PRiMER (Leawood, Kan.)最新文献

Background and objectives: Clinical preceptors serve a vital role in medical education. Recruiting and retaining clinical preceptors, especially in family medicine, is a growing challenge for US medical schools. This study aimed to investigate the incentives and barriers family physicians at the University of Colorado School of Medicine (CUSOM) face when deciding to serve as clinical preceptors, and to explain why these physicians become, remain, and/or stop serving as preceptors.

Method: A cross-sectional survey was distributed to 376 family physicians associated with CUSOM who were active clinical teachers, had been clinical teachers in the past, or were associated with practices that historically had taken medical student learners, with a 60.6% response rate. We calculated descriptive statistics for single-choice, closed-ended survey questions. For the open-ended questions, we adopted a thematic analysis.

Results: The results revealed that intrinsic motivators, such as a love for teaching (76.6%), a sense of duty to the profession (67.8%), and relationships with students (58.5%) were the primary reasons that preceptors chose to teach clinically. Conversely, time (an extrinsic factor), was the largest barrier to teaching that current (80.0%) and potential (51.3%) preceptors faced.

Conclusions: Our results indicate that family physicians largely balance intrinsic motivators against extrinsic barriers when deciding whether to clinically precept medical students. While a longitudinal integrated clerkship model can amplify the impact of these intrinsic motivators, addressing the preceptor shortage may require focus on the motivators that preceptors report as most meaningful and minimizing the impact of the time burden of teaching.

Background: The University of Washington School of Medicine (UWSOM) and other medical schools utilize a distributed medical education (DME) model to train medical students in real-world community settings. An inherent challenge in this model is maintaining high-quality teaching across large geographic areas and clinical settings. This study compares student perceptions of rural and nonrural preceptor teaching in the UWSOM-required clerkships.

Methods: Our study analyzed 41,684 medical student evaluations of preceptors from six required clerkships and over 4 clerkship school years. Using the Rural-Urban Commuting Area definitions, we categorized individual evaluations as either "rural" or "nonrural". We used Welch's unpaired t tests and descriptive statistics to compare rural and nonrural evaluation results.

Results: The evaluation data showed high ratings of preceptor teaching across all nine teaching evaluation categories for both rural and nonrural preceptors, with mean scores of 5.5 or higher on a 6-point Likert scale. Rural preceptors slightly outperformed their nonrural counterparts in seven out of nine teaching categories, including three categories reaching statistical significance.

Conclusions: Results suggest that Liaison Committee on Medical Education standards for comparable educational experiences are being met across distributed sites. We recommend a thematic analysis of student evaluation comments to contextualize the findings reported in our study.

Background and objectives: As the opioid epidemic continues in the United States, neonatal opioid withdrawal syndrome (NOWS) prevalence is rising. Research has shown positive outcomes from protocols to assess and treat infants with NOWS. A medical student preclinical elective was created to teach students about NOWS, substance use disorders (SUDs), social services, and trauma-informed care. This involved didactics, hospital volunteer experience, and reflection essays. Our study aimed to determine the impact of the course on medical student attitudes and beliefs toward people with SUDs.

Methods: Enrolled preclinical medical students completed a pre- and postcourse survey, an adapted 22 question version of the Drug and Drug Problems Perceptions Questionnaire (DDPPQ). We analyzed results through a Wilcoxon signed ranked test and we performed a thematic analysis on students' reflective essays.

Results: Twenty students completed the course during the study, with a 95% survey response rate. Survey results showed a statistically significant change between pre- and postcourse responses for seven of the 22 questions, showing positive changes in self-perceived knowledge, respect, and ability to find help. Reflective essays identified major themes of professional identity formation, interdisciplinary values, patient/family perspectives, empathy, and increased knowledge and confidence.

Conclusions: Implementing an elective that combines didactics and volunteer experiences can improve medical students' self-reported perceptions of people with SUD and interest in primary care and addiction medicine, a key to continued handling of the opioid epidemic.

Introduction: Physicians' biased attitudes toward people who use drugs (PWUD) can impact the care they deliver. Despite recommendations from national organizations, treatment of substance use disorders and harm reduction are often absent from medical school curricula. This absence may influence how medical students, as future physicians, perceive PWUD and therefore, impact the care they provide. Our study aimed to assess medical students' attitudes and, to a lesser extent, knowledge and self-confidence regarding substance use and harm reduction by identifying factors associated with positive beliefs about PWUD and students' self-confidence in managing their care.

Methods: We emailed an optional, anonymous Qualtrics survey of multiple-choice and Likert-type questions to all students at Florida International University's Herbert Wertheim College of Medicine (FIU HWCOM). The survey included demographics, prior exposure to PWUD, attitudes regarding drug acceptability, and substance use treatment.

Results: Of 496 medical students who received the survey, 172 (34.7%) responded to all questions. The primary outcome was attitudes, while secondary outcomes were knowledge and self-confidence. Clinical students reported significantly more positive attitudes toward PWUD compared with preclinical students. Similarly, students with personal or professional experience with PWUD had more positive attitudes and reported increased knowledge about substance use and treatment.

Conclusion: Our findings show that exposure to PWUD may positively impact medical students' attitudes and knowledge in caring for patients with substance use disorders. However, gaps in knowledge and self-confidence persist, particularly in preclinical years. Introducing harm reduction and substance use topics earlier in the curriculum may address knowledge gaps, shift attitudes, and ultimately equip students to provide equitable care.

Introduction: Continuous glucose monitoring (CGM) has become an essential tool in managing diabetes, offering real-time insights that improve patient engagement, decision-making, and clinical outcomes. Despite its benefits, CGM is underutilized in primary care due to perceived complexity and time constraints. This study aimed to enhance health care professionals' understanding of and confidence in prescribing CGM technology through two multidisciplinary, hands-on workshops.

Methods: A total of 51 participants, including family medicine residents, faculty, clinical staff, and pharmacists, attended hands-on workshops and wore a CGM for 10-14 days. We analyzed prescribing patterns using EHR data to compare CGM orders placed before and after the workshops. Additionally, we evaluated pre- and postworkshop surveys' changes in participants' comfort, knowledge, and likelihood of recommending CGMs to patients.

Results: Results showed a 31% improvement in participants' prescribing patterns of CGMs after holding the workshops. Qualitative feedback highlighted insights into device usability, blood sugar patterns, and patient counseling.

Conclusion: This study demonstrates the value of experiential learning in improving health care providers' competence with diabetes technologies. Future research should explore the long-term impact of such training on clinical practice and patient outcomes.

Introduction: CERA, the Council of Academic Family Medicine (CAFM) Educational Research Alliance, is a collaboration between four family medicine organizations that conduct omnibus surveys of different academic family medicine groups. This paper describes the methodology of the 2025 Clerkship Director (CD) Survey and demographic results of respondents.

Methods: Four topics for the annual CD survey were selected via peer review after a call for proposals in early 2025. The survey was sent to clerkship directors via email from June 3, 2025 to July 11, 2025. The demographics of the sampling frame vs sample were compared with χ² tests to determine if they were representative.

Results: One hundred eighty surveys were sent out; after receiving updated clerkship information, the final 2025 pool size was 174 survey recipients (161 in the United States and 13 in Canada). Although there are 43 DO schools in the US, the CD list maintained by STFM lacks these CDs. One hundred CDs responded for a response rate of 57.47%. We compared demographic data of the sampling frame with the sample. There were no significant differences in location, gender, or race/ethnicity. There was a significant difference in underrepresented in medicine status and being a physician.

Discussion: 2025 CD Survey respondents are representative of CDs. Few CAFM organization members submit to this survey and DO schools have not historically been included so are not represented. Targeted outreach to DO schools to identify their CD is planned prior to the launch of the 2026 CD survey.

Introduction: In regions characterized by limited access to pharmacies-commonly referred to as pharmacy deserts-medication adherence tends to be lower, particularly among underserved and vulnerable populations. Similarly, food deserts denote areas with constrained access to nutritious food options, thereby exacerbating food and nutrition insecurity. While both heavily influence health outcomes, a paucity of literature explores the intersection between pharmacy deserts and food deserts.

Methods: We combined two data sets: (a) community/retail pharmacy brand and location data, and (b) the Food Access data set. A scatterplot was created using the transformed values of pharmacies per 1,000 population and Food Access as the x and y coordinates, respectively. The scatterplot was divided into nine parts based on the 33rd and 67th percentile values of both variables, categorized as a combination of low, median, and high pharmacy and food access. For further analysis, we categorized zip codes with limited access by median income ratio, poverty level, and diversity.

Results: Overall, approximately one-third of all zip codes exhibited low pharmacy access, and another third demonstrated low food access. About 20% of zip codes experienced both low pharmacy and low food access. As the pharmacy access increased, food access also increased, suggesting that zip codes with greater pharmacy access tend to have disproportionately higher food access, consistent with an exponential-type relationship. Low pharmacy and food access were predominantly in zip codes with higher poverty rates and diversity.

Conclusions: Limited access to both pharmacies and nutritious food options places an added burden on vulnerable populations, contributing to challenges in managing chronic diseases and maintaining overall health. This limited accessibility highlights the need for targeted interventions that address these dual resource shortages.

Introduction: Family medicine contributes less scholarship and receives much less grant money than other specialties. Understanding when and how this disparity begins is a key step in addressing the gap in family medicine scholarship.

Methods: We analyzed data from the National Resident Matching Program's (NRMP's) Charting Outcomes in the Match (2016-2024) to compare family medicine applicants with applicants to other specialties (ie, internal medicine, pediatrics, and all specialties combined). We examined the mean number of research experiences and the number of presentations and publications applicants had completed prior to starting residency. Additionally, we analyzed NRMP surveys to evaluate the weight applicants placed on institutional research support when choosing a residency program and the weight program directors placed on applicants' research experience.

Results: Family medicine applicants consistently reported fewer research experiences and presentations/publications than applicants to internal medicine, pediatrics, and all specialties combined. Osteopathic applicants showed the lowest research participation across all specialties we compared. Among other specialties, family medicine applicants placed less importance on programs' research support, and family medicine residency program directors were less likely to consider research involvement when selecting applicants.

Conclusions: Our results suggest that family medicine's underrepresentation in research begins during the residency application process or sooner. Increased involvement in family medicine research among medical students should be a key component of strategies for bridging the research gap.