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Biomedical subjects

G W Kearl

Publications and source records attributed to G W Kearl.

7 recordsLinked to original sources
PubMed1993

Physicians' productivity and teaching responsibilities.

BACKGROUND: There is considerable concern about the impact of teaching responsibilities on physicians' productivity. Previous research employing independent sample designs has suggested that physicians who teach medical students are less productive then their nonteaching counterparts. METHOD: This study examined the productivity of 15 family practice faculty and third-year resident physicians practicing in the Family Medical Center of the University of Kentucky College of Medicine; in addition to the care of patients, the physicians were assigned to teach third-year medical students participating in an ambulatory primary care clerkship. The productivity of each physician (i.e., number of patients seen per half day) was measured during a four-month period in the spring of 1991. The physicians' levels of productivity with and without medical students were compared through the use of a paired-sample design. RESULTS: No significant difference in productivity levels was observed. CONCLUSION: Ambulatory-care teaching responsibilities may not diminish physicians' productivity in academic teaching practices.

Ambulatory Care↗
PubMed1993

Medical students' confidence and the characteristics of their clinical experiences in a primary care clerkship.

PURPOSE: To investigate the relationship between medical students' confidence and their experiences in caring for patients within a primary care clerkship, because hands-on experience is assumed to be positively related to the development of confidence (a subjective marker of competence). METHOD: The participants were 60 students from the class of 1992 who completed a required third-year ambulatory care clerkship at the University of Kentucky Medical Center. The students documented their one-on-one experiences in patient care (under the supervision of preceptors in family practice, general pediatrics, or general internal medicine) by completing data cards on each patient encounter. Also, for each encounter, the students used a Likert scale to rate their levels of confidence in dealing with the patient's primary diagnosis. The variables recorded on the cards were then used to predict the students' levels of confidence during the encounters. The statistical analysis included descriptive statistics, Pearson correlations, and a stepwise multiple-regression procedure. RESULTS: The mean number of patient encounters per student was 99. The regression procedure selected three variables from the data cards as significant independent predictors of the students' confidence: management responsibility for the patient's problem (R2 = .40), prior exposure to the patient's problem (R2 = .08), and performance of laboratory work during the patient encounter (R2 = .06). These variables were responsible for predicting 54% of the observed variance in the students' confidence (R2 = .54). CONCLUSION: Hands-on clinical experience was more important for building students' confidence than any other encounter variable.

Ambulatory Care↗
PubMed1992

Interdisciplinary treatment of abused families in Kentucky.

The recognition and management of child sexual abuse has gained increased attention by primary care physicians. Examined are the results of a 3-year interdisciplinary clinical treatment program and clinical data which enhance the primary care physician's assessment and management of child sexual abuse. Specific criteria used in diagnosis and strategies for abuse are explored. Psychological factors involved in the adaptation process and long-term impact on the child and family are discussed.

Child↗
PubMed1989

Gastrocolic fistula presenting as acute diarrhea.

Abdominal pain, diarrhea, weight loss, vomiting, foul eructation, feculent vomiting and melena are among the presenting symptoms of patients with a gastrocolic fistula. A routine physical examination is useful in ruling out the more common causes of the presenting complaints. Barium enema shows the gastrocolic fistula in 90 to 100 percent of cases. En bloc resection of the stomach and colon is the treatment of choice. Alternative therapies include a temporary diverting colostomy, total parenteral nutrition and antacid therapy.

Adult↗
PubMedDate not supplied

Influence of income, hours worked, and loan repayment on medical students' decision to pursue a primary care career.

OBJECTIVE: To assess the specialty plans of current fourth-year medical students and, for those not choosing primary care specialties, to investigate the potential effect that changes in key economic or lifestyle factors could have in attracting such students to primary care. DESIGN AND PARTICIPANTS: A survey study was sent to 901 fourth-year medical students in the 1993 graduating classes of six US medical schools. OUTCOME MEASURES: Comparisons were made between students choosing and not choosing primary care specialties. For the non-primary care students, we also evaluated whether alteration of income, hours worked, or loan repayment could attract them to primary care careers. RESULTS: Of the 688 responses (76% response rate), primary care specialties were chosen by 27% of the students and non-primary care specialties by 73%. One quarter (25%) of the non-primary care students indicated they would change to primary care for one of the following factors: income (10%), hours worked (11%), or loan repayment (4%). For students whose debt was $50,000 or greater, the loan repayment option became much more important than for students with lesser debt. In all, a total of 45% (n = 313) of the students indicated either they were planning to enter primary care (n = 188) or they would change to a primary care specialty (n = 125) with appropriate adjustments in income, hours worked, or loan repayment. CONCLUSION: Significant changes in economic and lifestyle factors could have a direct effect on the ability to attract students to primary care. Including such changes as part of health system reform, especially within the context of a supportive medical school environment, could enable the United States to approach a goal of graduating 50% generalist physicians.

Career Choice↗