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Objective: The objective of this survey was to obtain mental health professional perspectives on cognitive-behavioral therapy (CBT) for opioid use disorder (OUD) treatment., Methods: Respondents (N = 84) rated components of CBT for their efficacy in OUD treatment. Ratings were reported for the overall sample, by degree completed, and by clinicians versus nonclinicians. Respondents also ranked additional therapeutic strategies that might enhance the efficacy of CBT for OUD., Results: Respondents rated treatment alliance/rapport, coping skills, and motivational interviewing as the most effective CBT components for OUD. Forms and worksheets were rated as the least effective component. The most beneficial additions to CBT for OUD would be mindfulness, peer support, and medication adherence strategies. Finally, the survey responses suggested that addressing co-morbid mental health disorders and life stressors may be important within CBT treatment for OUD., (© 2021 Wiley Periodicals LLC.)

Background: Knowledge of ambulatory patients' satisfaction with clinic visits help improve communication and delivery of healthcare. The goal was to examine patient satisfaction in a primary care setting, identify how selected patient and physician setting and characteristics affected satisfaction, and determine if feedback provided to medical directors over time impacted patient satisfaction., Methods: A three-phase, semi-quantitative analysis was performed using anonymous, validated patient satisfaction surveys collected from 889 ambulatory outpatients in 6 healthcare centers over 5-years. Patients' responses to 21 questions were analyzed by principal components varimax rotated factor analysis. Three classifiable components emerged: Satisfaction with Physician, Availability/Convenience, and Orderly/Time. To study the effects of several independent variables (location of clinics, patients' and physicians' age, education level and duration at the clinic), data were subjected to multivariate analysis of variance (MANOVA).., Results: Changes in the healthcare centers over time were not significantly related to patient satisfaction. However, location of the center did affect satisfaction. Urban patients were more satisfied with their physicians than rural, and inner city patients were less satisfied than urban or rural on Availability/Convenience and less satisfied than urban patients on Orderly/Time. How long a patient attended a center most affected satisfaction, with patients attending >10 years more satisfied in all three components than those attending <1-5 years. Level of education affected patients' satisfaction only in the component Orderly/Time; patients without a high school education were significantly less satisfied than those with more. Patients in their 40's were significantly less satisfied in Availability/Convenience than those >60 years old. Patients were significantly more satisfied with their 30-40 year-old physicians compared with those over 60. On Orderly/Time, patients were more satisfied with physicians who were in their 50's than physicians >60., Conclusions: Improvement in patient satisfaction includes a need for immediate, specific feedback. Although Medical Directors received feedback yearly, we found no significant changes in patient satisfaction over time. Our results suggest that, to increase satisfaction, patients with lower education, those who are sicker, and those who are new to the center likely would benefit from additional high quality interactions with their physicians.

Context: The use of standardized patients (SPs) promotes and enhances interpersonal skill sets of medical students and provides a critical opportunity for students to display their relational competence during simulated patient encounters., Objective: To investigate whether SPs' ratings of osteopathic medical students' empathy and interpersonal skills correlate with students' self-rated empathy., Methods: The study used a cross-sectional quantitative design. After SP encounters, first-, second-, and third-year osteopathic medical students self-rated empathy using the Jefferson Scale of Empathy medical student version. Standardized patients also assessed students' empathy using the Jefferson Scale of Patient Perceptions of Physician Empathy and interpersonal skills using the Professionalism Assessment Ratings Scale., Results: Of 780 first-, second-, and third-year students, 717 students returned the survey (91.9%). In total, 383 students were women (53.4%) and 334 were men (46.6%). Of 717 SP encounters, SPs returned surveys for 648 encounters (90.3%). Ratings from SPs regarding their perceptions of osteopathic medical students' empathetic abilities and interpersonal skills did not correlate with students' self-rated empathy scores. Second- and third-year students were perceived by SPs as having better-developed empathetic and interpersonal skill sets when compared with first-year students. Results of SPs' ratings indicated that the higher the interpersonal skills, the higher the SP-perceived empathy for students across all years (r=0.66; P<.001)., Conclusion: Students' self-rated empathy did not correlate with SP-perceived empathy. However, the findings validated that students' core relational competencies increase as they progress through medical school.

Context: Empathy is an integral component of the patient-physician relationship and involves a cognitive ability to connect with others in a meaningful fashion. Multiple longitudinal studies have shown that self-reported allopathic medical student empathy declines significantly during year 3. However, to date, only 4 cross-sectional studies have been published on osteopathic medical students' empathy. Whereas studies of allopathic medical students reported a decline in empathy, similar results were not found in osteopathic studies., Objective: To investigate (1) self-reported empathy through years 1 to 3 of osteopathic medical students and (2) whether empathy declines during year 3., Design: Design included cross-sectional and test-retest data collection., Setting: Private osteopathic medical school in the Northeast region of the United States., Participants: Osteopathic medical students., Main Outcome Measure: The Jefferson Scale of Empathy medical student version., Results: Respondents (N=717) included 383 women (53%) and 334 men (47%). When empathy levels were examined by demographics, the only significant finding was that women reported significantly higher empathy levels than men (112.3 vs 109.3; P<.001). Cross-sectional results indicate that mean empathy levels were significantly lower for third-year students at the end of the year (108.7) compared with first- and second-year students at the beginning of the year (111.3 and 112.4, respectively; P<.05). Test-retest analyses of year 3 indicated significantly lower empathy levels from the beginning to the end of the academic year (111.2 and 108.7, respectively; P<.05)., Conclusion: Osteopathic medical students' empathy declined significantly during year 3, which is consistent with the findings from allopathic samples but differs from findings from osteopathic samples. More research is needed to build the data on osteopathic medical student samples and to achieve a better understanding of changes in empathy in osteopathic and allopathic medical students.

The current chart review study examined the relationship between self-reported cognitive distortions, attention-deficit/hyperactivity disorder (ADHD) symptoms, and co-occurring symptoms of depression and anxiety in a clinical sample of adults diagnosed with ADHD. Thirty subjects completed inventories measuring cognitive distortions, ADHD, anxiety, depression, and hopelessness as part of the standard diagnostic evaluation protocol used in a university-based outpatient clinic specializing in adult ADHD. A series of correlational analyses were conducted to assess the relationship between self-reported cognitive distortions, ADHD, anxiety, depression, and hopelessness. Results indicated a significant, positive correlation between self-reported cognitive distortions and ADHD. Responses to individual items on the measure of cognitive distortions were tabulated to identify the prevalence of specific cognitive distortion categories, with Perfectionism emerging as the most frequently endorsed. Further clinical implications of these findings are discussed., (Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.)

Background and Objectives: Traditional methods of resident evaluation have several limitations, including recall bias and memory decay. We developed a real-time, computerized, data-based evaluation system and determined 1) the feasibility of using such a system in an ambulatory care teaching center and 2) the types of evaluation data such a computer-based evaluation system provides to residency directors, faculty, and residents., Methods: We developed Precept-Assist, a computerized, data-based evaluation system. Reports from the system provide quantitative data, summative reports, and qualitative comments regarding specific competencies of residents. Following each precepting encounter between a faculty member and a resident, the faculty member entered into the system an array of coded information on the resident's level of performance, competencies achieved, and procedural skills., Results: We have entered more than 15,000 pieces of evaluative data on 4,504 precepting encounters. The average time to enter data was about 40 seconds per encounter. Reports were generated to monitor each resident's progress through the program. The information was used to generate learning plans tailored to each resident's needs., Conclusions: Precept-Assist was useful for evaluating the performance of residents in this study.

Patient satisfaction is of critical interest to medical care providers. The main objective of this study was to evaluate the psychometric properties of a patient satisfaction questionnaire. A preliminary 80-item questionnaire was created, and a random sample of 268 family practice patients participated. Subjects rated items on a 4-point Likert scale (strongly disagree, disagree, agree, strongly agree). Items were subjected to a principal components varimax rotated factor analysis and five factors (60 items) were extracted, accounting for 47.5% of the variance. These factors were: satisfaction with physician, dissatisfaction with practice management, physician availability, receptionist behavior, and wait time. Alpha reliability coefficients for factors 1-5 were: .96, .93, .89, .84, and .78, respectively. All items correlated highly with total scores on the respective factors. Factor intercorrelations were all significant (P less than .001) and in the expected direction. Patients with a higher level of education were significantly less satisfied about physician availability than patients without a high school education (P less than .05). Implications of the findings are discussed.

Factors on which family practice residents base their judgments about ranking programs are identified. Questionnaires were mailed to 1,810 first-year family practice residents who participated in the 1981 matching program; 830 (46 percent) responded. The questionnaire items were factor analyzed, and nine factors accounting for 59.4 percent of the variance emerged. Reliability for the questionnaire was estimated to be .82 using coefficient alpha. Factor scores for the nine subscales were computed and employed as dependent variables in several multivariate analyses of variance. Significant differences for sex, age, race, and geographical region were found on various factors; these findings indicated differences in what those groups considered important when selecting a residency.

Family physicians often rely solely upon patients' recollections of events in the assessment and treatment of psychological complaints. One important method that is likely to enhance the quality and quantity of relevant clinical data is patient self-monitoring. Self-monitoring involves utilizing patients as self-observers and systematic recorders of information concerning their target complaint(s). Self-monitoring affords several advantages to both the patient and physician. It is especially useful as a basis for performing a functional analysis of behavior. The most valuable aspect of patient self-monitoring lies in the systematic collection and summarization of clinical information that is crucial for the assessment and treatment of psychosocial complaints.