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Biomedical subjects

J Medder

Publications and source records attributed to J Medder.

4 recordsLinked to original sources
PubMed1987

Content of a preceptorship experience: effects of location, gender, and specialty choice.

Ambulatory care experiences for 37 medical students during six consecutive three-week preceptorships in family practice were assessed using student logbooks and end-of-preceptorship feedback forms. Comparisons were made by site of preceptorship (university or nonuniversity), by gender of medical student, and by the students' subsequent specialty choices. Rank orders of diagnoses using a Spearman's rho comparison of ranks were significantly correlated with national data as were most student-to-group comparisons. Students tended to see more patients of their own age group, and female students tended to see more female patients of child bearing age. Students with preceptors in the university setting saw patients who were older than those patients seen by students in nonuniversity preceptorship settings. Students in the university setting also saw fewer patients and performed fewer procedures during the three week preceptorship but had a higher level of participation in patient care. Females reported a lower level of participation in patient care than male students, and students who subsequently went into family practice residencies reported a higher level of participation than those students who entered other specialties.

Adolescent↗
PubMedDate not supplied

Dissemination and implementation of Put Prevention into Family Practice.

INTRODUCTION: The Put Prevention into Practice (PPIP) program was developed and disseminated to address patient, clinician, and office barriers that result in less than optimal delivery of preventive services in the United States. METHODS: To study the dissemination of PPIP by the American Academy of Family Physicians (AAFP), pre- and post-dissemination surveys of knowledge about PPIP and purchase order data were obtained from the AAFP. In addition, a mail questionnaire was sent to a random sample of purchasers to study their use of PPIP. RESULTS: After two years of active promotion, 27% of AAFP members had heard about PPIP, and PPIP components were purchased by 2,004 individuals during its inital dissemination. Flow sheets, health guides, exam room wall charts, and the Clinician's Handbook of Preventive Services were the PPIP items most frequently purchased and used. Excluding the Clinician's Handbook of Preventive Services, 58% of purchasers used one or more parts of the kit with an average of less than four items used per purchaser. CONCLUSIONS: Initial dissemination and implementation of PPIP among family physicians was limited; continued promotion will likely improve dissemination of PPIP. However, this study, and others suggest that the simple availability of a kit of materials is not sufficient to enhance the delivery of preventive services as envisioned by clinicians or policy makers. Additional strategies for dissemination and implementation of preventive services will be required, such as providing external consultation services to practices, incorporation of preventive services into HMO organizations, and training of residents in strategies for change in their future practices.

Attitude of Health Personnel↗
PubMedDate not supplied

Using practice genograms to understand and describe practice configurations.

BACKGROUND: Demands for change in medical practices are coming from multiple sources. Since interventions to change clinical practice continue to have limited success, understanding the functional structure of primary care practices and the dynamics of providing care have become increasingly important. METHODS: To portray and understand the primary care office system, we developed "practice genograms" that describe practice participants and their relationships with each other. Formal organizational structure is evaluated using family systems theory and family of origin genogram techniques. RESULTS: Practice genograms provided a more dynamic, relational model than the organizational chart and promoted identification of relationship strengths and weaknesses within a practice the same way that family genograms identify these characteristics in a family system. CONCLUSIONS: Research implications for the use of the practice genogram include enhanced data gathering, increased understanding of the complexity of practices as adaptive systems, and increased understanding of current and potential approaches to changing practices.

Family Practice↗