Biomedical subjects
Publications and source records attributed to Eric Henley.
Hormone replacement therapy (HRT) and antioxidant vitamin supplements (vitamins E and C) do not provide cardiovascular benefit for postmenopausal women with known coronary heart disease. Moreover, a potential for harm exists with each of the treatments. Therefore, neither should be prescribed specifically for cardiovascular benefit for postmenopausal women with coronary heart disease.
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BACKGROUND: Despite frequent recommendations that quality improvement (QI) be incorporated into medical education, reports of this activity are few. A pilot project to develop and implement a curriculum on QI into a family medicine clerkship was conducted in the 1999-2000 academic year. INTERVENTION: A five-part curriculum was developed and implemented on successive weeks of a family medicine clerkship. The curriculum involved students working alone and in small groups. After an orientation to QI principles, students performed a series of chart audits of diabetes care. They then met with QI coordinators from a local health system to review their results. Improvement recommendations were developed and presented to the clinic director. Evaluation included completion of the module, assessment of student knowledge and opinion, and interviews with the QI coordinators. EVALUATION: Two clinic sites and 30 third-year medical (M3) students participated. Each student conducted at least two chart audits, met with the QI coordinators, and developed at least one improvement recommendation. The QI coordinators felt that students were interested in the subject but needed more training in QI principles and more faculty development. Students assessed the curriculum as being moderately effective and useful. DISCUSSION: A curriculum in QI that involved active learning strategies was successfully implemented during a family medicine clerkship. Students viewed the curriculum as being appropriate to their learning. Future efforts should include more work on faculty development and role modeling of QI activity.
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In 1995 and 1996, US adults made more than 18 million office visits for the evaluation and treatment of hyperlipidemia, including 3.4% of all visits to family physicians. Among visits to family physicians, 4.1% included measurement of cholesterol levels.(1) Overall, mean cholesterol levels decreased from 220 in 1960-1962 to 203 in 1988-1994. During the same time period, the proportion of adults with elevated total cholesterol levels (> 240) decreased from 32% to 19%.(2) Despite this progress, the availability of more effective drugs, guidelines advocating increasingly aggressive treatment, and population-wide goals established in Healthy People 2010 will continue to increase the number of patients seen by family physicians for screening, diagnosis, and treatment of hyperlipidemia.
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