David Stern - Academia.edu (original) (raw)
Papers by David Stern
The American journal of managed care, 2002
To determine e-mail utilization patterns and attitudes toward e-mail use among primary care physi... more To determine e-mail utilization patterns and attitudes toward e-mail use among primary care physicians and their ambulatory outpatient clinic patients. Cross-sectional baseline survey. Participants included 476 consecutive outpatient clinic patients, 126 general medical and family practice physicians, and 16 clinical and office staff from 2 large primary care centers within an academic teaching system. They completed a survey about e-mail usage patterns and their attitudes toward using e-mail for patient-provider communication. More than half of patients (52.1%) were self-defined e-mail users, yet only 10.5% of those users had ever used e-mail to communicate with their doctors. Seventy percent of all patients said they would be willing to use e-mail to communicate with their doctors. Overall, patients were concerned about logistics, such as whether the message would get to the right person and how long it would take to get a response. Physicians and staff were more optimistic than p...
The virtual mentor : VM, 2003
Teaching and learning in medicine, 2007
Although it may take up relatively little time, hospitalized patients' interactions with thei... more Although it may take up relatively little time, hospitalized patients' interactions with their physicians are important elements of their hospital experience. We conducted a qualitative study to explore what is important to patients about bedside interactions with their physician teams. We interviewed medical inpatients and used grounded theory methodology to analyze interview transcripts. We recruited 17 patients from an academic medical center including a university hospital and a Veterans Administration (VA) hospital. We found that important aspects of patient-team interactions included the exchange of information, evidence of caring from their team, involvement in teaching, knowing the team members, and bedside manner. Patients also described team characteristics that were important to them such as team attributes and intrateam collaboration. This model clarifies the aspects of bedside interactions that patients value and will allow physicians to focus their limited time to ...
The American Journal of Bioethics, 2006
Training in ethics and professionalism is a fundamental component of residency education, yet the... more Training in ethics and professionalism is a fundamental component of residency education, yet there is little empirical information to guide curricula. The objective of this study is to describe empirically derived ethics objectives for ethics and professionalism training for multiple specialties. Study design is a thematic analysis of documents, semi-structured interviews, and focus groups conducted in a setting of an academic medical center, Veterans Administration, and community hospital training more than 1000 residents. Participants were 84 informants in 13 specialties including residents, program directors, faculty, practicing physicians, and ethics committees. Thematic analysis identified commonalities across informants and specialties. Resident and nonresident informants identified consent, interprofessional relationships, family interactions, communication skills, and end-of-life care as essential components of training. Nonresidents also emphasized formal ethics instruction, resource allocation, and self-monitoring, whereas residents emphasized the learning environment and resident-attending interactions. Conclusions are that empirically derived learning needs for ethics and professionalism included many topics, such as informed consent and resource allocation, relevant for most specialties, providing opportunities for shared curricula and resources.
Women's Health Issues, 2008
Objective. We sought to explore optimism/pessimism, knowledge of HIV, and attitudes toward HIV sc... more Objective. We sought to explore optimism/pessimism, knowledge of HIV, and attitudes toward HIV screening and treatment among Ghanaian pregnant women.
The American Journal of Bioethics, 2004
Teaching and Learning in Medicine, 2004
One of the most effective methods for teaching physical diagnosis may be standardized patient ins... more One of the most effective methods for teaching physical diagnosis may be standardized patient instructors. To determine if a lecture plus standardized patient instructors with small-group sessions is more effective than a lecture alone for teaching the evaluation of patients with abdominal pain. Control (class of 2001) and intervention (class of 2002) groups both attended a lecture on the abdominal examination. The intervention group then underwent an exercise with standardized patient instructors and a review session with surgical faculty. An evaluation 18 months later used standardized patient instructors to complete evaluations assessing history-taking and physical examination skills. The intervention group performed significantly better than the control group on both the history and the physical examination subscales. It is possible to have an important, measurable, and lasting effect on physical examination skills by adding standardized patient instructors and small-group discussion to a lecture presentation.
Obstetrical & Gynecological Survey, 1992
The effect of comprehensive prenatal care on birth weight was examined using a prospective random... more The effect of comprehensive prenatal care on birth weight was examined using a prospective randomized design. A total of 428 pregnant women were randomly assigned to comprehensive prenatal care (n = 217) or standard prenatal care (n = 211). Comprehensive care was provided by a multidisciplinary team of nurse-midwives, social workers, a nutritionist, paraprofessional home visitors, and a psychologist. Standard prenatal care consisted of medical care provided by obstetric residents. Multiple regression analysis using behavioral, demographic, and medical variables showed a strong relationship between the set of predictors and birth weight. Comprehensive care was related to higher birth weights for primiparous but not multiparous mothers. Separate analyses of variance for primiparas and multiparas similarly showed a favorable effect of comprehensive care on birth weight for primiparous but not multiparous mothers.
New England Journal of Medicine, 2005
T h e ne w e ngl a nd jou r na l o f m e dic i ne n engl j med 353;25 www.nejm.org december 22, 2... more T h e ne w e ngl a nd jou r na l o f m e dic i ne n engl j med 353;25 www.nejm.org december 22, 2005 abstract background Evidence supporting professionalism as a critical measure of competence in medical education is limited. In this case-control study, we investigated the association of disciplinary action against practicing physicians with prior unprofessional behavior in medical school. We also examined the specific types of behavior that are most predictive of disciplinary action against practicing physicians with unprofessional behavior in medical school. methods
New England Journal of Medicine, 2006
Medical Teacher, 2007
Defining global standards for medical education in the form of competencies and the methods to ev... more Defining global standards for medical education in the form of competencies and the methods to evaluate whether an individual student possesses these competencies at graduation has long been a dream of some medical educators. The development of such standards, the methods to assess their presence and the pilot test study of the standards in graduating students at eight medical schools in China, as well as the process for establishing student and school performance "cut points", has been previously described. This paper reports on the performance of a single student who went through the assessment process, the performance of all students at one of the eight medical schools and the collective performance of all students at all eight medical schools. The actual quantitative data is presented, as is the conclusion of where the student, the school and all schools had strengths, where they were borderline in performance and/or where they need improvement. The results are serving as a blueprint for medical education reform in China. Implications of the pilot test and the entire process are discussed, as is the potential for global adoption of outcome based assessments.
Medical Education, 2005
OBJECTIVE The purpose of this study was to establish outcome measures for professionalism in medi... more OBJECTIVE The purpose of this study was to establish outcome measures for professionalism in medical students and to identify predictors of these outcomes. DESIGN Retrospective cohort study. SETTING A US medical school.
Journal of Infection, 2005
Objectives. Over time, quarantine has become a classic public health intervention and has been us... more Objectives. Over time, quarantine has become a classic public health intervention and has been used repeatedly when newly emerging infectious diseases have threatened to spread throughout a population. Here, we weigh the economic costs and benefits associated with implementing widespread quarantine in Toronto during the SARS outbreaks of 2003.
Journal of General Internal Medicine, 2003
OBJECTIVES: E-mail communication between patients and their providers has diffused slowly in clin... more OBJECTIVES: E-mail communication between patients and their providers has diffused slowly in clinical practice. To address concerns about the use of this technology, we performed a randomized controlled trial of a triage-based e-mail system in primary care.
Journal of General Internal Medicine, 2001
OBJECTIVE: Today's medical school graduates have significant deficits in physical examination ski... more OBJECTIVE: Today's medical school graduates have significant deficits in physical examination skills. Medical educators have been searching for methods to effectively teach and maintain these skills in students. The objective of this study was to determine if an auscultation curriculum centered on a portable multimedia CD-ROM was effective in producing and maintaining significant gains in cardiac auscultatory skills.
Journal of General Internal Medicine, 2001
OBJECTIVE: The One-Minute Preceptor (OMP) model of faculty development is used widely to improve ... more OBJECTIVE: The One-Minute Preceptor (OMP) model of faculty development is used widely to improve teaching, but its effect on teaching behavior has not been assessed. We aim to evaluate the effect of this intervention on residents' teaching skills.
Journal of General Internal Medicine, 2005
Academic Medicine, 2003
Problem Statement and Background. Cross-cultural experiences are in increasing demand by both gra... more Problem Statement and Background. Cross-cultural experiences are in increasing demand by both graduate and undergraduate medical students, yet the benefits of these experiences are not clearly established. Method. A review of the literature was conducted to identify articles on the outcomes of cross-cultural experiences. Themes were identified and categorized into domains. Results. Forty-two studies were found; 27 articles used qualitative methods, nine used quantitative methods, and six used both. Most (24) were from the nursing literature, 18 were from the medical literature. All studies reported positive outcomes along four domains: students' professional development, students' personal development, medical school benefits, and host population benefits. Conclusions. Studies reviewed were primarily case controlled or case series. Future research is needed that more clearly defines outcome measures and uses more rigorous methods. Although results suggest positive outcomes in all domains, additional research is needed before cross-cultural rotations can be supported based on evidence.
The American journal of managed care, 2002
To determine e-mail utilization patterns and attitudes toward e-mail use among primary care physi... more To determine e-mail utilization patterns and attitudes toward e-mail use among primary care physicians and their ambulatory outpatient clinic patients. Cross-sectional baseline survey. Participants included 476 consecutive outpatient clinic patients, 126 general medical and family practice physicians, and 16 clinical and office staff from 2 large primary care centers within an academic teaching system. They completed a survey about e-mail usage patterns and their attitudes toward using e-mail for patient-provider communication. More than half of patients (52.1%) were self-defined e-mail users, yet only 10.5% of those users had ever used e-mail to communicate with their doctors. Seventy percent of all patients said they would be willing to use e-mail to communicate with their doctors. Overall, patients were concerned about logistics, such as whether the message would get to the right person and how long it would take to get a response. Physicians and staff were more optimistic than p...
The virtual mentor : VM, 2003
Teaching and learning in medicine, 2007
Although it may take up relatively little time, hospitalized patients' interactions with thei... more Although it may take up relatively little time, hospitalized patients' interactions with their physicians are important elements of their hospital experience. We conducted a qualitative study to explore what is important to patients about bedside interactions with their physician teams. We interviewed medical inpatients and used grounded theory methodology to analyze interview transcripts. We recruited 17 patients from an academic medical center including a university hospital and a Veterans Administration (VA) hospital. We found that important aspects of patient-team interactions included the exchange of information, evidence of caring from their team, involvement in teaching, knowing the team members, and bedside manner. Patients also described team characteristics that were important to them such as team attributes and intrateam collaboration. This model clarifies the aspects of bedside interactions that patients value and will allow physicians to focus their limited time to ...
The American Journal of Bioethics, 2006
Training in ethics and professionalism is a fundamental component of residency education, yet the... more Training in ethics and professionalism is a fundamental component of residency education, yet there is little empirical information to guide curricula. The objective of this study is to describe empirically derived ethics objectives for ethics and professionalism training for multiple specialties. Study design is a thematic analysis of documents, semi-structured interviews, and focus groups conducted in a setting of an academic medical center, Veterans Administration, and community hospital training more than 1000 residents. Participants were 84 informants in 13 specialties including residents, program directors, faculty, practicing physicians, and ethics committees. Thematic analysis identified commonalities across informants and specialties. Resident and nonresident informants identified consent, interprofessional relationships, family interactions, communication skills, and end-of-life care as essential components of training. Nonresidents also emphasized formal ethics instruction, resource allocation, and self-monitoring, whereas residents emphasized the learning environment and resident-attending interactions. Conclusions are that empirically derived learning needs for ethics and professionalism included many topics, such as informed consent and resource allocation, relevant for most specialties, providing opportunities for shared curricula and resources.
Women's Health Issues, 2008
Objective. We sought to explore optimism/pessimism, knowledge of HIV, and attitudes toward HIV sc... more Objective. We sought to explore optimism/pessimism, knowledge of HIV, and attitudes toward HIV screening and treatment among Ghanaian pregnant women.
The American Journal of Bioethics, 2004
Teaching and Learning in Medicine, 2004
One of the most effective methods for teaching physical diagnosis may be standardized patient ins... more One of the most effective methods for teaching physical diagnosis may be standardized patient instructors. To determine if a lecture plus standardized patient instructors with small-group sessions is more effective than a lecture alone for teaching the evaluation of patients with abdominal pain. Control (class of 2001) and intervention (class of 2002) groups both attended a lecture on the abdominal examination. The intervention group then underwent an exercise with standardized patient instructors and a review session with surgical faculty. An evaluation 18 months later used standardized patient instructors to complete evaluations assessing history-taking and physical examination skills. The intervention group performed significantly better than the control group on both the history and the physical examination subscales. It is possible to have an important, measurable, and lasting effect on physical examination skills by adding standardized patient instructors and small-group discussion to a lecture presentation.
Obstetrical & Gynecological Survey, 1992
The effect of comprehensive prenatal care on birth weight was examined using a prospective random... more The effect of comprehensive prenatal care on birth weight was examined using a prospective randomized design. A total of 428 pregnant women were randomly assigned to comprehensive prenatal care (n = 217) or standard prenatal care (n = 211). Comprehensive care was provided by a multidisciplinary team of nurse-midwives, social workers, a nutritionist, paraprofessional home visitors, and a psychologist. Standard prenatal care consisted of medical care provided by obstetric residents. Multiple regression analysis using behavioral, demographic, and medical variables showed a strong relationship between the set of predictors and birth weight. Comprehensive care was related to higher birth weights for primiparous but not multiparous mothers. Separate analyses of variance for primiparas and multiparas similarly showed a favorable effect of comprehensive care on birth weight for primiparous but not multiparous mothers.
New England Journal of Medicine, 2005
T h e ne w e ngl a nd jou r na l o f m e dic i ne n engl j med 353;25 www.nejm.org december 22, 2... more T h e ne w e ngl a nd jou r na l o f m e dic i ne n engl j med 353;25 www.nejm.org december 22, 2005 abstract background Evidence supporting professionalism as a critical measure of competence in medical education is limited. In this case-control study, we investigated the association of disciplinary action against practicing physicians with prior unprofessional behavior in medical school. We also examined the specific types of behavior that are most predictive of disciplinary action against practicing physicians with unprofessional behavior in medical school. methods
New England Journal of Medicine, 2006
Medical Teacher, 2007
Defining global standards for medical education in the form of competencies and the methods to ev... more Defining global standards for medical education in the form of competencies and the methods to evaluate whether an individual student possesses these competencies at graduation has long been a dream of some medical educators. The development of such standards, the methods to assess their presence and the pilot test study of the standards in graduating students at eight medical schools in China, as well as the process for establishing student and school performance "cut points", has been previously described. This paper reports on the performance of a single student who went through the assessment process, the performance of all students at one of the eight medical schools and the collective performance of all students at all eight medical schools. The actual quantitative data is presented, as is the conclusion of where the student, the school and all schools had strengths, where they were borderline in performance and/or where they need improvement. The results are serving as a blueprint for medical education reform in China. Implications of the pilot test and the entire process are discussed, as is the potential for global adoption of outcome based assessments.
Medical Education, 2005
OBJECTIVE The purpose of this study was to establish outcome measures for professionalism in medi... more OBJECTIVE The purpose of this study was to establish outcome measures for professionalism in medical students and to identify predictors of these outcomes. DESIGN Retrospective cohort study. SETTING A US medical school.
Journal of Infection, 2005
Objectives. Over time, quarantine has become a classic public health intervention and has been us... more Objectives. Over time, quarantine has become a classic public health intervention and has been used repeatedly when newly emerging infectious diseases have threatened to spread throughout a population. Here, we weigh the economic costs and benefits associated with implementing widespread quarantine in Toronto during the SARS outbreaks of 2003.
Journal of General Internal Medicine, 2003
OBJECTIVES: E-mail communication between patients and their providers has diffused slowly in clin... more OBJECTIVES: E-mail communication between patients and their providers has diffused slowly in clinical practice. To address concerns about the use of this technology, we performed a randomized controlled trial of a triage-based e-mail system in primary care.
Journal of General Internal Medicine, 2001
OBJECTIVE: Today's medical school graduates have significant deficits in physical examination ski... more OBJECTIVE: Today's medical school graduates have significant deficits in physical examination skills. Medical educators have been searching for methods to effectively teach and maintain these skills in students. The objective of this study was to determine if an auscultation curriculum centered on a portable multimedia CD-ROM was effective in producing and maintaining significant gains in cardiac auscultatory skills.
Journal of General Internal Medicine, 2001
OBJECTIVE: The One-Minute Preceptor (OMP) model of faculty development is used widely to improve ... more OBJECTIVE: The One-Minute Preceptor (OMP) model of faculty development is used widely to improve teaching, but its effect on teaching behavior has not been assessed. We aim to evaluate the effect of this intervention on residents' teaching skills.
Journal of General Internal Medicine, 2005
Academic Medicine, 2003
Problem Statement and Background. Cross-cultural experiences are in increasing demand by both gra... more Problem Statement and Background. Cross-cultural experiences are in increasing demand by both graduate and undergraduate medical students, yet the benefits of these experiences are not clearly established. Method. A review of the literature was conducted to identify articles on the outcomes of cross-cultural experiences. Themes were identified and categorized into domains. Results. Forty-two studies were found; 27 articles used qualitative methods, nine used quantitative methods, and six used both. Most (24) were from the nursing literature, 18 were from the medical literature. All studies reported positive outcomes along four domains: students' professional development, students' personal development, medical school benefits, and host population benefits. Conclusions. Studies reviewed were primarily case controlled or case series. Future research is needed that more clearly defines outcome measures and uses more rigorous methods. Although results suggest positive outcomes in all domains, additional research is needed before cross-cultural rotations can be supported based on evidence.