摘要:

In the current environment of cost containment pressures on health care providers, teaching hospitals are facing increased financial risks that could jeopardize their special role in the health care delivery system. One of these risks is that the Medicare prospective payment system does not adequately account for severity of illness. Whether teaching hospitals treat a case mix of patients with more severe illness than do nonteaching hospitals was tested in the study reported here using two severity measures, Horn's severity of illness index and Gonnella's “disease staging.” Teaching hospitals were found to treat a significantly greater proportion of severely ill patients than community hospitals, especially when measured by the severity of illness index. Differences in case mix of severity of illness among hospitals can have a significant impact on patient care costs, which may not be adequately met by a reimbursement system based on diagnosis related groups. Hospital managers can use severity of illness measures to assess the resource needs of patients and the practice patterns of physicians. If severity of illness measures help describe the special burden of treatment that teaching hospitals bear, they should be used to establish the case for adequate financial support.

ISSN:0022-2577    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

A national, stratified random sample of 405 graduate medical education program directors was surveyed on the way they selected their residents. The results from the 237 respondents reaffirm earlier studies which found that the interview was the most important selection variable. The results indicate that the recent increase in competition for residency positions has increased the importance of academic variables. For example, 86 percent of the respondents stated that they would not rank a candidate who had not passed the National Board of Medical Examiners Part I examination. Because 86 percent also stated that they give preference in ranking students to those who have done well in an elective at their hospitals, the senior year of medical school may be used as a “residency chase” rather than for the general professional education of the physician.

ISSN:0022-2577    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

To understand better the role of faculty development in training family medicine researchers, the authors examined in a comprehensive literature review the characteristics of productive researchers, their training, and their work environment. Areas reviewed were faculty development and evaluation, career development, professional socialization, organizational development, and faculty vitality in higher education, medicine, and corporate research and development. Findings reveal that, besides prerequisite knowledge and skills in a research area, successful researchers have academic values and attitudes derived from specific socialization experiences. They also receive meaningful support from their organization, mentors, and peers.

ISSN:0022-2577    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

A small-scale, comparative study of medical and law students was undertaken at a large, southern state university to examine the sources and consequences of stress during professional training. Specifically, the impact of stress on personal relationships was explored. The authors of the study reported here found gender differences in the source and degree of stress perceived by students. Women reported significantly more stress than men. Unlike the men, women found sexism and difficulties with partners to be particular sources of stress. Although both men and women reported that the stress of their professional training had resulted in strained personal relationships, proportionately more women than men stated that their personal relationships had ended.

ISSN:0022-2577    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

A computer-based curriculum data base was developed at the University of Toronto Faculty of Medicine to provide curriculum planners accurate information on what was being taught, who was teaching, and where in the curriculum subjects were being taught. In this paper, the authors report the use of the curriculum data base, its implications for curriculum management and planning, and plans for its further development and use. Applications that address problems of curriculum overlap, integration, and correlation are discussed. The results indicate that the medical school curriculum can be successfully stored and analyzed by computer and that the data base and system can provide valid descriptions of curriculum content in nonclinical courses.

ISSN:0022-2577    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

Alcoholism is a widespread illness which in its early stages can be treated effectively. It is important, therefore, that medical residents be able to diagnose alcoholism prior to end-stage disease and organ damage. To assess the ability of residents to diagnose alcoholism, a survey was conducted of 95 patients from the ambulatory care internal medicine practice of the Johns Hopkins Hospital. The patients' alcohol consumption was measured by a self-report questionnaire, and the patients answered an alcoholism questionnaire, the responses to which have been shown to correlate with alcoholism. The questionnaire contains four questions, one each on cutting down on alcohol consumption, annoyance at criticism of alcohol consumption, guilty feelings about alcohol consumption, and use of alcohol early in the day. The answers to the questionnaire were compared with the residents' diagnoses of alcoholism on the medical record. Alcoholism was diagnosed by the residents in only 11 of the 20 patients (55 percent) who had given three or more yes answers on the alcoholism questionnaire and in only 14 of the 31 patients (45 percent) who had given two or more yes answers. (Yes answers indicate that patients suffer from alcoholism.) The residents' diagnosis of alcoholism correlated with signs of physical damage or dependence. These results demonstrate a moderate underdiagnosis of alcoholism by residents in the ambulatory care setting and suggest that diagnosing alcoholism in early stages of the disease should be made a part of the training curriculum.

ISSN:0022-2577    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

Although physicians are required to act as leaders in a variety of situations, leadership ability and leadership training have been largely ignored by medical educators. The leadership styles and leadership effectiveness of 17 residents in a community hospital were studied as part of a leadership training seminar. Self-ratings and ratings of the residents by nurses who had worked with them were used to assess the residents' leadership style and the nurses' perceptions of the effectiveness of those styles. Styles that emphasized relationships with co-workers (encouraging and coaching styles) predominated over low relationship-oriented styles (delegating and structuring). The nurses perceived individual residents who exhibited encouraging and coaching leadership styles as being distinctly more effective leaders than the residents who exhibited structuring and delegating styles. The residents, however, rated all four styles as similarly effective. Leadership training programs and studies of the type reported here may provide an opportunity for faculty members to help residents learn more appropriate and productive styles of leadership.

ISSN:0022-2577    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

No abstract available.

ISSN:0022-2577    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

No abstract available.

ISSN:0022-2577    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

No abstract available.

ISSN:0022-2577    

出版商:OVID    

年代:1986

数据来源: OVID