Increasing physician awareness of the common uses and contraindications of herbal medicines: utility of a case-based tutorial for residents.

OBJECTIVES: To determine the need for incorporating herbal medicine into residency curricula and to assess efficacy of a case-based tutorial. DESIGN: Pilot survey of residents' knowledge, practice, and desire to learn about herbal remedies indicated need for instruction. A case-based tutorial was given as a required conference for residents. Participants were pretested, post-tested within 2 weeks, and their satisfaction evaluated. The pretest, tutorial text, and post-test were distributed at clinic to residents who had missed conference. The tutorial was also placed online. SETTINGS/LOCATION: Stony Brook University Hospital and Northport VA Medical Center, affiliates of the State University of New York at Stony Brook, School of Medicine, Stony Brook, NY. They serve a suburban/rural population. SUBJECTS: Eight-two (82) residents were pretested (49 medicine, 7 preventive medicine, 12 family medicine, 10 obstetrics-gynecology, and 4 anesthesia). Sixty-six (66) participated in the tutorial. Residents in the pilot group (n = 12) graduated before the tutorial was given. It was not offered to anesthesia residents (n = 4). Because of scheduling, only 37 tutorial participants were available for post-testing. INTERVENTION: Tutorial on uses, contraindications, and drug interactions of popular herbal medicines was presented as a live session, text-only exercise, and online. RESULTS: Pretest scores revealed a knowledge deficit, room for improvement in doctor-patient dialogue, and demand for instruction on herbal medicine. The mean knowledge score of all post-tested participants (n = 37) rose from 34% to 61% (p < 0.0001). The live lecture group (n = 29) increased from 32% to 63% (p < 0.0001). The text-only group (n = 8) increased from 40% to 55% (p = 0.004). Satisfaction was high. Residents did not access the online tutorial, so it was not evaluated. CONCLUSIONS: Residents request instruction on uses, contraindications, and drug interactions of herbal medicines and should ask patients about use more routinely. A live, case-based tutorial appears effective for introducing herbal medicine into residency curricula.

A hypothesis on the most prevalent psychological type for chief residents in the field of internal medicine.

Communication is the key to good doctor-patient relations. Resident learning occurs through the process of observation and role modeling. We hypothesize that the most prevalent personality type for chief residents will be in discordance with the most prevalent type (Sensor) in the general population. We set out to determine the communication styles of a national sampling of recent chief residents in the field of medicine. The survey based on Jung's Psychological types: thinker, feeler, the intuitor and sensor. Overall self report of psychological types revealed the majority, both male and female (45.6%) to be in the 'feeler' category. Feelers are described as persons with a high need for interpersonal harmony. They value compassion and empathy and enjoy meeting other people's needs.

The morphology of the fourth abdominal ganglion of the hermit crab: A light microscope study.

The hermit crab, Pagurus pollicarus, has the same organization in its fourth abdominal ganglion as its macruran relatives in spite of the reduction in abdominal muscles, sensory receptors, and appendages. Connective axons are grouped into discrete bundles between which five groups of commissural fibers run to connect left and right sides. The neurites of ventral cell bodies run dorsally in characteristic groups between the connective bundles. The hermit crab fourth ganglion has two thirds as many cells as the crayfish and is laterally compressed. This reduction appears related to the reduction in the sizes of the ganglionic roots. The ventral fine fibered neuropil is larger on the left than the right side reflecting the loss of pleopods on the right side. The basic organization of decapod abdominal ganglia appears to permit considerable integrative flexibility within a relatively conservative morphological framework.