Dennis Gingrich

Effects of caffeine deprivation on complex human functioning

Twenty-five managers who reported an average daily caffeine consumption of 575 mg participated in two complex simulations. A double-blind cross-over design was employed to assess the effects of normal caffeine consumption versus caffeine deprivation upon seven validated measures of managerial effectiveness. Data from a Caffeine Withdrawal Questionnaire indicated discomfort upon deprivation. Systolic blood pressure increased during “normal” caffeine consumption levels but fell quickly and remained lower during deprivation. Several measures of managerial performance indicated decreased effectiveness upon caffeine deprivation. In contrast to prior research from simpler task settings, cognitive effectiveness (during complex task performance) was diminished. However, a measure of strategic performance which requires a relatively high level of cognitive effort showed no impact of caffeine deprivation.

Excess coffee consumption in simulated complex work settings : Detriment or facilitation of performance ?

Twenty-four managers who normally consume between 400 and 1,000 mg of caffeine per day participated in all-day quasi-experimental simulations. In a crossover, doubleblind design, they made complex managerial decisions either on treatment with their typical daily dose of caffeine or on treatment with 400 mg of caffeine in excess of daily consumption. The effect of caffeine treatment on various validated performance indicators was investigated. The impact of excess caffeine consumption was mild. Increased caffeine facilitated speed of response to incoming information but decreased utilization of opportunity. No significance was obtained for other measures of managerial effectiveness (such as activity, breadth, strategy, and emergency response).

Effects of Alcohol Intoxication on Risk Taking, Strategy, and Error Rate in Visuomotor Performance

Adult men (N = 44) participated for 2 days (alcohol vs. placebo treatment) in a double-blind, crossover experiment. Performance on the Digit Symbol Substitution Task (DSST) and a visuomotor (VM) task was measured 4 times each day. On the alcohol-treatment day, data were obtained once during ascending breath alcohol levels (BALs), once during maximal BALs (0.05 or 0.10), and twice during descending BALs. Data were collected at the same time points on the placebo-treatment day. Limited evidence for acute tolerance was obtained with the DSST, but error rates on the VM task were higher during maximal and descending BALs. Error rates remained near placebo values, and participants displayed slightly greater caution, while BALs were ascending. Strategy scores on the VM task exceeded placebo scores during maximal intoxication. Data interpretation is focused on individuals in higher level (e.g., professional) positions.

Tobacco world: evaluation of a tobacco cessation training program for third-year medical students.

Background Training in tobacco cessation counseling is deficient in medical schools. Tobacco World, a tobacco cessation training program, was implemented in a family medicine clerkship and subsequently evaluated. Method In the pilot year, students were assigned to either standard clerkship training (comparison group) or a group that also received Tobacco World training (intervention group). All students received intervention training in the second year of the study. A 35-item questionnaire was administered before and after the four-week clerkship to assess knowledge, attitude, and confidence regarding tobacco cessation counseling. Results Intervention training was highly rated. Students in the intervention group from both years demonstrated significant improvements in some key measurements of knowledge, attitude, confidence, and increased frequency of tobacco cessation counseling. Conclusions This smoking cessation training program addresses an underrepresented area of medical school education and has the potential to translate into improved smoking cessation counseling by future physicians.

Frequency and negative impact of medical student mistreatment based on specialty choice: a longitudinal study.

Purpose According to responses to the Association of American Medical Colleges’ Medical School Graduation Questionnaire, 17% to 20% of medical students report mistreatment. This study examined the longitudinal nature of medical student mistreatment based on specialty choice. Method From 2003 to 2010, the authors surveyed all medical students at one institution at the end of their third year, assessing the frequency and impact of any mistreatment based on specialty choice. They analyzed quantitative data on the frequency, impact, sources, and trends over time and qualitative data from students’ open-ended responses and compared data by specialty interest (primary care versus subspecialty). Results Of the 1,059 students sent the survey, 801 (76%) responded. Mistreatment based on specialty choice was common. The frequency and impact of such mistreatment were tightly correlated (Pearson r = 0.8, P < .001). The nature of mistreatment differed between students interested in primary care and those interested in a subspecialty, occurred more commonly on specific clerkships, and originated most often from resident physicians. Students perceived that teaching opportunities and evaluations were negatively affected by their specialty choice. An association was found between the theme of respect and students reconsidering their specialty choice. These patterns of mistreatment were stable over the study period, despite several professionalism initiatives. Conclusions Mistreatment based on specialty choice is a distinct and common phenomenon perpetuated by faculty, residents, and peers. More research is needed to explore the potential hidden curriculum drivers of these findings and to develop interventions specifically targeting this type of mistreatment.

Recruiting and selecting generalist-oriented students at Pennsylvania State University College of Medicine.

The authors describe the strategies developed at the Pennsylvania State University College of Medicine, as part of The Robert Wood Johnson Foundations Generalist Physician Initiative, to increase the proportion of graduating medical students entering generalist disciplines. These strategies included modifying the admission process to involve more primary care faculty so that students with identified potential for primary care would make up at least half of each entering class, and partnering with selected colleges and universities in Pennsylvania to increase the number of applicants with the potential for primary care. They describe partnering and outreach programs--Primary Care Day, off-campus cluster meetings, and the Primary Care Scholars Program for college seniors--and present promising information about the results.