A JAMA THEME ISSUE Edited by Robert M. Golub, MD
Two articles in this issue report national data on work hours among interns. First, Ayas and colleaguesArticle assessed the relationship between extended work duration and rates of percutaneous injuries. They found that extended work duration and night work were associated with an increased risk of percutaneous injuries. Second, Landrigan and colleaguesArticle report that during the first year of implementation of the Accreditation Council for Graduation Medical Education (ACGME) duty-hour standards, interns reported that noncompliance with the standards was common. In a commentary, Leach and PhilibertArticle discuss ACGME duty-hour reforms and effects on quality of graduate medical education.
Among internal medicine residents participating in a longitudinal study by West and colleagues, 34% of residents reported self-perceived medical errors that were associated with significant reductions in quality of life, decreased empathy, and increased symptoms of depression.
In a retrospective cohort study, Grumbach and ChenArticle assessed whether a postbaccalaureate premedical program that targets underrepresented minority and disadvantaged students improves medical school matriculation rates. Comparing program participants with nonparticipants and controlling for grade-point average, demographic characteristics, and Medical College Admissions Test score, the authors found that participants had a better chance of matriculation. In an editorial, Cohen and SteineckeArticle discuss strategies to build a diverse physician workforce.
Figueiras and colleagues report results of a cluster-randomized controlled trial to evaluate an intervention to improve reporting of adverse drug reactions (ADRs) among physicians in Portugal. They found that the intervention was associated with an increased rate of ADR reports vs baseline rates and vs control group physicians not receiving the intervention.
Having a mentor is purported to influence personal and professional development. Sambunjak and colleagues conducted a systematic review of the literature on mentoring in academic medicine and found that fewer than 50% of medical students and as few as 20% of physicians in some specialties reported having a mentor.
In a systematic review of the literature on evidence-based practice (EBP) teaching evaluation instruments, Shaneyfelt and colleagues identified high-quality, objective instruments for evaluating the EBP competence of trainees, determining the effectiveness of EBP curricula, and assessing the clinical performance of some EBP behaviors or patient-level outcomes.
“I wonder today (and did I wonder at the time? I am not sure) whether any of us, besides the patients, believed that what we were doing was helpful.” From “Swan's Way.”
A systematic literature reviewArticle suggests physicians have limited ability to accurately self-assess their competence. An editorialArticle discusses self-assessment and the public trust.
To effectively apply 21st-century science to patient care, more emphasis on humanistic, legal, and management sciences is needed in the premed and medical curricula.
An overview from the theme issue editor.
Information on undergraduateArticle and
graduateArticle medical education programs.
For your patients: Information about evidence-based medicine.
This Week in JAMA . JAMA. 2006;296(9):1029. doi:10.1001/jama.296.9.1029