Holloway Rl

Psychosocial effects in long-term head and neck cancer survivors

To identify and rate the importance of several psychosocial and physiologic influences on quality of life (QOL) among a cohort of 5‐year head and neck cancer survivors, we conducted a cross‐sectional study of a convenience sample that used both questionnaires and physiologic evaluations.

Task selection and locus of control in two ability groups' recall

Abstract This study intended to clarify the locus of control × academic achievement relationship by asking subjects to select structurally different instructional tasks under one condition and having these tasks assigned to them under another condition. These variables (task selection, locus of control, and task structure) were examined across a subject pool containing both high and average ability subjects. A random half of the subjects chose their own tasks (self-selection) and the remaining half were given tasks based on their scores on Rotters [Psychological Monographs, 1966, 80 (1, Whole No. 609)] locus of control scale (prescriptive assignment). Tasks were defined as either “structure provided” (external control) or “self-structured” (internal control). Results of a regression analysis revealed that the factor of ability contributed the most significant portion of variance to the recall of the entire subject pool. When subjects were divided into high and average ability groups, the “high” group showed significance for locus of control and the interaction of locus of control and selection. No factor was significant in the low ability group.

The Complexion of Collaboration: An Overview of the Psychologist-Physician Relationship

The core of the collaborative enterprise between psychologists and primary care physicians is the patient encounter. Individual cases provide opportunities for physicians and psychologists to collaborate effectively; the focus of such collaborations must always remain on the health and well-being of the patient. Any number of collaborative models may be used, depending on the specific situation and specific conditions of the collaboration, coupled with the needs of the patient. Collaboration may range from informal consultation, to formal consultation, to coprovision of care, to cotherapy between physician and psychologist. As an introduction to this special issue, this article outlines these models of collaboration, as well as the importance of agreed-upon goals, ongoing communication, and problem solving to address barriers between collaborative partners.

Academic ranks and medical schools of underrepresented minority faculty in family medicine departments.

Purpose To examine academic rankings and educational backgrounds of underrepresented minority (URM) family medicine faculty and compare their academic ranks with national trends. The authors also determined the extent to which international and historically black educational institutions contributed URM faculty to family medicine. Method In 1999 questionnaires were sent to 129 family medicine departments asking for academic ranks and educational institutions attended by their URM faculty. Comparisons were made between URM facultys academic ranks and all family medicine faculty, medical school minority faculty, and medical school faculty. Results A total of 80% of URM faculty were assistant professors or instructors, and 4.4% were professors. URM family medicine faculty had significantly lower rankings compared with medical school minority faculty and all family medicine faculty. URM family medicine faculty at historically black medical schools were more likely to have received their degrees from historically black undergraduate institutions and medical schools than were URM family medicine faculty at non—historically-black medical schools. Conclusions URM family medicine faculty appear to experience a double disadvantage: being minority and working for family medicine departments. Their academic ranks remain far below those of both minority medical school faculty and family medicine faculty, a discouraging finding considering the current shortage of URM faculty in family medicine departments. Historically black medical schools cannot address the shortage alone, so non—historically-black medical schools need to both recruit URM faculty and follow up with appropriate mentoring of those faculty.

The biopsychosocial model in medicine: lost or reasserted?

The biopsychosocial model, which has extraordinary merit for explaining and predicting health and well-being, has had relatively limited acceptance over the past 25 years. There may be a variety of reasons for this, but the forces that shape medical education must be taken into account if the biopsychosocial model is to be more fully accepted than it is currently. Two factors, medical school financing and medical school curricula, that are influenced by powerful forces within medical education are examined. Unless these forces are moved in a direction to benefit from the biopsychosocial model, it is unlikely that this important contribution will be fully acknowledged.

Training the "assertive practitioner of behavioral science": advancing a behavioral medicine track in a family medicine residency.

Objective: This article describes the development of a Behavioral Medicine track in a family medicine residency designed to train physicians to proactively and consistently apply advanced skills in psychosocial medicine, psychiatric care, and behavioral medicine. Methods: The Behavioral Medicine track emerged from a behavioral science visioning retreat, an opportunity to restructure residency training, a comparative family medicine-psychiatry model, and qualified residents with high interest in behavioral science. Training was restructured to increase rotational opportunities in core behavioral science areas and track residents were provided an intensive longitudinal counseling seminar and received advanced training in psychopharmacology, case supervision, and mindfulness. Results: The availability of a Behavioral Medicine track increased medical student interest in the residency program and four residents have completed the track. All track residents have presented medical Grand Rounds on behavioral science topics and have lead multiple workshops or research sessions at national meetings. Graduate responses indicate effective integration of behavioral medicine skills and abilities in practice, consistent use of brief counseling skills, and good confidence in treating common psychiatric disorders. Conclusion: As developed and structured, the Behavioral Medicine track has achieved the goal of producing “assertive practitioners of behavioral science in family medicine” residents with advanced behavioral science skills and abilities who globally integrate behavioral science into primary care.

Building a primary care discipline: Notes from a psychologist in family medicine.

Psychologists of a variety of emphases have actively participated in the growth of family medicine as an academic discipline. Rather than simply collaborate, they have shaped the very nature of the field. This paper describes a number of contributions from psychologists in family systems and educational arenas. In particular, physician-psychologist collaborative work is highlighted.

Original Research: A Process Model for Teaching and Learning Communications Skills

This paper describes a model which specifies what teachers of communication skills should be teaching and what students in primary health care should be learning.