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Biomedical subjects

M A Greganti

Publications and source records attributed to M A Greganti.

17 recordsLinked to original sources
PubMed1986

Two combined residency programs in internal medicine and pediatrics.

Combined residency training in internal medicine and pediatrics is becoming a popular postgraduate program among graduating medical students. The number of such programs has increased rapidly but with little interchange of ideas and without the benefit of a national data base. In this paper, the authors review the experience of two combined programs. Initially established because of the desire to provide broad-based training in primary care, the programs now offer a curriculum that prepares residents for primary care or education in the subspecialties. The difficulty for residents of achieving competence in two disciplines is compounded by a lack of faculty role models. The two programs offer special advantages to the residents and the departments involved. The career outcomes of program graduates have varied from primary care or subspecialty practice in one or both disciplines to faculty positions in teaching institutions. Whether the program remains successful will depend on the ability of its graduates to offer special talents to academic and clinical practice settings and on the availability of funding.

Career Choice↗
PubMed1984

Toward consensus. Training in procedural skills for internal medicine residents.

The faculty, residents, and fellows of the Department of Medicine, University of North Carolina (UNC) School of Medicine, Chapel Hill, were surveyed about procedures that graduates of general internal medicine programs should be able to perform independently. More than 95% of the 177 respondents agreed that, of 71 procedures, all program graduates should be able to perform 13 without supervision. Our results are similar to those of studies at two other universities with geographically distant and philosophically different departments of medicine. The UNC faculty, fellows, and residents had significant differences of opinion on the need for training in 18 procedures. Residents tended to endorse training in the largest number of procedures, faculty the fewest, with fellows in between. The respondents' subspecialty affiliations did not influence their opinions on any of the procedural skills.

Clinical Competence↗
PubMed1983

Patients' priorities for medical care.

Relatively little research has been done on the importance patients attach to various aspects of their medical care when their options are constrained. We studied priorities for care among 225 patients attending the medical clinics of a university teaching hospital. Eight attributes of medical care were considered: continuity, coordination, comprehensiveness, availability, convenience, cost, expertise, and compassion. Priorities were established by the method of paired comparisons. Continuity of care was the highest priority for these patients, while cost and convenience were lowest. Priorities varied in subgroups of patients defined by demographic, illness, and utilization characteristics. Patients with acute problems preferred coordination and expertise, while those with chronic problems ranked continuity higher. Patients younger than 30 years old valued coordination most; older patients preferred continuity and comprehensiveness. Since all aspects of medical care cannot be provided to all people, and choices are necessary, patients' priorities should be considered when planning health services.

Adolescent↗
PubMed1982

Personal characteristics of house staff candidates: a quantitative analysis of relative weights.

We surveyed the faculty, fellows, and residents of a department of medicine to determine the relative importance of each of eight personal characteristics evaluated during the interview of house staff candidates. A booklet containing all possible pairings of the eight characteristics was distributed to 219 participants who were asked which member of each pair should have greater weight for assigning an overall interview grade. Usable data were returned by 172 persons (79%) and analyzed by the psychometric scaling method of paired comparisons. The four characteristics with the greatest relative weights were professional attitude, maturity, enthusiasm and energy, and knowledge. The faculty, fellows, and residents were highly consistent in their judgments. However, three of the characteristics (motivation for clinical practice, knowledge, and verbal skill) significantly distinguished the three departmental groups. These results show that utility of the paired comparison method for identifying a department's weighting of variables for selection of house staff.

Attitude of Health Personnel↗
PubMed1982

Primary health care: perspective of the faculty of a department of medicine.

A full-time faculty in one dependent of medicine, 66 (85%) of whom are subspecialists, were surveyed to determine standards for provision and attitudes toward the teaching and practice of primary health care (PHC). A 40-item questionnaire on specific attributes of PHC provision was given to 70 eligible faculty members; 66 (94%) responded. Of 17 standards, nine were supported by 50 (75%) or more of the faculty and eight by from 24 (44%) to 48 (73%) faculty members. However, 51 faculty members (77%) indicated some discomfort with primary responsibility for the complete, ongoing care of their patients. Most frequent reasons for this discomfort were clinic inefficiency (31 votes [47%]) and competing commitments (29 votes [44%]). Few faculty indicated they did not enjoy PHC (eight [12%] of the faculty) or considered PHC inappropriate for academic physicians (ten [15%] of the faculty). These results indicate the complexity of faculty attitudes toward PHC and point to a need for departments of medicine to examine thier teaching and practice of PHC.

Attitude of Health Personnel↗
PubMed1979

Acute pulmonary edema after the intravenous administration of contrast media.

Acute pulmonary edema developed in two young, previously healthy women immediately after the intravenous administration of contrast media. The pulmonary edema, rare in young persons, could not be explained by classical anaphylaxis, contrast media overdose, sodium and fluid overload, or acute myocardial infarction. A nonimmunologic osmotic mechanism causing reversible pulmonary capillary leak might explain the clinical events observed in both patients. Both responded to continuous positive airway pressure (CPAP), indicating the possible utility of CPAP in treating pulmonary capillary-leak contrast reactions.

Adolescent↗