Exploring Family Medicine Residents' Experiences Teaching Medical Students.

INTRODUCTION: Near-peer teaching offered by residents is common in a medical students' educational career, so preparation of residents for their role as teachers is essential. Understanding resident perspectives on interactions with medical students may provide insight into this near-peer relationship and allow stakeholders to emphasize concepts that add value to this relationship when preparing residents to teach. This study presents the results from an inquiry focusing on a cohort of family medicine residents' experiences with medical students in their role as teachers. METHODS: Family medicine residents at a Southeastern US academic medical center participated in one of three focus groups to assess resident perceptions of their role in teaching students and approaches employed. We coded focus group transcripts for themes. RESULTS: Themes identified from questions on residents' perceptions of teaching role and employed teaching approaches focused on teaching interactions and methods. Six categories of major themes were derived from this qualitative analysis: (1) the learning environment, (2) stimulating learning, (3) supervising, (4) role modeling, (5) collaborating, and (6) transferring knowledge. Trends within these categories include creating a safe environment for clinical reasoning and inquiry, setting expectations, developing clinical reasoning skills through practical application of knowledge, providing appropriate student supervision and autonomy, and including students as part of the team. CONCLUSIONS: Residents adopted a variety of teaching approaches that assist medical students in their transition into and ability to function within a clinical environment. Findings from this study have implications for program directors and educators when preparing residents as teachers.

Gallbladder Dysfunction: Cholecystitis, Choledocholithiasis, Cholangitis, and Biliary Dyskinesia.

The prevalence of gallstones is 10% to 15% in adults. Individuals with acute cholecystitis present with right upper quadrant pain, fever, and leukocytosis. Management includes supportive care and cholecystectomy. The prevalence of choledocholithiasis is 10% to 20%, and serious complications include cholangitis and gallstone pancreatitis. The goal of management in individuals with choledocholithiasis consists of clearing common bile duct stones. Acute ascending cholangitis is a life-threatening condition involving acute inflammation and infection of the common bile duct. Treatment includes intravenous fluids, analgesia, intravenous antibiotics, and biliary drainage and decompression. Biliary dyskinesia includes motility disorders resulting in biliary colic in the absence of gallstones.

Specialty Recertification.

The recognition of specialty boards started with the National Board of Medical Examiners and eventually gave rise to the Liaison Committee for Specialty Boards. The most appealing feature of any organization is its ability to provide quality of care. Because the timeframe for recertification may vary greatly among specialties, an approach that encourages physicians to participate in ongoing education between the 6- to 10-year certification deadlines is encouraged. Recertification demonstrates the physician's knowledge of new, innovative practices true competency, however, should encompass a physician's overall knowledge and ability to provide care that is both appropriate and effective. The standardization of healthcare is more evident now with healthcare reform underway, and with changes in the system. A physician's services need to be acceptable, and certification is a step in assuring that a standard of care is being met.