (1) whether it is feasible to effectively blind human subjects to the presence of the insect repellents N,N-diethyl-m-toluamide (DEET) and permethrin; (2) whether DEET affects the absorption of permethrin; and (3) whether combat videotape viewing and mental arithmetic are ...
journal_title:Military medicine
pub_type: 杂志文章,随机对照试验
doi:10.7205/milmed.171.2.122
更新日期:2006-02-01 00:00:00
abstract:OBJECTIVE:To test the hypothesis that a supply of frozen red blood cells and a system for processing pyrogen-free crystalloid solution would meet the needs of an echelon 3 medical treatment facility in the U.S. military, caring for casualties during the initial phase of a military medical operation. DATA SOURCES:Blood...
journal_title:Military medicine
pub_type: 杂志文章
doi:
更新日期:1994-05-01 00:00:00
abstract::The federal government is the largest single employer of clinically active physician assistants (PAs) in the United States, with > 3,000 PAs in 2008. PAs are present within the Departments of Defense, Veterans Affairs, Health and Human Services, Justice, and Homeland Security. Most are civil servants or hold a commiss...
journal_title:Military medicine
pub_type: 杂志文章,评审
doi:10.7205/milmed.173.9.895
更新日期:2008-09-01 00:00:00
abstract::The use of explosive armaments during Operation Iraqi Freedom, Operation Enduring Freedom, and Operation New Dawn has resulted in a significant number of injured U.S. service members. These weapons often generate substantial extremity trauma requiring multiple surgical procedures to preserve life, limb, and restore fu...
journal_title:Military medicine
pub_type: 杂志文章
doi:10.7205/MILMED-D-15-00315
更新日期:2016-08-01 00:00:00
abstract::More than 300,000 cases of sudden cardiac death (SCD) occur in the United States each year. Left coronary artery anomaly (LCAA), although rare, is second only to hypertrophic cardiomyopathy as the most common cause of SCD associated with structural cardiovascular abnormalities. This case illustrates SCD secondary to L...
journal_title:Military medicine
pub_type: 杂志文章
doi:
更新日期:2000-02-01 00:00:00
abstract:OBJECTIVE:To describe the development of the Combat Casualty Critical Care Database, a comprehensive database of critically injured combat casualties to identify potentially modifiable risk factors for morbidity and mortality in this population. METHODS:The Department of Defense's Joint Theater Trauma Registry was que...
journal_title:Military medicine
pub_type: 杂志文章,评审
doi:10.7205/MILMED-D-13-00393
更新日期:2014-04-01 00:00:00
abstract::Camp Bullis, Texas, is an active training facility for the U.S. Army and Air Force with a storied history dating back to the late 19th century. In the early 1940s, an epidemic of a seasonal tick-borne rickettsial-like illness occurred at Camp Bullis; the last case was reported in 1947. To date, the etiology of this di...
journal_title:Military medicine
pub_type: 历史文章,杂志文章
doi:10.7205/milmed.169.11.863
更新日期:2004-11-01 00:00:00
abstract::Glucose-6-phosphate dehydrogenase (G6PD) deficiency is the most prevalent human enzyme deficiency, affecting an estimated 400 million people worldwide. G6PD deficiency increases erythrocyte vulnerability to oxidative stress and may precipitate episodes of hemolysis when individuals are exposed to triggering agents. Al...
journal_title:Military medicine
pub_type: 杂志文章
doi:10.7205/milmed-d-00-7608
更新日期:2009-05-01 00:00:00
abstract::Military personnel deployed to Iraq and Afghanistan often develop mental health difficulties, which may manifest as problematic driving behavior. Veterans may be more likely to engage in risky driving and to subsequently be involved in motor vehicle accidents and fatalities. This article reviews literature on driving ...
journal_title:Military medicine
pub_type: 杂志文章,评审
doi:10.7205/MILMED-D-13-00327
更新日期:2014-06-01 00:00:00
abstract::As a result of Operation Desert Storm, a neurology service was established in the Fort Leonard Wood MEDDAC. Between January 1 and April 30, 1991, a total of 315 new neurology patients were seen in consultation. This number plus all the follow-up visits add up to a total of 750 clinical encounters during that period. T...
journal_title:Military medicine
pub_type: 杂志文章
doi:
更新日期:1992-10-01 00:00:00
abstract::Academic medical centers (AMCs) have traditionally symbolized technological advancements and specialization in patient care. AMCs are defined as institutions that include at a minimum a hospital and associated clinics and a medical education role. Today, these institutions face a transition to managed care and radical...
journal_title:Military medicine
pub_type: 杂志文章,评审
doi:
更新日期:1999-08-01 00:00:00
abstract::An outbreak of rubella occurred among visiting German troops involved in a combined military exercise at Fort Bragg, North Carolina, in April 1995. Public health and military operational concerns centered on the significant contact the German soldiers had had with host battalion dependents and the impact of the outbre...
journal_title:Military medicine
pub_type: 杂志文章
doi:
更新日期:1999-09-01 00:00:00
abstract:INTRODUCTION:Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) belonging to the family Coronaviridae and genus Betacoronavirus is the causative agent of COVID-19 disease and was first identified in Wuhan, China. SARS-CoV-2 spread globally with >28 million cases and 911,000 deaths recorded worldwide as of Sep...
journal_title:Military medicine
pub_type: 杂志文章
doi:10.1093/milmed/usaa525
更新日期:2020-11-30 00:00:00
abstract::Testicular pain has a wide differential and the nonspecific presentation should be triaged rapidly for urgent diagnosis and treatment. Scrotal pyoceles are uncommon collections of purulent fluid between the visceral and parietal tunica vaginalis, usually secondary to acute epididymo-orchitis, intra-abdominal infection...
journal_title:Military medicine
pub_type: 杂志文章
doi:10.1093/milmed/usz316
更新日期:2020-06-08 00:00:00
abstract::Active duty military personnel and civilian government employees are at risk for exposure to a variety of pathogens as they meet their mission requirements throughout the world. When they present with a systemic disease, the clinician must entertain a broad differential diagnosis due to the multitude of infectious, ne...
journal_title:Military medicine
pub_type: 杂志文章
doi:10.7205/milmed-d-09-00017
更新日期:2010-05-01 00:00:00
abstract::Medical data from 120 U.S. Marine Corps trauma admissions to second-echelon facilities during Operation Desert Shield/Storm were examined. Sixty-five percent of the admissions occurred between February 22 and February 28, the time frame corresponding to the ground war and the preliminary mobilization period. Penetrati...
journal_title:Military medicine
pub_type: 杂志文章
doi:
更新日期:1993-08-01 00:00:00
abstract::The Clinical Laboratory Improvement Amendments of 1988 (CLIA'88) established national standards of laboratory practice and test performance in the areas of registration and certification, inspection, proficiency testing, personnel qualifications, quality control, patient test management, and quality assurance. A memor...
journal_title:Military medicine
pub_type: 杂志文章
doi:
更新日期:2000-07-01 00:00:00
abstract:BACKGROUND:Post-traumatic headache (PTH) is a commonly experienced symptom after mild traumatic brain injury (mTBI). Blast injury- or blunt injury-related mechanisms for mTBI in veterans can also affect musculoskeletal structures in the neck, resulting in comorbid neck pain (NP). However, it is unknown whether the pres...
journal_title:Military medicine
pub_type: 杂志文章
doi:10.1093/milmed/usaa532
更新日期:2020-12-11 00:00:00
abstract:OBJECTIVE:Soldier deployment can create a stressful environment for U.S. Army families with young children. Prior research has identified elevated rates of child maltreatment in the 6 months immediately following a soldier's return home from deployment. In this study, we longitudinally examine how other child- and fami...
journal_title:Military medicine
pub_type: 杂志文章
doi:10.7205/MILMED-D-17-00031
更新日期:2017-09-01 00:00:00
abstract:INTRODUCTION:Carbon monoxide (CO) is produced from incomplete combustion of hydrocarbons and is a by-product of tobacco smoking. Chronic cigarette smokers often have carboxyhemoglobin (COHb) concentrations as high as 10%. We report a case of severely elevated COHb and polycythemia because of tobacco smoking and provide...
journal_title:Military medicine
pub_type: 杂志文章
doi:10.1093/milmed/usz280
更新日期:2020-02-12 00:00:00
abstract::We present a 30-year-old combat veteran with an unclear exposure history, with multiple deployments who was later diagnosed with acute renal failure as a result of light-chain deposition disease. Despite a drastic decline in kappa light chains following chemotherapy; his renal function worsened, and he progressed to e...
journal_title:Military medicine
pub_type: 杂志文章
doi:10.7205/MILMED-D-17-00164
更新日期:2017-11-01 00:00:00
abstract::Expedited Partner Therapy (EPT) is the practice of treating the partners of patients with sexually transmitted infections by providing medications for the patient to deliver to his or her sexual partner (s) without direct clinical assessment of the partner(s). EPT is an evidence-based option that can augment existing ...
journal_title:Military medicine
pub_type: 杂志文章,评审
doi:10.7205/MILMED-D-14-00590
更新日期:2015-08-01 00:00:00
abstract::The purpose of this study was to examine physical work performance, energy cost, and physiological fatigue in military personnel during simulated operational conditions. Using a within-subject, repeated-measures design, 34 military personnel volunteered to undergo two experimental conditions: with body armor (BA+) and...
journal_title:Military medicine
pub_type: 杂志文章
doi:10.7205/milmed.173.9.817
更新日期:2008-09-01 00:00:00
abstract:Introduction:Breast cancer care imposes a significant financial burden to U.S. healthcare systems. Health services factors, such as insurance benefit type and care source, may impact costs to the health system. Beneficiaries in the U.S. Military Health System (MHS) have universal healthcare coverage and access to a net...
journal_title:Military medicine
pub_type: 杂志文章
doi:10.1093/milmed/usy052
更新日期:2018-11-01 00:00:00
abstract::A 36-year-old man with chronic severe exertional myalgias had a normal serum lactate elevation and diminished serum ammonia elevation on an ischemic forearm exercise test (IFET). The IFET is commonly performed in the evaluation of patients with complaints of exertional myalgias, cramps, and rhabdomyolysis. The finding...
journal_title:Military medicine
pub_type: 杂志文章
doi:
更新日期:1999-09-01 00:00:00
abstract::Dietary supplement use is common among military service members; approximately 17 to 20% report using high-risk weight-loss, performance-enhancing, and bodybuilding supplements. To date, no overarching policy or program has been approved or implemented to inform service members or educate health care providers on the ...
journal_title:Military medicine
pub_type: 杂志文章
doi:10.7205/milmed-d-12-00249
更新日期:2012-12-01 00:00:00