The advanced clinical skills program in medical interviewing: a block curriculum for residents in medicine.

OBJECTIVE: This study sought to demonstrate whether an intensive block curriculum would lead to learning of basic medical interviewing skills by first year residents in medicine. METHOD: Pairs of brief clinical interviews done before and after a four week block program in medical interviewing were rated using the Rhode Island Hospital Interview Checklist (RIC). The data were analyzed using the McNemar Test to look for possible improvement following the course. RESULTS: Of the nineteen categories measured, fourteen showed statistically significant improvement (p < .05) in Year 1 and twelve in Year 2. Combining the data for the two years gave statistically significant results in sixteen of the nineteen categories. CONCLUSIONS: An intensive block curriculum in medical interviewing led to a significant degree of learning of basic skills by first year medical residents as judged by interviews done at the end of the block. The intensive approach also allowed for a degree of personal growth and solidification of identity as a physician. These factors can be expected to influence interviewing proficiency as well.

Spectrum of diseases for resident education in internal medicine.

We examined the spectrum of diseases to which medical residents were exposed in a fully integrated residency program comprised of a voluntary and a municipal acute-care hospital. Although circulatory disorders and diseases of the respiratory and nervous systems accounted for the majority of cases, a broad spectrum of diseases was present for residents' training at both institutions. These observations must be considered within the context of the changing nature of medical practice in the United States, with a marked shift from inpatient to outpatient and office medical care.

Temperature dependence in the effect of ouabain on rabbit atria.

Quiescent rabbit left atria were exposed to ouabain for 200 min at various temperatures ranging from 27 degrees to 35 degrees C. Effects produced by the drug were noted when stimulation of the atria was resumed. At or below 31 degrees C, little effect on stimulation was seen and approximately 80 min were required to reach maximum effect of the drug. At and above 32 degrees C, effects could be seen immediately upon stimulation and only 45 min were required to reach maximum effect. In the range from 31 degrees to 32 degrees C, an increment of as little as 0.25 degrees altered both the time to reach maximum effect and the maximum force obtained. Experiments with tritiated ouabain showed no difference in uptake of the drug by atria, whether beating or quiescent, at 30 degrees C or 35 degrees C. Possible mechanisms are discussed.