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Biomedical subjects

S Wartman

Publications and source records attributed to S Wartman.

8 recordsLinked to original sources
PubMed2001

The Interdisciplinary Generalist Curriculum (IGC) project: an overview of its experience and outcomes.

The Interdisciplinary Generalist Curriculum (IGC) Project was a competitive, seven-year demonstration project funded by the Health Resources and Services Administration (HRSA). It was established to determine whether specific interdisciplinary innovations in preclinical medical school curricula could affect students' selection of careers in family medicine, general internal medicine, or general pediatrics. Through collaboration among the three generalist disciplines, the IGC innovation exposed all preclinical students in ten demonstration schools to a new or significantly enhanced preclinical curriculum that included a direct supervised clinical experience with a generalist physician preceptor. The project was managed by an interdisciplinary executive committee that was codirected by one representative each from family medicine, general internal medicine, and general pediatrics. A national advisory committee with representation from the academic and professional organizations of family medicine, internal medicine, pediatrics, and osteopathy provided input to the executive committee in guiding the project. The project was externally evaluated. Major outcomes of the IGC Project include sustained curricular changes in ten institutions, prompted by relatively few dollars and demonstration of models for collaboration at institutional and national levels. This supplement describes the IGC Project's experience and outcomes so that others may draw pertinent information to apply to their own efforts in medical education.

Curriculum↗
PubMed2001

Implementation of the Interdisciplinary Generalist Curriculum Project: considerations of structure, funding, and design.

Implementation of the Interdisciplinary Generalist Curriculum (IGC) Project involved complex processes that reflect structural, funding, and intervention design considerations. Among structural considerations, the IGC Project benefited from a national structure above the level of the demonstration schools. Governance by committee was highly effective because it harnessed and balanced power. At the national level, governance by committee was enhanced by strong central coordination, and it had a role-modeling effect for governance at the school level. The IGC experience over the seven-year course of the project suggests that it is important to revisit the role of a national advisory committee over time and to revise that role as warranted. Funding considerations, including the importance of funding evaluation for a period of time long enough to measure intended impacts and the length and amount of funding to demonstration schools, are discussed. Prescription of the IGC intervention and the focus on years one and two of medical education are critical design considerations. The authors conclude that the IGC Project used relatively few federal dollars to demonstrate a highly prescribed intervention in a limited number of medical schools toward a clear and limited goal. IGC lessons apply to programs specifically targeting primary care education, but also to other medical school curricular innovations, and perhaps, to a larger framework of multi-site educational interventions.

Curriculum↗
PubMed2001

Curricular change: recommendations from a national perspective.

Recommendations on future directions, funding, and organizational and curricular issues have emerged from the complexity of the Interdisciplinary Generalist Curriculum (IGC) Project. For example, future demonstration projects aimed at innovations in medical education that are funded through the contracting mechanism are recommended, and funding intended to serve as institutional leverage for demonstrating desired curricular innovations in medical education is encouraged. Funding provided to entities that can maximize influence within the institutions is recommended. Also, the period of time over which funds are provided needs to take into consideration the breadth of the impact of the funded program on the larger curriculum and the length of time needed to measure desired outcomes. Organizational findings are that multi-site projects with administrative oversight bodies should be governed by representatives of concerned disciplines who have stakes in the demonstration of the innovations in medical education, and roles of the executive and advisory committees involved in the effort need to be made explicit at the onset and revisited over time. Similarly, the role of the funder needs to be explicit. Curricular recommendations are that medical schools are encouraged to develop longitudinal generalist preceptorship experiences early in medical education for all students, regardless of their eventual career choices. Schools should anticipate that curricular innovations in the preclinical years may require modifications of the educational process in the clinical years.

Curriculum↗
PubMed1990

Primary care internal medicine: a challenging career choice for the 1990s.

A career in primary care internal medicine can be challenging and rewarding, yet during the last decade fewer medical students have selected training in internal medicine. We wish to inform medical students, their advisors, and other physicians about the field of primary care internal medicine. We define the discipline, compare it with traditional internal medicine and with family practice, and describe features of strong primary care internal medicine training programs. We discuss common misconceptions and concerns about training programs and the career and give examples of career paths chosen by graduates of primary care programs. We encourage students to consider the option of primary care internal medicine when making career decisions and provide faculty advisors unfamiliar with primary care internal medicine training programs with a reference resource.

Career Choice↗
PubMed1990

The role of partners in selecting a residency.

To study the influence of medical students' partners (that is, those to whom they are married or engaged, or with whom they are living as "significant others") on students' selections of their residency programs, the authors surveyed fourth-year medical students and their partners at 20 medical schools in 1986. Forty-six percent of 770 eligible couples responded to the questionnaire; data from 314 couples were used in this study. Sixty-five percent of the medical students were men. Eighty-five percent of the partners were employed outside the home. The partner was the most influential person in the students' choice of a residency. Twenty-six percent (81) of the couples mutually made the decision and over 50% (186) tried to satisfy equally both partners' needs. However, the women medical students had less influence over the decision and were more apt to sacrifice their needs for their partners' (p less than .05). The women students were also significantly less satisfied with their role in the decision-making process (p less than .05). Attention to these issues by both medical students and residency programs could help couples deal with the stresses involved in choosing a residency location.

Career Choice↗
PubMed1987

Norwalk-like gastroenteritis epidemic in a Toronto hospital.

An epidemic of gastroenteritis in a teaching hospital affected 57 patients and 69 staff over a 26-day period. The index case was a patient admitted with acute abdominal pain and diarrhea two days prior to the outbreak. The epidemic curve indicated person-to-person transmission. The incubation period, duration and types of symptoms were typical of Norwalk gastroenteritis, and Norwalk-like virus particles, serologically different from the prototype Norwalk virus strain, were observed in 17 of 20 fecal specimens examined by immune-electron microscopy.

Disease Outbreaks↗
PubMed1984

Medical clinic referrals to psychiatric social work: review of 100 cases.

This study examines 100 consecutive patient referrals from a general medical clinic to psychiatric social work. While much has been written from a theoretical or anecdotal perspective on the contribution of social work to medical care, there have been relatively few attempts to look in detail at actual practices. Of the 100 patients, 52 were referred for "concrete services," 30 for evaluation of a psychiatric disorder (such as depression or somatoform disorder), 20 for counseling, and 11 for assistance for a drug or alcohol problem. Although the most frequent referral to psychiatric social work by the medical clinic staff was for concrete services, half of these cases actually involved overlooked psychiatric problems, and no concrete service of any sort was perceived as necessary by the psychiatric social worker in 30% of these cases. Referring medical staff tended to view patient distress in terms of concrete needs and chose to refer to social work even when significant psychiatric diagnostic problems were identified. Analysis of the differences in reasons for referral versus actual clinical problems has implications not only for the training needs of social work in this setting, but also for the relationship between social work and psychiatry, and for the organizational and educational needs of ambulatory medical services.

Adolescent↗