A Randomized Controlled Trial Using Insinuated Standardized Patients to Assess Residents' Domestic Violence Skills Following a Two-Hour Workshop

Background: Residents feel inadequately trained to treat domestic violence victims.

Purpose: The purpose was to assess clinical skills of residents participating in a domestic violence workshop.

Methods: Twenty-seven internal medicine residents were randomized to receive one of two workshops (domestic violence or control workshop). Standardized patients were trained to two domestic violence cases (depressed; injured). The two cases were randomized and insinuated into each resident's continuity clinic at either 1 to 3 months or more than 3 months after the workshops.

Results: The domestic violence workshop residents did not identify the standardized patients as domestic violence victims any more often than residents participating in the control workshop; 16/25 (64%) versus 13/23 (56%), p = .86. However, domestic violence workshop residents were more likely to score 75% or higher on the domestic violence checklist items compared to control workshop residents; 9/25 (36%) versus 2/23 (9%), p = .04.

Conclusions: Once a standardized patient was identified in clinic as a domestic violence victim, domestic violence workshop participating residents demonstrated better clinical skills than a control group.     

Training in basic computer skills for academic physicians: The certificate of added qualification approach

Background: In the course of an academic fellowship program, many of the physicians participating expressed the need for computer skills training.

Purpose: The purpose of the tutorial program was to promote the effective and efficient learning of academic computer skills within the context of a busy fellowship program.

Methods: A series of self‐instructional tutorials was developed, including competency tests and practice tasks. Physician fellows participated in the voluntary computer skills tutorial program. Topics included system software, word processing, and graphics. Competency testing led to a “Certificate of Added Qualification,”; (CAQ) in computer skills.

Results: Eleven of 20 (55%) physician fellows completed all CAQ requirements during their fellowship program. The results of a follow‐up questionnaire indicated that 95% of the CAQ participants reported using computers at least several times per week.

Conclusion: By focusing on the tasks computer novices immediately need to perform, and keeping the instruction “lean,”; one can help academic medicine faculty acquire computer skills in an effective and efficient manner.     

Further evidence of construct validity of standardized patient‐based performance examinations

The purpose of this study was to gather additional evidence pertinent to the construct validity of standardized patient‐based clinical performance examinations. Specifically, the study determined whether students who indicated they had previously read about, seen, or worked up a case on the examination performed differently on that case from those students who had not. Overall, it was found that students with previous reading or direct experiences with cases on the test tended to have higher case mean scores on those cases than those who had not. These results demonstrated that scores on standardized patient‐based performance examinations are sensitive to the examinees’ various learning experiences.     

Chemotherapy‐Induced Neuropathic Pain and Its Relation to Cluster Symptoms in Breast Cancer Patients Treated with Paclitaxel

Abstract The majority of patients with breast cancer receiving chemotherapy report multiple symptoms. Compelling evidence has shown that subgroups of patients can be clustered by the severity of symptoms. Recent studies demonstrate that chemotherapy with such substances as paclitaxel can cause neuropathic pain (CINP) and consequently neural damage. Objectives: the present study examined the relationship between symptom clusters and CINP among 40 patients with breast cancer. The study was based on 2 sessions conducted before and during paclitaxel treatment. In each session, neuropathic pain was assessed by the DN4 Questionnaire. In the second session, the Lee Fatigue Scale, the General Sleep Disturbance Scale, and the Center for Epidemiological Studies–Depression Scale were also administered, and the worst pain intensity was assessed. Using cluster analysis, 2 symptom clusters were identified on the basis of the severity of the 4 symptoms scores. Patients in the High Cluster (37%) experienced a high level of all symptoms, whereas patients in the Low Cluster (63%) experienced a low level of all symptoms. Twenty patients (50%) were diagnosed with CINP. A subgroup of patients (23%) from the High Cluster was identified as having CINP; 35% were in the Low Cluster and free of CINP. In conclusion, there appears to be a specific subgroup of patients with hypersensitive cancer who need greater attention to symptom management. Early detection of symptoms, together with careful dose selection and assessment of early stages in the development of neuropathic pain, are essential for preventing the simultaneous occurrence of severe multiple symptoms and CINP.     

Summer Research Training for Medical Students: Impact on Research Self‐Efficacy

There is a well‐documented shortage of physician researchers, and numerous training programs have been launched to facilitate development of new physician scientists. Short‐term research training programs are the most practical form of research exposure for most medical students, and the summer between their first and second years of medical school is generally the longest period they can devote solely to research. The goal of short‐term training programs is to whet the students’ appetite for research and spark their interest in the field. Relatively little research has been done to test the effectiveness of short‐term research training programs. In an effort to examine short‐term effects of three different NIH‐funded summer research training programs for medical students, we assessed the trainees’ (N = 75) research self‐efficacy prior to and after the programs using an 11‐item scale. These hands‐on training programs combined experiential, didactic, and mentoring elements. The students demonstrated a significant increase in their self‐efficacy for research. Trainees’ gender, ranking of their school, type of research, and specific content of research project did not predict improvement. Effect sizes for different types of items on the scale varied, with the largest gain seen in research methodology and communication of study findings.