Family Medicine最新文献

Background and objectives: Limited knowledge is present regarding how fellowship training correlates with graduate outcomes and whether current residents desire an additional year of residency training. The aim of this study is to examine trends in fellowship training and compare residency and practice outcomes between those interested and those not interested in fellowship training as well as the proportion of residents desiring an additional year of residency training.

Methods: We compared data from the American Board of Family Medicine Initial Certification Questionnaire (2017-2019) to the National Graduate Survey (NGS; 2020-2022). We used bivariate analysis and ꭓ2 tests to assess for changes over time and to determine whether an association exists between those likely to pursue a fellowship and those interested in an additional year of residency training.

Results: The final sample included 4,930 residency graduates with NGS data (response rate 46.8%). Overall, most (71.0%) respondents were not interested in any type of additional training. We found no differences in interest in a fellowship based on in-training examination (ITE), certification scores, or milestones attainment. Respondents without interest in a fellowship were more likely to provide continuity of care in practice, while respondents with interest in a fellowship were more likely to be faculty and less likely to have symptoms of burnout.

Conclusions: Intention for fellowship training is associated with future faculty members and lower rates of symptoms of burnout and continuity practice. A majority of responding family medicine residents (>70%) do not favor an additional year of residency training.

Background and objectives: Health care leaders use interprofessional collaborative practice as a strategy to improve health outcomes, and they have stressed its importance in the education of primary care medical providers to apply public health concepts like the social determinants of health and community collaborations. Interprofessional education (IPE) prepares students from different professions for collaborative practice as they enter the health workforce by developing core competencies. Understanding the importance of IPE is vital toward improving person and client-centered care and population health outcomes. This study aims to evaluate IPE workshops' effects on participants' confidence in applying public health concepts to improve health outcomes and intention to collaborate with local resources.

Methods: Public health-focused workshops were provided to encourage collaboration between Master of Public Health (MPH) students and residents in a family medicine residency program. We analyzed change using McNemar's tests to determine significant differences between pre- and postworkshop responses.

Results: In total, 33 family medicine residents and 41 MPH students provided full data for the evaluation. We found statistically significant differences between self-efficacy levels and intention to partner with resources between pre- and postworkshop surveys.

Conclusions: Results point to the efficacy and value of IPE opportunities in the education of family medicine residents and MPH students. This study presents a viable and useful example of IPE integration between MPH students and family medicine residents. Understanding social determinants of health and the use of local resources to better the health of the community is vital for both groups.

Background and objectives: Family medicine implemented program signals and geographic and setting preferences in the 2023-2024 residency application cycle. We performed a qualitative study with the following aims: (a) describe residency program experiences with implementation of signaling and preferences; and (b) identify opportunities for applicants, advisors, residency leadership, and policymakers to optimize these two programs.

Methods: This qualitative study used the RE-AIM framework (reach, effectiveness, adoption, implementation, and maintenance) to guide interviews of family medicine program faculty from the Midwest United States between January and April 2024. We analyzed data using a thematic analysis.

Results: We interviewed 21 faculty members. About half of respondents somewhat or strongly agreed that program signals (10, 48%) and geographic and setting preferences (11, 52%) added value to the current system. We identified four themes: (1) Faculty adopted signals and preferences strategically to complement their existing application review strategies; (2) Signals were perceived as reducing application volume and burden; (3) Signals did not impact diversity and equity, but geographic preferences may benefit community health; (4) Modifications to signals and preferences are recommended to optimize use in family medicine.

Conclusions: Program faculty implemented signals and preferences into holistic review to reduce application review burden. Signals and preferences should support the unique experiences of family medicine residencies and needs for primary care physician workforce development. Future research should focus on refining signals and preferences and their impact on match outcomes and Supplemental Offer and Acceptance Program participation rates.

Background and objectives: The proportion of family physicians caring for children is decreasing. At the same time, US family medicine residency training requirements have increased flexibility in how to train future family physicians in caring for this population. Our objective was to evaluate the correlation between residency program structures and curriculum with graduates caring for children.

Methods: We conducted a prospective cohort study of family medicine graduates using the 2018 Council of Academic Family Medicine Education Research Alliance program director study to measure program characteristics and pediatric curricular elements, and the 2021 family medicine National Graduate Survey (NGS) of residents who graduated in 2018 to measure outcomes. We used logistic regression to determine associations between residency elements and graduate practice of outpatient pediatrics, inpatients pediatrics, or newborn hospital care.

Results: After data from the two sources were merged, our final sample was 779 family medicine graduates (48% of the NGS sample), where 74.7% reported practicing outpatient pediatrics, 16.8% inpatient pediatrics, and 25.9% newborn care. In multivariate analyses, residency processes associated with the care of children in one or more settings included having more than 10% of continuity clinic patients under the age of 10 and having two or more family medicine faculty supervising inpatient pediatrics or newborn care.

Conclusions: In a large national cohort study, we found that residency processes-especially faculty role modeling care of children and the inclusion of children in continuity clinic-are positively associated with residency graduates providing care for children. With residency training requirements changing, these results offer evidence-based interventions for programs to produce graduates who will care for children.

Background and objectives: A recognized gap exists between primary care physicians' training in musculoskeletal (MSK) medicine and the burden of MSK complaints in primary care. Family medicine interns often lack adequate baseline MSK physical exam skills, which prompted a proposal to introduce a fourth-year preceptorship to reinforce MSK education. The aim of this study was to prioritize the most important elements to include in this new clinical rotation.

Methods: We employed a three-round, modified Delphi method to derive consensus. Eleven panelists with experience and expertise in MSK training, medical education, or both generated a list of 118 elements. Each panelist then ranked each element by level of importance, and we reviewed the results. The ranking process was repeated two more times with a goal of achieving consensus.

Results: Seventy-seven curricular elements (topics, skills, experiences) achieved consensus recommendation by being ranked either "fairly important" or "very important" for inclusion in the curriculum. Twenty-eight items were unanimously ranked "very important," 42 received a mix of "very important" and "fairly important" rankings, and seven received unanimous ranking of "fairly important." Three items were unanimously ranked "neither important nor unimportant."

Conclusions: Longitudinal repetition of physical exam skills, reinforcement of relevant anatomy, and incorporation of specific frameworks for approaching MSK care are important components. Physical examination of the shoulder, knee, back, and hip are especially meaningful clinically.