Joint ventures and home health care.
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Aged↗
Biomedical subjects
K J Keith
Publications and source records attributed to K J Keith.
The teaching of liberal arts in internal medicine residency training.
Forty-four members of the Association of Program Directors in Internal Medicine and 58 members of the Society for Research and Education in Primary Care Internal Medicine completed questionnaires on the teaching of liberal arts in internal medicine residency programs and the importance of liberal arts to the practice of medicine. They rated economics of medical care and bioethics as essential to residency training. Law and organization of the health care system as well as economics and bioethics were rated as essential to medical practice. Although there was great variability in the curricula represented, over 40 percent of the respondents reported having formal lecture and/or seminar exposure to these topics in their programs. Problems encountered in implementing liberal arts programs included lack of curriculum time, limited-faculty members, and a lack of interest on the part of residents. There is a need both to arrive at a consensus among residency directors and to explore means of developing interdisciplinary faculties if the liberal arts are to form an established part of internal medicine residency training.
Bioethics↗
Medical students' attitudes toward the elderly.
A study was designed to examine the relationship between students' attitudes, their willingness to work with elderly patients, and the impact of a geriatric rotation on a randomly selected subset of the group. A pretest/post-test design was used in which 148 third-year medical students completed a multidimensional questionnaire on two occasions eight weeks apart. Highly significant correlations were found between the expressed intention of the student to work with the elderly and positive feelings about previous professional contact (r = .26, P less than .001), previous personal contact (r = .17, P less than .002), belief that working with the elderly is rewarding (r = .30, P less than .0001), high degree of comfort in working with the elderly (r = .21, P less than .01), and positive stereotypes about the elderly (r = .14, P less than .05). Despite the students' positive rating of the geriatric rotation, multiple regression analysis indicated that the best predictor of an index of intentions to work with elderly patients on the post-test was this same index of intentions on the pretest (multiple r = .58, P less than .001). These findings, as well as the actual attitudes and stereotypes held by the students, have major implications for the planning and development of medical students' experiences in geriatrics.
Aged↗
Planning for program effectiveness in quality assurance.
Quality assurance programs are now a fact of life in health care institutions, yet the effectiveness of these programs in improving care is unproven. Reports of quality assurance activities rarely discuss "remedy implementation" or the outcome of such attempts. Effectiveness does not flow naturally from sound methodology or documentation but is the most challenging part of the program. This article examines reasons for this difficulty, and the authors recommend strategies for improving problem resolution and increasing the influence of the program in the organization. They urge attention to program implementation and emphasize active participation by clinicians, patients, administration, and staff. This broad representation promotes examination of a wide range of patient care issues as well as medical audits, allows the program to enlist support for change, and enables the program to anticipate and make timely contributions to the decisions of policymaking groups.
Health Facilities↗