Studies of doctor-patient communication generally advocate a partnership communication style. However, in Southeast Asian settings, we often see a more one-way style with little input from the patient. We investigated factors underlying the use of a one-way consultation style by doctors in a Southeast Asian setting. We conducted a qualitative…

Systems-based practice (SBP) is rarely taught or evaluated during medical school, yet is one of the required competencies once students enter residency. We believe Texas A&M College of Medicine students learn about systems issues informally, as they care for patients at a free clinic in Temple, TX. The mandatory free clinic rotation is part of…

Learning theories, which suggest that experienced faculty use collaborative teaching styles, are reflected in qualitative studies of learners in hospital settings. However, little research has used resident focus groups to explore characteristics of successful teachers in outpatient clinics. Therefore, focus group discussions with first through…

Contradictory data exist regarding optimal methods and instruments for intimate partner violence (IPV) screening in primary care settings. The purpose of this study was to determine the optimal method and screening instrument for IPV among men and women in a primary-care resident clinic. We conducted a cross-sectional study at an urban, academic,…

Background: Adaptation to learning styles has been proposed to enhance learning. Objective: We hypothesized that learners with sensing learning style would perform better using a problem-first instructional method while intuitive learners would do better using an information-first method. Design: Randomized, controlled, crossover trial. Setting:…

Some of the differences between in-hospital and ambulatory medicine and their implications for the teaching and practice of ambulatory care are explored. The availability of time, the role of patient cooperation, and the decision-making process differ in the two settings. (MLW)

A total of 200 patients were interviewed at 2 out-patient settings to quantify the patients' perspectives on their illness by measuring their requests for help. Results showed specific requests were made by most patients that focused either on the problem and/or the treatment. (GLR)

An ambulatory medicine program for university hospital clinic residents was found to be effective in improving students' knowledge, enhancing attitudes toward the clinic, and improving performance of influenza vaccinations. No adverse program effects were found. (MSE)

An academic general medicine clinic (GMC) was studied and profiles were generated to determine current patterns, shortcomings, and potential solutions. Conclusions include that GMC offers insufficient variety of patient presentations for optimal postgraduate medical education and inadequate accessibility for comprehensive medical care. (Author/JMD)

A review of 287 patient visits to a teaching hospital polyclinic shows that most patients had multiple problems that required the help of subspecialists. However, the patients' needs for accessibility, comprehensiveness, coordination, and continuity are as great as those of patients receiving primary care. Implications for academic internal…

A cost containment program initiated in 1975 on the medical teaching service of Charlotte Memorial Hospital, a University of North Carolina affiliated hospital, has led to a significant improvement in hospital house staff utilization of facilities and procedures. In the outpatient setting an actual reduction in patient-encounter cost was realized…

The implementation of a continuity of a care clinic in a highly subspecialized Veterans Administration internal medicine training program for postgraduate medical students is described, with focus on resolving problems created by the idiosyncratic administrative features and resource limitations of the hospital. (Author/JMD)

We have set out to investigate an approach to improve patients' ability to self-manage chronic illness. For effective health care in chronic disease, we believe patients need to work in partnership with their doctor; patient-centred consultations are one way to achieve this. This report describes our experience of training specialists in…

Internal medicine residency programs that put increasing emphasis on outpatient experience and continuity of care place demands on residents that conflict with inpatient responsibilities. The development and implementation at the University of Virginia Hospital of a rotational scheduling system aimed at alleviating the conflict is described.…

The purpose of this study was to assess the effect of organizational changes in the general medicine clinic on residents' and patients' satisfaction, including their perceptions of the quality of care. Questionnaires to assess satisfaction were administered to the residents (N=80) and patients (N=577) using a pre- and posttesting design. (MLW)