A group of 103 undergraduate students responded to a semantic differential measure of the attitude toward old men, and to a number of measures assessing potential correlates of this attitude. Attempts were also made to assess the validity of an indirect measure of the attitude toward elderly. Older men were evaluated less positively; they were judged less decisive, and instrumental as compared with younger men. Of all the variables studied only two were significantly related to attitudes toward older men, i.e., socioeconomic status of parents and frequency of contact with elderly. The outcomes with regard to the validity of the indirect measure of attitudes were ambiguous at best.
Compliance with the Accreditation Council for Graduate Medical Education resident duty hours rules has created unique educational and patient-care challenges for the general medicine inpatient teaching (GMIT) teams at Texas A&M/Scott & White Memorial Hospital, including multiple patient hand-offs, multiple resident absences during teaching time, and loss of continuity of care for individual patients, all of which may have compromised patient safety. The Texas A&M/Scott & White Memorial Hospital internal medicine residency program initially complied with the duty hours rules by having residents take call every fourth night, followed by a six-hour post-call day. This system proved to be inefficient because it significantly disrupted patient care and resident education. Residents reported that this call system frequently caused them to approach the 80-hour limit and that they had difficulty leaving post-call because of unfulfilled responsibilities. They also reported sleep interruption and inadequate time to prepare for and attend educational conferences.After determining the peak admission times at the hospital, program leaders designed a call system during which the primary call team takes admissions from 12:00 pm to 8:00 pm each day, then leaves by 10:00 pm and returns after 10 hours for a full post-call day. After-hours admissions are managed by hospitalists. The solution did require hiring additional hospitalists for night-call coverage. The new structure has greatly improved the residents' experience on the GMIT teams. The entire team works together on call and post-call. Rounds and inpatient teaching continue normally on post-call days. Residents attend clinics and conferences post-call. Hand-offs are reduced greatly, and residents report that they are better rested. Residents also state that the new call system significantly enhances their education, patient care, and personal life.
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