From an educational perspective, at this point the available evidence does not support providing Palms to medical residents. Further research is still needed to determine if the use of Palm Pilots will result in better patient outcomes or resident efficiency. , 4) Menopause, Osteoporosis and Hormone Replacement, 5) Psychosocial Issues, 6) Resident Presentations and Posttest. Also included in the curriculum is a three-hour visit to the local domestic violence prevention center. All necessary reading materials are handed out during the first session after the pretest. The didactic sessions start with a brief case presentation by the participating resident(s); this is followed by an in-depth discussion of the topics of the day with expected resident participation. Each session except the introductory and resident presentation session ends with role-plays where the instructor plays the role of the patient and the resident the doctor. This enables the resident(s) to put into immediate practice what they have just learned. Clinical practice of women's health is expected to occur when residents see female patients in their primary care practices. To expand the scope of this curriculum beyond these limited topics both residents and faculty have been encouraged to incorporate into everyday teaching and learning how various conditions may differ or are unique in women. Participating residents are expected to make a formal thirty to forty-five minute presentation on a topic in women's health not covered in this curriculum. Learners are evaluated by the completion of a standard evaluation form used in the residency program. Evaluations are based on the residents' performance on the posttest, participation during the didactic sessions and their presentations. Learners evaluate the curriculum by completing a survey. RESULTS: The curriculum was well received by all residents. All residents surveyed either agreed or strongly agreed that they would now be able to evaluate, manage or appropriately refer female patients as a result of knowledge gained during the month. The mean posttest score was 81%, an improvement over the mean pretest score of 66%. Residents stated particularly that role-plays helped improve their understanding of the topics. A survey of these residents in their third year regarding their perceptions on the women's health education they received in this program and how well they think it has prepared them for their future practices year is planned. CONCLUSION: The curriculum improved the knowledge of residents in selected women's health topics. Using the same curricular model, topics can be adapted to meet the learning needs of residents in other residency programs. (COPD)). Each physician subject saw a simple and a complex case for each disease. Fifteen physicians were randomly selected at each site, yielding a total of 120 visits. From these, we randomly selected 10 percent of these visits to audio record the SP physician interaction yielding 1 recording for each of the 12 SPs. To make the visits as realistic as possible, physicians consented not to be informed if a patient was an SP or if the visit was being recorded. SPs rated clinical care provided by physicians using closed-ended checklists that contained explicit quality criteria developed from national guidelines. Transcribed recordings were scored identically using the same checklists to determine if SP reports were valid. We calculated the percentage of criteria where SP checklists and recordings were in agreement and disagreement. McNemar's chi-square test for paired proportions was used to determine the statistical significance of differences between the two methods. RESULTS: The overall rate of agreement between SPs and recordings was 90.3 percent (p = 0.00). The rate of agreement ranged from 86.9 percent (p < 0.01) for the complex depression case to 95.3 percent (p = 0.375) for the simple COPD case. Eighty-five percent of the disagreements between SPs and recordings occurred when SPs recorded that physicians performed actions that were not verified by the recording. CONCLUSION: The high rate of agreement between SPs and recordings indicates that SPs are valid measures of the quality of outpatient care. The higher rate of agreement in the COPD cases as compared to depression may be related to two factors: 1) the larger number of items in the depression checklists, and 2) the subtlety of checklist items in the history section of these cases. The preponderance of overrecording vs. underrecording suggests that SPs may tend to give physicians the benefit of the doubt in the presence of ambiguity. Unannounced SPs are attractive quality measurement tools in the outpatient setting because they are inherently adjusted for case mix. These prospectively obtained results indicate that SP reports are valid measures of the quality of care, and may be useful for comparative evaluation of physician training across health care systems. Little is known about changes in end-of-life care attitudes among medical and pharmacy students following experiences working with patients at the end of life. METHODS: 8 medical or pre-medical students and 19 pharmacy students served as volunteer "patient advocates" (n = 27), providing social support in the form of weekly phone calls and monthly visits to patients with end-stage congestive heart failure, chronic obstructive pulmonary disease, and cancer. Students worked in pairs with an individual patient for a 4-month period. In addition, students participated in a 10-hour series of physician-led discussions about end-stage illness, the patient and family experiences of illness, and the emotional and spiritual dimensions of end-of-life care. Using a confidential, self-administered questionnaire with 10-point Likert responses (1 =very negative; 10 = very positive), student attitudes about the end of life were assessed before and following their work as advocates and participation in the class. The mean values among all respondents pre-and post-training were compared and analyzed using the two-tailed t-test. RESULTS: The response rate was 70% (n = 19). Students felt that the quality of their experiences with patients at the end of life was more positive after the course than before (mean = 7.0 post vs. 5.7 pre; p = 0.013). Students also felt more comfortable working with patients at the end of life (mean = 7.3 post vs. 6.4 pre; p = 0.045). Additionally, following their experiences, students estimated the average quality of life for patients at the end of life as higher (mean = 6.3 post vs. 4.7 pre; p = 0.028). Following their experiences, student belief in the possibility for growth at the end of life did not change significantly (mean = 8.7 post vs 8.9 pre; p = 0.48). Following their experience, students' rank of the professional importance of working with patients at the end-of-life remained high (mean = 9.0 post vs 9.6 pre; p = 0.077). CONCLUSION: Direct contact with patients at the end of life and formal physician-led discussions about end-of-life care led to improved quality in students' experiences with people at the end of life, as well as increased comfort working with patients at the end of life. While endof-life care experiences led students to estimate that patients' quality of life was higher than initially expected, following their work, students were no more likely to believe that growth at the end of life was possible. The influence of early end-of-life care experiences on preprofessional students is generally positive, but should be explored further as students receive increased training in end-of-life care. PURPOSE: Mentorship has been associated with greater career satisfaction among academic physicians, but has not been studied during residency training. While female physicians may benefit more from mentorship, little is known about mentorship among female residents. We compared the prevalence and characteristics of mentorship between male and female residents in medicine. METHODS: We developed a questionnaire to collect data on attitudes regarding mentorship, satisfaction with mentorship, and satisfaction with residency education. After pilot testing the questionnaire, we mailed it to residents in the five internal medicine residency programs affiliated with Harvard Medical School. We sent two additional mailings to nonrespondents. We compared responses between men and women, and then used logistic regression to identify factors significantly associated with having a mentor and being satisfied with mentorship or career guidance. RESULTS: Among 329 respondents (response rate 65%), 47% were women. Of the women, 57% were white, 29% Asian and 9% underrepresented minorities. Although 50% of both men and women had a current mentor, and both men and women were equally likely to report satisfaction with mentorship (46% vs 38%, p=0.16), women were more likely to report that having a mentor was important during residency training (96% vs 90%, p=0.04). While women were more likely than men to want a mentor of the same gender (35% vs 8%, p < 0.01) and were more likely to have a female mentor (52% vs 17%, p < 0.01), having a female mentor was not associated with satisfaction with mentorship. In addition, regardless of whether they had a preference for a female mentor, women were equally likely to have a mentor and to be satisfied with mentorship. In multivariable models adjusting for ethnicity, year of training, being assigned a mentor and history of mentorship, women and men were equally likely to have a mentor and to be satisfied with mentorship. However, after adjusting for ethnicity, year of training and having a mentor, women were more likely than men to report receiving inadequate guidance with career decisions [adjusted odds ratio 1.8 (95% confidence interval 1.1, 2.8)] and were less likely than men to think that their residency was doing the best possible job preparing them for a future career [0.6 (0.4, 0.9) ]. CONCLUSION: Although women in residency training developed mentoring relationships as often as men and were equally satisfied with mentorship, they were significantly more likely to judge guidance with career decisions as inadequate, and were less likely than men to believe that their residency was doing the best possible job preparing them for a future career. PURPOSE: Since mentorship has been associated with greater career satisfaction among academic physicians, some residency training programs assign mentors to all house officers. We compared characteristics of mentorship between residents who were assigned a mentor by their training program, and those who were not assigned a mentor. METHODS: We developed a questionnaire to collect data on attitudes regarding mentorship, satisfaction with mentorship, and satisfaction with residency education. After pilot testing the questionnaire, we mailed it to residents in the five internal medicine residency programs affiliated with Harvard Medical School. We sent two additional mailings to nonrespondents. Using logistic regression, we identified factors associated with three different outcomes: having a mentor, being satisfied with mentorship, and being satisfied with career preparation. RESULTS: Among the 329 respondents (response rate 65%), 34% were in residency programs that assigned mentors (assigned), and 66% were in programs that did not assign mentors (nonassigned). Most (87%) residents in programs that assigned mentors knew that they were assigned a mentor. Residents in assigned programs were significantly more likely to identify a mentor than those in nonassigned programs (82% vs 43%, p < 0.01). Residents with mentors in assigned programs were less likely than residents with mentors in nonassigned programs to report their mentor was helpful with professional development (64% vs 77%, p=0.05) or personal development (45% vs 69%, p < 0.01). However, residents with mentors in assigned programs were more likely to be satisfied with mentorship than residents with mentors in nonassigned programs (53% vs 36%, p < 0.01). In multivariable models adjusting for sex, ethnicity, year of training and history of mentorship, residents in assigned programs were more likely to identify a mentor [adjusted odds ratio 8.1 (95% confidence interval 4.3, 15.