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Fertility Awareness-Based Methods for Family Planning and Women’s Health: Impact of an Online Elective 基于生育意识的计划生育和妇女健康方法:在线选修课的影响
Pub Date : 2024-05-23 DOI: 10.22454/fammed.2024.562177
Marguerite R. Duane, Logan Waechtler, Margaret May, Deepa Manda, Noah F. Gomez, Theresa M. Stujenske
Background and Objectives: Fertility awareness-based methods (FABMs) are evidence-based means of tracking observable biomarkers of a woman’s fertility for the purpose of reproductive health monitoring and family planning. However, medical education regarding FABMs is limited. The purpose of this study was to examine the effect of a 4-week, two-part online elective on students’ knowledge of FABMs, confidence in explaining and offering them to patients, and anticipated behaviors in future practice.Methods: The online elective, “FABMs for Family Planning and Women’s Health,” was delivered from August 2020 to May 2023. Students completed pre- and postknowledge surveys. Paired t tests and the Wilcoxon signed rank test were used for analysis of the data.Results: A total of 571 students completed the elective, and 462 students completed both pre- and posttest surveys (response rate=81%). Students’ knowledge of FABMs increased significantly. Posttest scores increased by a mean of 9.02 for Part A and 5.95 for Part B. We identified a significant increase in students’ confidence discussing FABMs to avoid pregnancy, achieve pregnancy, monitor reproductive health, and address reproductive health concerns. At the completion of the elective, students were significantly more likely to offer FABMs as an option for most or all women.Conclusions: This online elective addresses the knowledge gap in FABMs and was effective in improving students’ knowledge of FABMs and their confidence and willingness to offer these methods to patients for family planning and management of common women’s health conditions.
背景与目标:基于生育意识的方法(FABMs)是一种循证手段,用于跟踪妇女生育力的可观察生物标志物,以达到生殖健康监测和计划生育的目的。然而,有关 FABMs 的医学教育却很有限。本研究旨在考察为期 4 周、由两部分组成的在线选修课对学生了解 FABMs、向患者解释和提供 FABMs 的信心以及未来实践中预期行为的影响:在线选修课 "计划生育和妇女健康中的 FABMs "于 2020 年 8 月至 2023 年 5 月进行。学生们完成了知识前和知识后调查。数据分析采用了配对 t 检验和 Wilcoxon 符号秩检验:共有 571 名学生完成了选修课,462 名学生完成了测试前和测试后的调查(回复率=81%)。学生对 FABM 的了解有了显著提高。我们发现,学生在讨论 FABMs 以避免怀孕、实现怀孕、监测生殖健康和解决生殖健康问题方面的信心明显增强。在选修课结束时,学生们更愿意将 FABMs 作为大多数或所有女性的选择:该在线选修课弥补了 FABM 方面的知识空白,有效提高了学生对 FABM 的认识,增强了他们为患者提供这些方法以实现计划生育和治疗常见妇女健康问题的信心和意愿。
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引用次数: 0
Not-So-Simple Solutions for Improving Maternal Morbidity in Maternity Care Deserts 改善孕产妇护理荒漠地区孕产妇发病率的不简单解决方案
Pub Date : 2024-05-23 DOI: 10.22454/fammed.2024.892916
Alison N. Huffstetler
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引用次数: 0
From Crisis to Catastrophe: Care, COVID, and Pathways to Change 从危机到灾难:护理、COVID 和变革之路
Pub Date : 2024-05-21 DOI: 10.22454/fammed.2024.306922
P. Lazar
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引用次数: 2
Guardrails: Guiding Human Decisions in the Age of AI 护栏:人工智能时代的人类决策指南
Pub Date : 2024-05-21 DOI: 10.22454/fammed.2024.383539
Franklin J. Berkey
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引用次数: 0
Administrative Time Expectations for Residency Core Faculty: A CERA Study 住院实习骨干教师的管理时间期望:CERA 研究
Pub Date : 2024-05-20 DOI: 10.22454/fammed.2024.991075
Bryce Ringwald, Stephen Auciello, Joseph Ginty, Melissa Jefferis, Stephen Stacey
Background: Academic family medicine (FM) physicians aim to balance competing needs of providing clinical care with nonclinical duties of program administration, formal education, and scholarly activity. FM residency is unique in its scope of practice, clinical settings, and training priorities, which may differ between university-based and community-based programs. In both types of programs, these competing needs are a source of faculty dissatisfaction and burnout. We performed this study to explore the allocation of nonclinical administrative full-time equivalents (FTE) for FM residency core faculty members.Results: Reported nonclinical administrative FTE time allocation is equivalent between university/medical school-based and community-based programs. The ideal proportion of FTE distribution identified by DCs had greater amounts of direct clinical care compared to greater emphasis on precepting time identified by PDs. DCs and PDs agreed that administrative time should be used for advising residents, curriculum development and delivery, and evaluation of resident performance. Barriers to allocating additional administrative time for DCs included loss of revenue and pressure by hospital-level leadership. PDs responded that the need for clinical supervision of residents was most significant.Methods: We performed our research through a cross-sectional survey of FM department chairs (DC) and residency program directors (PD) conducted by the Council of Academic Family Medicine Educational Research Alliance. We used descriptive statistics to characterize the data and Pearson’s χ2 tests to evaluate bivariate relationships.Conclusions: DCs and PDs offer a similar ideal picture of core responsibilities, though subtle differences remain. These differences should be considered for the next revision of the Accreditation Council for Graduate Medical Education minimum program standards to best meet the needs of all FM programs.
背景:全科医学(FM)学术医生的目标是平衡提供临床护理与项目管理、正规教育和学术活动等非临床职责之间的竞争需求。全科医学住院医师培训在其实践范围、临床环境和培训重点方面具有独特性,大学项目和社区项目之间可能存在差异。在这两种类型的项目中,这些相互竞争的需求都是造成教师不满和职业倦怠的原因。我们进行了这项研究,以探讨调频住院医师培训核心教师的非临床行政全职当量(FTE)分配情况:结果:据报告,大学/医学院和社区项目的非临床行政全职时间分配相当。住院医师确定的理想全职时间分配比例中,直接临床护理的时间更多,而住院医生确定的全职时间分配比例中,则更强调带教时间。住院医师和住院医师一致认为,行政时间应用于为住院医师提供建议、课程开发与实施以及住院医师表现评估。为住院医师分配额外行政时间的障碍包括收入损失和医院领导层的压力。住院医师回答说,他们最需要的是对住院医师进行临床督导:我们通过全科医学教育研究联盟理事会对全科医学系主任(DC)和住院医师项目主任(PD)进行的横断面调查进行了研究。我们使用描述性统计来描述数据特征,并使用皮尔逊χ2检验来评估二元关系:尽管仍存在细微差别,但全科医生和全科医生对核心职责的理想描述是相似的。在下一次修订毕业后医学教育认证委员会最低项目标准时,应考虑这些差异,以最大限度地满足所有基础医学项目的需求。
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引用次数: 0
Social History 社会历史
Pub Date : 2024-03-01 DOI: 10.22454/fammed.2024.582535
John M. Westfall
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引用次数: 0
Ten-Year Outcomes: Community Health Center/Academic Medicine Partnership for Rural Family Medicine Training 十年成果:社区卫生中心/学术医学合作开展农村全科医学培训
Pub Date : 2024-03-01 DOI: 10.22454/fammed.2024.400615
Maria Gabriela Castro, Caroline Roberts, Emily M. Hawes, Evan Ashkin, Cristen P. Page
Background and Objectives: The widening gap between urban and rural health outcomes is exacerbated by physician shortages that disproportionately affect rural communities. Rural residencies are an effective mechanism to increase physician placement in rural and medically underserved areas yet are limited in number due to funding. Community health center/academic medicine partnerships (CHAMPs) can serve as a collaborative framework for expansion of academic primary care residencies outside of traditional funding models. This report describes 10-year outcomes of a rural training pathway developed as part of a CHAMP collaboration.Methods: Using data from internal registries and public sources, our retrospective study examined demographic and postgraduation practice characteristics for rural pathway graduates. We identified the rates of postgraduation placement in rural (Federal Office of Rural Health Policy grant-eligible) and federally designated Medically Underserved Areas/Populations (MUA/Ps). We assessed current placement for graduates >3 years from program completion.Results: Over a 10-year period, 25 trainees graduated from the two residency expansion sites. Immediately postgraduation, 84% (21) were in primary care Health Professional Shortage Areas (HPSAs), 80% (20) in MUA/Ps, and 60% (15) in rural locations. Sixteen graduates were >3 years from program completion, including 69% (11) in primary care HPSAs, 69% (11) in MUA/Ps, and 50% (5) in rural locations.Conclusions: This CHAMP collaboration supported development of a rural pathway that embedded family medicine residents in community health centers and effectively increased placement in rural and MUA/Ps. This report adds to national research on rural workforce development, highlighting the role of academic-community partnerships in expanding rural residency training outside of traditional funding models.
背景和目标:医生短缺对农村社区的影响尤为严重,这加剧了城乡医疗成果之间日益扩大的差距。农村住院医师培训是增加农村和医疗服务不足地区医生安置的有效机制,但由于资金问题,其数量有限。社区卫生中心/学术医学合作项目(CHAMPs)可以作为一个合作框架,在传统资助模式之外扩大学术性初级保健住院医师培训。本报告介绍了作为 CHAMP 合作的一部分而开发的农村培训途径的 10 年成果:我们的回顾性研究利用内部登记和公共来源的数据,考察了农村培训路径毕业生的人口统计学特征和毕业后的实践特征。我们确定了毕业后在农村(符合联邦农村医疗政策办公室补助条件)和联邦指定的医疗服务不足地区/人群(MUA/Ps)的就业率。我们评估了毕业 3 年以上的毕业生目前的就业情况:10 年间,共有 25 名学员从两个住院医师培训基地毕业。毕业后,84% 的学员(21 人)在初级保健卫生专业人员短缺地区(HPSAs)工作,80% 的学员(20 人)在 MUA/Ps 工作,60% 的学员(15 人)在农村地区工作。16名毕业生距离课程结束还有3年以上的时间,其中69%(11人)在初级医疗保健专业人员短缺地区,69%(11人)在医疗保健专业人员短缺地区,50%(5人)在农村地区:该CHAMP合作项目支持了农村路径的发展,该路径将家庭医学住院医师嵌入社区医疗中心,并有效地增加了在农村和MUA/Ps的安置。该报告为全国农村劳动力发展研究增添了新的内容,强调了学术界与社区合作在传统资助模式之外扩大农村住院医师培训方面的作用。
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引用次数: 0
Moving Your Work From Presentation to Publication 将作品从展示转为出版
Pub Date : 2024-03-01 DOI: 10.22454/fammed.2024.429019
Octavia Amaechi, S. Schrager
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引用次数: 0
Maladies of Empire: How Colonialism, Slavery, and War Transformed Medicine 帝国的弊病:殖民主义、奴隶制和战争如何改变医学
Pub Date : 2024-03-01 DOI: 10.22454/fammed.2024.692838
Kenneth W. Lin
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引用次数: 0
Courage to Shape Our Future 塑造未来的勇气
Pub Date : 2024-03-01 DOI: 10.22454/fammed.2024.736919
James E. Hougas, J. Heidelbaugh, Aaron J. Michelfelder, David V. Power, Allison R. Newman
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引用次数: 0
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