Journal of general internal medicine
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Multicenter Study
Brief report: Brief instrument to assess geriatrics knowledge of surgical and medical subspecialty house officers.
Initiatives are underway to increase geriatrics training in nonprimary care disciplines. However, no validated instrument exists to measure geriatrics knowledge of house officers in surgical specialties and medical subspecialties. ⋯ This reliable, valid measure of clinical geriatrics knowledge can be used by a wide variety of surgical and medical graduate medical education programs to guide curriculum reform or evaluate program performance to meet certification requirements. The instrument is now available on the web.
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Comparative Study
Competency in chest radiography. A comparison of medical students, residents, and fellows.
Accurate interpretation of chest radiographs (CXR) is essential as clinical decisions depend on readings. ⋯ We identified factors associated with successful CXR interpretation, including level of training, field of training, interest in a pulmonary career and overall certainty. Although interpretation improved with training, important diagnoses were missed.
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Comparative Study
Brief report: Internal medicine residents', attendings', and nurses' perceptions of the night float system.
Residency training programs use the night float system increasingly to meet the new resident work hour regulations. ⋯ Residents had more positive perceptions than attendings and nurses. Nurses, in particular, had negative perceptions of resident performance in the setting of the night float system.
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Interns are expected to teach medical students, yet there is little formal training in medical school to prepare them for this role. To enhance the teaching skills of our graduating students we initiated a 4-hour "teaching to teach" course as part of the end of the fourth-year curriculum. ⋯ A course preparing fourth-year students to teach during internship is both feasible and reproducible, with a minimal commitment of faculty and resident time. Participants identify it as an important addition to their education and as useful during internship.
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Learning from mistakes. Factors that influence how students and residents learn from medical errors.
Trainees are exposed to medical errors throughout medical school and residency. Little is known about what facilitates and limits learning from these experiences. ⋯ Trainees are aware of medical errors, but remaining tensions may limit learning. Institutions can immediately address variability in faculty response and local culture by disseminating clear, accessible algorithms to guide behavior when errors occur. Educators should develop longitudinal curricula that integrate actual cases and faculty disclosure. Future multi-institutional work should focus on identified themes such as teaching and learning in emotionally charged situations, learning from errors and near misses and balance between individual and systems responsibility.