A longitudinal study of family practice residents' attitudes toward alcoholism.

BACKGROUND AND OBJECTIVES: This study sought to analyze whether the experience of residency training at a public hospital where alcoholism is highly prevalent, combined with a didactic program emphasizing community resources, would result in changes in residents' baseline attitudes. Previous research has suggested that alcoholism-related attitudes are therapeutically important. METHODS: Forty-three family practice residents took the Marcus Alcoholism Questionnaire at the beginning, and at the end, of their 3-year training program. Initial scores were compared with an "expert" sample (Toronto Alcohol and Drug Research Foundation). Residents' initial and final scores were also compared. RESULTS: Residents' entry attitudes were similar to those of the "expert" sample. On six of nine scales, there were no significant changes between entry and exit attitudes. At final testing, however, residents were significantly more likely to agree that a periodic excessive drinker can be an alcoholic (t = -3.15, P < .01), that alcoholism is not an illness (t = -2.57, P < .05), and that alcoholism is a harmless voluntary indulgence (t = 2.08, P < .05). However, exit means for the latter two scales still remained in a functional category, when compared with the expert sample. CONCLUSIONS: Resident attitudes did not show any substantial deterioration during the course of training. The structured curriculum emphasizing community resources and positive role models may have counterbalanced the frustrations of the clinical training site.

Resident evaluation of a family practice residency journal club.

This study sought to identify the attitudes of family practice residents toward journal clubs and the effect that preparing a journal club session has on the resident's view of the medical literature. Residents from Valley Medical Center were prospectively assessed over a three-year period. Residents selected the improvement of critical appraisal skills as the most important journal club goal. However, they reported that their journal club experiences did not improve their opinions of the journals selected. The results are discussed in the context of recent trends in journal clubs.

Pain relief associated with a religious visitation: a case report.

A 68-year-old black woman tolerated partial colectomy for resection of a carcinoma with minimal postoperative discomfort and without the need of any analgesia. She attributed her positive experience to the presence of protective angels. Psychologic interviews and testing revealed her to be fully in touch with reality. Her experience, as well as those of similar patients reported in the medical literature, has biological, sociocultural, and psychological components. The role of religious belief in the pain experience has received scant attention, but it constitutes a challenging area for future research.