PRiMER (Leawood, Kan.)最新文献

Introduction: Teaching graduate medical trainees to conduct forensic medical and mental health evaluations (FMEs) of people seeking asylum fosters knowledge and skills needed to care for displaced and trauma-exposed populations. The national Asylum Medicine Training Initiative (AMTI) is the new standard for training clinicians to conduct FMEs but has not yet been evaluated in graduate medical education.

Methods: We designed a novel, year-long, interdisciplinary, graduate medical elective in asylum medicine that combines AMTI's asynchronous didactics with experiential learning in the form of small group skills practice and mentored FMEs. We used a formative, mixed-methods approach to evaluate participants' acquisition of knowledge essential for conducting FMEs, self-reported comfort with relevant skills, and self-reported preparedness for conducting independent FMEs.

Results: Eight trainees participated in the elective from September 2022 to June 2023. The evaluation (response rate 100%, 8/8) showed a significant increase in knowledge essential for conducting FMEs, and most participants felt prepared to conduct FMEs independently. Qualitative analysis showed participants felt they benefited from the experiential learning and that, despite barriers to conducting FMEs, they intend to apply these skills in future work with displaced populations.

Conclusions: Though limited by small sample size and reliance on self-assessment, our results indicate that this novel curriculum helped prepare interdisciplinary trainees to conduct FMEs and improved their comfort with skills applicable to working with displaced populations. This elective could be replicated at other institutions because of the accessibility of the AMTI curriculum and use of virtual space for small groups and mentored FMEs.

Introduction: The Council of Academic Family Medicine (CAFM) Educational Research Alliance (CERA) consists of four family medicine organizations that aim to promote family medicine research. Each year, CAFM members can submit audience-specific survey questions. The purpose of this paper is to review the methods and demographics of the 2024 General Membership Survey and determine the generalizability of the survey respondents.

Methods: CERA opened its call for the annual General Membership Survey proposals from May 2024 to June 2024. Twelve proposals underwent a competitive peer-reviewed process, and five were chosen. Select CAFM members received survey invitations via Survey Monkey between October 15, 2024 and November 22, 2024. Demographics of potential survey respondents and actual survey respondents were compared using χ² tests or Fisher's exact tests.

Results: Of the 4,844 CAFM members invited to participate, 1,194 responded, yielding a response rate of 24.7%. Demographic data from potential survey respondents were compared to actual respondents. Statistically significant differences were found at the categorical variable analysis level for variables of race/ethnicity, self-identification as underrepresented in medicine, highest degree earned, and state/ province of practice/program, between the potential respondents and actual respondents. Differences in age and gender were not statistically significant between responders and nonresponders. Several characteristics were also found to not be statistically significantly different at an α of 0.05.

Conclusion: This paper describes the methods and the generalizability of the 2024 CERA General Membership Survey. The CERA surveys provide a mechanism for CAFM members to conduct national surveys on topics important to family medicine education.

Introduction: Since the shift to virtual residency interviews following the COVID-19 pandemic and the initial 2021 and 2022 endorsement from the Accreditation Council for Graduate Medical Education, applicants and programs have been weighing the benefits and disadvantages of this transition. This study examines the impact of debt concern among family medicine residency applicants and their likelihood of (1) accepting virtual interview offers and (2) recommending the digital format for future application cycles.

Methods: Using responses from the American Academy of Family Physicians 2023 Medical Student Education Survey, we applied descriptive bivariate analysis and rapid cycle thematic evaluation to explore associations between 2023 family medicine residency applicants' debt concern and their perception of digital residency interviews.

Results: A majority of our study sample (86%) had some level of debt concern. A majority (88.8%) also noted that most of their interviews were virtual. Regardless of debt concern, most students (87.4%) indicated that they accepted offers for virtual interviews that they otherwise may not have accepted if travel time and expenses were involved. Furthermore, most students (87.1%) recommended a virtual component to future residency interviews.

Conclusion: Contrary to our expectations, there was no association between concern for debt and preference for virtual interviews. Most candidates preferred the virtual setting, stating that they were more likely to accept virtual interview offers, and recommended this format for future cycles.

Introduction: Gender-based differences in medical student preferences are of growing interest. This study examines specialty choice and family planning preferences among medical students in Lubbock, Texas. It also assesses the impact of reproductive health policy changes on specialty choice and desired residency location.

Methods: A Qualtrics (Silver Lake) survey was sent to 172 first-year medical students from Texas Tech University Health Sciences Center (TTUHSC) School of Medicine. Males' responses were compared with females' responses using an unpaired t test with a significance threshold of 0.05.

Results: Surveys were returned by 90 male and 82 female participants. Results show that both genders exhibited moderate interest in primary care and surgical specialties, with males showing higher interest in becoming medical subspecialists (P=.0010). Female participants were less inclined than males to consider having a child during medical school (P=.0168) and residency (P=.0461). Males expressed lower concern than females about reproductive health policy impacts on specialty choice (P<.0001) and preferred residency location (P=.0003). Family planning considerations were equally moderate in impacting specialty choice for both genders.

Conclusions: The findings indicate that male students are more open to the idea of having a child during training and that reproductive health policy changes have had a larger influence on female students' specialty choice and desired match location. To support physicians-in-training, educators should integrate family planning discussions, prioritize reproductive health education, advocate for and improve residency transparency on parental leave policies, and help students navigate residency applications amid policy changes.

Introduction: Inbox management in outpatient primary care consumes a substantial amount of time, and residency training programs face unique challenges related to provider schedules. Long work hours, provider burnout, and worse patient outcomes can all be attributed to task management burden. Team-based care models can provide support through coverage systems and group inboxes. However, more empirical study of these systems may help to inform their implementation in interdisciplinary medical residency outpatient clinics.

Methods: The current study investigated the implementation of a "task buddy" system, which paired providers in teams to manage electronic health record (EHR) tasks. Data were collected on average task age and number of late tasks preimplementation, postimplementation, and 6 months postimplementation. Paired samples t tests were used to compare average task age for each task team. Participation was encouraged through a small monetary reward.

Results: A total of 23 resident physicians and 13 faculty from multiple disciplines participated. Our data demonstrated that the average age of tasks was more than 1 day lower with this system, but total late tasks did not improve.

Conclusions: The task buddy system resulted in quicker response time to complete tasks, but the number of late tasks stayed stagnant. Future studies should assess any correlation between improved patient outcomes with more efficient EHR task management. Additional studies across multiple residencies and specialties could better elucidate generalizability and provider perspectives of this pilot program.

Introduction: Promoting family medicine (FM) among medical students is essential for strengthening future primary care systems. This study examines Japanese medical students' perspectives on FM and compares them with findings from an identical study conducted in China to identify effective strategies for promoting FM.

Methods: A cross-sectional, self-administered, online survey was conducted from November 2020 to February 2021, involving 438 medical students across 28 medical schools in Japan. The survey, modeled after an identical study in China, assessed career decision factors, perceptions of FM careers and lifestyles, and attitudes toward FM, using a 5-point Likert scale.

Results: Of the 363 respondents who indicated a preferred specialty, 19.8% selected FM, making it the second most popular choice. Japanese medical students valued social commitment, manageable work hours, and career stability but perceived FM as less prestigious compared to medical students in China. Both groups recognized the importance of FM in rural health care and the role of government support. However, Japanese medical students were less optimistic about FM careers offering good income and work-life balance.

Conclusion: While FM is relatively popular among medical students in Japan, challenges such as perceptions of low prestige and poor work-life balance remain. Addressing these issues might enhance interest in FM. Study limitations include response bias, cultural differences affecting generalizability, and differences in timing of the survey and participant grade levels between studies. Future research should address these limitations and further explore cultural influences on medical students' career decisions.

Introduction: Oral health is important and affects overall health. Medical students face both common and unique barriers to preserving their own oral health care. This study was designed to survey medical students at the University of Massachusetts Chan Medical School (UMass Chan) to evaluate their oral health hygiene practice and identify barriers to dental care.

Methods: We disseminated a 15-question survey to the student body via email, class Facebook pages, and in-person lecture announcements. We used bivariate analyses (using χ² tests) to identify any associations among select variables.

Results: Fifty-four percent of students responded to the survey. Of those, 84% brushed their teeth at least twice a day, however only 63% visited a dentist in the last 12 months. Reported barriers to dental visits included being too busy, not knowing how to find local dentists that accepted student dental insurance plans, and lack of finances especially for Hispanic students. We found no significant differences between preclinical and clinical students, however younger age (<26) was associated with more recent dental visits. Students enrolled in Medicaid had larger gaps in care compared to those with private insurance.

Conclusions: UMass Chan students face barriers to professional dental care and do reasonably well on personal dental hygiene. To improve access to dental care, especially for those on Medicaid, efforts should be made to provide referral resources and consider an on-campus dental clinic. Hispanic students may need more money in their loan package. More study on this topic is needed nationally.

Introduction: CERA, the Council of Academic Family Medicine (CAFM) Educational Research Alliance, is a program that provides an infrastructure for educational survey research. Members of the CAFM organizations can submit proposals to survey subgroups within academic family medicine. CERA's mission includes the production of rigorous medical education research as well as mentorship for newer researchers. The purpose of this article is to describe the methodology of the 2024 CERA Department Chair survey.

Methods: The call for proposals for the survey was open from April 1-30, 2024. Ten proposals were received and five were accepted following a competitive peer-review process. The survey, which included questions from these five research teams as well as standard demographic questions, was approved by the American Academy of Family Physicians Institutional Review Baord. The sample was all chairs of departments of family medicine in the United States and Canada, as identified using member databases of CAFM organizations and responses to prior CERA surveys. The survey was then sent out via email using the Survey Monkey platform from August 13, 2024 through September 20, 2024.

Results: The survey received 111 responses out of a population 218 potential participants, for a response rate of 50.92%. No significant differences were found for race/ethnicity, gender, age, or location between responders and the overall population.

Conclusions: The 2024 CERA Department Chair Survey had an acceptable response rate, and no difference was found in demographic characteristics between responders and the overall population.

Introduction: CERA, the Council of Academic Family Medicine (CAFM) Educational Research Alliance, is a collaboration between four family medicine organizations to conduct omnibus surveys of different groups within family medicine. This article describes the methodology of the 2024 Clerkship Directory (CD) Survey, presents the demographic results of respondents, and categorizes CD topics from 2012 through 2024.

Methods: Five topics for the annual CD survey were selected via peer review after a call for proposals in early 2024. The survey was sent to family medicine clerkship directors from June 4, 2024 to July 12, 2024. We used χ² tests to compare the demographics of sampling frame against the sample to determine if they were representative of the sampling frame. We used program records to describe past survey topics.

Results: One hundred seventy-nine surveys were sent out; after receiving updated clerkship information, the final 2024 pool size was 173 survey recipients (158 in the United States and 15 in Canada); 91 clerkship directors completed the survey, with a response rate of 52.60% (91/173). We compared demographic data of sampling frame with the sample. There was no significant difference in demographics including location, gender, race/ethnicity, underrepresented in medicine status, or MD degree. CD survey topics from 2012-2024 included 6 on preceptors, 29 on content/curriculum, 8 on grading/assessment, 8 on administration, and 9 on other.

Discussion: 2024 Clerkship Directory Survey respondents are representative of clerkship directors. From 2012-2024 the most studied topic was content/curriculum. The Clerkship Director Survey continues to offer important scholarship opportunities and insights into current themes in undergraduate medical education.