Identifying and Co-managing the HIV-infected Adult: A Guidebook for Primary Care Clinicians

This guidebook was designed to help primary care clinicians improve their performance in terms of HIV identification and co-management. Surmounting barriers to opt-out screening, making an HIV diagnosis, and preventing transmission and opportunistic infections will be discussed, as will selection of initial therapy and considerations for patients receiving antiretroviral therapy (ART)

Exacerbation of dideoxycytidine-induced neuropathy with dideoxyinosine

Dideoxycytidine (ddC) and dideoxyinosine (ddl) are nucleoside derivatives that exhibit antiretroviral activity against the human immunodeficiency virus (HIV). Both of these agents are under active investigation as potential therapies for patients with HIV infection. In addition, both drugs may be obtained for HIV-infected individuals who cannot tolerate zidovudine. A major focus of the research effort involving these agents has been to define their toxicities. Both agents may cause peripheral neuropathy. We wish to report a patient who developed severe neuropathy following the administration of ddl that was given shortly after the patient was removed from a clinical trial of ddC. The rapid development of toxicity indicates that this side effect is additive or synergistic for these agents. © 1991 Raven Press, New York

Does perspective-taking increase patient satisfaction in medical encounters?

Purpose: To assess whether perspective-taking, which researchers in other fields have shown to induce empathy, improves patient satisfaction in encounters between student-clinicians and standardized patients (SPs). Method: In three studies, randomly assigned students (N = 608) received either a perspective-taking instruction or a neutral instruction prior to a clinical skills examination in 2006-2007. SP satisfaction was the main outcome in all three studies. Study 1 involved 245 third-year medical students from two universities. Studies 2 and 3 extended Study 1 to examine generalizability across student and SP subpopulations. Study 2 (105 physician assistant students, one university) explored the effect of perspective-taking on African American SPs satisfaction. Study 3 (258 third-year medical students, two universities) examined the intervention\u27s effect on students with high and low baseline perspective-taking tendencies. Results: Intervention students outscored controls in patient satisfaction in all studies: Study 1: P = .01, standardized effect size = 0.16; Study 2: P = .001, standardized effect size = 0.31; Study 3: P = .009, standardized effect size = 0.13. In Study 2, perspective-taking improved African American SPs satisfaction. In Study 3, intervention students with high baseline perspective-taking tendencies outscored controls (P = .0004, standardized effect size = 0.25), whereas those with low perspective-taking tendencies did not (P = .72, standardized effect size = 0.00). Conclusions: Perspective-taking increased patient atisfaction in all three studies, across medical schools, clinical disciplines, and racially diverse students and SPs. Perspective-taking as a means for improving patient satisfaction deserves further exploration in clinical training and practice. Copyrite © by the Association of Amarican Medical Colleges

Impact of a personal CYP2D6 testing workshop on physician assistant student attitudes toward pharmacogenetics

© 2016 Future Medicine Ltd. Aim: We assessed the impact of personal CYP2D6 testing on physician assistant student competency in, and attitudes toward, pharmacogenetics (PGx). Materials & methods: Buccal samples were genotyped for CYP2D6 polymorphisms. Results were discussed during a 3-h PGx workshop. PGx knowledge was assessed by pre- and post-tests. Focus groups assessed the impact of the workshop on attitudes toward the clinical utility of PGx. Results: Both student knowledge of PGx, and its perceived clinical utility, increased immediately following the workshop. However, exposure to PGx on clinical rotations following the workshop seemed to influence student attitudes toward PGx utility. Conclusion: Personal CYP2D6 testing improves both knowledge and comfort with PGx. Continued exposure to PGx concepts is important for transfer of learning

Impact of a personal CYP2D6 testing workshop on physician assistant student attitudes toward pharmacogenetics.

© 2016 Future Medicine Ltd. Aim: We assessed the impact of personal CYP2D6 testing on physician assistant student competency in, and attitudes toward, pharmacogenetics (PGx). Materials & methods: Buccal samples were genotyped for CYP2D6 polymorphisms. Results were discussed during a 3-h PGx workshop. PGx knowledge was assessed by pre- and post-tests. Focus groups assessed the impact of the workshop on attitudes toward the clinical utility of PGx. Results: Both student knowledge of PGx, and its perceived clinical utility, increased immediately following the workshop. However, exposure to PGx on clinical rotations following the workshop seemed to influence student attitudes toward PGx utility. Conclusion: Personal CYP2D6 testing improves both knowledge and comfort with PGx. Continued exposure to PGx concepts is important for transfer of learning

Minority Physician Assistant Faculty: A Phenomenological Assessment of Factors Leading to Retention in the Faculty Role

Improving racial and ethnic diversity in the physician assistant (PA) profession is important to providing better care for underserved communities. The recruitment and retention of minority PA faculty is one aspect of helping to attract and retain a more diverse student body. Previous research has indicated that minority status is associated with the increased attrition of PA faculty but has not provided insight into the specific factors involved in the retention or attrition of minority PA faculty. The purpose of this qualitative research study was to describe the experience of minority PA faculty through a critical race theory lens. We used a phenomenological approach using structured interviews of minority PA faculty. Better understanding of the experience of minority PA faculty might lead to improved efforts at recruiting and supporting a more diverse faculty workforce. We conducted 13 interviews of PA faculty representing a variety of underrepresented minorities, geographic regions, types of schools, and stages of their careers. Major themes that emerged across the participants\u27 experiences included opportunities for success in the form of both internal and external support systems and mentorship. As a corollary, barriers to the retention of minority PA faculty including a lack of institutional support, gaps in mentorship, and lack of a solid support network were cited