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Objective: Resident research teams were established at this community hospital in the 1997 academic year. Research productivity, including publications and presentations in the years before establishing research teams and the 8 years subsequent to establishment of research teams with faculty mentors, was reviewed., Methods: Each team is supported by a research specialist who provides assistance with project design, data evaluation, statistical analysis, manuscript editing, and preparation of research presentations. Every resident is assigned to a research team that meets monthly. The teams consist of a 4th- or 5th-year resident, 2nd- or 3rd-year resident, surgical intern, research team mentor, and research specialist. The resident is required to be an active contributing co-investigator on 1 team project per year, contributing to the development and performance of the study, participating in writing the manuscript, and must be able to defend the study. By the end of the third year, the resident is required to complete 1 individual project that is submitted to the postgraduate competition for residents. In addition, a completed manuscript must be ready to submit to a peer-reviewed journal. Promotion can be denied if the appropriate time has not been devoted to research. Minimum completion requirements include a case report and a presentation at a national or regional meeting. The research registry was reviewed for all presentations and publications given by the surgical residents during the 8 years before the teams were established and the 8 years after the teams were formed., Results: In the 8 years before the establishment of research teams, 60 papers were published. After the establishment of research teams, 77 papers were published. During the 8 years before research teams were being established, 69 presentations were given. During the subsequent 8 years with the use of mentoring and research teams, 92 presentations were given. The research teams resulted in a 33% increase in presentations and a 13% increase in publications., Conclusions: Establishment of research teams and mentoring can help stimulate research interest and activity. Continuity on research teams throughout the 5-year residency is also crucial for the progression and development, duration, and completion of projects. Continuity of the mentor and research specialists also helps facilitate productivity and completion of the task. This method has been highly successful in improving the research presentations and publications in a community-based hospital residency.

Background: As part of the general competencies set forth by the Accreditation Council for Graduate Medical Education (ACGME), residents must have an understanding of systems-based practice, which is demonstrated by an awareness of-and responsiveness to-the comprehensive health care system. Residents must be able to effectively access and use system resources to provide care that is of optimal value. Essential to understanding and implementing systems-based practice is an awareness of how different patient populations perceive health care; one key factor that influences patients' perceptions of health care is their level of education., Methods: We surveyed 2900 adult patients in the Cincinnati, Ohio area and stratified them into 2 groups based on their level of education. Group 1 included patients with some high school education or a high school degree. Group 2 included patients with some college education, an undergraduate degree, or graduate/professional-level coursework. We then compared the groups' perceptions of common health care issues, including physician compensation, patient obligation for medical bills, and increased cost for the freedom to choose a physician., Results: Of 395 respondents, a higher percentage of Group 2 patients, compared with those in Group 1, understood that physicians do not collect 100% of what they bill (p < 0.001) and that businesses do influence the amount a physician is paid by insurance companies (p = 0.009). Conversely, a higher percentage of Group 1 patients thought that physicians are overpaid (p = 0.030) and that they keep a large portion of what they charge (p < 0.001). Further, fewer Group 1 respondents felt obligated to pay medical bills not covered by insurance (p = 0.002); they also were less willing to pay more for better medical care (p = 0.002) or for the freedom to choose a physician (p = 0.015)., Conclusions: This study indicates that patients with a lower level of education believe that physicians are overpaid and that they keep a large portion of insurance reimbursement. These findings may explain why fewer patients in this group feel that they are obligated to pay medical bills not covered by insurance and why they are less likely to pay more for better medical care or for the freedom to choose a physician.