Adaptive, simulation-based Internet training sites with intelligent agents can offer medical students a virtual clinic for learning about the process and multiple outcomes of patient decision making.
A medical student describes and comments on a case in which a patient who experienced complications following a cardiac catheterization wished to remain in the hospital until the injury to his groin was entirely healed.
Physicians need to manage expectations and clearly explain the prognosis of ICU patients to their families, particularly when the outcome is a negative one.
Physicians should demonstrate compassion when the parent of an ill child asks the physician for his or her personal opinion regarding the parents' choice to continue experimental treatment when the prognosis is not good.
Physicians who treat children with Down's syndrome should ensure that their parents fully understand the children's capabilities and long-term prognosis and counsel them on the appropriate actions to take regarding their children's care.
Residency programs should include a system composed of night float teams, wide cross-coverage, and effective communication at the time of patient hand-off in order to maintain an 80-hour work week.
A physician argues in favor of moving family residency programs into local ambulatory clinics as a way to strengthen community-based physicians and link practical patient care to academic medical centers.
The morbidity and mortality conference serves an important educational role for physicians and underscores the importance of error disclosure in improving patient safety.