The new, improved Index to Chiropractic Literature

icl_new.png  Welcome to the latest version of the Index to Chiropractic Literature. This free bibliographic database is produced by the librarians of CLIBCON, the Chiropractic Library Consortium. The site was designed by and is hosted by Anne Holmes & Associates.

We have just added a number of new features, the most significant of which is the ability to download into personal bibliographic managers. Do a search, choose your citations, then click Download using the Tagged format. In your citation manager, choose the PubMed filter and your citations will download beautifully.

If you have questions or comments, please use ICL’s Feedback form. And if you would like to see what ICL looked like a few years ago, take a look here.

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The new, improved SACME Web site

sacme.png  Welcome to the new and improved Society for Academic Continuing Medical Education (SACME) Web site. This site has been around since 1999, but over the past winter it has been redesigned and the content reorganized and updated. Do explore the site, particularly the CME Best Practices section, and you will be amazed at the amount and variety of content.

It’s amusing to trace the evolution of this site through the Internet Archive waybackmachine. Here is the home page for April 1, 2001. Now, if you would like to see the very first Web page ever created by yours truly, take a look at this. Ah, the World Wide Web, 1996 to 2007.

Musculoskeletal medicine: An assessment of the attitudes and knowledge of medical students at Harvard Medical School

back.jpg   From the May 2007 issue of Academic Medicine:

Day CS, Yeh AC, Franko O, Ramirez M, Krupat E. Musculoskeletal medicine: An assessment of the attitudes and knowledge of medical students at Harvard Medical School. Acad Med 2007; 82(5):452-457.

PURPOSE: To assess medical students’ knowledge and clinical confidence in musculoskeletal medicine as well as their attitudes toward the education they receive in this specialty.
 
METHOD: A cross-sectional survey of students in all four years of Harvard Medical School was conducted during the 2005-2006 academic year. Participants were asked to fill out a 30-question survey and a nationally validated basic competency exam in musculoskeletal medicine.

RESULTS: The response rate was 74% (449/608). Medical students rated musculoskeletal education to be of major importance (3.8/5) but rated the amount of curriculum time spent on musculoskeletal medicine as poor (2.1/5). Third-year students felt a low to adequate level of confidence in performing a musculoskeletal physical examination (2.7/5) and failed to demonstrate cognitive mastery in musculoskeletal medicine (passing rate on competency exam: 7%), whereas fourth-year students reported a similar level of confidence (2.7/5) and exhibited a higher passing rate (26%). Increasing exposure to the subject by taking clinical electives resulted in greater clinical confidence and enhanced performance on the exam (P < .001). Students’ feedback suggested that musculoskeletal education can be better integrated into the preclinical curriculum, more time should be spent in the field, and more focus should be placed on common clinical conditions.

CONCLUSIONS: These findings, which are consistent with those from other schools, suggest that medical students do not feel adequately prepared in musculoskeletal medicine and lack both clinical confidence and cognitive mastery in the field. Implementing a four-year integrated musculoskeletal curriculum is one way that medical schools can address this concern.

Notes: Dr Day is assistant professor in orthopedic surgery and director, Musculoskeletal Curriculum, Harvard Medical School, and chief, Orthopedic Hand Surgery, Beth Israel Deaconess Medical Center, Boston, Massachusetts Mr Yeh is a fourth-year undergraduate, Harvard College, Cambridge, Massachusetts Mr Franko is a second-year medical student, Harvard Medical School, Boston, Massachusetts Mr Ramirez is a third-year medical student, Harvard Medical School, Boston, Massachusetts Dr Krupat is director of evaluation and associate professor of psychology, Center for Evaluation, Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
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Managing conflict of interest in clinical practice

mayoclinic.gif From the May 2007 issue of the Mayo Clinic Proceedings [free full text available]:

Camilleri M, Cortese DA. Managing conflict of interest in clinical practice [commentary]. Mayo Clin Proc 2007; 82(5):607-614.

Excerpt: Conflict of interest, even the appearance of potential conflict, has long been a concern for physicians and scientists. Conflict of interest arises when an activity is accompanied by a divergence between personal or institutional benefit when compared to the responsibilities to patients and to society; it arises in the context of research, purchasing, leadership, and investments. Conflict of interest is of concern because it compromises the trust of the patient and of society in the individual physician or the medical center.
Scenario 1: Selection of Medication From a Menu of Drugs With Similar Efficacy
Scenario 2: Selection From a Menu of Devices With Similar Efficacy Projected for an Individual Patient
Scenario 3: Development of Practice Guidelines and Their Use by Formulary Committees   
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