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Biomedical subjects

T G DeWitt

Publications and source records attributed to T G DeWitt.

28 records · Page 2Linked to original sources
PubMed1994

A program to develop residents as teachers.

Residents are recognized as important and influential teachers of medical students. Although they are expected to teach and evaluate students, few residents have been taught how, and most would like to receive training to develop and improve their skills as teachers. We developed a "Residents as Teachers" retreat based on our faculty development program for clinical preceptors. We focused on clinical precepting skills, including evaluation/feedback, and the ability to prepare and deliver a brief presentation. The program increased knowledge and skills and improved attitudes about teaching, as reflected in self-reports, observed performance, and medical student ratings. The retreat also provided a valuable social experience for residents. The program has been considered beneficial by residents, program faculty members, medical students, the student clerkship director, and the residents' primary care preceptors. The retreats form the centerpiece of our curriculum for residents as teachers and have become an annual tradition in the residency program.

Attitude of Health Personnel↗
PubMed1993

Confidentiality in health care. A survey of knowledge, perceptions, and attitudes among high school students.

OBJECTIVE: To assess adolescent knowledge, perceptions, and attitudes about health care confidentiality. DESIGN: Anonymous self-report survey with 64 items addressing confidentiality issues in health care. SETTING: Rural, suburban, and urban high schools in central Massachusetts. PARTICIPANTS: Students in ninth through 12th grades from three schools. RESULTS: A total of 1295 students (87%) completed the survey: 58% had health concerns that they wished to keep private from their parents, and 69% from friends and classmates; 25% reported that they would forgo health care in some situations if their parents might find out. There were differences in response by gender, race, and school. About one third were aware of a right to confidentiality for specific health issues. Of those with a regular source of care, 86% would go to their regular physician for a physical illness, while only 57% would go there for questions about pregnancy, the acquired immunodeficiency syndrome, or substance abuse that they wished to keep private. Sixty-eight percent had concerns about the privacy of a school health center. CONCLUSIONS: A majority of adolescents have concerns they wish to keep confidential and a striking percentage report they would not seek health services because of these concerns. Interventions to address confidentiality issues are thus crucial to effective adolescent health care.

Adolescent↗
PubMed1993

Developing community faculty. Principles, practice, and evaluation.

Medical education is increasingly emphasizing outpatient experiences in community settings, and, concurrently, the development and assessment of the teaching skills of community faculty. These skills can be addressed through a faculty development program focusing on (1) issues relevant to community education, (2) adult learning principles, and (3) logistics that facilitate the participation of community medical faculty. Using a series of 1- to 3-day seminars, the program described focused on clinical precepting and brief presentations, used interactional teaching and practicums, and actively involved participants in the evaluation and planning fo the seminars. Evaluation of the program suggested that it was successful in increasing participants' knowledge and application of educational principles taught. Such programs can result in the development of an effective and potentially abundant resource of faculty members for the medical education of students and residents.

Clinical Competence↗
PubMed1990

Local anesthesia in pediatric patients: topical TAC versus lidocaine.

Lacerations requiring sutures are a common surgical emergency in children. Traditional anesthesia prior to suturing has been intradermal lidocaine. TAC (0.5% tetracaine, 1:2,000 adrenalin, 11.8% cocaine) is a topically applied anesthetic. A randomized, placebo-controlled, double-blind clinical study was conducted to test the hypothesis that topical TAC and intradermal lidocaine are equally efficacious with respect to patient compliance with the suturing process, ie, anesthetic application and placement of sutures, and development of wound complications. Patients less than 18 years old, with lacerations 5 cm or less in length, located in well vascularized, nonmucous membrane areas were included. Patients were entered into the intradermal or topical groups; the intradermal group received lidocaine and the topical group was randomized to receive either TAC or placebo. One hundred fifty-one patients were enrolled in the study. There was no significant difference in the rates of successful initial anesthesia with TAC (89%) and lidocaine (79%). TAC was significantly better (P less than .002) with regard to patient compliance with the suturing process than lidocaine or placebo. Seventeen percent of patients who received placebo had initial anesthesia. These results suggest that TAC, when applied correctly, may be the preferred anesthetic for laceration repair in children.

Administration, Topical↗
PubMed1989

Acute diarrhea in children.

Acute diarrhea is a common problem in children. Understanding the different pathologic processes that cause diarrhea, and the agents that are associated with those processes, can aid the clinician in predicting the etiology of the diarrhea in an individual patient. Small bowel involvement, most commonly caused by Rotavirus, produces a high incidence of vomiting, often before the onset of diarrhea, and large, watery, and relatively infrequent stools. Large bowel involvement, usually due to Campylobacter, Salmonella, or Shigella produces frequent, often bloody stools containing leukocytes. Treatment of diarrhea should be focused on correcting dehydration, principally with oral rehydration solutions containing appropriate concentrations of electrolytes and carbohydrates. Early refeeding, avoiding foods containing lactose, should be considered for most pediatric patients with acute diarrhea. Antimicrobial therapy should be reserved primarily for parasitic infectious, pseudomembranous enterocolitis, and the early stages of a Campylobacter dysentery. The etiology of acute pediatric diarrhea can be predicted in most patients and early, appropriate treatment can be instituted.

Acute Disease↗
PubMed1985

Clinical predictors of acute bacterial diarrhea in young children.

This prospective study assessed the value of presenting history, physical examination, and screening laboratory tests in predicting whether diarrhea in a young child is associated with a stool culture positive for a bacterial pathogen. Acutely ill children less than 4 years old were studied in a hospital outpatient setting. Two hundred patients were seen in a 9 1/2-month period, which encompassed the seasons of summer, fall, and winter. One hundred ninety-five patients had cultures completed and twenty-nine (15%) had a bacterial pathogen isolated. The best predictive variable for a stool culture positive for a bacterial pathogen was the presence of polymorphonuclear cells in the stool, with a sensitivity of 85%, a specificity of 88%, and positive and negative predictive values of 59% and 97%, respectively. A cluster of three historical variables--abrupt onset of diarrhea, greater than four stools per day, and no vomiting before the onset of diarrhea--was identified that delineated a subpopulation of patients with an increased probability of having a stool culture positive for a bacterial pathogen (27% v 4% if any of the three variables was absent). It is suggested that these findings can be combined in a stepwise manner using the historical cluster as an initial screening, followed by examination for stool polymorphonuclear cells in the high probability subgroup, to identify those patients with a very high probability of having a bacterial pathogen isolated in their stool.

Aeromonas↗