Journal of the American Board of Family Medicine最新文献

The Family Medicine Research Summit culminated in a strategic action plan to enhance research in family medicine and expand the primary care research workforce. The strategic plan focuses on infrastructure, mentorship, and funding objectives needed for robust family medicine research. Trainees play a central role in the success of the strategic plan. This commentary outlines how the strategic plan impacts trainees from undergraduate students to postdoctoral research fellows through funding initiatives for research and trainees, fostering curiosity among family medicine clinician trainees, transdisciplinary collaboration, enhancing primary care research knowledge, and mentoring the next generation of researchers.

Family medicine as a discipline is the foundation of health care systems. In addition to clinical practice and education, research is a professional duty for family physicians. Unfortunately, the culture of family medicine has historically de-emphasized research. As a specialty, our clinical practices provide an excellent opportunity to create patient-oriented evidence that can benefit the patients and communities we serve. To accomplish this task, family medicine should weave curiosity into the fabric of the specialty. To create a culture of curiosity which normalizes the production of practice-based research and scholarship, the authors describe 2 approaches - top-down and grass-roots - that can be used to develop a culture of curiosity among individuals and institutions. Methods to sustain a culture of curiosity that leads to inquiry and creates further improvements in research and scholarship are also described. By harnessing the power of curiosity, we can transform our discipline into one that values and excels in research and scholarship and produces generations of family physicians that will include practice-based research as an essential part of their daily activities.

The Building Research Capacity (BRC) initiative was founded in 2015 as a collaboration between the Association of Departments of Family Medicine (ADFM) and the North American Primary Care Research Group (NAPCRG). It aims to enhance family medicine research engagement by helping develop researchers, research educators, and research leaders. Through consultations, a fellowship, tailored presentations at national conferences, and ongoing assessment, BRC addresses the dynamic needs of various stakeholders in family medicine research. There is a growing need for organized efforts in primary care research capacity development, and BRC is positioned to provide ongoing leadership and direction. Targeted areas of growth for BRC are expansion and diversification, collaboration, and iterative evaluation and adaptation. A commitment to innovation, inclusivity, and adaptability propels BRC toward transformative growth in family medicine research.

Primary care researchers are increasingly at the forefront of developing innovations and new research methods to address complex issues in health care, including multi-morbidity, social determinants of health, health equity, managing population health in clinical practice, patient satisfaction, and provider burnout. Research demonstrates that "primary care is the only health care component where an increased supply is associated with better population health and more equitable outcomes."¹As a primary care specialty, family medicine has evolved beyond its initial focus on clinical practice and education to realizing the imperative for the discipline to robustly engage in research and embrace the responsibility to generate the evidence that drives changes in primary care practice and policy.² The primary care clinic is increasingly seen as a complement to medical school laboratories as a powerful site for developing new evidenced-based medicine, and essential for translating new clinical knowledge into practice. Practice-Based Research Networks (PBRNs) comprising primary care clinicians working in the "real world" of clinics promise to bridge "the gaps between communities, funders and policy makers"³ and the National Institutes of Health has shown increased interest in strengthening Clinical Translational Science Awardees' collaborations with PBRNs.⁴ Despite primary care's proven ability to deliver improved outcomes at a lower cost, not enough family physicians are currently engaging in research to improve practice and inform policy. This commentary attempts to describe the wide range of family physicians' intensity of involvement in primary care research and the prospects of mentoring for these needs.

Family medicine as a specialty has steadily increased its research capacity. Specific approaches are needed to attain the following: 1) Advocate for increased funding for Departments of Family Medicine from institutional leadership. 2) Identify and promote promising practices for chairs to support and fund research participation within their departments and institutions. Having each assumed the chair position recently, the authors summarize the specific approaches taken to expand the research capacity in a midsized urban and a large research intensive urban public university family medicine department. They included: obtaining adequate support from the Dean and other institutional programs at the time of on-boarding, focusing on established research themes within the department, ensuring the recruited faculty had high likelihood of success via their track record and mentorship, and getting the buy-in from all faculty through sharing of vision and helping everyone establish their scholarly niche.

Introduction: The 1985 Hames Consortium convened family medicine researchers to identify outstanding questions in their practice.

Method: In this descriptive review, we collected, codified, and analyzed available literature to describe the availability of evidence to answer these questions.

Results: Of 136 total questions, researchers rated 33 questions as not at all answered (24.2%), 49 questions as somewhat answered (36.0%), 37 as mostly answered (27.2%), and 17 as fully answered - will implement in practice (12.5%). Notably, 2 of the categories with the highest number of total questions, community oriented primary care and the value of comprehensive care, had the highest percentage of unanswered questions.

Discussion: The Hames 100 questions and categories themselves demonstrate the values and purpose of family medicine research and can serve as a powerful tool to discuss the future of family medicine research. The varied questions illustrate the broad scope of interest of family physicians in 1985, which remains just as relevant today. Our findings indicate that relatively few questions were fully answered, with even fewer questions answered in family medicine journals.

Collaboration, particularly interdisciplinary collaboration, is very common in family medicine research. Interdisciplinary collaboration and team science are encouraged and have significant advantages but they also have challenges to implementation. Addressing those challenges, even with changes to how promotion and tenure are conceptualized to reward team science is necessary for family medicine research to continue to grow and prosper.