Teaching interviewing skills to students in clinical years: a comparative analysis of three strategies.
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Education, Medical↗
Biomedical subjects
M Quirk
Publications and source records attributed to M Quirk.
The pyropoikilocytosis-elliptocytosis syndrome in a black South African infant: clinical and hematological features.
A black infant presented in the newborn period with severe red cell fragmentation, pyknocytosis, and hemolysis necessitating repeated exchange transfusions. Exposure of the red cells to 45 degrees C in vitro caused membrane budding, fragmentation, and sphering similar to that described in pyropoikilocytosis. By 12 months of age the clinical and hematologic picture had evolved to one of a compensated hemolytic disorder with elliptocytosis, but the degree of abnormal thermal sensitivity remained unchanged. Osmotic fragility and authohemolysis tests gave results intermediate between hereditary elliptocytosis and hereditary pyropoikilocytosis. It appears that there is considerable heterogeneity within the red cell membrane disorders exhibiting altered thermal sensitivity.
Anemia, Hemolytic, Congenital↗
Increasing the efficacy of physician-delivered smoking interventions: a randomized clinical trial.
OBJECTIVE: To assess the relative impacts of three physician-delivered smoking interventions in combination with follow-up contact from behavioral counselors. DESIGN: Randomized controlled trial with pre- post measures of smoking rates. This paper reports six-month outcome data. SETTING: Participants were recruited from among patients seen by 196 medical and family practice residents in five primary care clinics. PARTICIPANTS: Participants were 1,286 patients out of 1,946 eligible smokers approached. The patient group was 57% female and 91% white, had an average age of 35 years, and smoked, on average, slightly over one pack per day. INTERVENTION: Physicians were trained to provide each of three interventions: advice only, brief patient-centered counseling, and counseling plus prescription of nicotine-containing gum (Nicorette). Half the patients received follow-up in the form of telephone counseling at three-monthly intervals from behavioral counselors. MEASUREMENTS AND MAIN RESULTS: Changes in smoking behaviors were assessed by telephone interview six months after physician intervention. The differences in one-week point prevalence cessation rates among the physician interventions were significant (p less than 0.01): advice only, 9.1%; counseling, 11.9%; counseling plus gum, 17.4%; with no effect for telephone counseling. The time elapsed from physician encounter to initial quitting and the length of that period of abstinence also showed significant benefit of the counseling interventions. Patients receiving physician counseling were much more likely than those not receiving counseling to rate their physician as very helpful (p less than 0.001). Multiple regression analyses are also reported. CONCLUSION: Smoking intervention counseling provided by physicians is well received by patients and significantly increases the likelihood of cessation at six months, an effect that is augmented by the prescription of nicotine-containing gum, when compared with physician-delivered advice. Follow-up telephone counseling does not contribute significantly to smoking behavior changes.
Adult↗
Primary care for women. The art of interviewing.
This article focuses on the skills, attitudes, and goals required for effective history-taking during comprehensive health assessment in the primary care setting. The approach presented is characterized as "patient-centered" in that the woman is engaged in the problem-solving process. Specific communication skills are discussed, and attitudes and goals that enable primary care providers to adopt a patient-centered approach to relationship-centered care are included.
Communication↗
The effectiveness of a mobile worksite health promotion program in lowering employee health risk.
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Adult↗
Why students chose family medicine: state schools graduating the most family physicians.
This study identifies factors which influenced a career choice of family practice by students from the class of 1990 in the public medical schools that have graduated the most family physicians in the last decade. One hundred and thirty-nine new graduates who entered family practice residencies in 1990 responded to a questionnaire that determined the importance of curricula, teachers, departmental support, practice characteristics, and personal issues in decision making. Practice characteristics of family practice and the clinical curriculum were found to be the most important influences. Differences among subjects on the basis of their levels of interest in family practice prior to medical school were examined. Educational considerations, related to curricula and teachers, were more important to those students with little or no prior interest, whereas practice characteristics and personal issues were more important to students with high levels of prior interest. Implications for educational planning are discussed.
Adult↗
Videotape analyses of medical students' interviewing skills.
This research project investigates medical students' interviewing skills before and after a six-week clerkship in family and community medicine. Male and female medical students participating in a clerkship in family and community medicine were asked to conduct a pre- and post-videotape interview with a simulated patient. After the pre-test videotape, the student received feedback from the simulated patient and from a faculty member. Students than participated in a six-week clerkship with a family physician. Multivariate and univariate analyses of variance of pre- and post-test interviews showed significant pre-post differences on seven of ten interviewing skills and focal areas. Significant differences relating to students' year in medical school were also found.
Clinical Clerkship↗