Recent Publications by CFE Educators

PURPOSE

Pheochromocytomas and paragangliomas are rare tumors of chromaffin cell origin. Their identification is likely increasing owing to the increased use of radiographic images detecting incidental adrenal masses.

RECENT FINDINGS

The pathophysiology of hypertension induced by the release of catecholamines and newly discovered peptides has been shown to be more complex than the concept of episodic catecholamine release.

SUMMARY

This review looks at the most recent advances in the physiology and molecular basis of these tumors.

PURPOSE

This study examined the teaching points made by preceptors in response to two videotaped teaching encounters to determine if (1) different preceptors use similar teaching points in response to the same case, (2) preceptors' teaching points vary by case, and (3) preceptors' teaching points vary by teaching model (One-Minute Preceptor and traditional preceptor models).

METHOD

Preceptors (n = 116) at seven universities participated in a within-groups experimental design study in 2000. The preceptors viewed videotaped encounters depicting two cases and two precepting models. They were asked to list two teaching points after viewing the initial case presentations and after the teaching encounters were completed. Frequency of teaching points listed by preceptors was examined for each case and teaching model. Teaching points were coded using qualitative methods and then analyzed using repeated-measures analysis of variance.

RESULTS

Of the 843 total teaching points identified by preceptors, 63 were discrete teaching points that were aggregated into 15 categories. Most preceptors (82%) listed three to five separate teaching points, which varied significantly by case and model. Those observing the traditional precepting model were more likely to teach generic skills such as history-taking skills, presentation skills, and risk factors, and those observing the One-Minute Preceptor were more likely to teach about the illness focusing on a broader differential diagnosis, further diagnostic tests, and the natural presentation of disease.

CONCLUSIONS

Preceptors use three to five common teaching points that vary by case and teaching model. The One-Minute Preceptor model shifted teaching points away from generic clinical skills toward disease-specific teaching.

PURPOSE

To compare the One-Minute Preceptor (OMP) and traditional models of ambulatory teaching in terms of the preceptors' (1) ability to correctly diagnose patients' medical problems, (2) ability to rate students' skills and confidence in doing so, and (3) satisfaction with both models.

METHOD

A within-groups experimental design study was conducted with 116 preceptors at seven universities in 2000. Participants viewed scripted, videotaped precepting encounters of both models using two cases and were asked to rate students' abilities, their confidence in rating the students' abilities, and the effectiveness and efficiency of the teaching encounters.

RESULTS

Preceptors who viewed the videotapes of the OMP model were equally or better able to correctly diagnose the patients' medical conditions than those viewing the traditional model. Preceptors viewing the OMP rated students' abilities higher on history taking/physical examination, presentations, clinical reasoning, and fund of knowledge than did those viewing the traditional model. Preceptors viewing the OMP rated themselves as more confident in rating students' abilities in presentation, clinical reasoning, and fund of knowledge. Preceptors rated the OMP as more effective and more efficient than the traditional model.

CONCLUSIONS

Preceptors viewing scripted, videotaped teaching encounters using the OMP model were equal to or better able to correctly diagnose patients' medical problems, had greater self-confidence in rating students, and rated the encounter as more effective and efficient than when viewing the traditional model.

The idiopathic interstitial pneumonias are a heterogeneous group of poorly understood diseases with often devastating consequences for those afflicted. Subclassification of the idiopathic interstitial pneumonia based on clinical-radiological-pathological criteria has highlighted important pathogenic, therapeutic and prognostic implications. The most critical distinction is the presence of usual interstitial pneumonia, the histopathological pattern seen in idiopathic pulmonary fibrosis. Idiopathic pulmonary fibrosis has a worse response to therapy and prognosis. New insight into the pathophysiology of usual interstitial pneumonia suggests a distinctly fibroproliferative process, and antifibrotic therapies show promise. While the clinical and radiographic diagnosis of idiopathic interstitial pneumonias can be made confidently in some cases, many patients require surgical lung biopsy to determine their underlying histopathology. A structured, clinical-radiological-pathological approach to the diagnosis of the idiopathic interstitial pneumonias, with particular attention to the identification of idiopathic pulmonary fibrosis, insures proper therapy, enhances prognostication, and allows for further investigation of therapies aimed at distinct pathophysiology.