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In This Issue of JAMA |

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JAMA. 2013;310(21):2221. doi:10.1001/jama.2013.5442.
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MEDICAL EDUCATION ISSUE

Edited by Robert Golub, MD

Dogs Playing Doctor

For JAMA readers who enjoy fine art on the cover, we herewith present an homage to the early 20th-century artist Cassius Marcellus Coolidge. Although his works had titles such as A Friend in Need and A Bold Bluff, collectively his oeuvre is most commonly referred to as Dogs Playing Poker. While the subjects of his paintings also included such diverse topics as ballroom dances and the courtroom, the editors are not aware of any pieces that focused on medical education and provide this cover to fill that gap.

In a prospective before-and-after intervention study involving 84 pediatric resident physicians and 1255 inpatient admissions, Starmer and colleagues found that implementation of a multifaceted resident handoff program that included standardized communication and handoff training was associated with a significant reduction in medical errors and preventable adverse events among hospitalized children—without adverse changes in resident workflow. In an Editorial, Horwitz discusses the evidence that improving handoffs can reduce harm to patients.

Related Editorial

To assess the effects of communication skills training on patient- and family-reported quality of communication with health professionals, Curtis and colleagues randomly assigned 391 internal medicine and 81 nurse practitioner trainees to a simulation-based communication skills intervention or usual education. The authors report that the simulation-based communication training did not improve the quality of communication with patients about end-of-life care but was associated with an increase in patients’ depressive symptoms. In an Editorial, Chi and Verghese discuss the need for new and innovative ways to teach clinical skills and assess whether teaching has succeeded.

Related Editorial

Deane and Murphy evaluated the relationship between student attendance at clinical- and tutorial-based activities and academic performance in a prospective cohort study involving 147 fourth-year medical students completing their obstetrics/gynecology clinical rotation. The authors found a positive correlation between student attendance and year-end written and clinical and oral examination scores.

In a retrospective cohort study of 44 612 US physicians who entered anesthesiology residency programs from 1975 to 2009, Warner and colleagues assessed the incidence of substance use disorder, substance use–related deaths, and rates of substance use relapse. The authors found that 0.86% of the anesthesiology residents had evidence of substance use disorder during training, that there were 28 deaths related to substance use, and that an estimated 43% of individuals with evidence of substance use disorder experienced a relapse during a median 8.9 years of follow-up.

Guevara and colleagues analyzed 2000-2010 data from the Association of American Medical Colleges Faculty Roster—representing approximately 128 000 active medical school faculty—to assess associations between minority faculty development programs and underrepresented minority faculty representation, recruitment, and promotion. The authors report that numbers of underrepresented faculty increased modestly from 2000 to 2010; however, presence of a minority faculty development program was not associated with greater underrepresented minority faculty representation, recruitment, or promotion.

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