PRiMER (Leawood, Kan.)最新文献

Introduction: Little is known about patients' perceptions of their risk for type-2 diabetes (T2D), or if knowledge of risk could facilitate weight and diabetes prevention discussions with health care professionals.

Methods: In our academic family medicine practice, 25 patients completed a previsit T2D risk assessment on their phone and answered interview and survey questions to assess their understanding of their risk for developing T2D.

Results: Interest in their T2D risk was high, but self-estimation of risk before obtaining their score was low (21/25 reported ≤30% chance of developing diabetes). All patients perceived T2D to be very serious, most remembered their risk score (18/23 correct) when interviewed 3-5 days later, and many reported that the score increased their motivation to prevent T2D development. Despite this, the calculated risk result was not considered accurate by 8/23 patients and only 4/23 patients shared their score during their appointment visit.

Conclusion: T2D risk evaluation can facilitate patient awareness of their risk and lifestyle improvement, but clinician engagement and communication are needed for interpretation, treatment, and linkage to prediabetes care.

Introduction: The COVID-19 pandemic encouraged widespread implementation of telemedicine. With the increased normalization of telemedicine in clinical practice, the authors sought to characterize telemedicine training during family medicine clerkships after the return to in-person care.

Methods: Data were collected as part of the 2023 Council of Academic Family Medicine's Educational Research Alliance (CERA) survey of family medicine clerkship directors (CDs). Along with baseline demographics about the clerkship and themselves, CDs answered which Association of American Medical Colleges (AAMC) telehealth competencies were taught during family medicine clerkships and indicated challenges related to involving medical students in telemedicine visits.

Results: More than half of the responding family medicine clerkships (57.3%) did not teach any of the AAMC telehealth core competencies and only 4.3% taught all six competencies. The three most commonly taught competencies during the clerkship included communication via telehealth (32.2%), patient safety and appropriate use of telehealth (27.1%), and technology for telehealth (17.7%). Most family medicine clerkships (68.0%) identified at least one challenge of the three possible perceived challenges with "limited site resources" as the most reported barrier. There was no significant difference in telemedicine training from CD based on type of medical school (P=.73), gender (P=.82), being a CD for 5 years or less (P=.41), or self-identification as an underrepresented minority in medicine (P=.19).

Conclusions: Of those CDs who responded, many still do not teach the AAMC telehealth core competencies within their family medicine clerkship. The majority reported limited site resources as a barrier to telehealth education.

Background and objectives: Resident physicians experience high levels of burnout and depression compared to the general population. While focus on promoting resident wellness, including required wellness programming from the Accreditation Council for General Medical Education (ACGME), has increased, research into resident perspectives on what should be included in these programs has been limited. This study aimed to evaluate resident perspectives on a wellness program at the University of Michigan Family Medicine Residency (UM FMR).

Methods: This qualitative study evaluated transcripts from a focus group and an anonymous survey of residents at UM FMR. Two authors reviewed transcripts using descriptive coding and a classical analysis strategy. All authors reached consensus on themes, which were then sent to residents for review and feedback.

Results: Six themes emerged as important to the resident wellness program: (a) program variety, (b) developing a supportive resident community, (c) workplace wellness skills development, (d) addressing basic needs, (e) options for processing difficult situations, and (f) acknowledgment of structural limitations to resident wellness.

Conclusions: This analysis of the survey revealed opportunities for improvements in this residency wellness program and also serves as a model for future studies on resident perspectives on resident wellness.

Introduction: Currently there is a primary care physician shortage in the United States, and this shortage is expected to worsen into the foreseeable future. In 2023, only 7.5 % of US allopathic graduates entered family medicine (FM) residencies. Opportunities to create increased interest in family medicine as a career choice and address hidden curriculum messages in career choice must be explored to address shortages in family medicine.

Methods: A 5-day inpatient experience with family medicine residents on a family medicine inpatient service was implemented during a required third-year core medical student clerkship in family medicine. Students who participated in this clerkship change were invited to complete a survey on how this experience altered their perceptions on the roles of family medicine physicians in inpatient medical care, intrapartum care, and care of the newborn, and how it affected their view of FM as a career choice.

Results: Of the eligible students, 34% completed the survey. Participating in the FM inpatient experience significantly enhanced students' perceptions about the depth of knowledge and skill needed for the specialty, increased students' respect for the specialty, and contradicted students' perceptions about the complexity of cases treated in the specialty.

Conclusion: Adding an inpatient component to a third-year FM clerkship experience significantly can change the perceptions of medical students about the specialty of FM. Brief inpatient exposure to medical students has an impact on hidden curriculum messaging about family medicine.

Introduction: A level of hesitancy existed among parents when United States Food and Drug Administration (FDA)-approved pediatric COVID-19 vaccines were introduced. We explored attitudes, beliefs, and willingness of health care personnel (HCP) as parents to vaccinate children less than 18 years of age.

Methods: We developed a cross-sectional survey for HCPs as parents, including clinical and nonclinical staff, researchers, and trainees at a single academic medical institution. We assessed role categories by vaccination status, willingness to vaccinate their children, and COVID-19 history. We analyzed data via cross tabulation and Pearson correlation to examine relationships across variables.

Results: There were a total of 1,538 research respondents. Nurses had a higher COVID-19 history compared to other roles (29.2%, P<.001). Vaccinated nurses were more likely to vaccinate their children (64.6%, P<.001). There was a significant negative correlation between self-identification as a nurse and willingness to vaccinate themselves (r=-.157, P<.001) or any child (r=-.150, P<.001), and a significant positive correlation among nurses having any COVID-19 history (r=.118, P<.001). Having a positive COVID-19 history was negatively correlated with personal vaccine status (r=-.217, P<.001) and intent to vaccinate any child (r=-.252, P<.001). While 77.8% (n=123) of all nurses with children were vaccinated willingly, 65.8% (n=104) had at least one child vaccinated; 81.3% of willingly vaccinated nurses (n=100) vaccinated at least one child, vs 11.4% (n=4) of nurses who mandated or were unvaccinated themselves.

Conclusions: Nurses were more hesitant to vaccinate themselves than other roles, had higher rates of COVID-19 history, and were more hesitant to vaccinate their children if they were unvaccinated.