B. D. Rowley

A Randomized Controlled Study of Brief Interventions To Teach Residents about Domestic Violence.

PURPOSE To test an educational intervention regarding domestic violence. METHOD Residents beginning their training in 1995 or 1996 were randomly assigned to attend, at their hospital orientation, either a 20-minute session emphasizing the importance of screening for domestic violence or a session on an unrelated topic. RESULTS Seventy-one percent of the residents in the experimental group diagnosed domestic violence; 52% in the control did so (RR, 1.35; 95% CI, 0.96-1.90; p = .07) in the nine to 12 months following the intervention. Rates of diagnosis differed by specialty (p <.01): 100% family practice, 90% emergency medicine, 80% obstetrics-gynecology, 63% pediatrics, 47% internal medicine, 0% surgery. Change in knowledge was assessed in 1996; significant improvement was noted (p = .002). CONCLUSION An intervention about domestic violence conducted at orientation for residents improved the rate of diagnosis of domestic violence. While the improvement was not statistically significant in this case, the intervention was brief and harmless. Other institutions should consider this kind of brief intervention.

Professionalism and professional values in orthopaedics.

During a consensus conference in Fall, 1998, the Academic Orthopaedic Society identified the values and qualities of professionalism as defined by its members. One hundred eighty-six respondents rated 20 characteristics and values describing professionalism, based on the extent to which they believed each item was appropriate. The five items receiving highest average ratings were: integrity, trustworthiness, responsibility, reliability, and accountability. Principal components analysis yielded five factors that captured 62% of the total variability. These factors were labeled respect and relationships, altruism, accountability and reliability, integrity, and excellence. The authors anticipate that the Academic Orthopaedic Society will find these data useful, and incorporate this information into their decisions concerning evaluation of current residents and applicants to their programs. An additional challenge will be to develop a values curriculum (formal curriculum) and a learning environment (informal curriculum) that will encourage residents and faculty to aspire to the highest in professional values and professional conduct.

Racial and ethnic discrimination during residency: results of a national survey.

No abstract available.

Assessing rural community resources for health care: The use of health services catchment area economic marketing studies

A relatively simple method for estimating the ability of rural communities to support health provider personnel services, the utilization of this tool is described and illustrated. Special aspects of the approach include: (1) its application on a systematic basis to an entire state, utilizing identified economic marketing areas and local determination of data; (2) the use of the finished product, or study, as a focus for community discussion and decision making; (3) its use as a recruitment device for physicians as well as communities; and (4) its use for long term state health and educational planning. Within this broad approach, the specific figures and conclusions are less important than the interpretation, application and use of the method.

A Model for Recruitment and Service - the University of Nevada's Summer Preceptorships in Indian Communities

DESPITE EFFORTS TO INCREASE the numbers of Indians entering or enrolled in the various health professions and occupations during the past few years, their numbers remain far below the proportion that would be representative of this minority in the population and needed to provide adequate health care to a significantly underserved population. Historically, access to the health professions and occupations for Indians has been limited by economic costs, geographic isolation, and deficiencies in their early education. Equally important, however, has been a widespread lack of appropriate role models, as well as cultural support from the Indian community itself for such career choices by its youth. As a result, many Indian students have failed to consider a number of socially and economically desirable health careers. Nevada is the seventh largest State in the nation, covering more than 100,000 square miles. Within it live more than 10,000 Indians who are registered on the tribal rolls of Nevadas 23 reservations and urban colonies. Several thousand others are unregistered, since they reside in urban areas or work as transients. As elsewhere in the nation, Nevadas Indians suffer from poor health and poor health care as measured by nearly every index. An increase in trained health personnel motivated for service to this population undoubtedly would result in significant improvements in these indices.