Introducing managed care to the medical school curriculum: effect on student attitudes.

In order to assess the effect of clinical training and didactic instruction on medical student attitudes toward managed care, we conducted a survey of all medical students at the midpoint of their third year clerkships at the University of Massachusetts Medical School. The students were exposed to clinical training in managed care settings and a 2-day required course on the principles underlying managed care. The main outcome measures were student attitudes toward the concepts of managed care, managed care organizations, and future careers in managed care. Students also assessed the attitudes of medical faculty toward managed care. Attitudes of students with previous clinical training in managed care settings did not differ from those of students without such exposure toward the concepts underlying managed care or managed care organizations and were less positive about careers in managed care. Student responses before and after the 2-day course on managed care demonstrated that attitudes moved in a significantly positive direction. Seventy-one percent of students reported that the opinions they had heard from medical faculty about managed care were negative. Preparing medical students to practice medicine effectively in managed care settings will require focused attention on managed care issues in the medical school curriculum and the combined efforts of academic health centers and managed care organizations.

Infant body composition in the PEA POD® era: what have we learned and where do we go from here?

The availability of clinically feasible infant body composition assessment can inform current questions regarding the developmental origins of chronic disease. A strategic approach will facilitate more rapid advancement in knowledge. The objective of this study was to summarize published evidence and ongoing research activity in infant body composition using the PEA POD® infant body composition system. All published studies using the PEA POD® were identified and grouped according to study population and question. All centers with PEA POD® units were invited to participate in an online survey regarding past, current and future PEA POD® use, and results were analyzed using descriptive statistics. The resulting information was used to identify gaps or limitations in existing knowledge, thus highlighting potential research priorities. Twenty-seven published articles were identified and grouped into six research themes. Although the number of infants studied is significant in some areas, interpretation of data is limited by methodological differences. Survey responses were received from 16 of ∼60 centers. Research themes echoed those identified from the published literature. Controlling for or reporting potential confounding variables is essential for understanding infant body composition data. Measurement of health outcome variables would be helpful in identifying associations.