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Protocol for the 2023 CERA General Membership Survey 2023 年 CERA 普通会员调查规程
Pub Date : 2024-04-17 DOI: 10.22454/primer.2024.609918
Tiffany Ho, B. Marzolf, Andrew D. Curtin, Ray Biggs
Introduction: CERA, the Council of Academic Family Medicine (CAFM) Educational Research Alliance, represents a unique collaboration between family medicine organizations, conducting annual surveys of distinct groups within family medicine. CERA’s mission is to support family medicine educational research. This paper presents the methods and demographic results of the 2023 General Membership Survey. Methods: CERA’s call for proposals for the annual General Membership Survey opened from June 2023 to July 2023. We received 16 proposals, and after a peer review process, five topics were accepted. Each author was assigned a research mentor. Because all the accepted proposals targeted physicians, the survey was distributed to select members of the CAFM organizations via SurveyMonkey from November 20, 2023 through December 22, 2023. We used χ2 and Fisher’s exact tests for analysis. Results: The final pool size was 3,598. Eight-hundred thirty-three members completed the survey, for a response rate of 23.2% (833/3,598). Demographic data of potential survey respondents were compared with data of actual respondents. There were no significant differences in gender, location and underrepresented in medicine status. Actual survey respondents were slightly older, less likely Asian, and more likely to have a doctor of medicine (MD) or combined doctorate degree compared to potential survey respondents. Conclusion: This paper describes the methods of the 2023 CERA General Membership Survey. The 2023 survey focused on active physicians. The demographics of the survey respondents differed slightly from potential respondents. Authors of the five accepted survey topics are responsible for publishing their study findings.
导言:全科医学学术委员会(CAFM)教育研究联盟(CERA)代表了全科医学组织之间的独特合作,每年对全科医学中的不同群体进行调查。CERA 的使命是支持全科医学教育研究。本文介绍了 2023 年普通会员调查的方法和人口统计结果。调查方法:CERA 于 2023 年 6 月至 2023 年 7 月征集年度普通会员调查的提案。我们收到了 16 份提案,经过同行评审,有 5 个主题被采纳。每位作者都分配了一位研究导师。由于所有被接受的提案都是针对医生的,因此调查问卷于 2023 年 11 月 20 日至 2023 年 12 月 22 日通过 SurveyMonkey 分发给了部分 CAFM 组织成员。我们使用 χ2 和费雪精确检验进行分析。结果:最终样本量为 3,598 人。有 833 名成员完成了调查,回复率为 23.2%(833/3,598)。潜在调查对象的人口统计数据与实际调查对象的数据进行了比较。在性别、地区和在医学领域代表性不足等方面没有明显差异。与潜在调查对象相比,实际调查对象年龄稍大,不太可能是亚裔,更有可能拥有医学博士 (MD) 或综合博士学位。结论本文介绍了 2023 年 CERA 普通会员调查的方法。2023 年调查的重点是在职医生。调查对象的人口统计学特征与潜在调查对象略有不同。五个被接受的调查主题的作者负责公布其研究结果。
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引用次数: 0
Assessing the Impact of Nutrition Training Among Medical Students 评估营养培训对医学生的影响
Pub Date : 2024-04-11 DOI: 10.22454/primer.2024.834650
Kevin Robinson, J. Reilly
Introduction: Nutrition education remains inadequate in American medical schools, and physicians often cite lack of nutrition knowledge as a barrier to counseling patients. The goal of this study was to evaluate the impact of additional nutrition curriculum on first-year medical students.Methods: We created a 1-hour nutrition lecture, delivered to first-year medical students. Using pre-, post-, and 3-month follow-up surveys, we assessed the following: (1) change in student knowledge; (2) confidence in counseling patients; (3) motivation to change their personal dietary behaviors; and (4) satisfaction with the curriculum. We assessed objectives using multiple choice questions and 10-point Likert scale questions.Results: Of the 142 students who attended the live lecture, 105 (73.9%) completed both pre- and postsurveys, and 65 (45.8%) completed the 3-month follow-up survey. Students’ knowledge of the material increased from 37% to 82%, but retention dropped to 65% at the 3-month mark (P<.001). Comfort in assessing and counseling patients improved across the three survey iterations, from 3.53 to 5.90 to 8.00 (P<.001). Motivation to change personal behaviors was high overall at 8.04, 8.36 and 8.25 [P<.05]). Moreover, students were satisfied with the lecture, with a rating of 8.58/10.Conclusions: This study supports the value of additional medical student nutrition education. This curriculum significantly increases student knowledge, comfort with the material, and confidence in counseling their future patients. A longitudinal curriculum that reinforces concepts over time will help improve long-term retention.
导言:美国医学院校的营养教育仍然不足,医生经常将缺乏营养知识作为为患者提供咨询服务的障碍。本研究的目的是评估增加营养课程对一年级医学生的影响:方法:我们为一年级医学生开设了一个 1 小时的营养讲座。通过课前、课后和 3 个月的跟踪调查,我们对以下方面进行了评估:(1) 学生知识的变化;(2) 辅导病人的信心;(3) 改变个人饮食行为的动力;(4) 对课程的满意度。我们使用多项选择题和 10 点李克特量表问题对目标进行评估:在参加现场讲座的 142 名学生中,105 人(73.9%)完成了事前和事后调查,65 人(45.8%)完成了 3 个月的跟踪调查。学生对教材的了解程度从 37% 提高到 82%,但 3 个月后的保留率下降到 65%(P<.001)。评估和咨询患者的舒适度在三次调查中均有所提高,从 3.53 到 5.90 再到 8.00(P<.001)。改变个人行为的动机总体较高,分别为 8.04、8.36 和 8.25 [P<.05])。此外,学生对讲座的满意度为 8.58/10:本研究支持对医学生进行额外营养教育的价值。该课程极大地提高了学生的知识水平、对教材的熟悉程度以及为未来病人提供咨询服务的信心。随着时间推移不断强化概念的纵向课程将有助于提高学生的长期保留率。
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引用次数: 0
Protocol for the 2023 CERA Department Chair Survey 2023 年 CERA 系主任调查协议
Pub Date : 2024-03-22 DOI: 10.22454/primer.2024.812665
Heather L. Paladine, Ray Biggs, Miranda A. Moore
Introduction: CERA, the Council of Academic Family Medicine Educational Research Alliance, is a program sponsored by the academic family medicine organizations with the goal of supporting and improving educational research in family medicine. CERA produces surveys of different groups in academic family medicine, including an annual survey of department chairs, and members can apply to add their question sets to these surveys. This article describes the methods and demographics of the 2023 CERA Department Chair Survey.Methods: The call for proposals for the CERA Department Chair Survey was open from April 3, 2023 through May 9, 2023. Fifteen proposals were received, and five were accepted for the final survey based on scoring by peer reviewers. The Institutional Review Board of the American Academy of Family Physicians approved the survey. The final survey, including question sets from five research teams and standard demographic questions, was sent to 227 department chairs in the United States and Canada.Results: Overall, 114 chairs responded to the survey, for a response rate of 50.2%. Demographic variables, including race/ethnicity, gender, age, and region of the country, did not differ between respondents and nonrespondents.Discussion: The CERA Department Chair Survey provides a framework for members of academic family medicine organizations to conduct survey research on topics that are important to the specialty. Advantages of the CERA process include a national sample and robust response rate. Disadvantages are primarily the limitation in number of survey questions and the fact that not all proposals are accepted.
导言:CERA(全科医学学术教育研究联盟理事会)是由全科医学学术组织发起的一项计划,旨在支持和改进全科医学的教育研究。CERA 对全科医学学术界的不同群体进行调查,包括对系主任的年度调查,成员可以申请在这些调查中加入自己的问题集。本文介绍了 2023 年 CERA 系主任调查的方法和人口统计:CERA 系主任调查的提案征集从 2023 年 4 月 3 日开始,至 2023 年 5 月 9 日结束。共收到 15 份提案,根据同行评审员的评分,最终调查接受了 5 份提案。美国家庭医生学会机构审查委员会批准了该调查。最终调查包括五个研究小组的问题集和标准人口统计学问题,发送给了美国和加拿大的 227 位科室主任:共有 114 位科主任对调查做出了回复,回复率为 50.2%。包括种族/民族、性别、年龄和国家地区在内的人口统计学变量在回复者和未回复者之间没有差异:讨论:CERA 系主任调查为全科医学学术组织的成员提供了一个框架,就对本专业重要的主题进行调查研究。CERA 程序的优点包括全国性样本和可靠的回复率。缺点主要是调查问题的数量有限,以及并非所有提案都会被接受。
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引用次数: 0
Assets in Primary Care: Community Health Workers Tackle Inequities in Texas 初级保健资产:得克萨斯州社区医疗工作者解决不平等问题
Pub Date : 2024-03-18 DOI: 10.22454/primer.2024.879447
Kennedi Wilson, Rosemary Agwuncha, Jason Franco-Castano, Lauren Gilbert
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引用次数: 0
Utilizing Community Procedure Clinics to Enhance Resident Procedural Education 利用社区手术诊所加强住院医师手术教育
Pub Date : 2024-03-13 DOI: 10.22454/primer.2024.300997
Michael T. Kopec, Tyler Barreto
Introduction: Procedure training in family medicine residency is important for future full-spectrum practice. Some residency programs have cited difficulty providing adequate procedure education. Residency collaboration with nonfaculty attending physicians working at community nonresidency clinics may help programs increase resident exposure to procedures. We assessed the feasibility of such an educational model by establishing recurring procedure clinics in a nonresidency family medicine site supervised by nonfaculty physicians.Methods: Twice monthly, half-day procedure clinics were conducted at a community site, where family medicine residents were supervised by nonfaculty community family physicians. After participation, we surveyed residents about their perceptions of the clinics. Using retrospective chart review, we determined quantity and type of procedures performed.Results: Fifteen residents participated in 21 procedure clinics, featuring 18 procedure types and 268 procedures. Skin lesion excision, nail removal, punch and shave procedures, joint injection, newborn circumcision, and implantable contraception management were most consistently performed. Residents rated clinics highly and were satisfied with procedure number and variety, opportunity to learn new procedures and techniques, and feedback received. Over 80% of residents noted experiences in procedures that were less commonly encountered in their residency.Conclusion: Procedure clinics at a nonresidency site hosted by nonfaculty attending physicians provided additional training in a variety of primary care procedures. The clinics were favorable to residents and may help programs address training gaps.  
简介:全科住院医师培训中的手术培训对未来的全科实践非常重要。一些住院医师培训项目表示难以提供足够的手术培训。住院医师与在社区非住院医师诊所工作的非教职主治医师合作,可以帮助项目增加住院医师接触手术的机会。我们评估了这种教育模式的可行性,在非住院医师全科诊所建立了由非教职医师监督的经常性手术诊所:方法:每月两次,每次半天,在一个社区医疗点开设手术诊所,由非教职的社区家庭医生指导家庭医学住院医师。参加活动后,我们对住院医师对诊所的看法进行了调查。通过回顾性病历审查,我们确定了所实施手术的数量和类型:结果:15 名住院医师参加了 21 次手术门诊,共进行了 18 种手术和 268 次手术。皮损切除术、拔甲术、打孔和剃须术、关节注射、新生儿包皮环切术和植入式避孕药管理是最常见的手术。住院医师对诊所的评价很高,并对手术的数量和种类、学习新手术和技术的机会以及收到的反馈表示满意。超过 80% 的住院医师指出,他们在住院医师培训中较少接触到手术:结论:由非教职主治医师在非住院医师培训基地举办的手术诊所为住院医师提供了各种初级护理手术的额外培训。这些诊所对住院医师很有帮助,可帮助项目弥补培训方面的不足。
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引用次数: 0
Longitudinal Medical Student Collaborative Care in Primary Care Patients With Type 2 Diabetes 医学生对 2 型糖尿病初级保健患者的纵向协作护理
Pub Date : 2024-03-01 DOI: 10.22454/primer.2024.436038
Maria Aristova, Melissa Shaw, Emily Hendel, M. Tschoe
Introduction: The Education-Centered Medical Home (ECMH) is a longitudinal clerkship that emphasizes continuity and quality improvement in primary care. We aimed to evaluate our ECMH’s ability to improve type 2 diabetes mellitus (T2DM) care through a systematic chart audit and care planning process. The effect of this intervention was measured by adherence to process and outcome measures.Methods: From November 2015 to March 2017, medical students were educated on and performed monthly chart audits of guideline-based quality metrics: hemoglobin A1c systolic blood pressure; lipid and microalbuminuria evaluation; annual ophthalmic and foot examinations; flu, hepatitis, and pneumonia vaccination; and statin therapy. Patients were included if they had a diagnosis of T2DM and were seen by the ECMH clinic before and after the audits started. Students shared audit logs, using them to plan patient appointments. We assessed changes in proportion of patients meeting each guideline with Fisher’s exact test. Results: The project included 11 patients with T2DM. ECMH adherence to the annual eye exam increased significantly 1 year postintervention, compared to preintervention (73% vs 55%; P=.03) and 6 months (73% vs 46%, P=.01). Conclusion: The metric with significant improvement during the chart audit, annual eye exam, is a process measure requiring advance planning. This small study suggests that a formal, regular audit process can improve student adherence to evidence-based care guidelines, particularly for tasks that require advance planning or action by the care team outside the day of a patient visit.
介绍:以教育为中心的医疗之家(ECMH)是一种纵向实习,强调初级保健的连续性和质量改进。我们旨在评估 ECMH 通过系统的病历审核和护理规划流程改善 2 型糖尿病(T2DM)护理的能力。该干预措施的效果通过对过程和结果测量的坚持程度来衡量:从 2015 年 11 月到 2017 年 3 月,医学生接受了有关指南质量指标的教育并每月进行病历审核:血红蛋白 A1c 收缩压;血脂和微量白蛋白尿评估;年度眼科和足部检查;流感、肝炎和肺炎疫苗接种;他汀类药物治疗。如果患者被诊断出患有 T2DM,并且在审计开始之前和之后在 ECMH 诊所就诊过,就会被纳入审计范围。学生们共享审核日志,并利用日志计划患者预约。我们用费雪精确检验法评估了符合各项指南的患者比例的变化。结果该项目包括 11 名 T2DM 患者。与干预前(73% 对 55%;P=.03)和干预后 6 个月(73% 对 46%;P=.01)相比,ECMH 对年度眼科检查的坚持率在干预后 1 年显著提高。结论:在病历审核过程中,年度眼科检查这一指标有了明显改善,这是一项需要提前规划的过程性指标。这项小型研究表明,正式、定期的审核流程可以提高学生对循证护理指南的遵守程度,尤其是对于那些需要提前计划或护理团队在患者就诊当天之外采取行动的任务。
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引用次数: 0
Response to Dr Snellings: Learning From Other Combined Programs 回应 Snellings 博士:向其他合并计划学习
Pub Date : 2024-02-29 DOI: 10.22454/primer.2024.837001
Gregory P. Conners
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引用次数: 0
Family Medicine and Internal Medicine: Let Our Powers Combine! 家庭医学和内科医学:让我们的力量结合在一起
Pub Date : 2024-02-29 DOI: 10.22454/primer.2024.657509
John E. Snellings
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引用次数: 0
Response to: "Family Medicine and Internal Medicine: Let Our Powers Combine!" 回应:"家庭医学和内科医学:让我们的力量结合在一起!"
Pub Date : 2024-02-29 DOI: 10.22454/primer.2024.602418
Jolene Kittle
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引用次数: 0
Virtual Wellness Workshop for Medical Students: Effects on Healthy Lifestyle Behavior 医学生虚拟健康研讨会:对健康生活方式行为的影响
Pub Date : 2024-02-28 DOI: 10.22454/primer.2024.293111
Rachel S. Wasson, William H. O'Brien, Kelsey M. Dietrich
Introduction: Medical students experience high levels of stress, burnout, depression, suicidal ideation, and compassion fatigue. Mindfulness interventions in this population have demonstrated improvement in psychological outcomes. However, it is unclear if these improvements are maintained. Evaluation of changes in lifestyle behaviors may provide insight into factors that sustain improvements. Specific aims of this study were to (1) assess feasibility and acceptability of an innovative, virtual program involving experiential learning, social support, and motivational interviewing; and (2) evaluate preliminary healthy lifestyle behaviors and psychological outcomes from preprogram to postprogram and 4-week follow-up.Methods: We used a mixed-methods approach to investigate feasibility, acceptability, and effects of the virtual program using validated measures and open-ended questions. Participants were 20 first- and second-year medical students at one Midwestern US medical college who participated between October 2020 and December 2020. Participants were enrolled in one of two groups for the 8-week program via Webex. Participants completed surveys at preprogram, postprogram, and 4-week follow-up. They also completed weekly home practice assessments.Results: Nineteen of 20 participants completed the program (95% retention rate). All participants attended six or more sessions. Repeated measures analysis of variance revealed that participants had significant improvements in healthy lifestyle behaviors, burnout, self-compassion, and stress across time. Results were supported by qualitative themes of increased social support, wellness skills, and overall positive experiences.Conclusion: Findings suggest that the virtual program was feasible and acceptable to medical students, and improved healthy lifestyle behaviors and psychological outcomes that were maintained or increased at 4-week follow-up.
导言:医学生的压力、职业倦怠、抑郁、自杀倾向和同情疲劳程度都很高。对这一人群的正念干预已证明其心理结果有所改善。然而,目前尚不清楚这些改善是否能够保持。对生活方式行为变化的评估可能有助于深入了解维持改善的因素。本研究的具体目标是:(1)评估涉及体验式学习、社会支持和动机访谈的创新虚拟计划的可行性和可接受性;(2)评估从计划前到计划后以及 4 周随访的初步健康生活方式行为和心理结果:我们采用了一种混合方法,通过验证措施和开放式问题来调查虚拟项目的可行性、可接受性和效果。参与者为美国中西部一所医学院的 20 名一年级和二年级医学生,他们在 2020 年 10 月至 2020 年 12 月期间参加了该项目。参与者通过 Webex 分为两组,一组参加为期 8 周的课程。参与者在课程前、课程后和 4 周的随访中填写了调查问卷。他们还完成了每周的家庭实践评估:结果:20 名参与者中有 19 人完成了课程(保留率为 95%)。所有参与者都参加了六次或六次以上的课程。重复测量方差分析显示,参与者在健康生活方式行为、职业倦怠、自我同情和压力方面都有显著改善。结果得到了社会支持、健康技能和总体积极体验等定性主题的支持:研究结果表明,该虚拟项目对医学生来说是可行和可接受的,它改善了健康的生活方式行为和心理结果,并在 4 周的随访中得以保持或提高。
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引用次数: 0
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