MODALITIES. E.H. Green 1 , R. Granieri 1 ; 1 University of Pittsburgh School of Medicine, Pittsburgh, PA PURPOSE: Internal medicine residency training involves exposure to different learning modalities including rounds, lectures, small group discussion, and independent study. Little is known about learners' views regarding different educational interventions. We administered a questionnaire to assess current medical residents' attitudes towards different learning modalities. METHODS: Second and third year medical residents from an academic residency program and closely affiliated community residency program were surveyed (n = 91). Respondents were asked to rate, using a Likert scale and list ranking, the contribution of various educational activities to their understanding of clinical medicine, preparation for standardized tests, and overall education. Subgroup analysis was done according to level of training, career goals (primary care or subspecialty medicine; academic or community), gender, college major, and additional education. RESULTS: A total of 50 residents (55%) responded.``Noon conference'' (core lecture series) and morning report were highly valued, with 82 and 84% of residents rating these endeavors as moderately or very important to their overall education. Attending rounds were less important, with 68% rating them as moderately or very important. Further, 44% of residents felt``too much'' time was devoted to attending rounds. Medical grand rounds had the least contribution to residency education with 33% rating it as moderately or very important. In contrast, 92% of residents rated independent learning with as moderately or very important. Independent study was the only educational activity that residents thought prepared them equally well for clinical medicine and standardized exams. Residents actively pursued independent study with a mean of 12.69 topics researched in the 3 months prior to the study. However, 52% of respondents felt they had``too little'' time for this endeavor. Independent study and morning report were independently identified as the two most important educational activities during residency. The only significant finding from subgroup analysis was that residents with advanced degrees valued independent study more than their colleagues (p = .038). CONCLUSION: In this study, internal medicine residents valued lectures and morning report over attending rounds or medical grand rounds. However, independent study is the most highly valued educational method, and house officers are very involved in this despite a perceived lack of time. Medical residents seem to be mastering the principles of adult, independent learning: future curricular reform should consider incorporating more time and opportunities for independent study. used; whether PDA's replaced medical texts; and subjective responses regarding the impact of PDA's on patient care and medical education. 114 of the 133 surveys were returned (86% response rate). RESULTS: 62% of medical residents owned PDA's (100%-based on the Palm operating system). The mean age of the cohort was 28 years, and 55% of PDA owners were male. Ownership was inversely correlated with both age and level of training. The most commonlyused medical applications were drug formulary references, medical formula calculators, medical note-taking, and reference texts. Interestingly, only 15% of PDA owners replaced their paperbased drug references with the PDA version. Relatively few residents used their PDA's for patient tracking, appointment scheduling, or to log procedures. The most-commonly used nonmedical applications included the built-in address book, memo pad, to-do list, calculator, local city guides, and games. 83% of owners felt that PDA's improve efficiency, and a majority felt that they were useful in medical education. 69% responded favorably when asked if PDA's improve patient care, but only 48% believed that PDA's decrease medical errors. 37% of nonowners were committed to purchasing a PDA within 12 months. CONCLUSION: The majority of internal medicine house officers at New York-Presbyterian Hospital already own PDA's. Most residents use drug references and medical calculators, perhaps because they provide point-of-care answers to direct questions. The majority of residents believe that PDA's are useful for improving efficiency, medical education, and patient care. However, more research is required to correlate these positive perceptions with objective improvements in clinical outcomes, as well as broadening the applicability of the results to other specialties. Furthermore, as PDA's and the availability of medical applications continue to proliferate, issues of medical privacy and quality-assurance of medical content will become increasingly important. PURPOSE: Despite calls to incorporate active learning strategies into medical education, many teachers believe that efficient delivery of content can only be achieved through didactic lectures. The goal of this study was to examine the effects of reducing didactic lecturing and adding small group work, a commonly employed active learning strategy, on learner participation, attitudes, and knowledge acquisition. METHODS: We recruited residents in internal medicine, pediatrics, and family medicine to attend a session on effective use of diagnostic tests, and assigned them to one of two groups. The control group received a standard 'slide and lecture' session where the lecturer spent a full hour delivering content. The intervention group received a session where residents were assigned to groups of 4-5 and completed a series of 3 small-group tasks with large-group lecturer-facilitated discussion between tasks; in this session, the lecturer delivered content only during large group discussions (approx. 30 minutes). Both sessions used the same lecturer and covered the same content. We measured resident demographics before and self-perception of active learning after both sessions. We measured attitudes toward the session content and knowledge before and after both sessions. We also employed trained observers, blinded to the study purpose, who used a standardized instrument to observe resident patterns of behavior during each session. RESULTS: 27 residents completed the control session and 36 completed the intervention session. The study groups did not differ significantly in demographic variables, baseline attitudes about, or baseline knowledge of the session content. As measured by the trained observers, during the intervention session more students were communicating with other students (p < .001) than during the control session. Students in the intervention group also selfrated their participation in the session higher (p=.001). While both groups improved in both knowledge and attitude scores from pre-to post-session (p < .001 for all comparisons), there were no significant differences in the amount of improvement between groups. CONCLUSION: In these sessions conducted in a controlled environment, we reduced the time spent 'lecturing' by the teacher by 50 percent and covered the same amount of content with no detrimental effects on knowledge acquisition or attitude enhancement. In addition, our incorporation of active learning strategies produced residents who both self-rated and were observed to be more actively engaged with each other and with the learning process. Our future work will measure the effects of this active engagement on long-term retention of content and attitudes. PURPOSE: Existing data suggests that physicians who demonstrate patient-centered behaviors enjoy high patient satisfaction. However, little data exists to link physician attitudes about medical care with patient-centered outcomes. In this study, we explored associations between student physicians' attitudes toward the physician-patient relationship and patients' perceptions of students' humanism during the medical interaction. METHODS: At the beginning of a primary care (PC) clerkship, we surveyed 293 third-year students using the Patient-Practitioner Orientation Scale (PPOS), a validated instrument that measures attitudes toward the physician-patient relationship. PPOS scores range from patientcentered (egalitarian, whole person-oriented) to physician-centered (paternalistic, less attuned to psychosocial issues). During the PC clerkship, all students performed a medical interview with a series of 5 standardized patients (SPs) who were trained to portray varying biopsychosocial issues. All SPs were unaware of the students' PPOS scores. After each interaction, each SP completed a 7-item validated instrument that measured their perceptions of the student physician's humanism. We calculated a total humanism score for each student and compared these to students' attitudes as measured by PPOS.