PubMed Health⌕ Search

Biomedical subjects

R Folse

Publications and source records attributed to R Folse.

At least 37 records · Page 2Linked to original sources
PubMed1985

The relationship between stress and attitudes toward leisure among first-year medical students.

The purpose of the study reported in this article was to examine first-year medical students' attitudes toward their free time and how these attitudes relate to self-reported stress levels. Members of the entering class of 1982-83 at the Southern Illinois University School of Medicine were asked to complete surveys designed to measure perceived stress and leisure attitudes. The results indicated a significant negative correlation between the total leisure scale and the stress scale. This correlation supported the hypothesis that students who perceived that they had high stress levels scored low on the leisure attitude scale. These findings suggest a need for educating students about the benefits of well spent leisure time as a stress management mechanism that is important in coping with daily pressures and anxieties.

Adult↗
PubMed1984

Correlates of honor ratings in a clinical clerkship employing a faculty forum evaluation system.

5he purpose of this study was to determine whether or not suspected variables affected a surgery clerk's chances of being awarded an honor rating. Findings indicated a significant relationship between a student receiving an honor rating and his or her preceptor's predetermined level of student advocacy, the number of completed patient interview and physical examination write-ups, and final examination scores. There was no significant relationship found between honor ratings and the preceptor's status, the sequence in which the student was discussed or the length of time spent discussing the student at the final evaluation meeting, or the number of clinical faculty present at the meeting. These results lend support to the faculty forum evaluation approach, but suggest a need for further scrutiny of some influencing variables to ensure all students are fairly considered and honor ratings judiciously awarded.

Clinical Clerkship↗
PubMed1983

Determining the content of a surgical curriculum.

The purpose of undergraduate surgical education is to prepare the student for both the residency and eventual practice of medicine. To help determine the surgical knowledge and skills that would eventually the useful to the student, we conducted a survey of residents in training, physicians in practice, and surgical educators (department chairpersons and clerkship directors). Members of the Curriculum Committee of the Association for Surgical Education developed a questionnaire in which the respondents were asked to grade the functional importance of 84 areas of knowledge and 46 skills (0 = unnecessary, 3 = proficiency necessary). Using a modified Delphi technique to collect information, we sent the questionnaire to eight medical school graduation classes of 1975 (730 persons) and 1980 (776 persons) and all department chairpersons and/or clerkship directors (179). The results of the survey (46% response) revealed considerable agreement about the importance of certain skills and areas of knowledge, enabling us to rank order skills and knowledge based on mean responses (0.0 to 3.0). Physicians in practice, residents, and educators believed that certain areas of knowledge (e.g., acute abdominal problems, appendicitis, shock, cancer of the breasts) and skills (e.g., history taking and physical examination, gowning, suture removal) were very important (greater than 2.250, while other areas of knowledge (e.g., transplantation, liver abscess, soft tissue sarcomas) and skills (e.g., insertion of Swan-Ganz catheter, abdominal paracentesis, cricothyroidotomy) were less important (less than 1.3). This approach allows us to assign priorities to areas of knowledge and skills when determining curriculum content and to include functional criteria when developing educational objectives.

Attitude of Health Personnel↗
PubMed1982

Cancer in cystic lesions of the thyroid.

We reviewed the records of 341 patients who underwent thyroidectomy for the suspicion of cancer between 1975 and 1980. Cancer of the thyroid was found in 14% of them. Although cysts of the thyroid (pathologic finding of a fluid-filled cavity greater than 1 cm in diameter) were encountered in 35% of the patients, cysts were similarly distributed among patients with benign conditions (27%) or with cancer (33%). Most of the thyroid cysts in patients with carcinoma measured 2 to 4 cm in diameter. The cancer was found within the cystic cavity. The cysts in patients with cancer appeared to originate from necrosis of the tumor. B-mode ultrasonography was not reliable in differentiating cystic and solid lesions. The demonstration of the cystic nature of a thyroid nodule does not rule out the diagnosis of cancer of the gland.

Adenoma↗
PubMed1980

Surgical manpower and practice patterns in a nonmetropolitan area. Nonmetropolitan surgical manpower.

Surgical practice in a nonmetropolitan area was studied with a field survey of 33 general surgeons and family practitioners. Instruments included a physician interview and questionnaire, a nurse-receptionist questionnaire, a sample of 3,733 office patient records, and a sample of hospital operating room logbooks. The general surgeons reported spending an average of 22 hours a week seeing an average of 74 patients in their office practices. Twenty-six percent of the presenting problems and 32% of the principal diagnoses identified in the sample of general surgeons' office patient records were defined as primary care problems. Twenty-two percent of the problems and diagnoses were defined as specialty surgical problems, such as urological problems. An indication of patient referral was found in 2% of the records. In hospital practice the surgeons estimated spending an average of 14 hours a week in the operating room, and performed an average of seven to eight procedures a week. The mean California relative value (CRV) for each procedure was 10.0 CRV. The family physicians managed patients with a broad range of problems, including surgical, in their office practices, and performed an average of three operative procedures each week in the hospital.

Family Practice↗
PubMed1979

Lower extremity arterial insufficiency after long-term methysergide maleate therapy. Its evaluation with Doppler ultrasonic velocity detector.

Iatrogenic ergotism is the primary source of ergot intoxication. The patient whose case is reviewed had migraine headaches and received methysergide maleate for 13 years. She had, in July 1977, severe claudication of the lower extremities. Measurements of the peripheral arterial circulation were made using the Doppler ultrasonic velocity detector. The extent of disease and subsequent reversal were documented using arteriographic examination. Initial measurements showed the patient was able to walk for one minute and 34 seconds on a treadmill (2 mph, 10% grade) before stopping because of claudication. Symptoms cleared after drug withdrawal and repeated testing produced no claudication. The calculated index (posterior tibial/arm pressure) increased from a mean of 0.22 to 0.74 during the eight-month period following discontinuance of methysergide therapy with no recurrence of migraine headaches. A review of the literature is also presented.

Constriction, Pathologic↗
PubMed1979

Chart review skills: a dimension of clinical competence.

A study of undergraduate medical students' abilities to identify salient information in reviewing patient charts was conducted by members of the Department of Surgery at Southern Illinois University School of Medicine. Specific goals of the two-year study were to develop and test a method for assessing chart skills and to test the following hypotheses: (a) knowledge base is a component of chart review skill; (b) chart skills are related to basic observational skills; (c) performance on one chart is positively correlated with performance on other charts; (d) chart performance is affected by distraction and time pressure; and (e) chart performance improves with clinical experience. Evaluation instruments and methodology are described. Hypotheses a, b, and e and the time effect hypothesized in d were supported; hypothesis c was not supported. Results of the study provide a foundation for further research exploring the effect of instruction on chart performance and investigating the relationships between chart performance and other measures of clinical competence.

Clinical Competence↗
PubMed1978

Medical problems of the elderly in nonmetropolitan Illinois.

Are the medical problems of the ambulatory elderly in a nonmetropolitan area different from the problems of the metropolitan elderly? What relation does the availability of physician resources in a nonmetropolitan area have to the care delivered to the elderly? The study involved an analysis of 965 patient records sampled from the office practices of 16 family practitioners and 12 general surgeons. Data were extracted using the survey instrument developed for the National Ambulatory Medical Care Survey (DHEW, 1974). Results were obtained describing patient status, presenting problems, principal diagnoses, reasons for visit, and disposition. Comparisons of the medical problems managed by the family practitioners were made with those managed by the general surgeons. Problems managed by the nonmetropolitan physicians were compared with the data on the elderly obtained from the National Ambulatory Medical Care Survey. The data suggest that nonmetropolitan physicians, regardless of specialty, manage a broad range of chronic and acute problems. The survey of office records, however, does not provide information about how the elderly obtain access to other services essential to a coordinated, comprehensive system of health care.

Aged↗
PubMed1978

Medical education for practice in nonmetropolitan areas.

A study of patient records sampled from the office practices of 28 family practitioners and general surgeons in a 16-county nonmetropolitan area revealed that a sizable percentage of the diagnoses of problems encountered by family practitioners concern conditions the management of which is primarily taught on a residency service other than family practice, internal medicine, or pediatrics. Surgeons, conversely, are seeing a large percentage of patients with conditions the management of which is generally taught on a primary care residency service. Data from office records were augmented by interview responses of 32 family practitioners and general surgeons to questions about the training that family practice and general surgical residents should receive if they are to be well prepared for practice in nonmetropolitan areas.

Delivery of Health Care↗
PubMed1974

Thrombophlebitis and thromboembolism: results of a prospective study.

Thrombophlebitis leading to pulmonary embolism has been stated to cause as many as 9% of hospital deaths. Its diagnosis, sites of common occurrence, treatment and immediate sequelae have long been controversial subjects. A prospective study of thrombophlebitis was set up to evaluate these problems. One hundred and sixty-six patients diagnosed clinically as having thrombophlebitis or pulnmonary embolus were studied with the ultrasonic flow detector (doppler). To assess the stated accuracy of this instrument, venograms were done when possible. The doppler proved in this series to be 93% accurate as compared to venography which is comparable to other series. Pulmonary scans and angiograms were obtained from patients suspected of having pulmonary emboli. Results were as follows: 1) Of 113 patients suspected of having thrombophlebitis clinically, only 26 (23%) of the cases were confirmed by doppler; 2) Of 53 patients suspected of having pulmonary embolus clinically, only 18 (34%) had confirmation by scan, angiogram or doppler; 3) Of 39 patients in this series who had thrombophlebitis, 11 (23%) were not suspected of having lower extremity venous disease until pulmonary embolus occurred, 4) Calf vein thrombosis without additional proximal occlusion was present in only 10% of cases; and 5) Thirty per cent of doppler or venographically proven cases of thrombophlebitis occurred after orthopedic injuries or operations. It was concluded that physical examination alone was grossly inaccurate in determining the recurrence of lower extremity thrombosis. In fact physical examination alone appeared to select out for treatment large numbers of patients without venous disease while a significant number of patients with thrombophlebitis remained clinically asymptomatic until pulmonary embolism occurred. Most deep venous disease was found in the larger veins above the knee, explaining the paucity of diagnostic symptoms in these individuals. The ultrasonic flow detector was found to be an extremely accurate, simple and rapid bedside test that could be applied daily to the high risk groups. The appearance of thrombosis could then be treated with heparin with excellent prospects of preventing occurrence of pulmonary embolus.

Angiography↗