Factitious hematuria and self-induced Candida albicans fungemia.
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Adult↗
Biomedical subjects
G H Gordon
Publications and source records attributed to G H Gordon.
Mood changes during the internship.
A prospective study using two standardized psychological tests, the Profile of Mood States (POMS) and the Self-Rating Depression Scale (SDS), was conducted in an effort to quantify the emotional changes experienced by internal medicine house staff members during the internship. In contrast to instruments used in previous investigations of this type, the POMS and the SDS are standardized tests with proven reliability and validity. The six mood factors measured, "tension-anxiety," "depression-dejection," "anger-hostility," "vigor-activity," "fatigue-inertia," and "confusion-bewilderment," are reported to be among those factors most often affected by the internship experience. Twenty-three interns completed both tests at four-month intervals during one academic year. One-way analysis of variance for repeated measures revealed that the level of only anger-hostility of the mood factors changed significantly during the year. The intensity of this factor increased between the first and third testing periods before dropping at the end of the year. In contrast to findings in previous studies, the depression and fatigue factors did not increase during the year. By characterizing interns' reactions to the stresses of postgraduate medical education, standardized psychological tests can contribute to improved understanding of these reactions and to more intelligent planning of support systems.
Anger↗
Somatization in primary care: patients with unexplained and vexing medical complaints.
Somatizing patients experience or express emotional discomfort and psychosocial distress as physical symptoms. Somatization occurs in a broad spectrum of illnesses, in association with a wide variety of mental disorders, including depression, anxiety, and the somatoform disorders. Primary care providers must detect and treat these patients. Diagnosis is based on positive criteria. Care rests upon conservative medical management and evaluation; a physician-patient relationship based on acceptance, caring, and trust; reinforcement of positive behaviors and elimination of destructive ones; and the gradual use of the relationship to promote healthy relating in the patient.
Anxiety Disorders↗
Stress during internship: a prospective study of mood states.
Mood changes of interns during the internship year were studied using the Profile of Mood States (POMS), a standardized adjective checklist. All 35 interns in the University of California, Irvine-Long Beach Medical Program completed the POMS at internship orientation and at five other times during the year. Of the six mood factors measured by the POMS, four changed significantly during the testing period. Anger-hostility scores were higher (p less than 0.01) in December than at orientation and remained so throughout the year. Tension-anxiety scores were higher (p less than 0.01) and fatigue-inertia scores were lower (p less than 0.01) at orientation than at any other time during the year. Vigor-activity scores were higher (p less than 0.01) at orientation than at the end of the year. Depression-dejection and confusion-bewilderment scores did not change significantly during the study period. Recognition of these mood changes is helpful for drawing the attention of house staff and faculty members to emotional stresses of training, and for identifying issues for discussion in intern support groups.
Adult↗
Sex and the teacher--learner relationship in medicine.
As the numbers of women medical students, residents, and faculty increase, sexuality in teacher-learner relationships will present challenges for individuals and institutions. Ethical and legal guidelines regarding sexual harassment and contact already exist for many medical schools, hospitals, and professional organizations, as well as state and federal law. Individuals and institutions can begin to address these issues through policy development and educational sessions addressing human sexuality, communication skills, and the process of becoming a physician.
Adult↗
The teacher simulation exercise: changes in physician teaching emphasis and strategy. The SGIM Task Force on the Medical Interview.
OBJECTIVES: The objective of the study was to determine the effect of a faculty development course in teaching medical interviewing on participants' ability to provide effective feedback to interviewers. DESIGN: The study used a non-concurrent control group design which randomized subjects into two groups before the intervention. The two groups completed different pre-tests; each group then completed the other group's pre-test as its post-test. The post-course scores of one group were compared with the pre-course scores of the other group to establish differences. SETTING: The research was conducted at the 1985 faculty development course sponsored by the SGIM Task Force on the Medical Interview. PARTICIPANTS: 49 of 52 teachers of medical interviewing attending the course completed the study. INTERVENTION: The week-long intervention consisted of a variety of educational activities which assisted the participants in defining and actively pursuing their learning objectives in interviewing, teaching, and self-awareness. MEASUREMENTS AND MAIN RESULTS: In their assessment of two videotaped segments of initial medical visits, participants were more likely after the course to comment on the interviewer's lack of attention to patient affect (69.0% versus 27.2%, p = 0.005 in one segment) and somewhat more likely to identify teaching strategies that actively involved the interviewer (47.2% vs. 35.0%, p = 0.09 in one segment). Both shifts were congruent with assessments made by course faculty. CONCLUSIONS: Faculty development can influence teachers to recognize the need to provide feedback on skills that expert teachers would emphasize. The non-concurrent control group design provides an innovative approach to common constraints in evaluating faculty development courses.
Curriculum↗