Group items tagged

"They review some classics including: "The rational clinical examination. Is this patient having a myocardial infarction?" in JAMA 1998. "The International Registry of Acute Aortic Dissection (IRAD): new insights into an old disease" in JAMA 2000. "Evaluation of D-dimer in the diagnosis of suspected deep-vein thrombosis" in NEJM 2003. "The Canadian C-spine rule versus the NEXUS low-risk criteria in patients with trauma" in NEJM 2003. "Computed tomography of the head before lumbar puncture in adults with suspected meningitis" in NEJM 2001."

Recommendations issued in current ACC/AHA clinical practice guidelines are largely developed from lower levels of evidence or expert opinion. The proportion of recommendations for which there is no conclusive evidence is also growing. These findings highlight the need to improve the process of writing guidelines and to expand the evidence base from which clinical practice guidelines are derived.

"Banning the handshake from the health care environment may require further study to confirm and better describe the link between handshake-related transmission of pathogens and disease. "

"The effective practice of medicine requires narrative competence, that is, the ability to acknowledge, absorb, interpret, and act on the stories and plights of others. Medicine practiced with narrative competence, called narrative medicine, is proposed as a model for humane and effective medical practice. "

"It's not just patients who can learn from tools that help them make evidence-based decisions. Assessing patients' understanding of the information provided and the reasons for their health care choices has been an educational experience for Dale Collins Vidal, MD, director of the Center for Informed Choice at Dartmouth Medical School in Hanover, New Hampshire."

Fifty-five word stories are brief pieces of creative writing that use elements of poetry, prose, or both to encapsulate key experiences in health care. These stories have appeared in Family Medicine1 and JAMA2 and have been used to teach family medicine faculty development fellows.3 Writers and readers of 55-word stories gain insight into key moments of the healing arts; the brevity of the pieces adds to both the writing and reading impact. Fifty-five word stories may be used with trainees to stimulate personal reflection on key training experiences or may be used by individual practitioners as a tool for professional growth.

"In this national study of internal medicine residents, suboptimal QOL and symptoms of burnout were common. Symptoms of burnout were associated with higher debt and were less frequent among international medical graduates. Low QOL, emotional exhaustion, and educational debt were associated with lower IM-ITE scores. "

The median reported time dedicated to LGBT-related topics in 2009-2010 was small across US and Canadian medical schools, but the quantity, content covered, and perceived quality of instruction varied substantially.

"In comparison with no intervention, technology-enhanced simulation training in health professions education is consistently associated with large effects for outcomes of knowledge, skills, and behaviors and moderate effects for patient-related outcomes. "

Doctors with good communication less likely to be sued

"Physicians often redirect patients' initial descriptions of their concerns. Once redirected, the descriptions are rarely completed. Consequences of incomplete initial descriptions include late-arising concerns and missed opportunities to gather potentially important patient data. Soliciting the patient's agenda takes little time and can improve interview efficiency and yield increased data."

"46.4% of all respondents stated that they had been abused at some time while enrolled in medical school, with 80.6% of seniors reporting being abused by the senior year. More than two thirds (69.1%) of those abused reported that at least one of the episodes they experienced was of "major importance and very upsetting." Half (49.6%) of the students indicated that the most serious episode of abuse affected them adversely for a month or more; 16.2% said that it would "always affect them." "

" It is essential to set clear expectations for professional behavior with faculty and residents. A notice of deficiency should define the expected acceptable behavior, timeline for improvement, and consequences for noncompliance. Faculty should note and address systems problems that unintentionally reinforce and thus enable unprofessional behavior. "