Effects of an educational intervention on residents' knowledge and attitudes toward interactions with pharmaceutical representatives.

To assess primary care resident and faculty knowledge and attitudes concerning interactions between physicians and pharmaceutical representatives (PRs) and to measure changes in residents' knowledge and attitudes after an educational intervention, we conducted preintervention and postintervention surveys with a causal-comparative group in a university-based primary care residency program. All primary care internal medicine and internal medicine-pediatrics residents and faculty were given the voluntary survey. In general, residents and faculty demonstrated similar responses for the preintervention survey. Differences between faculty and resident opinions were seen in two areas. Faculty were more likely than residents to believe that PRs sometimes use unethical marketing practices (p < .05) and that the amount of contact with PRs in the outpatient clinic is excessive (p < .01). The postintervention survey of residents demonstrated significant differences between the control and intervention groups for three attitude scales. After the intervention, residents showed an increased belief that PRs may use unethical marketing practices (p < .01), that marketing gifts with no patient benefit may be inappropriate (p = .05), and that other physicians' prescribing patterns could be negatively influenced through the acceptance of gifts (p < .05). A brief educational intervention can change resident attitudes concerning physician interactions with PRs.

Fifteen years of a videotape review program for internal medicine and medicine-pediatrics residents.

The medical interview remains the most valuable component in patient evaluation. In addition to its diagnostic usefulness, it is the foundation upon which the doctor-patient relationship is built. It is essential, therefore, that health care providers be well trained in interviewing. Evidence suggests that having residents conduct videotaped interviews with patients and review the videotapes with faculty is an excellent way to teach interviewing skills. Videotape review has been part of the residency programs in primary care internal medicine and medicine-pediatrics at Wayne State University School of Medicine for 15 years. Throughout the history of the videotape program, the authors have endeavored to make the review process less stressful for residents by ensuring that the reviews are nonthreatening, nonjudgmental, and learner-centered. In this paper, the authors discuss (1) the structure and process of the videotape review program; (2) recurrent themes of the review sessions; (3) residents' perspectives on the process; and (4) potential barriers to a successful videotape review program and suggestions for how to avoid or overcome them.

Readability of pediatric patient education materials. Current perspectives on an old problem.

Written patient education materials are an important part of ambulatory pediatric practices. We evaluated the readability of 33 representative pediatric education materials using three common formulas: Fog, Fry, and SMOG. The majority of pamphlets had readabilities of grade nine or above. The need to use multiple readability formulas was also demonstrated. Although the three readability formulas were highly correlated, they were significantly different from each other when using a repeated measures analysis of variance (ANOVA) design. In almost half, the readability estimates differed by at least two grade levels. In addition, a large intrapamphlet variability for some pamphlets suggests a need to focus more attention on the readability of multiple sections within a pamphlet, not only on the overall or average readability. We conclude that the readability levels of patient education materials continue to be too high.

The attitudes of beginning nursing and medical students toward care of dying patients: a preliminary study.

The attitudes of entering classes of nursing and medical students toward the care of dying patients were compared using a self-administered instrument designed for the study measuring aversive and attractive components of these attitudes. Both groups exhibited similar aversive attitude items: Talking About Death elicited the most negative scores, General Interaction was slightly less negative, and Touching was the least negative. Among the attractive items, medical students were more positive on the Professional Challenge subscale, while the nursing students were more positive on the Personal Satisfaction subscale.

Children's understanding of death: a review of three components of a death concept.

This review of the empirical literature on the development of the concept of death focuses on 3 components of that concept: irreversibility, nonfunctionality, and universality. These findings overall suggest that the majority of healthy children in modern urban-industrial societies achieve an understanding of all 3 components between 5 and 7 years of age. Since this is also the age at which most children make the transition from preoperational to concrete-operational thinking, some relationship between these 2 processes seems likely. However, attempts to empirically validate that relationship have thus far yielded ambiguous results. Possible reasons for this ambiguity are suggested.