A Facilitated Peer Mentoring Program With a Dedicated Curriculum to Foster Career Advancement of Academic Hospitalists.

Introduction: In the field of hospital medicine, there is both a limited pool of senior faculty to mentor the rapidly growing number of junior faculty and a lack of career development curricula focused on scholarly activities specific to the needs of the hospitalist. These deficits have resulted in a disproportionately low number of academic hospitalists being promoted to associate and full professor. We implemented a facilitated peer mentoring program with a dedicated curriculum to foster career advancement of academic hospitalists. Methods: We recruited 29 academic hospitalists and divided them into five small groups, each guided by one senior faculty. Peer members participated in a 9-month curriculum consisting of alternating large- and small-group sessions that reviewed topics important for academic advancement. Quantitative analysis assessed feasibility of the program, as measured by participation and knowledge improvement on curriculum topics, with pre- and postprogram surveys. Results: Results demonstrated feasibility of the large-group sessions as measured through participation. Small-group participation was more variable. Pre- and postsurvey results showed significant knowledge improvement (p < .05) in nearly all of the curriculum topics. Discussion: Currently, there is a gap in both mentorship and scholarly skills of academic hospitalists. Our facilitated peer mentoring program with a dedicated curriculum can be used as a framework for other hospitalist programs to support career development.

Preparing for Medical Internship: A Case-Based Strategy to Teach Management of Common Overnight Calls to Students.

Introduction: More medical schools are offering a transition-to-intern-year course to better prepare graduates for residency. Sessions where students simulate receiving cross-cover calls are frequently included and highly rated. However, simulated sessions are often resource intensive and therefore challenging to implement in all schools. We developed a case-based exercise to address this need. Methods: In 2009, our school implemented a required course focused on the transition-to-intern year, including a common overnight calls (COC) module. Students rotated through different stations in small groups which were each led by a facilitator. Topics have evolved in response to feedback, and current topics included altered mental status, chest pain, and other frequent calls. Results: Over 1,000 students have participated in the module. The students consistently reported that they perceived themselves to be more prepared for internship. Between 2009 and 2016, the mean rating of "the COC module helped prepare me for internship" was 6.29 on a 7-point Likert scale (1 = strongly disagree and 7 = strongly agree). The 2017 data are limited. In 2018 and 2019, students continued to feel more prepared for their intern year, 4.72 in 2018 and 4.71 in 2019 on a 5-point Likert scale (1 = strongly disagree and 5 = strongly agree). The students perceived the COC format as effective. Discussion: Small-group case-based classroom simulations are an effective way to improve students' perceived preparedness for responding to common overnight calls during intern year.

Facets of career satisfaction for women physicians in the United States: a systematic review.

Women make up a growing proportion of the physician workforce, and their career satisfaction may affect their health. The authors hypothesized that many facets adversely affecting career satisfaction in women physicians were extrinsic, therefore, preventable or modifiable. The authors conducted a systematic review of the literature in English published through February 2010 to examine facets of career satisfaction of U.S. women physicians. The authors used the women physician AND job satisfaction OR career satisfaction Medical Subject Headings (MeSH) terms, and reviewed bibliographies of key articles to ensure inclusion of relevant studies. The authors used the "Strengthening the Reporting of Observation Studies in Epidemiology" quality tool. Of an initial 1,000 studies, only 30 met the inclusion criteria. Facets reported most frequently to influence career satisfaction for women physicians were income/prestige, practice characteristics, and personal/family characteristics. Overall, career satisfaction for women and men physicians was 73.4% (range = 56.4% to 90%) and 73.2% (range = 59% to 90%), respectively. When compared with men, women physicians were more concerned with perceived lack of time for relationships with patients, colleagues, and family; less satisfied with mentoring relationships and support from all sources; and less satisfied with career-advancement opportunities, recognition, and salary. Career satisfaction can affect health, as well as health and safety of patients. Many factors adversely affecting career satisfaction for women physicians are extrinsic and, therefore, modifiable.

The challenge of eliminating cervical cancer in the United States: a story of politics, prudishness, and prevention.

Exciting strides in reducing the incidence of and mortality from cervical cancer have been made over the last century in the United States. The issues surrounding the implementation of the human papillomavirus vaccine are remarkably similar to the issues involved in the gradual adoption of the Pap test and initiation of cervical cancer screening beginning nearly a century ago. The following review of the reduction of cervical cancer morbidity and mortality demonstrates the importance of the interplay between basic science, clinical medicine, social mores, and public policy.

Ha sentido sola? Culturally competent screening for intimate partner violence in Latina women.

OBJECTIVE: Intimate partner violence (IPV), a common public health problem, affects women irrespective of ethnicity. Primary care visits provide an excellent opportunity to identify IPV survivors; however, among immigrant Latina women, language can be a barrier. Several IPV screening instruments are available in English, but few are available in Spanish. Therefore, we sought to estimate the screening characteristics of seven validated screening questions translated into Spanish. METHODS: Participants included 105 Spanish-speaking Latina women, aged 18-64 years, seen for primary care in an urban teaching hospital. Measures used were (1) screening questions: seven dichotomous response-option IPV screening questions, and (2) comparison standard: Index of Spouse Abuse (ISA), adapted for lifetime IPV. All measures were professionally translated into Spanish. Sensitivity and specificity, with 95% confidence intervals (CI), of all questions were estimated using 2 x 2 tables. Sensitivity and specificity with 95% CIs were estimated for the two questions with highest sensitivity. RESULTS: Mean age was 38.5 years (SD 11.4); 89.5% were uninsured, and 33% reported lifetime IPV. Spanish translations of the following questions: "Have you ever been in a relationship where you have felt controlled by your partner?" and "Have you ever been in a relationship where you have felt lonely?" had the highest individual sensitivity. The sensitivity of an affirmative response to either question was 94% (95% CI 86%, 100%), and the specificity of an affirmative response to both questions was 86% (95% CI 78%, 94%). CONCLUSIONS: Simple screening questions used in combination are highly sensitive for IPV detection in immigrant Latina women and may assist clinicians caring for them to identify a history of IPV.

Integrative clinical experience: an innovative program to prepare for internship.

BACKGROUND: Interns experience tremendous challenges on the transition from student to new physician. There is limited literature describing curriculum that enhances medical students' preparation for internship. DESCRIPTION: To prepare graduating medical students at our institution for the new responsibilities and stressors that they will face as interns, an elective course, Integrative Clinical Experience, was implemented. Over a 2-week period, participating medical students rotate through 1 to 3-hr modules that cover four major domains: managing acutely ill patients, teaching, communicating, and coping with stressors. EVALUATION: Participants evaluated the course qualitatively and quantitatively through verbal and written feedback. Students found the course useful and educationally valuable. They also had a statistically significant increase in perceived preparedness for internship upon completion of the course. CONCLUSIONS: A 2-week, concentrated course is a feasible and effective method for raising students' perceived preparedness for internship.

Survivors of domestic violence: demographics and disparities in visitors to an interdisciplinary specialty clinic.

Although the traditional response to domestic violence has been undertaken by legal and human service agencies, this societal issue has become increasingly recognized as a national public health concern. While identification and intervention in cases of domestic violence are widely recommended, little data exist on intervention outcomes. This retrospective study describes similarities and disparities in sociodemographic variables, health status, referral characteristics, and management strategies among patients referred to a specialty clinic for survivors of domestic violence.

The hidden health menace of elder abuse. Physicians can help patients surmount intimate partner violence.

As many as 2 million elderly persons in the United States experience physical, psychologic, or sexual abuse each year. Nationally spouses or intimate partners commit between 13% and 50% of elder abuse.1 Physicians can be instrumental in preventing and intervening in intimate partner violence in their elderly patients.