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This Week in JAMA
December 5, 2012

This Week in JAMA

JAMA. 2012;308(21):2171. doi:10.1001/jama.2012.3363

In a cluster randomized crossover trial involving 62 attending physicians at a university-affiliated teaching hospital, Lucas and colleagues examined the effects of 2- vs 4-week inpatient attending physician rotations on patient-, trainee-, and attending physician–related outcomes. The authors report that 2-week rotations were not associated with an increase in unplanned patient revisits at 30 days; 2-week rotations were associated with less burnout and emotional exhaustion among attending physicians but with worse evaluations from trainees.

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In a randomized trial that involved 103 internal medicine interns at 2 hospitals, Volpp and colleagues found that compared with a standard call schedule, implementation of a 5-hour protected sleep period during overnight call resulted in increased overnight sleep duration and improved next-morning alertness.

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In a cluster randomized trial conducted in 7 resource-limited countries and involving 204 postgraduate trainees, Kulier and colleagues found that an evidence-based medicine course that featured electronic-learning modules and was integrated into routine clinical practice resulted in higher knowledge and skill scores than a traditional, predominantly self-directed evidence-based medicine course. In an editorial, Prasad discusses the importance of teaching evidence-based medicine in resource-limited countries.

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Yeates and colleagues randomly assigned 41 attending physicians to view videos depicting good or poor resident performance on the Mini Clinical Evaluation Exercise and then examined the effect of viewing good vs poor performers on their subsequent ratings of borderline examination performances. They found that physicians who viewed videos of good performances gave lower scores to borderline performances than did physicians who viewed videos of poor performances.

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Eva and colleagues examined the association between a medical school admission process that includes a multiple mini-interview (MMI) component—focusing on ethical issues, communication, and collaborative tasks—and Canadian national licensing examination parts I and II scores in a study involving 1071 medical school applicants. The authors found that compared with students rejected by the admission process that used MMI assessment, students who were accepted had higher licensing examination scores. In an editorial, Kirch discusses transformation of medical school admissions.

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To evaluate internal medicine residents' career plans, West and Dupras analyzed survey data from 16 781 residents who had completed the Internal Medicine In-Training Examination in 2009-2011. Among the authors' findings was that a minority of graduating residents—including those in primary care training programs—reported a plan to practice general internal medicine. In an editorial, Schwartz discusses the physician workforce and funding of graduate medical education.

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Research during residency

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International medical graduates: reduction in US training positions

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Professionalism and duty hour restrictions

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“Suddenly in a new world, or in my case a new country, I didn't know everything anymore, but I opened my mind to others around me.” From “Not Born in the USA.”

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The empiricists strike back: medical education 2012

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Join Laura N. Gitlin, PhD, and coauthors December 19 from 2 to 3 PM eastern time to discuss nonpharmacologic management of behavioral symptoms in dementia. To register, go to http://www.ihi.org/AuthorintheRoom.

Dr Golub summarizes and comments on this week's issue. Go to http://jama.ama-assn.org/misc/audiocommentary.dtl

For your patients: Information about health care professionals and qualifications.

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