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The Resident Scholars Program for Workforce Diversity: A Qualitative Study About Supporting Family Medicine Abortion Providers. 劳动力多样性的住院学者计划:支持家庭医学堕胎提供者的定性研究。
IF 1.8 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-11-11 DOI: 10.22454/FamMed.2024.484479
Aleza K Summit, Destiney Kirby, Diana N Carvajal

Background and objectives: While workforce diversity helps mitigate health inequities, few initiatives support prospective abortion providers who are underrepresented in medicine (URiM). To address this issue, Reproductive Health Education in Family Medicine established the Resident Scholars Program for Workforce Diversity (RSPWD), a year-long program for URiM and other Black, Indigenous, People of Color (BIPOC) residents committed to sexual and reproductive health (SRH) provision. Program elements include: (a) mentorship by BIPOC family physicians; (b) virtual didactic sessions about SRH integration into primary care, advocacy, leadership, reproductive justice, and patient-centered care; (3) conference sponsorship; and (4) community-building among residents and mentors.

Methods: We conducted a qualitative study with the program's first cohort of residents and mentors to examine perspectives about program successes and needed improvements. We used a semistructured interview guide along with a direct contact analysis approach.

Results: We interviewed eight scholars and four mentors. From the interviews, we gleaned data on three main themes: (a) value of mentorship, (b) importance of community, and (c) program improvement suggestions. Scholars expressed appreciation for SRH mentorship from BIPOC mentors who had lived experiences similar to their own, noted the mentorship's importance for career-building, and spoke positively of their sense of safe community among all program participants. Respondents shared suggestions for improved scheduling and requested better guidance for navigating the mentee-mentor relationship.

Conclusions: The RSPWD success is reflected in the enthusiasm and gratitude for the program and the resulting mentorship and community that fostered supportive personal and professional relationships, including career opportunities. When considering the importance yet dearth of workforce diversification in family medicine, this program offers a promising model for supporting a more diverse and representative future SRH workforce that may apply to other family medicine clinical niches.

背景和目标:虽然劳动力多样性有助于减轻卫生不平等现象,但很少有举措支持在医学界代表性不足的准堕胎提供者。为了解决这一问题,家庭医学生殖健康教育部门设立了劳动力多样性住院学者计划(RSPWD),这是一个为期一年的计划,面向乌林大学和其他致力于性健康和生殖健康(SRH)的黑人、土著和有色人种(BIPOC)住院医生。项目内容包括:(a) BIPOC家庭医生的指导;(b)关于性健康和生殖健康纳入初级保健、宣传、领导、生殖正义和以病人为中心的护理的虚拟教学会议;(三)会议赞助;(4)居民与导师之间的社区建设。方法:我们对项目的第一批住院医师和导师进行了定性研究,以检查项目成功的观点和需要改进的地方。我们使用了半结构化面试指南和直接接触分析方法。结果:我们采访了8位学者和4位导师。从访谈中,我们收集了三个主要主题的数据:(a)指导的价值,(b)社区的重要性,以及(c)项目改进建议。学者们对来自BIPOC导师的SRH指导表示感谢,这些导师有与他们相似的经历,指出了指导对职业发展的重要性,并积极评价了他们在所有项目参与者中的安全感。受访者分享了改进日程安排的建议,并要求更好的指导来引导师徒关系。结论:RSPWD的成功反映在对项目的热情和感激,以及由此产生的指导和社区,培养了支持性的个人和专业关系,包括职业机会。当考虑到家庭医学中劳动力多样化的重要性和缺乏时,该计划提供了一个有希望的模式,以支持更多样化和更具代表性的未来SRH劳动力,这可能适用于其他家庭医学临床利基。
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引用次数: 0
Coaching With the End in Mind: Developing Coaching Skills Toward Meaningful Individual Learning Plans. 以目的为指导:为有意义的个人学习计划发展指导技能。
IF 1.8 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-11-04 DOI: 10.22454/FamMed.2024.678104
Randolph Pearson, Tonya L Caylor
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引用次数: 0
Authors' Response to "The Growing Divide Between Teaching Empathy and Being Empathetic". 作者对 "移情教学与被移情之间的鸿沟越来越大 "的回应。
IF 1.8 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-10-24 DOI: 10.22454/FamMed.2024.999682
A Emiko Blalock, Madison Tluczek, Stacey Pylman
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引用次数: 0
The Growing Divide Between Teaching Empathy and Being Empathetic. 教人移情与做人移情之间的鸿沟越来越大。
IF 1.8 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-10-23 DOI: 10.22454/FamMed.2024.376434
Arindam Sarkar
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引用次数: 0
Supporting International Medical Graduate Workforce Integration in the 2024 US Election. 在 2024 年美国大选中支持国际医学毕业生队伍的融合。
IF 1.8 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-10-16 DOI: 10.22454/FamMed.2024.706876
Cameron J Sabet, Mohamed Khalif, Nguyen Quoc Hoan, Sarah Kureshi
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引用次数: 0
Where Are They Now? Alumni Outcomes From a Medical School Primary Care Pathway Program. 他们现在在哪里?医学院初级护理路径项目的校友成果。
IF 1.8 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-10-16 DOI: 10.22454/FamMed.2024.942291
Jo Marie Reilly, Isabel Edge, Ilana Greenberg

Background and objectives: Many medical schools have implemented primary care tracks to increase the number of medical students pursuing primary care. The Primary Care Program (PCP) at the Keck School of Medicine of University of Southern California is a 4-year primary care pathway that trains medical students to work in urban, underserved communities and has shown high student match rates into primary care residencies. This study evaluates the PCP graduates in residency and after residency, and assesses their career outcomes, their career characteristics, and the impact their PCP experience had on their careers.

Methods: All PCP alumni who graduated between 2015 and 2022 were invited to complete a 21-item Qualtrics (Qualtrics, LLC) survey. Descriptive data analysis was conducted through Qualtrics, and open-ended data were coded for themes.

Results: Seventy percent of PCP alumni (86/122) responded to the survey, with 65% (56/86) in residency/fellowship and 35% (30/86) in practice. Among those who matched into primary care residencies (61/86, 71%), the percentage that practiced or intended to practice general primary care was 70% (43/61). Respondents in practice (30) described their practice characteristics, including locations and payor mix consistent with majority underserved communities. Open-ended responses captured the impact that the PCP had on alumni's careers, with themes including mentorship, friendship/community, educational/service experiences, future career, exposure to types/kinds of practice, and social determinants of health exposure.

Conclusions: PCP alumni credit this program with impacting their retention in primary care and their career trajectories. This program can serve as a model for other institutions to help increase the number of medical students who pursue primary care careers.

背景和目标:许多医学院都开设了初级护理方向,以增加从事初级护理的医学生人数。南加州大学凯克医学院的初级保健项目(PCP)是一个为期 4 年的初级保健方向,它培训医学生在城市、服务不足的社区工作,并显示出学生进入初级保健住院医师培训机构的高匹配率。本研究评估了初级保健专业毕业生在住院实习期间和实习结束后的情况,并评估了他们的职业成果、职业特点以及初级保健专业经历对其职业生涯的影响:所有在 2015 年至 2022 年期间毕业的初级保健医生校友都受邀完成了一项包含 21 个项目的 Qualtrics (Qualtrics, LLC) 调查。通过 Qualtrics 进行描述性数据分析,并对开放式数据进行主题编码:70%的初级保健医生校友(86/122)对调查做出了回应,其中 65%(56/86)在实习/研究中,35%(30/86)在实践中。在符合初级保健实习条件的受访者中(61/86,71%),从事或打算从事普通初级保健的比例为 70%(43/61)。正在执业的受访者(30 人)描述了他们的执业特点,包括与大多数服务不足社区一致的地点和付款人组合。开放式回答反映了初级保健项目对校友职业生涯的影响,主题包括导师、友谊/社区、教育/服务经历、未来职业、接触实践类型/种类以及接触健康的社会决定因素:初级保健医生校友们认为,该计划对他们留在初级保健行业及其职业轨迹产生了影响。该计划可作为其他院校的典范,帮助增加从事初级医疗职业的医学生人数。
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引用次数: 0
Upstream Advocacy: Family Medicine Promotion of Voting. 上游宣传:家庭医学促进投票。
IF 1.8 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-10-16 DOI: 10.22454/FamMed.2024.724313
Bich-May Nguyen
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引用次数: 0
Resident Instruction: Improving End-of-Year Medical Student Ultrasound Performance. 住院医师指导:提高医科学生的年终超声成绩。
IF 1.8 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-10-14 DOI: 10.22454/FamMed.2024.326354
Michael J Taylor, Ayesha Gittens, Drew Beaubian, James Grady, Meghan Kelly Herbst

Background and objectives: Having a limited number of trained faculty is a barrier to successful incorporation of ultrasound into undergraduate medical education. We evaluated the effectiveness of a resident-led extended focused assessment with sonography in trauma (eFAST) session administered to fourth-year medical students during their emergency medicine clerkship by measuring students' end-of-year eFAST performance and confidence.

Methods: This was a single-site cross-sectional study of all graduating medical students enrolled in fourth-year clerkships between May 1, 2022 and April 30, 2023. A 60-minute, team-based eFAST session (intervention), taught by emergency medicine residents, was added to students' fourth-year emergency medicine clerkship in September 2022. All students were assigned to review an eFAST video (control). End-of-year performance and self-reported confidence assessments used a 20-point objective structured clinical examination (OSCE) and a 5-point Likert scale, respectively. The mean OSCE and confidence scores for control and intervention groups were compared using two-sample t tests and repeated after removing students exposed to additional US experiences.

Results: Of 113 eligible students, 103 students participated: 48 in the control group, 55 in the intervention group. The intervention group scored higher on the OSCE than the control group (11.9 ±4.6 vs 9.9 ±5.1, P=.04) and reported similar confidence (3.2 ±1.0 vs 2.8 ±1.2; P=.09). After removing the 28 students with additional US experiences, the intervention group scored higher (10.8 ± 4.4 vs 8.2 ± 4.0; P=.01) and reported higher confidence (3.0 ±1.0 vs. 2.3 ±1.0, P=.01).

Conclusions: Resident-taught eFAST instruction during emergency medicine clerkships led to improved end-of-year fourth-year medical student eFAST performance and confidence.

背景和目标:训练有素的教师人数有限是将超声技术成功纳入本科医学教育的一个障碍。我们通过测量学生的年终 eFAST 成绩和自信心,评估了由住院医师主导的创伤超声造影扩展重点评估(eFAST)课程对四年级医学生在急诊医学实习期间的效果:这是一项针对 2022 年 5 月 1 日至 2023 年 4 月 30 日期间所有即将毕业的四年级实习医学生的单点横断面研究。2022 年 9 月,在学生的四年级急诊医学实习中增加了由急诊科住院医师讲授的 60 分钟基于团队的 eFAST 课程(干预)。所有学生都被安排观看 eFAST 视频(对照组)。年终成绩和自我信心评估分别采用20分客观结构化临床考试(OSCE)和5分李克特量表。对照组和干预组的 OSCE 平均分和自信心平均分采用双样本 t 检验进行比较,并在剔除有额外美国经历的学生后进行重复:在 113 名符合条件的学生中,103 名学生参与了干预:对照组 48 人,干预组 55 人。干预组在 OSCE 考试中的得分高于对照组(11.9 ±4.6 vs 9.9 ±5.1,P=.04),并报告了相似的自信心(3.2 ±1.0 vs 2.8 ±1.2;P=.09)。剔除28名有额外美国经历的学生后,干预组得分更高(10.8 ± 4.4 vs 8.2 ± 4.0;P=.01),自信心更高(3.0 ±1.0 vs. 2.3 ±1.0,P=.01):结论:在急诊医学实习期间,由住院医师教授eFAST可提高四年级医学生的eFAST成绩和自信心。
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引用次数: 0
Editors' Picks: Top 10 Diversity, Equity, Inclusion, and Antiracism Papers in Family Medicine Journals. 编辑推荐:十大全科医学期刊多样性、公平、包容和反种族主义论文。
IF 1.8 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-10-09 DOI: 10.22454/FamMed.2024.211985
José E Rodríguez, Octavia Amaechi, Renee Crichlow, Valerie J Flattes, Sumi M Sexton

Physicians within the family medicine workforce are the most diverse compared to other medical specialties in both primarily clinical and academic settings. Family physicians also provide care to the most diverse patients and communities across the United States. As such, research and scholarly work from family physicians on diversity, equity, inclusion, and antiracism (DEIA) can be incredibly impactful. Yet many practicing and teaching physicians are unaware of their colleagues' scholarly DEIA work, which aims to elucidate inequities and barriers to optimal care and, importantly, to educate on ways physicians and learners can recognize and address specific needs of patients and communities marginalized by health care policies and practices. In collaboration with editors from several family medicine journals, the authors move beyond the traditional editorial space to share recent practice-changing and innovative articles, adding voice and momentum to improve DEIA efforts in all spaces where the practice and teaching of family medicine exists.

与其他医学专科相比,家庭医生队伍中的医生在临床和学术方面都是最多样化的。家庭医生也为全美国最多样化的病人和社区提供医疗服务。因此,家庭医生在多样性、公平、包容和反种族主义(DEIA)方面的研究和学术工作会产生难以置信的影响。然而,许多执业和教学医师并不了解他们同事的多样性、公平、包容和反种族主义(DEIA)学术工作,这些工作旨在阐明不公平现象和最佳护理的障碍,更重要的是,教育医师和学习者如何认识并满足被医疗保健政策和实践边缘化的患者和社区的特定需求。作者与多家全科医学期刊的编辑合作,超越传统的编辑空间,分享近期改变实践和创新的文章,为改善全科医学实践和教学的所有空间中的 DEIA 工作增添声音和动力。
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引用次数: 0
Orthopedic Injections: A Longitudinal Musculoskeletal Curriculum in a Family Medicine Residency. 骨科注射:全科住院医师培训中的纵向肌肉骨骼课程。
IF 1.8 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-10-01 Epub Date: 2024-08-19 DOI: 10.22454/FamMed.2024.687020
Jason Xu, John Billimek, Brian Y Kim

Background and objectives: Musculoskeletal (MSK) complaints comprise more than 20% of all visits to health care providers each year. Despite required experiences in MSK care, family physicians report low confidence in diagnosing and treating MSK conditions. The purpose of this study was to analyze the effects of early and longitudinal exposure to MSK education on residents' confidence in and likelihood of performing MSK physical exams and injections in future practice.

Methods: From 2017 to 2019, residents completed an annual survey assessing confidence in, frequency of, and future intentions to perform exams and injections for MSK conditions. We compared responses between family medicine residents who completed a 176-hour longitudinal sports medicine (LSM) curriculum distributed over all 3 years of residency and a comparable cohort of family medicine residents who completed a 188-hour concentrated MSK curriculum primarily in the final year of residency. We made comparisons using the Fisher exact test for categorical variables and an independent samples t test for numeric variables.

Results: We analyzed the 98 total responses from 50 residents. The proportion of residents reporting high ratings of their residency MSK education (26% to 60%), performing >5 injections (38% to 73%), reporting confidence in performing injections (12% to 40%), and indicating likelihood to perform MSK injections in the future (52% to 65%) were all greater in the LSM versus concentrated MSK curriculum cohorts (P<.05 for all).

Conclusions: Early and longitudinal exposure to MSK care and sports medicine in family medicine residency led to both an increase in MSK injections during residency training and a greater desire to perform these injections in postresidency practice.

背景和目标:每年到医疗机构就诊的患者中,肌肉骨骼(MSK)主诉占 20% 以上。尽管在 MSK 护理方面有必要的经验,但家庭医生表示对诊断和治疗 MSK 病症的信心不足。本研究旨在分析早期和纵向接触 MSK 教育对住院医师在未来实践中进行 MSK 体检和注射的信心和可能性的影响:从 2017 年到 2019 年,住院医师完成了一项年度调查,评估了对 MSK 病症进行检查和注射的信心、频率和未来意向。我们比较了完成 176 小时纵向运动医学(LSM)课程的全科住院医师和主要在住院医师培训最后一年完成 188 小时集中 MSK 课程的可比全科住院医师的回答。我们使用费舍尔精确检验对分类变量进行比较,使用独立样本 t 检验对数字变量进行比较:我们分析了来自 50 名住院医师的 98 份回复。对住院医师 MSK 教育给予高度评价(26% 至 60%)、进行 5 次注射(38% 至 73%)、对进行注射有信心(12% 至 40%)以及表示将来有可能进行 MSK 注射(52% 至 65%)的住院医师比例在 LSM 组别中均高于集中 MSK 课程组别(P<.05):结论:在全科医学住院医师培训中,早期和纵向接触 MSK 护理和运动医学可增加住院医师培训期间的 MSK 注射次数,并提高住院医师培训后进行这些注射的意愿。
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引用次数: 0
期刊
Family Medicine
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