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Le nouveau concours a conservé l'appellation d'internat, bien que sa vocation ne soit plus celle de l'ancien internat des hôpitaux, qui visait à pré-recruter le corps des praticiens hospitalo-universitaires. C'est désormais l'accès global aux spécialités qui se trouve régi par la loi du concours. L'analyse des conséquences de ce changement est au cœur de la recherche qui a été menée par notre équipe. Plusieurs hypothèses ont été formulées au départ, relatives, notamment, à une probable exacerbation de la division de la profession en segments étanches et inégalement légitimes. Chemin faisant, d'autres questions ont été soulevées, notamment en matière d'incidences sexuées de la réforme ou d'effets pervers sur les disparités régionales de développement sanitaire. En effet, les tendances démographiques générales témoignaient du peu d'incidences positives de la réforme sur l'équilibrage structurel et géographique de l'offre de soins. En outre, l'objectif de \" valorisation de la médecine générale \" méritait d'être interrogé, puisque le protocole de sélection faisait reposer l'orientation des étudiants en grande partie sur un \" rang de classement \". Toutes ces observations justifiaient la réalisation d'une recherche ad hoc afin, notamment, de mieux comprendre, au-delà du \" constat d'échec \", les mécanismes mis en œuvre à l'occasion de la réforme. Méthodologie L'enquête de terrain a été réalisée sur trois sites : les facultés de Lariboisière-Saint-Louis (Paris), Marseille et Nantes. Dans chaque université, un échantillon d'étudiants a été tiré de manière aléatoire à partir des listes d'inscrits en PCEM2 en 1973, 1975, 1978, 1980, 1984 et 1986. Les parcours des 1080 étudiants ainsi sélectionnés ont été relevés à partir de leurs dossiers et des procès-verbaux d'examens. Ce fichier a été complété par des données de carrière fournies par le Conseil national de l'Ordre des médecins et par les résultats des concours de l'internat nouveau régime, fournis par le Centre inter-universitaire de traitement de l'information (CITI II). Ces données ont été exploitées sous une forme anonyme et ont été complétées par des études de documents et des entretiens auprès d'une cinquantaine de médecins, dont plus de quarante étaient issus de l'échantillon statistique. Les effets induits de la réforme portent sur trois champs principaux : 1/ Les politiques universitaires et les stratégies étudiantes : au-delà des changements prévus au cours du troisième cycle, la réforme a contribué à modifier les deux premiers cycles des études. 2/ La structure du corps médical : selon leur université, les étudiants n'ont pas les mêmes chances de réussir le concours de l'internat, et les distorsions géographiques dans la répartition entre généralistes et spécialistes en sont accrues. À ces effets locaux, la concurrence entre les étudiants contribue à favoriser les plus proches des milieux universitaires et médicaux. Comme pour les concours des Grandes Écoles, le concours de l'internat fait barrage à la démocratisation de l'accès aux spécialités. En outre, les femmes apparaissent comme les grandes \" perdantes \" de la réforme, puisqu'elle s'orientaient, sous l'ancien régime, en majorité vers la médecine spécialisée et qu'elles deviennent aujourd'hui surtout omnipraticiennes. 3/ De l'éclatement d'un diplôme à la division d'une profession : le corps médical est, depuis la réforme, plus divisé que jamais. L'enquête rend bien compte de l'état permanent de concurrence dans lequel les étudiants se socialisent durant leurs études. En conséquence, l'écart se creuse entre des généralistes stigmatisés par \" l'échec à l'internat \" et des spécialistes considérés comme \" l'élite \" des étudiants en médecine. En outre, la standardisation des modes d'apprentissage, la prégnance des critères hospitaliers rendent plus difficile pour les étudiants une pratique ambulatoire centrée sur la clinique et à l'occasion de laquelle ils sont confrontés à des exigences économiques contredisant les principes selon lesquels ils ont été formés.", "reportNumber": "", "reportType": "report", "institution": "", "place": "", "date": "2001/11", "seriesTitle": "", "seriesNumber": "", "pages": "", "DOI": "", "ISBN": "", "citationKey": "", "url": "https://halshs.archives-ouvertes.fr/halshs-00847791/document", "accessDate": "2016-05-07T10:48:18Z", "ISSN": "", "archive": "", "archiveLocation": "", "shortTitle": "", "language": "fr", "libraryCatalog": "halshs.archives-ouvertes.fr", "callNumber": "", "rights": "", "extra": "", "tags": [], "collections": [ "PGG56IHU" ], "relations": {}, "dateAdded": "2016-05-07T10:48:18Z", "dateModified": "2016-05-07T10:48:18Z" } }, { "key": "EZ9PNPA3", "version": 35, "library": { "type": "group", "id": 246876, "name": "Biblio Internat Santé Publique", "links": { "alternate": { "href": "https://www.zotero.org/groups/biblio_internat_sant_publique", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/246876/items/EZ9PNPA3", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/biblio_internat_sant_publique/items/EZ9PNPA3", "type": "text/html" }, "up": { "href": "https://api.zotero.org/groups/246876/items/96EXN49M", "type": "application/json" } }, "meta": { "createdByUser": { "id": 156694, "username": "brunart", "name": "Bruna ALVES", "links": { "alternate": { "href": "https://www.zotero.org/brunart", "type": "text/html" } } }, "numChildren": 0 }, "data": { "key": "EZ9PNPA3", "version": 35, "parentItem": "96EXN49M", "itemType": "attachment", "linkMode": "imported_file", "title": "Massuda et al. - 2009 - Uma chama que se apaga residência de medicina pre.pdf", "accessDate": "", "url": "", "note": "", "contentType": "application/pdf", "charset": "", "filename": "Massuda et al. - 2009 - Uma chama que se apaga residência de medicina pre.pdf", "md5": "bcc78ddc222fe17dd19185d48a912ec7", "mtime": 1392679637000, "tags": [], "relations": {}, "dateAdded": "2014-02-17T23:27:17Z", "dateModified": "2014-02-17T23:27:17Z" } }, { "key": "96EXN49M", "version": 34, "library": { "type": "group", "id": 246876, "name": "Biblio Internat Santé Publique", "links": { "alternate": { "href": "https://www.zotero.org/groups/biblio_internat_sant_publique", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/246876/items/96EXN49M", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/biblio_internat_sant_publique/items/96EXN49M", "type": "text/html" } }, "meta": { "createdByUser": { "id": 156694, "username": "brunart", "name": "Bruna ALVES", "links": { "alternate": { "href": "https://www.zotero.org/brunart", "type": "text/html" } } }, "creatorSummary": "Massuda et al.", "parsedDate": "2009", "numChildren": 1 }, "data": { "key": "96EXN49M", "version": 34, "itemType": "journalArticle", "title": "Uma chama que se apaga: residência de medicina preventiva e social. (A failing light: preventive and social medical residence)", "creators": [ { "creatorType": "author", "firstName": "Adriano", "lastName": "Massuda" }, { "creatorType": "author", "firstName": "Nelson Filice de", "lastName": "Barros" }, { "creatorType": "author", "firstName": "Roberto Jorge Freire", "lastName": "Esteves" }, { "creatorType": "author", "firstName": "Viviane Ribeiro", "lastName": "Guimarães" } ], "abstractNote": "The extinction process which the Preventive and Social Medicine Residency Programs (PSMR) have experienced in the past several years constitutes a paradox in the face of the need for physicians with at Public Health background in the Brazilian National Health System (SUS). The present paper investigated which are the practice sceneries and how the practical and theoretical activities are developed into PSMR programs. After reviewing them, it was observed that most programs include activities in health care delivery, as well as those in the three main fields of Collective Health. However, significant differences were evidenced among the programs. It was possible construct a typology, identifying the type 'Generalist in Collective Health', who approaches the three main fields of Collective Health; the type 'Epidemiology', which focuses exclusively on this field; and the type 'Community Health', which is centered in Health Basic Care. From the crossing among historical construction processes and present reality, we coould infer that the inexistance of State Policies for graduate health professionals in this area, along with the lack of participation of other social stakeholders with this residence are the most important factors resulting in the demise of this once important medical specialty in Brazil.", "publicationTitle": "Revista brasileira de educação médica", "publisher": "", "place": "", "date": "2009", "volume": "33", "issue": "4", "section": "", "partNumber": "", "partTitle": "", "pages": "633-43", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "Rev. bras. educ. med.", "DOI": "", "citationKey": "", "url": "http://www.scielo.br/scielo.php?script=sci_pdf&pid=S0100-55022009000400014&lng=en&nrm=iso&tlng=pt", "accessDate": "2014-02-17", "PMID": "", "PMCID": "", "ISSN": "0100-5502", "archive": "", "archiveLocation": "", "shortTitle": "", "language": "Português", "libraryCatalog": "", "callNumber": "", "rights": "", "extra": "", "tags": [], "collections": [ "VKWS4ZMV" ], "relations": {}, "dateAdded": "2014-02-17T23:27:17Z", "dateModified": "2014-02-17T23:27:17Z" } }, { "key": "3RDPUVA5", "version": 27, "library": { "type": "group", "id": 246876, "name": "Biblio Internat Santé Publique", "links": { "alternate": { "href": "https://www.zotero.org/groups/biblio_internat_sant_publique", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/246876/items/3RDPUVA5", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/biblio_internat_sant_publique/items/3RDPUVA5", "type": "text/html" } }, "meta": { "createdByUser": { "id": 156694, "username": "brunart", "name": "Bruna ALVES", "links": { "alternate": { "href": "https://www.zotero.org/brunart", "type": "text/html" } } }, "creatorSummary": "Commission nationale informatique et libertés", "parsedDate": "2010-07-07", "numChildren": 0 }, "data": { "key": "3RDPUVA5", "version": 27, "itemType": "statute", "nameOfAct": "Délibération no 2010-229 du 10 juin 2010 dispensant de déclaration les traitements automatisés de données à caractère personnel mis en œuvre par des organismes à but non lucratif abrogeant et remplaçant la délibération no 2006-130 du 9 mai 2006 (décision de dispense de déclaration no 8)", "creators": [ { "creatorType": "author", "firstName": "", "lastName": "Commission nationale informatique et libertés" } ], "abstractNote": "", "code": "JORF", "codeNumber": "", "publicLawNumber": "CNIA1000008X", "dateEnacted": "2010-07-07", "pages": "", "section": "", "session": "", "history": "", "DOI": "", "citationKey": "", "url": "", "accessDate": "", "shortTitle": "", "language": "Français", "rights": "", "extra": "", "tags": [], "collections": [ "PGG56IHU", "RPBIRESP" ], "relations": {}, "dateAdded": "2014-02-06T16:11:56Z", "dateModified": "2014-02-06T16:24:30Z" } }, { "key": "9ITAQTAG", "version": 58, "library": { "type": "group", "id": 246876, "name": "Biblio Internat Santé Publique", "links": { "alternate": { "href": "https://www.zotero.org/groups/biblio_internat_sant_publique", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/246876/items/9ITAQTAG", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/biblio_internat_sant_publique/items/9ITAQTAG", "type": "text/html" } }, "meta": { "createdByUser": { "id": 156694, "username": "brunart", "name": "Bruna ALVES", "links": { "alternate": { "href": "https://www.zotero.org/brunart", "type": "text/html" } } }, "lastModifiedByUser": { "id": 238330, "username": "frederic.dugue", "name": "Frédéric DUGUÉ", "links": { "alternate": { "href": "https://www.zotero.org/frederic.dugue", "type": "text/html" } } }, "creatorSummary": "Al Shanafey et al.", "parsedDate": "2009-10", "numChildren": 0 }, "data": { "key": "9ITAQTAG", "version": 58, "itemType": "journalArticle", "title": "Surgical resident satisfaction with the current surgical training program in the Riyadh area", "creators": [ { "creatorType": "author", "firstName": "Saud", "lastName": "Al Shanafey" }, { "creatorType": "author", "firstName": "Ali", "lastName": "Alzahrani" }, { "creatorType": "author", "firstName": "Abdulrahman", "lastName": "AlBallaa" }, { "creatorType": "author", "firstName": "Abdulaziz", "lastName": "Alballaa" } ], "abstractNote": "BACKGROUND: The satisfaction of surgical residents with their training programs plays an important role in dictating its output. This survey was conducted to explore the satisfaction of surgical residents with their training programs in the Riyadh area. METHODS: A survey questionnaire was distributed in four major hospitals to explore the view of surgical residents regarding their training programs. Frequency tables were generated for each question in the survey. RESULTS: About 78 survey forms were distributed and 52 were retrieved (67%). About 45% of residents had a comprehensive orientation on admission to the program, but only 20% felt it was helpful. Only 40% of residents felt that their trainers were committed to training and that the consultants who were trained abroad were more committed than those trained locally (62% vs 36%, P =.01). Only 15% felt the residents themselves had enough bedside teaching or operative experience. Seventy-eight percent of the residents felt that current training does not meet their expectations. However, 85% felt that training abroad was better than local training, and 60% felt it should be mandatory. While 90% felt that training programs should be unified nationally and controlled by one organization, only 6% felt that the current governing body was capable of monitoring the training. Moreover, only 28% felt that current reviews of programs by the governing body are effective. CONCLUSIONS: These results show that surgical residents are generally dissatisfied with current training programs. The study suggests that there are significant weaknesses in the current programs and the governing body may be ineffective in monitoring the programs. We feel that a national review of surgical training programs is warranted in view of these results.", "publicationTitle": "Annals of Saudi Medicine", "publisher": "", "place": "", "date": "2009 Sep-Oct", "volume": "29", "issue": "5", "section": "", "partNumber": "", "partTitle": "", "pages": "388-392", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "Ann Saudi Med", "DOI": "", "citationKey": "", "url": "http://www.ncbi.nlm.nih.gov/pubmed/19700898", "accessDate": "2010-09-30T16:26:51Z", "PMID": "19700898", "PMCID": "", "ISSN": "0975-4466", "archive": "", "archiveLocation": "", "shortTitle": "", "language": "", "libraryCatalog": "NCBI PubMed", "callNumber": "", "rights": "", "extra": "", "tags": [ { "tag": "Attitude of Health Personnel", "type": 1 }, { "tag": "Education, Medical, Graduate", "type": 1 }, { "tag": "Faculty, Medical", "type": 1 }, { "tag": "General Surgery", "type": 1 }, { "tag": "Humans", "type": 1 }, { "tag": "Internship and Residency", "type": 1 }, { "tag": "Program Evaluation", "type": 1 }, { "tag": "Questionnaires", "type": 1 }, { "tag": "Saudi Arabia", "type": 1 } ], "collections": [ "3B2ZSEZA" ], "relations": {}, "dateAdded": "2014-02-06T16:11:56Z", "dateModified": "2014-02-06T16:18:09Z" } }, { "key": "GUMZU7HU", "version": 60, "library": { "type": "group", "id": 246876, "name": "Biblio Internat Santé Publique", "links": { "alternate": { "href": "https://www.zotero.org/groups/biblio_internat_sant_publique", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/246876/items/GUMZU7HU", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/biblio_internat_sant_publique/items/GUMZU7HU", "type": "text/html" } }, "meta": { "createdByUser": { "id": 156694, "username": "brunart", "name": "Bruna ALVES", "links": { "alternate": { "href": "https://www.zotero.org/brunart", "type": "text/html" } } }, "lastModifiedByUser": { "id": 238330, "username": "frederic.dugue", "name": "Frédéric DUGUÉ", "links": { "alternate": { "href": "https://www.zotero.org/frederic.dugue", "type": "text/html" } } }, "creatorSummary": "Fleming et al.", "parsedDate": "1975-04", "numChildren": 0 }, "data": { "key": "GUMZU7HU", "version": 60, "itemType": "journalArticle", "title": "From student to staff nurse: a nurse internship program", "creators": [ { "creatorType": "author", "firstName": "B W", "lastName": "Fleming" }, { "creatorType": "author", "firstName": "A G", "lastName": "Woodcock" }, { "creatorType": "author", "firstName": "B T", "lastName": "Boyd" } ], "abstractNote": "", "publicationTitle": "The American Journal of Nursing", "publisher": "", "place": "", "date": "Apr 1975", "volume": "75", "issue": "4", "section": "", "partNumber": "", "partTitle": "", "pages": "595-599", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "Am J Nurs", "DOI": "", "citationKey": "", "url": "http://www.ncbi.nlm.nih.gov/pubmed/1039247", "accessDate": "2010-09-29T08:49:16Z", "PMID": "1039247", "PMCID": "", "ISSN": "0002-936X", "archive": "", "archiveLocation": "", "shortTitle": "From student to staff nurse", "language": "", "libraryCatalog": "NCBI PubMed", "callNumber": "", "rights": "", "extra": "", "tags": [ { "tag": "Curriculum", "type": 1 }, { "tag": "Education, Nursing, Continuing", "type": 1 }, { "tag": "Evaluation Studies as Topic", "type": 1 }, { "tag": "Faculty, Nursing", "type": 1 }, { "tag": "Hospital Units", "type": 1 }, { "tag": "Hospitals, University", "type": 1 }, { "tag": "Inservice Training", "type": 1 }, { "tag": "Internship and Residency", "type": 1 }, { "tag": "Nursing Service, Hospital", "type": 1 }, { "tag": "Nursing, Supervisory", "type": 1 }, { "tag": "Referral and Consultation", "type": 1 }, { "tag": "Virginia", "type": 1 } ], "collections": [ "3B2ZSEZA" ], "relations": {}, "dateAdded": "2014-02-06T16:11:56Z", "dateModified": "2014-02-06T16:11:56Z" } }, { "key": "QQHX7UMQ", "version": 60, "library": { "type": "group", "id": 246876, "name": "Biblio Internat Santé Publique", "links": { "alternate": { "href": "https://www.zotero.org/groups/biblio_internat_sant_publique", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/246876/items/QQHX7UMQ", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/biblio_internat_sant_publique/items/QQHX7UMQ", "type": "text/html" } }, "meta": { "createdByUser": { "id": 156694, "username": "brunart", "name": "Bruna ALVES", "links": { "alternate": { "href": "https://www.zotero.org/brunart", "type": "text/html" } } }, "lastModifiedByUser": { "id": 238330, "username": "frederic.dugue", "name": "Frédéric DUGUÉ", "links": { "alternate": { "href": "https://www.zotero.org/frederic.dugue", "type": "text/html" } } }, "creatorSummary": "Espinoza G et al.", "parsedDate": "2009-07", "numChildren": 0 }, "data": { "key": "QQHX7UMQ", "version": 60, "itemType": "journalArticle", "title": "[Resident evaluation of general surgery training programs]", "creators": [ { "creatorType": "author", "firstName": "Ricardo", "lastName": "Espinoza G" }, { "creatorType": "author", "firstName": "Stefan", "lastName": "Danilla E" }, { "creatorType": "author", "firstName": "Fabio", "lastName": "Valdés G" }, { "creatorType": "author", "firstName": "Ignacio", "lastName": "San Francisco R" }, { "creatorType": "author", "firstName": "Osvaldo", "lastName": "Llanos L" } ], "abstractNote": "BACKGROUND: The profile of the general surgeon has changed, aiming to incorporate new skills and to develop new specialties. AIM: To assess the quality of postgraduate General Surgery training programs given by Chilean universities, the satisfaction of students and their preferences after finishing the training period. MATERIAL AND METHODS: A survey with multiple choice and Likert type questions was designed and applied to 77 surgery residents, corresponding to 59% of all residents of general surgery specialization programs of Chilean universities. RESULTS: Fifty five per cent of residents financed with their own resources the specialization program. Thirty nine percent disagreed partially or totally with the objectives and rotations of programs. The opportunity to perform surgical interventions and the support by teachers was well evaluated. However, 23% revealed teacher maltreatment. Fifty six percent performed research activities, 73% expected to continue training in a derived specialty and 69% was satisfied with the training program. CONCLUSIONS: Residents considered that the quality and dedication of professors and financing of programs are issues that must be improved. The opportunity to perform surgical interventions, obtaining a salary for their work and teacher support is considered of utmost importance.", "publicationTitle": "Revista Médica De Chile", "publisher": "", "place": "", "date": "Jul 2009", "volume": "137", "issue": "7", "section": "", "partNumber": "", "partTitle": "", "pages": "940-945", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "Rev Med Chil", "DOI": "/S0034-98872009000700013", "citationKey": "", "url": "http://www.ncbi.nlm.nih.gov/pubmed/19802424", "accessDate": "2010-09-30T16:27:47Z", "PMID": "19802424", "PMCID": "", "ISSN": "0034-9887", "archive": "", "archiveLocation": "", "shortTitle": "", "language": "", "libraryCatalog": "NCBI PubMed", "callNumber": "", "rights": "", "extra": "", "tags": [ { "tag": "Career Choice", "type": 1 }, { "tag": "Chile", "type": 1 }, { "tag": "Education, Medical, Graduate", "type": 1 }, { "tag": "Female", "type": 1 }, { "tag": "General Surgery", "type": 1 }, { "tag": "Humans", "type": 1 }, { "tag": "Internship and Residency", "type": 1 }, { "tag": "Male", "type": 1 }, { "tag": "Program Evaluation", "type": 1 }, { "tag": "Specialization", "type": 1 }, { "tag": "Statistics, Nonparametric", "type": 1 }, { "tag": "Students, Medical", "type": 1 } ], "collections": [ "3B2ZSEZA" ], "relations": {}, "dateAdded": "2014-02-06T16:11:56Z", "dateModified": "2014-02-06T16:11:56Z" } }, { "key": "RMA6TEWU", "version": 60, "library": { "type": "group", "id": 246876, "name": "Biblio Internat Santé Publique", "links": { "alternate": { "href": "https://www.zotero.org/groups/biblio_internat_sant_publique", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/246876/items/RMA6TEWU", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/biblio_internat_sant_publique/items/RMA6TEWU", "type": "text/html" } }, "meta": { "createdByUser": { "id": 156694, "username": "brunart", "name": "Bruna ALVES", "links": { "alternate": { "href": "https://www.zotero.org/brunart", "type": "text/html" } } }, "lastModifiedByUser": { "id": 238330, "username": "frederic.dugue", "name": "Frédéric DUGUÉ", "links": { "alternate": { "href": "https://www.zotero.org/frederic.dugue", "type": "text/html" } } }, "creatorSummary": "Curtis et al.", "parsedDate": "1994-10", "numChildren": 0 }, "data": { "key": "RMA6TEWU", "version": 60, "itemType": "journalArticle", "title": "Internal medicine residents' skills at identification of HIV-risk behavior and HIV-related disease", "creators": [ { "creatorType": "author", "firstName": "J R", "lastName": "Curtis" }, { "creatorType": "author", "firstName": "D S", "lastName": "Paauw" }, { "creatorType": "author", "firstName": "M D", "lastName": "Wenrich" }, { "creatorType": "author", "firstName": "J D", "lastName": "Carline" }, { "creatorType": "author", "firstName": "P G", "lastName": "Ramsey" } ], "abstractNote": "", "publicationTitle": "Academic Medicine: Journal of the Association of American Medical Colleges", "publisher": "", "place": "", "date": "Oct 1994", "volume": "69", "issue": "10 Suppl", "section": "", "partNumber": "", "partTitle": "", "pages": "S45-47", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "Acad Med", "DOI": "", "citationKey": "", "url": "http://www.ncbi.nlm.nih.gov/pubmed/7916825", "accessDate": "2010-09-29T08:48:15Z", "PMID": "7916825", "PMCID": "", "ISSN": "1040-2446", "archive": "", "archiveLocation": "", "shortTitle": "", "language": "", "libraryCatalog": "NCBI PubMed", "callNumber": "", "rights": "", "extra": "", "tags": [ { "tag": "Alcohol Drinking", "type": 1 }, { "tag": "Clinical Competence", "type": 1 }, { "tag": "Counseling", "type": 1 }, { "tag": "Evaluation Studies as Topic", "type": 1 }, { "tag": "Female", "type": 1 }, { "tag": "HIV Infections", "type": 1 }, { "tag": "Health Behavior", "type": 1 }, { "tag": "Hospitals, University", "type": 1 }, { "tag": "Humans", "type": 1 }, { "tag": "Internal Medicine", "type": 1 }, { "tag": "Internship and Residency", "type": 1 }, { "tag": "Male", "type": 1 }, { "tag": "Medical History Taking", "type": 1 }, { "tag": "Physical Examination", "type": 1 }, { "tag": "Risk-Taking", "type": 1 }, { "tag": "Sexual Behavior", "type": 1 }, { "tag": "Substance Abuse, Intravenous", "type": 1 }, { "tag": "Washington", "type": 1 } ], "collections": [ "3B2ZSEZA" ], "relations": {}, "dateAdded": "2014-02-06T16:11:56Z", "dateModified": "2014-02-06T16:11:56Z" } }, { "key": "ZJ5WESGD", "version": 60, "library": { "type": "group", "id": 246876, "name": "Biblio Internat Santé Publique", "links": { "alternate": { "href": "https://www.zotero.org/groups/biblio_internat_sant_publique", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/246876/items/ZJ5WESGD", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/biblio_internat_sant_publique/items/ZJ5WESGD", "type": "text/html" } }, "meta": { "createdByUser": { "id": 156694, "username": "brunart", "name": "Bruna ALVES", "links": { "alternate": { "href": "https://www.zotero.org/brunart", "type": "text/html" } } }, "lastModifiedByUser": { "id": 238330, "username": "frederic.dugue", "name": "Frédéric DUGUÉ", "links": { "alternate": { "href": "https://www.zotero.org/frederic.dugue", "type": "text/html" } } }, "creatorSummary": "Deisher", "parsedDate": "1978-11", "numChildren": 0 }, "data": { "key": "ZJ5WESGD", "version": 60, "itemType": "journalArticle", "title": "The problem-oriented unit record in residency management", "creators": [ { "creatorType": "author", "firstName": "J B", "lastName": "Deisher" } ], "abstractNote": "Application of the \"medical model\" of supervision to a university affiliated residency network resulted in a problem-oriented record for each unit. A data-base tabulation and standardized problem list were developed. These have been found useful in the supervision/consultation process for established programs, in the assistance of developers of new programs, and in evaluative reporting.", "publicationTitle": "The Journal of Family Practice", "publisher": "", "place": "", "date": "Nov 1978", "volume": "7", "issue": "5", "section": "", "partNumber": "", "partTitle": "", "pages": "1059-1060", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "J Fam Pract", "DOI": "", "citationKey": "", "url": "http://www.ncbi.nlm.nih.gov/pubmed/309928", "accessDate": "2010-09-29T08:48:59Z", "PMID": "309928", "PMCID": "", "ISSN": "0094-3509", "archive": "", "archiveLocation": "", "shortTitle": "", "language": "", "libraryCatalog": "NCBI PubMed", "callNumber": "", "rights": "", "extra": "", "tags": [ { "tag": "Evaluation Studies as Topic", "type": 1 }, { "tag": "Family Practice", "type": 1 }, { "tag": "Hospital Records", "type": 1 }, { "tag": "Hospitals, Teaching", "type": 1 }, { "tag": "Hospitals, University", "type": 1 }, { "tag": "Humans", "type": 1 }, { "tag": "Internship and Residency", "type": 1 }, { "tag": "Medical Records, Problem-Oriented", "type": 1 }, { "tag": "Models, Theoretical", "type": 1 }, { "tag": "Records as Topic", "type": 1 }, { "tag": "Washington", "type": 1 } ], "collections": [ "PGG56IHU" ], "relations": {}, "dateAdded": "2014-02-06T16:11:56Z", "dateModified": "2014-02-06T16:11:56Z" } }, { "key": "H4TPFBMK", "version": 59, "library": { "type": "group", "id": 246876, "name": "Biblio Internat Santé Publique", "links": { "alternate": { "href": "https://www.zotero.org/groups/biblio_internat_sant_publique", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/246876/items/H4TPFBMK", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/biblio_internat_sant_publique/items/H4TPFBMK", "type": "text/html" } }, "meta": { "createdByUser": { "id": 156694, "username": "brunart", "name": "Bruna ALVES", "links": { "alternate": { "href": "https://www.zotero.org/brunart", "type": "text/html" } } }, "lastModifiedByUser": { "id": 238330, "username": "frederic.dugue", "name": "Frédéric DUGUÉ", "links": { "alternate": { "href": "https://www.zotero.org/frederic.dugue", "type": "text/html" } } }, "creatorSummary": "Peeters and Pinto", "parsedDate": "2009-02", "numChildren": 0 }, "data": { "key": "H4TPFBMK", "version": 59, "itemType": "journalArticle", "title": "Assessing the impact of an educational program on decreasing prescribing errors at a university hospital", "creators": [ { "creatorType": "author", "firstName": "Michael J", "lastName": "Peeters" }, { "creatorType": "author", "firstName": "Sharrel L", "lastName": "Pinto" } ], "abstractNote": "BACKGROUND: Several complex and costly interventions reduce medication errors. Little exists on the effectiveness of providing education and feedback to institutional clinicians as a means of reducing errors. OBJECTIVE: To determine the impact on prescribing errors of a pharmacist-led educational intervention. DESIGN: Prospective, interrupted time series study. SETTING: This study was conducted among internal medicine residents at the 320-bed University of Toledo Medical Center. INTERVENTION: The educational intervention was conducted during a 6-month period beginning in November 2006. The intervention included an initial hour-long lecture followed by biweekly and then monthly discussions that used timely, institution-specific examples of prescribing errors. MEASUREMENTS: Data were collected at 5 time points: month 0 (preintervention period); months 1, 3, and 6 (intervention period); and month 7 (postintervention period). Errors were identified, transcribed, coded, and entered into a database. The primary outcome was the frequency of prescribing errors during each period. A Bonferroni-adjusted chi-square analysis was conducted with an a priori experiment-wise alpha of 0.05. RESULTS: A reduction in prescribing errors of 33% following the first intervention month and a mean 26% reduction during the study period were observed (P<0.0025). The frequencies of preintervention and postintervention errors did not differ significantly. CONCLUSIONS: A straightforward educational intervention reduced prescribing errors during the period of active intervention, but this effect was not sustained. Ongoing communication and education about institution-specific medication errors appear warranted.", "publicationTitle": "Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine", "publisher": "", "place": "", "date": "Feb 2009", "volume": "4", "issue": "2", "section": "", "partNumber": "", "partTitle": "", "pages": "97-101", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "J Hosp Med", "DOI": "10.1002/jhm.387", "citationKey": "", "url": "http://www.ncbi.nlm.nih.gov/pubmed/19219923", "accessDate": "2010-09-29T08:47:18Z", "PMID": "19219923", "PMCID": "", "ISSN": "1553-5606", "archive": "", "archiveLocation": "", "shortTitle": "", "language": "", "libraryCatalog": "NCBI PubMed", "callNumber": "", "rights": "", "extra": "", "tags": [ { "tag": "Chi-Square Distribution", "type": 1 }, { "tag": "Clinical Pharmacy Information Systems", "type": 1 }, { "tag": "Databases, Factual", "type": 1 }, { "tag": "Drug Utilization Review", "type": 1 }, { "tag": "Feedback", "type": 1 }, { "tag": "Hospital Bed Capacity, 300 to 499", "type": 1 }, { "tag": "Hospitals, University", "type": 1 }, { "tag": "Humans", "type": 1 }, { "tag": "Internal Medicine", "type": 1 }, { "tag": "Internship and Residency", "type": 1 }, { "tag": "Intervention Studies", "type": 1 }, { "tag": "Medication Errors", "type": 1 }, { "tag": "Ohio", "type": 1 }, { "tag": "Pharmacy Service, Hospital", "type": 1 }, { "tag": "Program Evaluation", "type": 1 }, { "tag": "Prospective Studies", "type": 1 } ], "collections": [ "3B2ZSEZA" ], "relations": {}, "dateAdded": "2014-02-06T16:11:56Z", "dateModified": "2014-02-06T16:11:56Z" } }, { "key": "PKJXNRZG", "version": 59, "library": { "type": "group", "id": 246876, "name": "Biblio Internat Santé Publique", "links": { "alternate": { "href": "https://www.zotero.org/groups/biblio_internat_sant_publique", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/246876/items/PKJXNRZG", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/biblio_internat_sant_publique/items/PKJXNRZG", "type": "text/html" } }, "meta": { "createdByUser": { "id": 156694, "username": "brunart", "name": "Bruna ALVES", "links": { "alternate": { "href": "https://www.zotero.org/brunart", "type": "text/html" } } }, "lastModifiedByUser": { "id": 238330, "username": "frederic.dugue", "name": "Frédéric DUGUÉ", "links": { "alternate": { "href": "https://www.zotero.org/frederic.dugue", "type": "text/html" } } }, "creatorSummary": "Luthy et al.", "parsedDate": "2004-10-16", "numChildren": 0 }, "data": { "key": "PKJXNRZG", "version": 59, "itemType": "journalArticle", "title": "Exploring the major difficulties perceived by residents in training: a pilot study", "creators": [ { "creatorType": "author", "firstName": "Christophe", "lastName": "Luthy" }, { "creatorType": "author", "firstName": "Arnaud", "lastName": "Perrier" }, { "creatorType": "author", "firstName": "Eliane", "lastName": "Perrin" }, { "creatorType": "author", "firstName": "Christine", "lastName": "Cedraschi" }, { "creatorType": "author", "firstName": "Anne-Françoise", "lastName": "Allaz" } ], "abstractNote": "OBJECTIVES: To assess residents' difficulties during the first year of residency. In contrast to previous studies that mainly used structured questionnaires, a qualitative procedure was applied. METHODS: Twenty-four consecutive first-year residents in internal medicine were asked to \"Please identify two to three major difficulties or concerns related to your practice of medicine within this hospital\". The answers were submitted to content analysis performed by three independent researchers. Inter-rater agreement was high (kappa coefficient = 0.92). Disagreements were solved by consensus. RESULTS: Physicians' characteristics: female 37%, mean age 28 +/- 2.2 years, mean duration of postgraduate training 2.5 +/- 1.3 years. Total number of answers: 122, average answers/resident 5.1 +/- 1.3. Nine categories were extracted from content analysis: communication problems at the workplace, feelings of not being respected, constraints of collaborative work, experiencing the gap between medical school and clinical care, work overload, responsibility towards and emotional investment in patients, worries about career plans, and lack of theoretical knowledge. Residents expressed major difficulties in communicating with and being respected by seniors and peers in particular, and hospital staff in general. They also voiced problems in coping with emotions, either their own or those of their patients. CONCLUSIONS: The residents' responses stressed the complexity of blending the requirements of the physician's role when instrumental/cognitive knowledge is not sufficient to deal with problems requiring personal and relational dimensions. Learning to combine medical knowledge and practice necessitates helping students/residents identify and deal with the constraints of these requirements.", "publicationTitle": "Swiss Medical Weekly: Official Journal of the Swiss Society of Infectious Diseases, the Swiss Society of Internal Medicine, the Swiss Society of Pneumology", "publisher": "", "place": "", "date": "Oct 16, 2004", "volume": "134", "issue": "41-42", "section": "", "partNumber": "", "partTitle": "", "pages": "612-617", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "Swiss Med Wkly", "DOI": "2004/41/smw-10795", "citationKey": "", "url": "http://www.ncbi.nlm.nih.gov/pubmed/15592955", "accessDate": "2010-09-29T08:47:52Z", "PMID": "15592955", "PMCID": "", "ISSN": "1424-7860", "archive": "", "archiveLocation": "", "shortTitle": "Exploring the major difficulties perceived by residents in training", "language": "", "libraryCatalog": "NCBI PubMed", "callNumber": "", "rights": "", "extra": "", "tags": [ { "tag": "Adult", "type": 1 }, { "tag": "Attitude of Health Personnel", "type": 1 }, { "tag": "Communication", "type": 1 }, { "tag": "Female", "type": 1 }, { "tag": "Hospitals, University", "type": 1 }, { "tag": "Humans", "type": 1 }, { "tag": "Internal Medicine", "type": 1 }, { "tag": "Internship and Residency", "type": 1 }, { "tag": "Interprofessional Relations", "type": 1 }, { "tag": "Male", "type": 1 }, { "tag": "Physician's Role", "type": 1 }, { "tag": "Physician-Patient Relations", "type": 1 }, { "tag": "Pilot Projects", "type": 1 }, { "tag": "Qualitative Research", "type": 1 }, { "tag": "Stress, Psychological", "type": 1 }, { "tag": "Switzerland", "type": 1 }, { "tag": "Workload", "type": 1 }, { "tag": "Workplace", "type": 1 } ], "collections": [ "PGG56IHU" ], "relations": {}, "dateAdded": "2014-02-06T16:11:56Z", "dateModified": "2014-02-06T16:11:56Z" } }, { "key": "63JWHQNN", "version": 59, "library": { "type": "group", "id": 246876, "name": "Biblio Internat Santé Publique", "links": { "alternate": { "href": "https://www.zotero.org/groups/biblio_internat_sant_publique", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/246876/items/63JWHQNN", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/biblio_internat_sant_publique/items/63JWHQNN", "type": "text/html" } }, "meta": { "createdByUser": { "id": 156694, "username": "brunart", "name": "Bruna ALVES", "links": { "alternate": { "href": "https://www.zotero.org/brunart", "type": "text/html" } } }, "lastModifiedByUser": { "id": 238330, "username": "frederic.dugue", "name": "Frédéric DUGUÉ", "links": { "alternate": { "href": "https://www.zotero.org/frederic.dugue", "type": "text/html" } } }, "creatorSummary": "Imseis and Galvin", "parsedDate": "2004-11", "numChildren": 0 }, "data": { "key": "63JWHQNN", "version": 59, "itemType": "journalArticle", "title": "Faculty and resident preference for two different forms of lecture evaluation", "creators": [ { "creatorType": "author", "firstName": "Hytham M", "lastName": "Imseis" }, { "creatorType": "author", "firstName": "Shelley L", "lastName": "Galvin" } ], "abstractNote": "OBJECTIVE: This study was undertaken to compare the use of 2 different lecture evaluation forms developed for obstetrics and gynecology residents to evaluate core curriculum lectures given by faculty. STUDY DESIGN: Content and delivery of faculty lectures were evaluated by residents using (1) a 10-question evaluation form that used a 5-point rating scale and (2) a checklist evaluation form that offered multiple options to improve lectures but provided no numerical score. Each form was used exclusively for 4 months. Faculty received feedback from both forms; then faculty and residents were surveyed regarding their preferences. RESULTS: A total of 384 rating scale and 398 checklist evaluation forms were completed during the study period. Residents preferred to complete the rating scale evaluation forms (67%), whereas faculty preferred feedback from the checklist evaluation forms (62%). Faculty were more likely to plan changes to their lecture format with feedback from the checklist evaluation forms (75% vs 25%, P = .031). CONCLUSION: Although devoid of structured positive feedback, the checklist lecture evaluation form was preferred by faculty.", "publicationTitle": "American Journal of Obstetrics and Gynecology", "publisher": "", "place": "", "date": "Nov 2004", "volume": "191", "issue": "5", "section": "", "partNumber": "", "partTitle": "", "pages": "1815-1821", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "Am. J. Obstet. Gynecol", "DOI": "10.1016/j.ajog.2004.07.068", "citationKey": "", "url": "http://www.ncbi.nlm.nih.gov/pubmed/15547571", "accessDate": "2010-09-29T08:47:57Z", "PMID": "15547571", "PMCID": "", "ISSN": "0002-9378", "archive": "", "archiveLocation": "", "shortTitle": "", "language": "", "libraryCatalog": "NCBI PubMed", "callNumber": "", "rights": "", "extra": "", "tags": [ { "tag": "Faculty", "type": 1 }, { "tag": "Gynecology", "type": 1 }, { "tag": "Hospitals, University", "type": 1 }, { "tag": "Humans", "type": 1 }, { "tag": "Internship and Residency", "type": 1 }, { "tag": "North Carolina", "type": 1 }, { "tag": "Obstetrics", "type": 1 }, { "tag": "Program Evaluation", "type": 1 }, { "tag": "Teaching", "type": 1 } ], "collections": [ "N2KKUCW8" ], "relations": {}, "dateAdded": "2014-02-06T16:11:56Z", "dateModified": "2014-02-06T16:11:56Z" } } ]