Journal of general internal medicine
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Graduate medical education is a critical period for fostering self-directed learning (SDL). This study introduced an academic coaching program to support SDL among internal medicine (IM) residents, leveraging Gallimore and Tharp's four-stage model as a scaffolding framework. ⋯ Sustained coaching, defined as two or more coaching meetings, is associated with improved IM-ITE performance. Qualitative findings underscore the program's role in enhancing residents' SDL.
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Millions of Americans remain infected with hepatitis C (HCV). Innovation in care delivery is required to achieve the goal of national elimination. ⋯ It is possible to both diagnose HCV and complete the entire pre-treatment evaluation in a single encounter and initiate treatment within 1 month, even for predominantly uninsured populations in rural areas.
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Long-acting injectable cabotegravir (CAB-LA), approved in 2021, is a more effective HIV prevention method than daily oral PrEP. CAB-LA expansion addresses key HIV prevention gaps, especially in the Southern United States (U.S.), to support national Ending the HIV Epidemic (EHE) goals. However, complex implementation requirements hinder CAB-LA expansion, highlighting the need for real-world data to guide effective and equitable scale-up. ⋯ We successfully implemented a CAB-LA PrEP program in a safety-net primary care center in the U.S. South, using an approach designed to address structural barriers to PrEP uptake and persistence.
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Poor quality communication and language barriers lead to worse care experiences and inferior health care outcomes for those with limited English proficiency. Fewer than one-third of outpatient providers regularly use professional interpreters when communicating with non-English preferring patients. Effective strategies to address language barriers in primary care are lacking and in demand. ⋯ Providers described barriers that organizations need to address to facilitate effective communication and language interpretation when caring for Spanish-preferring patients. Research is needed that identifies and tests language support strategies for providers and clinics and structural changes that preserve time during patient visits for providers and patients to spend on health care needs.