Research

Alec O'Connor, M.D.

Impact of Non-teaching Services on Resident Education

We have found that internal medicine resident patients are more complex than non-teaching service patients. We are in the process of assessing the impact of a non-teaching service on internal medicine resident and medical student education, and comparing costs and outcomes between services.

Pain Management in Emergency Patients

We are in the process of analyzing the outcomes associated with non-equianalgesic opioid dosing in ED patients. In addition, we are exploring the reasons prescribers select one opioid over a seemingly equivalent alternative, which may provide explanations for unusual prescribing behaviors. From a separate, large database, we are also exploring the management and outcomes of ED patients with pain.

Neuropathic Pain in MS Patients

We are enrolling MS patients with dysesthetic lower extremity pain in a randomized-controlled crossover trial comparing two alternative neuropathic pain medications with each other and with placebo.

Valerie Lang, M.D.

Impact of Hand-Offs on Performance of Third Year Students in the Medicine Clerkship

With the increased number of hand-offs generated by night float systems, work hour restrictions, and the concentration of longer length-of-stay patients on teaching services, students have fewer opportunities to evaluate "fresh" patients with undifferentiated problems. Evaluating undifferentiated patients gives students the opportunity to generate their own observations and hypotheses and practice their clinical reasoning skills. This observational study examines the impact of hand-offs on students' learning during the course of the Medicine Clerkship.

Impact of Non-Teaching Services on the Types of Patients Third Year Students Encounter in the Medicine Clerkship

We previously observed that residents on the impatient services encounter more complex, acutely ill, and longer length-of-stay patients than those found in the hospitalized patient population as a whole, when compared to non-teaching services at two hospitals.

Residents encounter fewer patients with some common diagnoses that they will be responsible for managing once they are in practice. Medical students rotate with the resident teams and are assigned a subset of the residents' patients to follow during their clerkship. This retrospective study examines the impact of non-teaching services on the distribution of patients to medical students, as compared to patients on non-teaching services and to the hospitalized population as a whole.

Dr. Alec O'Connor and Dr. Valerie Lang