Abstract:
OBJECTIVE:To observe and evaluate the performance of primary care internal medicine residents within the outpatient clinic milieu. DESIGN:Longitudinal descriptive study. PATIENTS/PARTICIPANTS:48 internal medicine resident encounters with two standardized patients at the University of Wisconsin General Internal Medicine Clinics. INTERVENTION:Residents were rated by the standardized patients with a medical skills checklist and an interpersonal skills checklist, and by the staffing physician with a clinical reasoning skills checklist. The investigators reviewed audiotapes of the standardized patient encounters for strategic management skills. MAIN RESULTS:Resident performance on these scales was examined for improvement with years of training; when considered separately, no such effect was seen for either standardized patient case. When the cases were grouped together, however, there was significant improvement on the Clinical Reasoning Instrument. The grouped standardized patient data were compared with data from inpatient faculty evaluations of the residents. Faculty evaluations correlated with standardized patient evaluations of resident performance only on the medical checklist. Finally, comparison of the four assessment scales demonstrated a significant correlation between interpersonal skills, as assessed by the patient, and strategic management skills. CONCLUSION:Resident outpatient performance, measured in a blinded setting, does not improve with year of training. Faculty inpatient assessments of residents correlate with medical "thoroughness" as measured by a medical skills checklist, and interpersonal skills as rated by standardized patients correlate with resident use of strategic medical management.
journal_name
J Gen Intern Medjournal_title
Journal of general internal medicineauthors
Day RP,Hewson MG,Kindy P Jr,Van Kirk Jdoi
10.1007/BF02599266subject
Has Abstractpub_date
1993-04-01 00:00:00pages
193-8issue
4eissn
0884-8734issn
1525-1497journal_volume
8pub_type
杂志文章abstract:BACKGROUND:We sought to examine the relationship between literacy and heart failure-related quality of life (HFQOL), and to explore whether literacy-related differences in knowledge, self-efficacy and/or self-care behavior explained the relationship. METHODS:We recruited patients with symptomatic heart failure (HF) fr...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1007/s11606-011-1668-y
更新日期:2011-09-01 00:00:00
abstract::We surveyed employers of general internists at teaching hospitals to determine whether they prefer that new hires are graduates of general internal medicine (GIM) fellowships. We surveyed former GIM fellows who graduated between 1988 and 1994 to determine whether they found jobs with protected research time and whethe...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1046/j.1525-1497.1998.00121.x
更新日期:1998-06-01 00:00:00
abstract:BACKGROUND:The patient-centered medical home (PCMH) has clinical benefits for chronic disease care, but the association with patient-reported outcomes such as health-related quality of life (HRQoL) is unexplored in patients with multimorbidity (two or more chronic diseases). OBJECTIVE:To examine if greater clinic-leve...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-019-05429-1
更新日期:2020-01-01 00:00:00
abstract:OBJECTIVE:To compare primary care providers' depression-related knowledge, attitudes, and practices and to understand how these reports vary for providers in staff or group-model managed care organizations (MCOs) compared with network-model MCOs including independent practice associations and preferred provider organiz...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1046/j.1525-1497.1999.00279.x
更新日期:1999-01-01 00:00:00
abstract:BACKGROUND:Individualized selection of antiretroviral (ARV) therapy is complex, considering drug resistance, comorbidities, drug-drug interactions, and other factors. HIV-ASSIST (www.hivassist.com) is a free, online tool that provides ARV decision support. HIV-ASSIST synthesizes patient and virus-specific attributes to...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-019-05531-4
更新日期:2020-05-01 00:00:00
abstract:OBJECTIVE:To determine the overdose rate of drugs that require renal dose adjustment and factors related with overdose. SUBJECTS:Total of 23,635,210 records of prescriptions and laboratory data of inpatients at a tertiary teaching hospital for the period from January 2002 to December 2005. METHODS:A clinical data mar...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-007-0336-8
更新日期:2008-04-01 00:00:00
abstract:BACKGROUND:Computerized physician order entry and clinical decision support systems are electronic prescribing strategies that are increasingly used to improve patient safety. Previous reviews show limited effect on patient outcomes. Our objective was to assess the impact of electronic prescribing strategies on medicat...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,meta分析
doi:10.1007/s11606-019-05236-8
更新日期:2019-10-01 00:00:00
abstract::The authors evaluated the perceptions and adjustments of surviving spouses following patient deaths. Of 128 married patients dying in a university hospital in 1983, the surviving spouses of 105 (82%) were personally interviewed a year after the death. The physicians' perspectives were recorded through chart review. Ha...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/BF02596210
更新日期:1986-09-01 00:00:00
abstract:BACKGROUND:Continuity clinics are a critical component of outpatient internal medicine training. Little is known about the population of patients cared for by residents and how these physicians perform. OBJECTIVES:To compare resident and faculty performance on standard population health measures. To identify potential...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-020-06420-x
更新日期:2021-01-21 00:00:00
abstract:OBJECTIVE:To assess the international health activities of departments of medicine, divisions of general medicine, and general medicine faculty and the interest among departments of medicine in joint international health ventures. DESIGN:15-item, mailed questionnaire. PARTICIPANTS:100 chiefs of divisions of general m...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/BF02599433
更新日期:1990-09-01 00:00:00
abstract:BACKGROUND:Clinician attitudes toward patients are associated with variability in the quality of health care. Attitudes are typically considered difficult to change, and few interventions have attempted to do so. Negative attitudes toward adults with sickle cell disease have been identified as an important barrier to t...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,随机对照试验
doi:10.1007/s11606-010-1605-5
更新日期:2011-05-01 00:00:00
abstract:BACKGROUND:Delivery of comprehensive care for persons with human immunodeficiency virus (HIV) infection in rural and low prevalence settings presents many challenges. We developed and evaluated a telehealth collaborative care (TCC) program for persons with HIV in a rural area. OBJECTIVE:To determine the feasibility of...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-013-2385-5
更新日期:2013-09-01 00:00:00
abstract:BACKGROUND:Since the 2011 Accreditation Council of Graduate Medical Education (ACGME) work hour rules for residents were implemented, 24-30 h call for interns has been replaced by shift work, including night-float. The impact of these changes on undergraduate medical education experiences in internal medicine has not b...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-015-3405-4
更新日期:2015-09-01 00:00:00
abstract:OBJECTIVE:In 1996, the Health Care Financing Administration (HCFA) introduced new evaluation and management (E&M) guidelines mandating more intensive supervision and documentation by attending physicians. We assessed the effects of the guidelines on inpatient teaching. DESIGN:Pretest-posttest, nonequivalent control gr...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,多中心研究
doi:10.1046/j.1525-1497.2000.07001.x
更新日期:2000-07-01 00:00:00
abstract:BACKGROUND:Many American Indian and Alaska Native veterans are eligible for healthcare from Veterans Health Administration (VHA) and from Indian Health Service (IHS). These organizations executed a Memorandum of Understanding in 2003 to share resources, but little was known about how they collaborated to deliver health...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-009-0962-4
更新日期:2009-06-01 00:00:00
abstract:BACKGROUND:Disclosure of medical errors is encouraged, but research on how patients respond to specific practices is limited. OBJECTIVE:This study sought to determine whether full disclosure, an existing positive physician-patient relationship, an offer to waive associated costs, and the severity of the clinical outco...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,随机对照试验
doi:10.1111/j.1525-1497.2006.00465.x
更新日期:2006-07-01 00:00:00
abstract:BACKGROUND:Clinician's knowledge of a woman's cancer family history (CFH) and counseling about health-related behaviors (HRB) is necessary for appropriate breast cancer care. OBJECTIVE:To evaluate whether clinicians solicit CFH and counsel women on HRB; to assess relationship of well visits and patient risk perception...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-006-0087-y
更新日期:2007-03-01 00:00:00
abstract:BACKGROUND:Studies have shown a mismatch between published cancer screening and genetic counseling referral recommendations and physician-reported screening and referral practices. Inaccurate cancer risk assessment is one potential cause of this mismatch. OBJECTIVE:To assess U.S. physicians' ability to accurately dete...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,随机对照试验
doi:10.1007/s11606-014-2768-2
更新日期:2014-05-01 00:00:00
abstract::To investigate the frequency of physician delivery of advice to stop smoking and patient characteristics affecting whether physicians deliver such advice, the authors surveyed 97 current cigarette smokers seen in two specialty and one general medicine clinic at a university medical center. Approximately two thirds of ...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/BF02596170
更新日期:1987-09-01 00:00:00
abstract::Initial reports on HemoQuant, a new quantitative test for occult gastrointestinal bleeding, suggest it is more sensitive than Hemoccult. Increased detection of upper gastrointestinal tract bleeding and dietary hemoglobin may reduce HemoQuant's specificity in the screening setting. The authors performed a cost effectiv...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/BF02596117
更新日期:1988-03-01 00:00:00
abstract:BACKGROUND:Although intrinsic motivating factors play important roles in physician well-being and productivity, most studies have focused on extrinsic motivating factors such as salary and work environment. OBJECTIVE:To examine the association of intrinsic motivators with physicians' career satisfaction, life satisfac...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-017-3997-y
更新日期:2017-07-01 00:00:00
abstract:OBJECTIVE:To determine the impact of an episode of serious cardiovascular disease on smoking behavior and to identify factors associated with smoking cessation in this setting. DESIGN:Prospective observational study in which smokers admitted to a coronary care unit (CCU) were followed for one year after hospital disch...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/BF02597426
更新日期:1991-07-01 00:00:00
abstract:BACKGROUND:Little is known about the outcomes of in-hospital cardiopulmonary resuscitation (CPR) in Asian populations including elderly patients in Japan. OBJECTIVE:To determine the survival outcome of in-hospital CPR among elderly patients in Japan, and to identify predictors associated with survival. DESIGN:Retrosp...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-018-4747-5
更新日期:2019-02-01 00:00:00
abstract::Impaired hearing, so common among older people, often has disastrous consequences. The infirmity, too frequently concealed or unknown by the patient, is invisible to others. Disability and frustration can be lessened considerably by greater awareness on the part of medical and lay people about various helpful measures...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/BF02596426
更新日期:1986-11-01 00:00:00
abstract:BACKGROUND:Medicare has selected 10 hospital-acquired conditions for which it will not reimburse hospitals unless the condition was documented as "present on admission." This "no pay for errors" rule may have a profound effect on the clinical practice of physicians. OBJECTIVE:To determine how physicians might change t...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,随机对照试验
doi:10.1007/s11606-010-1395-9
更新日期:2010-10-01 00:00:00
abstract:OBJECTIVE:The objective of the study is to examine the association between ambulatory care sensitive hospitalizations (ACSH) and dual Medicare/Veteran Health Administration use. PARTICIPANTS:A nationally representative sample of Medicare beneficiaries, who participated in the Medicare Current Beneficiary Survey (MCBS)...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-011-1788-4
更新日期:2011-11-01 00:00:00
abstract:BACKGROUND:The Centers for Medicare & Medicaid Services (CMS)/Premier Hospital Quality Incentive Demonstration (HQID) project aims to improve clinical performance through a pay-for-performance program. We conducted this study to identify the key organizational factors associated with higher performance. METHODS:An inv...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-009-0997-6
更新日期:2009-07-01 00:00:00
abstract::Evaluations of intensive care have largely focused on survival, cost, or functional status; however, these may not be the only outcomes of interest to patients, families, and health care providers. Quality of life is an important consideration in evaluating intensive care because it influences decisions about the use ...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/BF02596335
更新日期:1988-05-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:Affect and how it is regulated plays a role in pain perception, maintenance of pain, and its resolution. This randomized, controlled trial evaluated an innovative affective self-awareness (ASA) intervention, which was designed to reduce pain and improve functioning in individuals with fibromyal...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,随机对照试验
doi:10.1007/s11606-010-1418-6
更新日期:2010-10-01 00:00:00
abstract::Hospitalists provide a significant amount of direct clinical care in both academic and community hospitals. Peer feedback is a potentially underutilized and low resource method for improving clinical performance, which lends itself well to the frequent patient care handoffs that occur in the practice of hospital medic...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,评审
doi:10.1007/s11606-020-06235-w
更新日期:2020-12-01 00:00:00