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Context (Place) Matters
Frederic W. Hafferty, PhD
Arch Pediatr Adolesc Med. 2008;162(6):584-586.
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| Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings. |
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Former speaker of the US House of Representatives Thomas "Tip" O'Neill (1912-1994) is noted for saying, "All politics is local." He could have been talking about clinical decision making and, by extension, medical education.
In their comparative study of training sites and residents' attitudes about neonatal resuscitation, Janvier and colleagues1 report a series of compelling links between site (4 neonatal residency programs in the province of Quebec, Canada) and willingness to resuscitate a depressed infant at 24, 25, 26, and 27 weeks of gestation.1 They also identify a "site effect" for medical knowledge (cerebral palsy prevalence), along with the finding that knowledge does not substantially increase with level of training.
I find these data to be disquieting, socially predictable, and empirically affirming.
They are disquieting because they threaten the identity of medicine as a fundamentally scientific endeavor underscored by the principle of universalism. These data make . . . [Full Text of this Article] AUTHOR INFORMATION
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Relationship Between Site of Training and Residents' Attitudes About Neonatal Resuscitation
Annie Janvier, Keith Barrington, Marianne Deschênes, Elise Couture, Sophie Nadeau, and John Lantos
Arch Pediatr Adolesc Med. 2008;162(6):532-537.
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