Search PubMed⌕ Search

Biomedical subjects

D Campos-Outcalt

Publications and source records attributed to D Campos-Outcalt.

At least 19 recordsLinked to original sources
PubMed2003

Motor vehicle crash fatalities by race/ethnicity in Arizona, 1990-96.

OBJECTIVE: To compare rates of motor vehicle crash (MVC) fatalities among different race/ethnic groups in urban and rural Arizona. METHOD: Using the Fatality Analysis Reporting System and the National Center for Health Statistics Multiple Cause of Death file, MVC fatalities in Arizona from 1990-96 inclusive were classified by gender, race/ethnicity, and urban or rural residence. Age adjusted rates of total, occupant, pedestrian, and alcohol related fatalities were calculated. The total MVC fatality rate for each race/ethnic group was then adjusted for proportion of rural residence. RESULTS: Compared with non-Hispanic whites (NHWs), American Indians had raised relative risks for MVC fatality in all gender and residence subgroups. Hispanic females and rural Hispanic males had lower relative risks, as did rural African-American men. Raised relative risks for American Indian men and women included all subgroups: total, occupant, pedestrian, and alcohol related. Hispanic and African-American men both had raised relative risks of pedestrian related fatalities, and Hispanic men had a slightly higher relative risk while Hispanic women had a lower relative risks, for alcohol related fatality. Hispanic men and women and African-American men had lower occupant fatality rates. Close to half (45%) of the excess MVC fatality among American Indians can be attributed to residence in rural areas, where MVC fatality rates are higher. There were 1.85 occupants in crashes involving NHW deaths compared with 2.51 for Hispanics and 2.71 for American Indians (p<0.001). The proportion of occupants not using a seatbelt was higher in Hispanics and American Indians in both urban and rural areas. CONCLUSION: The major disparity in MVC fatality in Arizona is among American Indians. The higher MVC fatality rates among American Indians occur in all age groups, in both urban and rural areas, and among occupants and pedestrians. Rural residence, lower rates of seatbelt use, higher rates of alcohol related crashes, a greater number of occupants, and higher rates of pedestrian deaths all contribute to the American Indian MVC fatality disparity. High rates of pedestrian fatality occur in men in all three race/ethnic minorities in Arizona and among American Indian women. In contrast to other studies, African-Americans and Hispanics did not have raised total MVC fatality rates and compared to NHWs actually had lower rates in the rural areas of the state.

Accidents, Traffic↗
PubMed1999

A longitudinal, national study of the effect of implementing a required third-year family practice clerkship or a department of family medicine on the selection of family medicine by medical students.

PURPOSE: To conduct a longitudinal study of the effect of implementing a required third-year family practice clerkship or a department of family medicine on the proportion of graduating medical students choosing family practice as a specialty. METHOD: Using national data sets, the authors studied the proportion of students who chose family practice as a specialty at each medical school that implemented a required third-year family practice clerkship or a department of family medicine between 1984 and 1993. They compared the mean proportions of students choosing family practice for the three years before and three years after implementation of the required clerkship or the department. They controlled for national trends by comparing study schools with schools that did not have required family practice clerkships. RESULTS: The mean proportions of students who chose family practice increased 2.36% above control schools (95% CI = 1.06, 3.65) in public schools and 2.07% (95% CI = -2.58, 6.73) in private schools after a required third-year clerkship was implemented. The proportion of students choosing family practice declined by 0.84% (95% CI = -4.05, 2.47) after a department of family medicine was established. CONCLUSION: Implementing a required third-year family practice clerkship led to an immediate, significant increase in the proportion of students choosing family practice. Implementing a department of family medicine had no noticeable effect on the proportion of students choosing family practice in the first three years after implementation.

Career Choice↗
PubMed1999

Correlations of family medicine clerkship evaluations and Objective Structured Clinical Examination scores and residency directors' ratings.

BACKGROUND AND OBJECTIVES: This study validated the evaluation methods used in a family medicine clerkship by comparing students' scores to how students are rated in their first year of residency by residency directors. The clerkship evaluations consisted of three components: problem solving in small groups, clinical evaluations, and a final examination. These components were combined to form a composite clerkship score. Residency director ratings consisted of 20 individual scores and an overall average. METHODS: Scores received by students in the clerkship were correlated with ratings by residency directors given toward the end of the first year of residency. The correlations between Objective Structured Clinical Examination (OSCE) scores and residency directors' ratings were used as comparison. RESULTS: The composite clerkship score correlated with the director's rating, overall average, at r = .278. The highest individual component correlation was achieved by the clerkship final exam (r = .269). The total OSCE score correlated with the director's rating overall average at r = .304. CONCLUSIONS: This study provides evidence that, while not perfect, the family medicine clerkship evaluations perform nearly as well as the OSCE as a predictor of how students will be rated by their residency directors in their first year of residency.

Arizona↗
PubMed1997

A systematic analysis of how medical school characteristics relate to graduates' choices of primary care specialties.

PURPOSE: To examine medical school characteristics, in particular federal funding for biomedical research, as they relate to the graduates' choices of family medicine, general internal medicine, general pediatrics, or all three specialties. METHOD: Data were collected for 121 U.S. medical schools, including information on funding, faculty, curricula, and other school characteristics. In addition, a questionnaire was mailed to the schools requesting information about non-federal funding for primary care, primary care department characteristics, and primary care representation on the admission, curriculum, and promotion and tenure committees. Analyses were carried out separately for each specialty and for all three combined. The first multiple regression analysis was done to predict specialty choice (proximate predictors), the second to predict the predictors of specialty choice (intermediate predictors), and the third to predict those predictors (distal predictors). RESULTS: Prediction was best for family medicine practice. Interest at matriculation and required third-year and fourth-year time in primary care were the two best proximate predictors. The best predictors of initial interest were the percentage of rural students and special programs for primary care, while the best predictors of required time in primary care were funding for family medicine and the percentage of faculty in family medicine (intermediate predictors). The best predictor of the percentage of faculty in family medicine was funding for family medicine (distal predictor). CONCLUSION: The results suggest that the most effective way to increase the number of physicians with generalist practices is to increase the number of students interested in a family medicine career at matriculation.

Career Choice↗
PubMed1997

Commitment to the underserved: evaluating the effect of an extracurricular medical student program on career choice.

BACKGROUND: This study was conducted to compare the practice locations and characteristics of physicians who participated as medical students in an extracurricular program to foster interest in careers of service to medically underserved populations with those of their classmates who did not participate in the program. METHODS: Using a mailed questionnaire, we conducted a cross-sectional study of graduates from the classes of 1983-1987 at one southwestern, public medical school. All Commitment to Underserved People (CUP) participants (n = 94) and a random sample of nonparticipating classmates (n = 188) were surveyed. CUP is an extracurricular project with components in each of 4 years of medical school that provides peer and faculty support, curriculum enrichment, and direct service to medically underserved populations. Outcome measures included the size of community of practice, practice type, and practice patient characteristics. RESULTS: Sixty seven (71%) of CUP participants and 126 (67%) of nonparticipants responded. CUP participants were more likely to be women, to specialize in family practice, to practice in the Indian Health Service (IHS) or overseas, to be located in a community of 25,000 or less, and to have participated in the state, service-payback loan program. In multiple regression, the specialty of family practice was associated with practice in a small community, the IHS, and a community health center; CUP participation was correlated with practice in small communities, the IHS, and a foreign country. CONCLUSIONS: Participation in the CUP program was associated with the specialty choice of family practice and with practice in settings associated with medically underserved populations. The CUP program has been successful in sustaining entering medical students' interests in underserved practice.

Journal Article↗
PubMed1997

Motor-vehicle crash fatalities among American Indians and non-Indians in Arizona, 1979 through 1988.

OBJECTIVES: This study evaluated the contributions of rural residence, alcohol use, and pedestrian fatalities to the high American Indian motor-vehicle crash mortality rate in Arizona. METHODS: Records from the Fatal Accident Reporting System were used to examine mortality rates between 1979 and 1988. RESULTS: American Indians had increased relative risks in all motor-vehicle crash categories in all residence-gender groups. The percentage of excess mortality associated with alcohol varied from 36.8% to 66.7%, and the percentage associated with pedestrian deaths ranged from 27.2% to 55.4%. CONCLUSIONS: Efforts to reduce excess motor-vehicle crash mortality among American Indians should concentrate on preventing pedestrian and alcohol-related fatalities.

Accidents, Traffic↗
PubMed1995

Decentralization of health services in Western Highlands Province, Papua New Guinea: an attempt to administer health service at the subdistrict level.

In 1990, Western Highlands Province in Papua New Guinea, decentralized the administration of health services from the province (population 264,000) to 14 districts (equivalent to subdistricts elsewhere). Two years later interviews were conducted with health workers and district and provincial heads. Productivity data were obtained from the provincial health information system and financial data from the provincial and national budgetary report. Health workers had a predominately negative opinion of the results of the decentralization. The most common complaints listed were lack of qualifications of District Assistant Secretaries, a diversion of funds to other programs, unavailability of transportation, a lack of equity in personnel between districts and a lack of adequate professional supervision. The problems which developed in this attempt at further decentralization related to a lack of professional support and oversight of health professionals, a lack of role definition for provincial and district administrators, lack of management training for district officials, inadequate oversight by local elected officials and inadequate budgets.

Adolescent↗
PubMed1995

The effect of a required third-year family medicine clerkship on medical students' attitudes: value indoctrination and value clarification.

BACKGROUND: The effect of a required six-week third-year family medicine clerkship was examined within a framework of professional socialization. Socialization was considered to consist of an institutional process, i.e., value indoctrination, and a learner process, i.e., value clarification. METHOD: Pre- and postclerkship data from 1,095 students (classes of 1981-1993) at the University of Arizona College of Medicine were analyzed. In addition, specialty match data were obtained. Factor analysis of 19 items on the pre- and postclerkship questionnaires was used to derive four scales measuring attitudes related to family medicine. The students were first grouped into four groups: those who preferred family medicine before and after the clerkship, those who preferred other specialties both times, those who switched to family medicine, and those who switched away from family medicine. Then the students were grouped into eight groups by dividing each of the specialty-preference groups into two sections: those who matched to family medicine and those who did not. Statistical comparisons involved the use of the t and F statistics. RESULTS: Usable data were available for a maximum of 997 students (91%). The students' attitudes about family medicine changed during the clerkship to become more consistent with their postclerkship specialty preferences. In addition, more students preferred family medicine after the clerkship than before it. When each group was further divided into those matching and not matching into family medicine, no significant difference in attitudes was found between those matching and those not matching. CONCLUSION: These results reflect both a value clarification process and a value indoctrination effect. The discrepancy between postclerkship specialty preferences and later match data indicates that the indoctrination effect and clarification process continue into the fourth year.

Arizona↗
PubMed1995

The effects of medical school curricula, faculty role models, and biomedical research support on choice of generalist physician careers: a review and quality assessment of the literature.

The authors evaluated and reviewed the literature on the effects of medical school curricula, faculty role models, and federal biomedical research support on the specialty choices of U.S. medical students. All 275 articles on these subjects published from 1984 through 1993 were considered. An instrument was developed to assess the quality of the articles. A total of 85 articles met study criteria and were reviewed. The mean score achieved was 42.7% of the total possible points. Major educational reforms emphasizing primary care have resulted in significant increases in the percentages of graduates choosing generalist careers. Except for required clinical training in family practice, individual curriculum components have generally not been successful. Students and physicians often stated that faculty role models influenced specialty choices, and there is some evidence that faculty composition is related to students' career choices. There was a consistent inverse correlation between the amount of federal biomedical research support received and the percentage of a school's graduates choosing generalist careers. It is unknown whether this relationship is causative and, if so, how research funds affect specialty choices. The best strategies to enlarge the proportion of medical students choosing generalist careers include institutional reform to emphasize generalist training, increasing the size of generalist faculty, and requiring clinical training in family practice. The relationship of federal biomedical research support to the specialty choices of medical students needs to be studied further. Research on specialty choice could be improved by including a larger number of schools and students, studying trends over several years, and using validated measures and outcomes, control groups, and multivariate analyses.(ABSTRACT TRUNCATED AT 250 WORDS)

Career Choice↗
PubMed1994

Performances of underrepresented-minority students at the University of Arizona College of Medicine, 1987-1991.

PURPOSE: To compare the academic performances of underrepresented-minority (African American, Native American, and Hispanic) students and all other students at the University of Arizona College of Medicine. METHOD: The performances of 42 underrepresented-minority and 368 other students who graduated between 1987 and 1991 were compared using the following variables: undergraduate science, non-science, and overall grade-point average (GPA); scores on the Medical College Admission Test (MCAT); subtest and total scores on the National Board of Medical Examiners (NBME) Part I and Part II examinations; and three types of evaluations from a required family practice clerkship. In addition, a comparison was made of scores on an objective structured clinical examination (OSCE) taken in the fourth year by 25 underrepresented-minority and 165 other students. Data were analyzed using a three-way analysis of variance and Pearson correlation analysis. RESULTS: The underrepresented-minority students earned significantly lower GPAs and scored significantly lower on all standardized paper-and-pencil tests and the family practice clerkship final examination. There was no significant group difference in the family practice clerkship clinical evaluations or the majority of the OSCE scores. For both groups, overall GPAs and MCAT scores correlated equally well with NBME total scores but were not significantly corrected with OSCE scores or family practice clerkship clinical evaluations. CONCLUSION: While the underrepresented-minority students entered medical school with significant educational disadvantages and continued to score lower than the other students on paper-and-pencil tests, their clinical performances on the OSCE and family practice clerkship were nearly equivalent to those of the other students.

Black or African American↗
PubMed1994

Occupational health epidemiology and objectives for the year 2000.

This article summarizes epidemiologic data available on work-related morbidity and mortality and describes the occupational health surveillance systems currently in use. The NIOSH top 10 priority occupational illnesses and injuries and the year 2000 objectives for occupational health are described. Finally, statistics regarding occupational medicine specialists are presented.

Accidents, Occupational↗
PubMed1994

Correlations of family medicine clerkship evaluations with scores on standard measures of academic achievement.

BACKGROUND: The family medicine clerkship at the University of Arizona uses three methods to evaluate students. The purpose of this study is to 1) look for possible sources of bias in each method, 2) validate the evaluation methods by correlating with other measures of academic achievement, and 3) measure the amount of correlation between the three evaluation methods. METHODS: The three clerkship evaluation methods include a final exam, clinical evaluations, and problem-solving scores. The clerkship evaluations received by 482 students were correlated with undergraduate grade point averages, MCAT scores, National Board of Medical Examiners parts I and II subtests and total scores, gender, age, race, college major, and timing of the clerkship. RESULTS: Females and older students scored higher on problem solving and minority students scored lower on the final exam. Students in the second half of the year scored higher on the final exam. There were significant correlations found between the final exam score and all the scores on standard measures of academic performance except the MCAT quantitative subtest. Problem-solving scores correlated only with NBME part II. The clinical evaluations correlated with five NBME part I subtest scores, three NBME part II subtest scores, and both parts I and II total scores. All three evaluation methods correlated significantly with each other. CONCLUSIONS: These analyses highlight the need to examine all evaluation methods used in order to improve their validity and reliability and to find potential biases. In addition, more work is needed to document the predictive validity of clerkship evaluations by correlating them with future clinical performance.

Age Factors↗
PubMed1993

Family medicine role models at US medical schools. Why their relative numbers are declining.

A decline in medical student interest in family practice combined with an increasing demand for family physicians by managed care systems and the need to replace family and general practice physicians nearing retirement age make it likely that the future supply of family physicians will not be adequate. Specialty selection by medical students is influenced by the medical education environment, especially the presence of faculty role models. Due to a decline in federal support for family medicine and a growth in sources of medical school support that favor nonprimary care specialties, the proportion of clinical faculty in family medicine has declined. This has occurred simultaneously with declining student interest in family medicine. Suggestions are offered to increase the number and influence of family medicine role models at US medical schools.

Career Choice↗
PubMed1992

Breast and cervical cancer screening in minority populations: a model for using lay health educators.

Although mammography and the Pap smear have significantly reduced US deaths related to breast and cervical cancers, screening prevalence and survival rates for both diseases are disproportionately lower among minority women. This model program outlines techniques for recruiting and training minority women to serve as lay health educators who can effectively deliver preventive health care information to their peers. Lay health educators have three primary functions: to serve as mediators between minority women and health agencies, to establish a social network, and to offer social support. When properly recruited and trained, these educators can bridge the gap between health professionals and the community as well as help health professionals to better understand community and individual concerns about cancer. The goal is to increase the detection, prevention, and treatment of breast and cervical cancers in minority communities and thus decrease related deaths. An ongoing intervention by the Arizona Disease Prevention Center, targeting Yaqui Indian and Mexican-American women aged 35 and older, illustrates specific elements of the model.

Arizona↗
PubMed1992

Family practice specialty preference before and after a required clerkship.

Medical students' specialty preferences before and after participation in a required third-year family practice (FP) clerkship were compared to National Resident Matching Program (NRMP) results. Of 714 students studied, 18 (2.5%) changed their specialty preference away from FP during the clerkship and 66 (9%) changed their preference to FP. Sixty-nine (70%) of students who maintained a preference for FP pre- and post-clerkship matched in FP. Seventy-two students changed their specialty preference to FP and 19 changed their preference from FP during the clerkship; 32% of each of these groups matched in FP. Those with both pre- and post-clerkship preferences for other specialties matched in FP at a rate of only 4% but constituted 18% of everyone entering the specialty.

Age Factors↗
PubMed1992

Trichloroethylene: environmental and occupational exposure.

Trichloroethylene is used in paint strippers, rug cleaners, spot removers, typewriter correction fluid and industrial cleaners. It is a common environmental contaminant, detected in over one-third of hazardous waste sites and in 10 percent of groundwater sources. Acute workplace exposure above acceptable levels can cause neurologic, respiratory and hepatic problems. The health effects of prolonged occupational and environmental low-level exposure are probably minimal, but whether such exposure poses a risk remains controversial. Although trichloroethylene has been shown to cause cancer in some animals, it has not been proven to be a human carcinogen. Trichloroethylene has been involved in several well-publicized cases of contamination of community water supplies, and family physicians are likely to receive questions about this chemical.

Animals↗