A Facilitated Peer Mentoring Program With a Dedicated Curriculum to Foster Career Advancement of Academic Hospitalists.

Introduction: In the field of hospital medicine, there is both a limited pool of senior faculty to mentor the rapidly growing number of junior faculty and a lack of career development curricula focused on scholarly activities specific to the needs of the hospitalist. These deficits have resulted in a disproportionately low number of academic hospitalists being promoted to associate and full professor. We implemented a facilitated peer mentoring program with a dedicated curriculum to foster career advancement of academic hospitalists. Methods: We recruited 29 academic hospitalists and divided them into five small groups, each guided by one senior faculty. Peer members participated in a 9-month curriculum consisting of alternating large- and small-group sessions that reviewed topics important for academic advancement. Quantitative analysis assessed feasibility of the program, as measured by participation and knowledge improvement on curriculum topics, with pre- and postprogram surveys. Results: Results demonstrated feasibility of the large-group sessions as measured through participation. Small-group participation was more variable. Pre- and postsurvey results showed significant knowledge improvement (p < .05) in nearly all of the curriculum topics. Discussion: Currently, there is a gap in both mentorship and scholarly skills of academic hospitalists. Our facilitated peer mentoring program with a dedicated curriculum can be used as a framework for other hospitalist programs to support career development.

Perceptions of Communication Between Emergency Medicine and Internal Medicine physicians.

As part of an institutional effort to develop an atmosphere of communication and encourage mutual appreciation of respective viewpoints, we used a cross-sectional survey to investigate the perceptions of emergency (EM) and internal medicine (IM) residents and faculty, particularly, their attitudes about collaboration, mutual respect, and mistreatment. This cross-sectional survey was administered to the EM and IM faculty and residents of a county, academic hospital with a Level 1 Trauma Center to evaluate each specialty's current perception of professional behavior and observations of unprofessional behavior in order to identify areas for improvement. The survey items were answered using a 5-point Likert scale and was analyzed using the unpaired t-test. A total of 68 residents and faculty completed the survey, 32 (59.4% residents) from EM and 36 (94.4% residents) from IM. Among all EM and IM clinicians, 48.6% felt that there was a culture of clinical collaboration. Approximately half of the respondents (51.5%) felt that the state of professionalism between the two departments was below that of other departments. About 10% (11.8%) of all respondents reported experiencing unprofessional behaviors from the other department at least once a month. Challenges identified by EM faculty and residents included time to consult, recommendations, and disposition. Challenges identified by IM included difficulty contacting EM providers and lack of communication regarding patient's clinical status changes. Both specialties emphasized the importance of improved patient care transitional processes. This study is an important first look at the prevalence of negative attitudes and misperceptions between EM and IM providers. These perspectives can occur due to breakdown of communication and differing expectations. Such asynchronies can cause a toxic workplace environment, diminished performance, and poor patient outcomes.

Moderate to severe depressive symptoms among adolescent mothers followed four years postpartum.

PURPOSE: To examine race/ethnic differences in depressive symptoms among adolescent mothers during the first four years postpartum. METHODS: A prospective study of 623 adolescent mothers, 18 years or younger followed four years after delivery. Depressive symptoms were measured using the Beck Depression Inventory (BDI). These analyses focused on data collected at 3, 12, 24 and 48 months postpartum. RESULTS: Overall, 57% of the sample reported moderate to severe depressive (MSD) symptoms during the four-year period. The steepest increase in the percent reporting new MSD symptoms occurred during the first 12 months after delivery. The prevalence of MSD symptoms was highest at three months (36.7%) and steadily declined through 48 months (21.1%) for all race/ethnic groups with one exception: a slightly higher percentage of African-Americans reported MSD symptoms at 48 (20.0%) than at 24 months (16.9%). Logistic regression analysis used to calculate the relative odds of experiencing MSD symptoms revealed higher odds of depressive symptoms for Caucasians (adjusted odds ratio [AOR] 2.0; 95% confidence interval [CI] 1.2-3.4) at three months, and for Mexican-Americans at both 12 (AOR 2.6; 95% CI 1.4-4.8) and 24 (AOR 2.2; 95% CI 1.1-4.4) months. MSD symptoms at three months were significantly related to MSD symptoms at 48 months for all race/ethnic groups (p < .001). CONCLUSIONS: More than 50% of adolescent mothers experience MSD symptoms during the first postpartum year. As a group, African-American adolescent mothers appear to have the lowest rates of MSD symptoms, but higher rates of recurrence, when compared with Mexican-Americans and Caucasians.

Internists and adolescent medicine.

Internists can assume a greater role in the provision of health care to adolescents. Adding an understanding of adolescent development to the skills and knowledge already possessed by internists will allow internists to interact more comfortably and effectively with adolescent patients. Learning about specific areas of importance such as adolescent morbidity and mortality, consent and confidentiality, interviewing techniques, and preventive health care will further enhance an internist's knowledge regarding adolescent health. There are numerous resources available to help intensive care for adolescent patients.