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Biomedical subjects

J Garrard

Publications and source records attributed to J Garrard.

54 records · Page 3Linked to original sources
PubMed1977

Comparisons of medical student experiences in rural and university settings.

This paper is a report of the results of the Patient Encounter Project, which was designed to document all clinical experiences of medical students (N = 36) for seven months in the Rural Physician Associate Program (RPAP) and to compare these experiences with those of a control group of third-year students (N = 26) enrolled in the regular curriculum during the same time period at the University of Minnesota Medical School, Minneapolis. The purpose of RPAP is to provide education and clinical experience in rural health care for a limited number of third-year medical students for nine to 12 months and to encourage the eventual practice of medicine in a rural setting. Subjects completed one standardized form for every clinical encounter with a patient throughout the seven months' data collection period. Statistical differences between the two groups were found on all variables but one, including the numbers and kinds of clinical problems encountered, the skills reported, levels of responsibility, continuity of patient care, and types of patients.

Clinical Competence↗
PubMed1976

Follow-up effects of a medical school course in human sexuality.

The effects of a course in human sexuality for a class of second-year male medical students are described. The course consists of two interacting components: a 2-day seminar and a 2-week didactic presentation. The purpose of the seminar is to develop humanistic understanding and tolerance of one's own and others' sexuality. The didactic presentation focuses on factual information. A variety of evaluation instruments were used, and students were tested precourse, postcourse, and at the end of 6 and 12 months. Results show a significant pre-post increase in tolerance in attitude and amount of knowledge. There appears to be some moderation in level of attitude and knowledge gain at the 6-months point, and significant increases from the precourse level to the 12-months point persist. Participants almost uniformly report personal benefit, with a significant number described greater satisfaction in their own sexual behaviour.

Adolescent↗
PubMed1975

Longitudinal study of medical students selected for admission to medical school by actuarial and committee methods.

This study evaluates a "mid period" follow-up evaluation of the outcomes of selection of medical students by customary committee review procedures versus actuarial selection. One-third of a freshman class was selected solely on the basis of a predictor index which was a previously validated, optimally weighted combination of scores on the Medical College Aptitude Test and the premedical grade-point average. The remaining two-thirds were selected by committee decision based on review of the total application file which, in addition to the aptitude test scores and academic record, included basic demographic data, information on extracurricular activities, avocational interests, work experience, letters of recommendation, personality test profiles, and interview impressions. In a previous study, it was reported that the two groups of students were undifferentiated with respect to their academic standing at the close of their sophomore year. In the present study, the actuarially selected and committee selected students were compared on class rank at the end of the junior year, total and subtest scores on part II of the National Board Examinations administered toward the close of their senior year, and type and location of internship, and practice or training status one year after graduation. The two groups were not reliably differentiated on any of these variables. Implications of the findings are discussed with respect to reliability, efficiency, and economy in the selection process and the function of the admissions committees with respect to borderline cases and issues of school policy and philosophy.

Attitude of Health Personnel↗
PubMedDate not supplied

Clinical evaluation of the impact of a patient education program.

A 5-day patient education program, taught on an outpatient basis, was evaluated to determine its effect on metabolic control as reflected by glycosylated hemoglobin test values. A quasi-experimental design was used, consisting of a pretest, a posttest, and a follow-up assessment made approximately 6 months after the posttest. The 72 experimental and 324 comparison subjects all had insulin-dependent diabetes mellitus (IDDM), were between 14 and 78 years of age, and had a duration of diabetes ranging from 1 to 20 years. The experimental group demonstrated a statistically significant improvement in Hb A1 values from pre- to posttest and sustained these posttest levels upon follow-up, although not at statistically significant levels. The comparison group showed no pre- to posttest difference, but demonstrated an improvement from posttest to follow-up assessment.

Adult↗
PubMedDate not supplied

Psychometric study of patient knowledge test.

The results of a psychometric study of the Test of Patient Knowledge are reported. The 50-item, multiple-choice test, developed by Etzwiler and associates at the International Diabetes Center, consists of a total score and seven subscores based on seven nonoverlapping content categories: nutrition, insulin, general knowledge, methods of control, pattern control, exercise, and complications. The results described herein provide evidence for the validity of the test (content, concurrent, and discriminant validity), a high level of reliability (Cronbach's alpha = .88), readability for the layperson at the 7th- to 8th-grade level, and sensitivity to instructional gains. The literature on psychometric research with other tests of patient knowledge of diabetes is reviewed and compared with the results of this study.

Adolescent↗
PubMedDate not supplied

Evaluation of neuroleptic drug use by nursing home elderly under proposed Medicare and Medicaid regulations.

Federal regulations for use of neuroleptic drugs in Medicare- and Medicaid-certified nursing homes throughout the United States were implemented October 1, 1990. These regulations constitute the first time that prescription drugs are required, by law, to be justified by indications documented in the medical chart. This study used extant data to estimate ineligible neuroleptic use at the individual and nursing home levels had these regulations been in effect in 1976 through 1985. Subjects, randomly sampled admissions (N = 5752) and residents (N = 3191), were followed up for up to 24 months in 60 nursing homes. One half of neuroleptic use in each cohort could be considered ineligible under the regulations; all but one of the nursing homes had one or more individuals who were treated with the ineligible use of neuroleptics. Improvements in documentation and/or prescription of neuroleptic drugs for nursing home elderly will be needed to ensure compliance with these new regulations.

Aged↗
PubMedDate not supplied

Career paths of geriatric nurse practitioners employed in nursing homes.

The career paths of geriatric nurse practitioners (GNPs) trained with support from the W. K. Kellogg Foundation through the Mountain States Health Corporation (MSHC) were studied. Under this program, GNPs were recruited from sponsoring nursing homes and returned to GNP positions in the sponsoring facilities following training. Training was carried out under a continuing education model offered through six university-based schools of nursing. Questionnaires were sent to the 111 GNPs trained. Of the 102 respondents, 97 provided complete information about past and present education, work experience, and job functions. The GNPs were women with a median age of 45 years, and they were employed in rural settings in the western United States. More than 45 percent of the nurses had at least a baccalaureate degree at the time of GNP training. The GNPs remained employed in long-term care positions that implemented the practitioner role. The median length of GNP employment in their first jobs after training was more than 4.5 years. The resignation rate from this first position was 1.66 resignations for each 10 years of GNP employment. Job changes were likely to be attributed to organizational changes with subsequent positions shifting toward a diversification of the GNP role. The study demonstrates the success of the MSHC program in introducing and retaining GNPs in nursing homes.

Career Mobility↗