Journal of general internal medicine
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This paper describes teaching and learning methods that can be used to build the competencies needed by the generalist physician. Supervised patient care, problem-based learning, and ongoing feedback through standardized patients all have proven efficacy in several domains. ⋯ The authors review each method's principles, relationship to generalist competencies, examples of effective applications, and challenges to successful implementation. Where possible, they summarize what is known about the relationships of learning and teaching methods to career choices in generalism.
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Comparative Study
Do ratings on the American Board of Internal Medicine Resident Evaluation Form detect differences in clinical competence?
To determine whether raters using the American Board of Internal Medicine (ABIM) Resident Evaluation Form can detect differences among residents in clinical competence. ⋯ Ratings on the ABIM Resident Evaluation Form detect global differences among residents in clinical competence in the expected direction based on type of training program and performance on the ABIM certification examination, but fail to differentiate among the nine evaluated dimensions of clinical care. This rating method may be valid for assessing overall clinical performance, but is less useful for providing feedback in specific areas to individual residents.
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To identify primary care patients' and physicians' beliefs, attitudes, preferences, and expectations regarding discussions of end-of-life medical care, and to identify factors limiting the quality and frequency of these discussions. ⋯ Patients prefer end-of-life discussions earlier and with greater honesty than physicians may perceive. These discussions are inseparably linked with the patient-physician relationship. Physicians can better address patients' desires in end-of-life discussions by altering their timing, content, and delivery.