ABSTRACT: Graduating learners from Oregon Health and Sciences University programs and from the National College of Naturopathic Medicine were surveyed about their attitudes toward their training in women's health.
The survey addressed learner satisfaction with training in women's health, their preferred learning methods, and their clinical comfort in managing 17 clinical problems. The survey addressed knowledge of complementary and alternative medicine.
Satisfaction with training in women's health varied by program. Satisfaction increased with increasing proportion of women seen during training. Clinical confidence scores increased with increasing proportion of women seen during training. Physical assault and breast disease were areas of least clinical confidence. All groups preferred learning in clinical rather than didactic settings. Experience with alternative and complementary medicine was very limited except among naturopathic students.
Areas of common educational need were identified among a variety of learners. This information will assist educators in designing multidisciplinary programs to meet the needs of this diverse group.
American Journal of Obstetrics and Gynecology 07/2002; 186(6):1259-65; discussion 1265-7. · 3.47 Impact Factor
ABSTRACT: To increase the number of high-risk and homeless youth who receive human immunodeficiency virus (HIV) test results and posttest counseling.
Oral HIV testing and counseling were offered to high-risk and homeless youth at sites at which youth congregate throughout Portland, Oregon. Subjects were randomized to receive test results and posttest counseling either in a face-to-face manner or with the option of telephone notification. Self-reported demographic and risk-behavior information was collected prior to HIV testing. The differences in the proportion of youth who received their test results were analyzed according to the notification method and demographic characteristics using SPSS.
Among the 351 youth who were tested, 48% followed up to receive test results and posttest counseling. Adolescents most likely to receive their results were female, older (19-24 years), and white and those who reported high-risk behaviors. Those given the option of telephone notification were significantly more likely to receive their results than those required to have face-to-face notification (odds ratio = 2.301, 95% confidence interval of 1.499, 3.534). This was true regardless of age, race, history of previous HIV testing, or presence of high-risk behaviors. Two youths tested positive for HIV corroborating previous reports of low HIV prevalence in this population. Both were assigned to the face-to-face notification group and, therefore, no HIV positive results were given by telephone.
The option of telephone notification significantly increased the proportion of youth who received posttest counseling and results following community-based testing.
Journal of Adolescent Health 04/2002; 30(3):154-60. · 3.33 Impact Factor
ABSTRACT: The authors aim to determine whether pediatric residents used DSM-IV criteria to diagnose major depressive disorder and how this related to residents' confidence in diagnosis and treatment skills before and after clinical training with depressed adolescents.
Pediatric residents evaluated two different standardized patients portraying major depressive disorder before and after learning about adolescent depression. Residents' interactions with standardized patients were observed, and checklists containing DSM-IV criteria for major depressive disorder and other pertinent information, such as comorbidities, were completed for each interaction. After the encounter, residents completed a survey asking about the "patient's" diagnosis and the residents' confidence in their clinical skills.
Residents assessed significantly more checklist items in the second encounter with a standardized patient. Residents' confidence in treatment was significantly higher after the rotation, while confidence in diagnostic skills was unchanged, remaining high. Even after the rotation, residents did not use all DSM-IV criteria for major depressive disorder in their diagnoses.
Major depressive disorder is a common adolescent psychiatric disorder. Pediatricians must be equipped with appropriate interpersonal and diagnostic skills to detect this and other psychiatric disorders. Standardized patients represent one useful way to teach and assess these skills. This study suggests that residents' interpersonal and diagnostic skills can improve with practice. Although resident scores improved, post-encounter checklists showed that residents were still not asking all the necessary questions for a DSM-IV diagnosis, concluding prematurely that the standardized patients had major depressive disorder before satisfying all diagnostic criteria. The majority did not consider other depressive conditions or comorbid disorders.
Academic Psychiatry 33(5):389-93. · 0.81 Impact Factor