OBJECTIVE: To determine whether interns' performances of technical, preventive, and communication aspects of patient care improve during the intern year. DESIGN: A descriptive study. At the beginning and end of the intern year, interns' consultations with three simulated (standardized) patients were videotaped and scored according to explicit criteria set by an expert panel. Problems simulated were urinary tract infection, bronchitis, and tension headache. SETTING: The casualty outpatient department in a general teaching hospital in New South Wales, Australia. PARTICIPANTS: Twenty-eight interns rotated to the casualty department. RESULTS: Little improvement over the intern year in technical competence or preventive care was observed, even though initial levels of compliance with criteria were quite low for some items. Greater improvement was apparent in the area of communication skills. CONCLUSIONS: The results suggest that the internship should be restructured to more adequately teach the skills required for primary care.

Adult↗

PubMedDate not supplied

Group C streptococcal bacteremia: analysis of 88 cases.

Eighty-eight cases of group C streptococcal bacteremia were reviewed retrospectively. Most patients had underlying diseases (72.7%), predominantly cardiovascular disease (20.5%) or malignancy (20.5%). The infection originated most often from the upper respiratory tract (20.5%), the gastrointestinal tract (18.2%), or the skin (17.1%). Prior exposure to animals or animal products was reported in 23.9% of cases. The most common clinical manifestations of group C streptococcal bacteremia were endocarditis (27.3%), primary bacteremia (22.7%), and meningitis (10.2%). Of streptococcal isolates, 61.4% were not speciated, 19.3% were Streptococcus equisimilis, 17.1% were Streptococcus zooepidemicus, and two (2.3%) were Streptococcus equi. The isolates were sensitive to most antibiotics, and most patients were treated with beta-lactam agents. Mortality was high (25.0%), especially among older patients and patients with endocarditis, meningitis, and disseminated infection. Group C streptococcal bacteremia does not differ from bloodstream infection caused by other beta-hemolytic streptococci with regard to clinical presentation, treatment, or outcome.

Endocarditis, Bacterial↗

PubMedDate not supplied

Improving patient education in a small community hospital: a packet system for patient teaching.

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Hospitals, Community↗