Family Medicine最新文献

Background and objectives: Evidence-based medicine (EBM) is an important concept for family medicine and is part of several Accreditation Council for Graduate Medical Education milestones. Social media (SM) has become a cornerstone in most of our lives. Previous studies show the use of SM in medical education is expanding. The objective of this study is to use SM for medical education focusing on teaching EBM through an innovative, engaging video series.

Methods: This quasi-experimental study used pre- and postintervention surveys between May 2022 and June 2022 using the American Board of Family Medicine National Journal Club initiative as a foundation. A total of 196 residents and fellows from various family medicine residency programs were eligible to participate. Surveys consisted of SM usage, EBM engagement, EBM comfort and confidence adapted from a validated tool, and questions about the articles reviewed in the videos.

Results: A total of 44 of 196 residents and fellows from various family medicine residency programs participated in the preintervention survey. Most participants identified learning about EBM through residency didactics. The most popular SM platforms were Instagram and YouTube for medical content. Participants were least comfortable on the 10-point scale for critically appraising study methods. Postintervention cumulative scores for knowledge about the journal articles increased from 64% to 85%.

Conclusions: The video series taught EBM concepts and were well received, albeit with a low postintervention response rate. These findings contribute to the evolving landscape of medical education with implications for improving the effectiveness of EBM teaching through SM platforms.

Background and objectives: Physicians have long been considered valued members of a solid US health care system. Significant changes in medical education, health care, and society at-large suggest that current medical students may face a different future. To help guide educators and policy makers, we set out to understand medical students' perceptions of the future of health care and their place in it.

Methods: In year one of a longitudinal study, we conducted in-depth interviews of Case Western Reserve University medical students. A multidisciplinary team performed iterative thematic analyses and sampling until reaching saturation on major themes.

Results: Eleven medical student participants described social and health care issues as major influences on their professional futures. Concerns included health care system failings, unsustainable costs, climate change, demographic shifts, disinformation, and public distrust in health care. Students looked forward to team practice and using technology, data, and artificial intelligence in care delivery. They hoped for greater access and equity in health care, with a focus on prevention and social, behavioral, and environmental drivers of health. Most students expected to be employed rather than in private practice and sought time/flexibility for professional and personal interests. Paying off medical school debt and advocating for patients and change were priorities. Many saw primary care as important, but fewer envisioned it as their career path of choice.

Conclusions: Medical students envision a future shaped by health care systems and social issues. These findings can inform those helping students prepare for uncertainty and rapid change in their careers, their lives, and the lives of their patients.

Background and objectives: Cesarean section (c-section) rates among nulliparous, term, singleton, and vertex (NTSV) pregnancies are increasing, posing risk to the infant and birthing parent. To reach the Healthy People 2030 goal of an NTSV c-section rate below 23.6%, teams must remain aware of their NTSV c-section rate and implement mechanisms to reduce it. This project was conducted to assess the impact of quality improvement interventions implemented by family medicine residents to reduce a hospital's NTSV rate.

Methods: From 2021 to 2023, family medicine residents were educated on evidenced-based diagnosis of labor dystocia, failed induction of labor, arrest of dilation, and arrest of descent in first-time birthing parents. Learning was reinforced by implementing the Colorado Perinatal Care Quality Collaborative's labor dystocia checklist. Quarterly assessment of the hospital's NTSV rate and checklist utilization were monitored and widely reported.

Results: After the implementation of a standard checklist, the NTSV c-section rate at the tertiary care center declined from 35.6% in 2020 to a sustained rate below the 2030 Healthy People goal of 23.6%. Notably, patients with public insurance saw the greatest reduction in NTSV c-section rates. Hospital staff highlighted the benefits of using the checklist, including more effective electronic documentation of labor progression, improvement in team dynamics, and increased team communication.

Conclusions: Using a labor dystocia checklist is a successful method for teams to reduce NTSV c-section rates and can be used as a training tool for family medicine and obstetrics and gynecology residency programs that care for laboring persons.

Background and objectives: Physician demographics in North America do not yet reflect the diversity of the communities they serve, accounted to systemic barriers targeting underrepresented in medicine (URiM) groups. URiM medical graduates are more likely to pursue generalist specialties, including family medicine. Mini Med Schools (MMSs) are pathway programs intended to motivate URiM youth to pursue medicine. A gap in literature exists regarding the potential of MMSs to provide youth with useful information. We examined the extent to which youth reported a change in knowledge about medicine as a career before and after attending an MMS.

Methods: Asclepius Medical Camp for Youth is a weeklong MMS for high school students, held at one Canadian university. In 2022, 50 youth participants were invited to complete surveys and quizzes measuring their knowledge about pursuing a career in medicine.

Results: The mean self-reported knowledge differed significantly precamp (n=34, M=5.87/10, SD=1.9) versus postcamp (n=26, M=8.28/10, SD=1.4; t[35]=7.07, P<.05). Likewise, participants' scores demonstrated a significant difference in mean scores precamp (n=43, M=7.12, SD=2.39) versus postcamp (n=39, M=9.31, SD=1.13; t[42]=5.08, P<.05).

Conclusions: These findings highlight MMSs as a promising strategy to provide knowledge about medical careers beyond instilling motivation. By both inspiring and informing URiM youth, the long-term outcome of diversifying medicine may be achieved.