A new way of hearing

Leaving the room, I marveled at what we learn when we create the space to allow our patients to tell us their stories, to show us what they need and to teach us how they adapt. I was reminded how much easier it is to listen than to write and un-write my own stories about them

Episode 5: Penal Code

Qiuwei Yang and Dr. Hugh Silk are joined by family physician Dr. Lisa Gussak to discuss the impact of incarceration on health and medical care. Recorded November 2019. Dr. Gussak\u27s piece Penal Code was first published in Pulse: Voices from the Heart of Medicine. The transcript for this episode is available for download as an additional file

An Ounce of Prevention: How Are We Managing the Early Assessment of Residents\u27 Clinical Skills?: A CERA Study

BACKGROUND AND OBJECTIVES: Clinical skills deficits in residents are common but when identified early can result in decreased cost, faculty time, and stress related to remediation. There is currently no accepted best practice for early assessment of incoming residents\u27 clinical skills. This study describes the current state of early PGY-1 clinical skills assessment in US family medicine residencies. METHODS: Eleven questions were embedded in the nationwide CERA survey to US family medicine residency directors regarding the processes, components, and barriers to early PGY-1 assessment. Responses are described, and bivariate analyses of the relationship between assessment variables and percentage of international medical graduates (IMGs), type of program, and barriers to implementation were performed using chi square testing. RESULTS: Almost four of five (78.4%) responding programs conduct formal early assessments to establish baseline clinical skills (89.6%), provide PGY-1 residents with a guide to focus their learning goals (71.6%), and less often, in response to resident performance problems (34.3%). Barriers to implementing PGY-1 early assessment programs include cost of faculty time (56.3%), cost of tools (42.1%), and time for the assessment during the PGY-1 resident\u27s schedule (41.0%). Cost of faculty time and time for assessment from the PGY-1 resident\u27s schedule were statistically significant major/insurmountable barriers for community-based, non-university-affiliated programs. CONCLUSIONS: Early PGY-1 assessments with locally developed tools for direct observation are commonly used in family medicine residency programs. Assessment program development should be targeted toward using existing, validated tools during the PGY-1 resident\u27s patient care schedule

Lichen

I enjoy photography as it allows me to see the world in new and interesting ways. I am drawn to patterns, shapes and colors as they appear in the natural world. I like seeing things out to their normal context, such that the small things are made large or vice versa. I find that capturing the details of the everyday world I am forced to see things in new and exciting ways. All my pictures are shot with my iPhone. Lichen: a favorite thing to photograph. I am fascinated by the colors, the details and the otherworldliness of these small collections of prehistoric plants. This was found on a rock near a lake in CT, shot with my macro lens

Leaf Bag

I enjoy photography as it allows me to see the world in new and interesting ways. I am drawn to patterns, shapes and colors as they appear in the natural world. I like seeing things out to their normal context, such that the small things are made large or vice versa. I find that capturing the details of the everyday world I am forced to see things in new and exciting ways. All my pictures are shot with my iPhone. Leaf bag: on a rainy day in Greenville NC I noticed the wet clippings from someone’s yard in a bag. The pattern of the water droplets caught my eye