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Biomedical subjects

K J Sheets

Publications and source records attributed to K J Sheets.

18 recordsLinked to original sources
PubMed1996

Questions asked by family physicians who want to serve as medical student preceptors.

This article addresses the needs of family physician preceptors who teach medical students in their community-based practices. Responses are provided to 20 typical questions that a family physician might ask when considering whether to become a preceptor. Areas covered by the questions and responses include physician motivation for becoming a preceptor, characteristics of good preceptors, specific issues related to working with students in the office, what to teach students, how to give students feedback, evaluation of students, and relationships with the medical school.

Communication↗
PubMed1994

A multivariate model for specialty preference by medical students.

BACKGROUND: Numerous studies have demonstrated differences among students regarding their preference of a medical specialty. The goal of the present research was to develop a model for the selection of a primary care specialty (ie, family practice, general internal medicine, medicine/pediatrics, and general pediatrics). METHODS: A self-administered questionnaire was mailed to 822 first-year through fourth-year medical students at the University of Michigan Medical School in Ann Arbor. Students listed their first preference for medical specialty, anticipated income and work hours, and the influence of attitudinal and social factors on their preference. A total of 645 (78.5%) students responded. Average age was 25; 58% were male, and 77% resided in Michigan. RESULTS: Overall, 34.3% of the medical students who responded to the questionnaire expressed a preference for a surgical specialty; 27.3%, primary care; 19.9%, a hospital-based practice; and 18.5%, nonprimary care and non-hospital based practice. A multiple logistic regression model developed on preference for a primary care specialty achieved a classification accuracy of 82%. The most important factors influencing specialty preference were sex, expected income, attitudes about general medicine issues, attitudes about surgery, and the influence of other people. CONCLUSIONS: No single factor dominates a student's preference for primary care. Students preferring primary care were most strongly influenced by their perceptions of practice variations. Students preferring nonprimary care specialties were more interested in income, prestige, and hospital-based practice. Medical school faculty had no significant impact on the preferences of either group of students.

Adult↗
PubMed1993

Influencing the attitudes of medical students toward diabetes. Results of a controlled study.

OBJECTIVE: To determine the effect of two educational interventions on the diabetes-related attitudes of medical students. RESEARCH DESIGN AND METHODS: We studied 67 junior and senior medical students who were participating in the University of Michigan Medical School's Family Practice elective clerkship. Students were assigned to one of two interventions. The first was a 1-wk living-with-diabetes behavioral simulation that involved injections, blood glucose monitoring, diet, exercise, and record keeping. The second intervention involved reading an autobiography about living with diabetes and viewing a videotape about the psychosocial impact of diabetes. RESULTS: No differential impact was found between the two interventions. However, both interventions were followed by a modest positive change in the attitudes of the medical students (which were very positive to begin with) toward the importance of patient autonomy and the value of the team approach to diabetes care. The attitude gains persisted at follow-up for patient autonomy but returned to baseline for team care. CONCLUSIONS: This study suggests that these two educational interventions resulted in modest increases in the already positive attitudes of medical students toward the importance of patient autonomy and team care in diabetes. However, because the study did not include a group that received no treatment, we cannot be certain on this point. The attitude gain related to team care did not persist at follow-up. These findings are consistent with classical attitude research, which suggests that attitudes are sensitive to influences such as these interventions, but that attitude changes may not persist when those influences are changed or withdrawn. We were not able to find a differential impact between the two interventions and suspect that the general nature of the DAS used as the dependent measure may not have been sensitive enough to capture such a differential impact.

Analysis of Variance↗
PubMed1992

Association between clinical experiences in family practice or in primary care and the percentage of graduates entering family practice residencies.

In 1990 the authors surveyed all U.S. medical schools in order to solicit information about students' clinical experiences in family practice and in primary care. Of 126 schools, 104 (82.5%) responded. Survey data were correlated with each school's quartile ranking based on the average percentage of graduates who entered family practice residencies. A significant association (p = .0013) was found between required family practice clerkships or preceptorships and institutions ranked in the highest quartile (i.e., having more than 17% of their graduates enter family practice). A similarly significant association (p = .0056) was found for those 12 institutions that had more than 30% of their students select family practice options in required primary care clerkships or preceptorships. The authors suggest that active recruiting of students to take such options may increase the number of graduates who enter family practice.

Career Choice↗
PubMed1992

Influences on specialty choice of family physician graduates of a tertiary care medical school.

A survey of 392 University of Michigan Medical School family physician alumni who graduated from medical school between 1950 and 1984 explored factors influencing respondent specialty choice and satisfaction with specialty choice. The strongest influences on specialty choice were the opportunity to treat a variety of illnesses, know patients personally, and work with people as opposed to things. The traditional medical school setting offered an environment of high-quality education, opportunities to see a variety of illnesses, and a model of tertiary, uncoordinated, discontinuous care that the respondents were determined not to replicate in their own medical careers. Fifty-nine percent of the respondents had no reservations about their decision to become family physicians, 74% said they would return to the University of Michigan if they were to enter medical school again, and 91% were greatly or moderately satisfied with their choice, indicating their satisfaction with their career choice and medical school.

Adult↗
PubMed1992

Primary care research funding sources.

BACKGROUND: Numerous studies and anecdotal reports have identified lack of funding as a major obstacle to recruiting young physicians to academic medicine and to developing research in primary care. The focus of this study is the comparison of funding sources reported for published research in the primary care disciplines of family medicine, general internal medicine, pediatrics, and obstetrics and gynecology. METHODS: Articles from a representative sample of the journals of each discipline were eligible for review and inclusion in the study if the work was an original research article. The eligible articles were reviewed and classified by specialty and by funding source. The reported funding sources were categorized into federal, private foundation, local, discipline specific, corporate, and none. After all of the articles had been categorized, 40 articles from each discipline that had not reported any funding source were randomly selected. The primary author of each study was then contacted by telephone for a structured interview to verify the absence of reported funding in the published study. RESULTS: Eligible published articles used in this study numbered 319 in family medicine, 208 in general internal medicine, 522 in obstetrics and gynecology, and 888 in pediatrics. There was a statistical difference between the disciplines regarding the source of funding (chi 2 = 223.0, P less than .0001). Family medicine research was funded primarily by federal and discipline sources. Obstetrics and gynecology research was funded primarily by federal, private foundation, and corporate sources. General internal medicine research and pediatric research were funded primarily by federal and private foundation sources. The majority of the research articles in all four disciplines did not report any funding source. CONCLUSIONS: All four disciplines had diverse sources of funding with many similarities and relatively few differences. An important finding of the study was the amount of unfunded research conducted and published in these primary care disciplines.

Family Practice↗
PubMed1991

Preparing surgery house officers for their teaching role.

The medical education literature was reviewed in four categories: (1) general studies of house officer teaching, (2) perceptions of the house officer's teaching role, (3) assessing and improving resident teaching skills, and (4) the teaching role of surgery residents. An agenda for research and development related to surgery resident teaching skills was proposed based on four research questions: (1) What types of teaching skills are most appropriate for surgery residents? (2) How do faculty and student expectations of resident teaching influence surgery resident teaching? (3) What type of intervention is most successful in improving surgery resident teaching skills? (4) What are other outcomes of improved surgery resident teaching besides resident and learner satisfaction? This important teaching role should be more formally and widely acknowledged by surgery faculty, and appropriate teaching skill improvement activities should be provided for all surgery house officers.

Education, Medical, Graduate↗
PubMed1991

Patient satisfaction with gynecologic care provided by family practice resident physicians.

This study assessed the impact on patient satisfaction of second-year family practice residents participating in a one-month gynecology rotation at a university-owned satellite ambulatory care facility. Its purpose was to examine whether residents can be incorporated into university-operated satellite health centers for patient care and resident education without decreasing patient satisfaction. With the exception of one item on the patient satisfaction questionnaire, results showed no significant difference in patient satisfaction ratings between one family practice faculty physician and five family practice residents. This finding supports increased efforts to incorporate residents into academic ambulatory care satellites in limited direct patient care roles similar to those described in this report.

Evaluation Studies as Topic↗
PubMed1991

Development of a curriculum in colposcopy.

BACKGROUND: Colposcopy for the detection of genital malignancy and disease associated with human papillomavirus, along with cytologic screening and histopathologic correlation, allows for intervention before the onset of invasive disease. Family physicians are interested in learning colposcopy, but there are few reports in the literature on the training of colposcopists. METHODS: A colposcopy curriculum for family physicians was designed with goals, objectives, and instructional strategies selected to enhance learning and quality assurance of the current principles of colposcopic evaluation. During the pilot project, a third-year resident studied a syllabus and reviewed slides, practiced performance skills, and observed colposcopies. After demonstrating competence, the resident evaluated patients with instructor supervision and feedback. RESULTS: Resident performance data from written test scores and a performance checklist indicated an excellent learning curve. High resident satisfaction was reported. Suggestions from expert reviewers were incorporated into the final curriculum product. The evaluation data indicated that, based on this pilot program, family practice residents can effectively learn colposcopy. CONCLUSIONS: Colposcopy is a highly technical skill that can be learned by family physicians through professional training. Competency in colposcopy can provide a new dimension to their practice in the diagnosis and treatment of female lower-genital-tract disease. This colposcopy curriculum is an initial effort in the identification of the content and process required to train family physicians in the use of this diagnostic procedure.

Clinical Competence↗
PubMed1988

Teaching skill improvement for graduate medical trainees. An agenda for research and development.

The medical education literature concerned with the teaching role fulfilled by house officers was reviewed by the authors. Articles were presented in three categories: (1) studies of house officer effort, (2) perceptions of the house officer's teaching role, and (3) assessing and improving house officer teaching skills. House officers are involved in a large amount of teaching, greatly influence students, and fulfill a unique teaching role in medical education that is complementary to the faculty teaching role. An agenda for research and development in the area of research teaching skills was proposed based on three broad research questions: (1) What types of teaching skills are most appropriate for residents? (2) How do faculty and student expectations of resident teaching influence resident teaching? (3) What type of intervention is most successful in improving resident teaching skills?

Education, Medical, Graduate↗
PubMedDate not supplied

Where, how, and from whom do family practice residents learn? A multisite analysis.

This paper presents the results of a multisite study of 2,481 teacher-learner events reported by family practice residents in four separate training programs. Teacher-learner events were characterized by the location, activity, and teacher involved. Distinct patterns of teacher-learner interaction emerged across each of the three years of training. Hospital based direct patient care under the supervision of a non-family practice specialist was the most frequent type of educational experience in each of the three years. In contrast, family practice faculty influence throughout each of the three years is minimal. Learning in the outpatient setting with another specialist matched, or in some cases, exceeded that with a family physician. This study raises several important issues regarding the type and appropriate nature of educational influences on family practice physicians. Of greatest concern is the adequacy of role modeling and direct teaching by family practice specialists of family practice residents.

Family Practice↗
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↗