A survey of 330 internal medicine residency directors found two-thirds of programs had ongoing academic affiliations. Support for the arrangements was stronger in university programs than in community or other hospitals, where such affiliations were considered less equitable and mutually trusting. Experience with consortia mitigated objections to…

As internal medicine residency programs struggle to produce enough general internists adequately prepared for practice, the graduate medical education system must have a clear picture of what competencies these practitioners will need. It must constantly monitor the changing practice environment and its varied generalist career choices.…

Item response theory's (IRT) suitability for medical examination data was examined, using data on 2,000 candidates who took the 1980 and 1982 American Board of Internal Medicine Certifying Examinations. Focus was on determining whether the tests met IRT assumptions and applying one-parameter and three-parameter IRT models to the data. (TJH)

A study investigated performance of 51 second-year internal medicine residents on an objective structured clinical examination and analyzed the test's role in evaluating clinical competence. The examination included nine physical diagnoses and several test-interpretation stations. Performance was analyzed statistically and correlated with…

Medical education's current goal of producing 50% generalists, composed of practitioners in internal medicine, family practice, and pediatrics, is examined. Issues include the definition of generalist, the number of generalists needed, changes needed in graduate and undergraduate medical education, changes needed in the practice environment, and…

A preceptorship in an internal medicine clerkship at Southern Illinois University School of Medicine is discussed and evaluated. The results of a telephone survey indicate that the preceptorship had an important impact on the students, who learned time management, office management, and management of chronic clinical problems. (MLW)

A study investigated possible differences in standardized patient examination scores for three groups of undergraduate (n=176) and graduate (n=221) medical students assessed at different sites over two years. Results show no systematic change in scores over testing dates, suggesting no problems with breach of test security. (MSE)

The development, validation, and use of a multiple-choice test to assess physicians' knowledge of current approaches to diabetes management is outlined, and the test's current use among family practice and internal medicine physicians, residents, and medical students is described. (MSE)

A problem-based continuing medical education program to improve the diagnosis and treatment of alcoholism by primary care physicians used a computer-simulated patient, individualized feedback, and a follow-up reading. Participating physicians felt the program improved their performance, but the results could not be substantiated. (MSE)

A study of 28 medical residents' skills in evaluating research compared student evaluations of a journal article with 1 developed by means of a Delphi technique utilizing 5 experts. Residents' scores were not significantly associated with residency year or self-assessed critical appraisal skill. The method is proposed as an objective means of…

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…

The University of Rochester has developed a third-year medical school clerkship in which students spend the second half of the clerkship in the offices of practicing internists. Participating faculty are carefully chosen and trained. Experience indicates the approach is feasible, academically effective, and acceptable to students and faculty.…

It is proposed that medical schools recruit students from rural areas, have them choose family practice, and train them in rural settings. Specific recommendations for improving content and context of rural medical care education are made, including merging internal medicine, family practice, and pediatrics as a single primary care specialty.…

A study of precepting conversations between 11 pairs of internal medicine interns and faculty preceptors found strategies used to correct the interns consistent with pedagogic norms favoring discovery learning and with societal norms favoring egalitarianism and respect for individuals. However, this raises questions about effects on interns'…

A study at the University of Vermont investigated the effectiveness of using a continuous quality improvement (CQI) cycle for teaching internal medicine residents the importance and techniques of psychosocial evaluation in patient examinations. Social workers audited students' examination data and provided feedback. The method was found to improve…