Family Medicine最新文献_第10页

IF 1.8 4区医学

Family Medicine Pub Date : 2024-05-01 Epub Date: 2024-04-29 DOI: 10.22454/FamMed.2024.944797

Sarna R Becker

引用次数: 0

Underfunding for Research Training and Career Development: The Impact on Family Medicine Research. 研究培训和职业发展资金不足：对家庭医学研究的影响。

IF 1.8 4区医学

Family Medicine Pub Date : 2024-05-01 Epub Date: 2024-03-15 DOI: 10.22454/FamMed.2024.453278

Mechelle Sanders, Kevin Fiscella

{"title":"Underfunding for Research Training and Career Development: The Impact on Family Medicine Research.","authors":"Mechelle Sanders, Kevin Fiscella","doi":"10.22454/FamMed.2024.453278","DOIUrl":"10.22454/FamMed.2024.453278","url":null,"abstract":"Background and objectives: The National Institutes of Health and related federal awards for research training (RT) and research career development (RCD) are designed to prepare applicants for research careers. We compared funding rates for RT and RCD for anesthesiology, dermatology, emergency medicine, family medicine, internal medicine, neurology, obstetrics-gynecology, pathology, pediatrics, and psychiatry.Methods: We estimated the denominator using the number of residency graduates from different specialties from 2001 to 2010 from the Association of American Medical Colleges data. For the numerator, we used published data on federally funded awards by specialty from 2011 to 2020. We also examined the correlation between RCD funding and overall research funding.Results: Family medicine had the lowest rate per graduating resident for RT (0.01%) and RCD (0.77%) awards among 10 specialties and was lower than the mean/median for the other nine specialties, ranging from 2.15%/1.19% and 9.83%/8.74%. We found a strong correlation between rates of RCD awards and mean federal funding per active physician, which was statistically significant (ρ=0.77, P=.0098).Conclusions: Comparatively low rates for family medicine awards for RT and RCD plausibly contribute to poor federal funding for family medicine research, underscoring the need to bolster the research career pathway in family medicine.","PeriodicalId":50456,"journal":{"name":"Family Medicine","volume":" ","pages":"317-320"},"PeriodicalIF":1.8,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11216765/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140177544","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Transitioning From AFMRD Entrustable Professional Activities to ABFM Core Outcomes to Measure Clinical Preparedness. 从 AFMRD 委托专业活动过渡到 ABFM 核心成果，以衡量临床准备情况。

IF 1.8 4区医学

Family Medicine Pub Date : 2024-04-01 Epub Date: 2024-02-21 DOI: 10.22454/FamMed.2024.649460

Bryce A Ringwald

引用次数: 0

Abortion Training in Family Medicine Residency Programs: A National Survey of Program Directors 5 Months After the Dobbs Decision. 全科住院医师培训项目中的堕胎培训：多布斯决定 5 个月后对项目主任的全国调查。

IF 1.8 4区医学

Family Medicine Pub Date : 2024-04-01 Epub Date: 2024-01-19 DOI: 10.22454/FamMed.2024.683874

Aleza K Summit, Erica Chong

{"title":"Abortion Training in Family Medicine Residency Programs: A National Survey of Program Directors 5 Months After the Dobbs Decision.","authors":"Aleza K Summit, Erica Chong","doi":"10.22454/FamMed.2024.683874","DOIUrl":"10.22454/FamMed.2024.683874","url":null,"abstract":"Background and objectives: Routine abortion training during family medicine (FM) residency leads to higher rates of postresidency provision; increased availability of abortion care in the FM setting could greatly improve access. Especially in the post-Dobbs context, understanding the landscape of abortion training in US family medicine residency programs (FMRPs) is critical.Methods: We invited all directors of US FMRPs accredited by the Accreditation Council for Graduate Medical Education to complete a larger omnibus online survey that included questions on abortion training. We compiled descriptive statistics and conducted χ2 tests and multivariate regression analyses to detect associations with abortion training.Results: The response rate was 42% (N=286). Nineteen percent of programs had routine medication abortion (MAB) training and 10% had routine aspiration training. In addition, 58% of programs offered elective MAB training and 52% offered elective aspiration training. In multivariate regression, the presence of abortion training was associated with a program having 31 or more residents, being in a state with protected abortion access, not having a Catholic affiliation, and having a program director who believed abortion training should be routine in FMRPs.Conclusions: While more than half of responding FMRPs reported some abortion training, much of it was elective, and 40% of programs lacked abortion training completely. Although abortion training is severely limited or prohibited in states with abortion bans, more training opportunities in the states where abortion is possible could increase access to abortion within primary care.","PeriodicalId":50456,"journal":{"name":"Family Medicine","volume":" ","pages":"242-249"},"PeriodicalIF":1.8,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11189119/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139503061","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Block Scheduling for LARC in a Family Medicine Residency Program. 全科医学住院医师培训项目中的 LARC 分段排期。

IF 1.8 4区医学

Family Medicine Pub Date : 2024-04-01 Epub Date: 2023-12-20 DOI: 10.22454/FamMed.2023.253918

Elisabeth F Callen, Rahmat Na'Allah, Artis Lewis, James Kerns, Christina M Hester

{"title":"Block Scheduling for LARC in a Family Medicine Residency Program.","authors":"Elisabeth F Callen, Rahmat Na'Allah, Artis Lewis, James Kerns, Christina M Hester","doi":"10.22454/FamMed.2023.253918","DOIUrl":"10.22454/FamMed.2023.253918","url":null,"abstract":"Background and objectives: Only 20% of family physicians report providing long-acting reversible contraception (LARC). Clinician-related barriers include confidence and comfort with LARC counseling and insertion/removal, and limited availability and uptake. Training during residency may address barriers and increase access/availability of LARC to support reproductive autonomy. We sought to determine the impact of block scheduling LARC clinics on resident comfort and confidence with LARC counseling and insertion/removal.Methods: LARC block schedules were established in a Midwest family medicine residency's primary clinic (FMC) and in a federally qualified health center rotation clinic. Baseline and end-of-study surveys, compared by Mann-Whitney U and Wilcoxon signed-rank tests, were used to assess comfort and confidence with counseling and inserting LARC. The number of LARC devices placed at the FMC were collected for the intervention year and the year prior.Results: Twenty of 30 residents completed the baseline survey; 13 completed the end-of-study survey. At the group and individual levels, comfort increased for counseling on Levonorgestrel (LNG) intrauterine devices (IUDs) and for inserting implants and LNG IUDs. Individual comfort increased for copper IUDs. Resident willingness to recommend LARC increased, and more devices were placed during the intervention year than the year prior in the FMC (all: P<.05).Conclusions: Block scheduling of LARC clinics was associated with increased residents' comfort and confidence with counseling and placement of implants (LNG IUDs) and with an increase in LARCs placed at one clinic. Changes to scheduling may be an effective educational strategy that may increase access/availability to LARC.","PeriodicalId":50456,"journal":{"name":"Family Medicine","volume":" ","pages":"259-263"},"PeriodicalIF":1.8,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11189126/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139503049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Novel Performance Rating Instruments for Gynecological Procedures in Primary Care: A Pilot Study. 用于初级保健妇科手术的新型性能评定仪器：一项试点研究。

IF 1.8 4区医学

Family Medicine Pub Date : 2024-04-01 Epub Date: 2023-09-11 DOI: 10.22454/FamMed.2023.261011

Parisa Rezaiefar, Nisha Waqas, Douglas Archibald, Susan Humphrey-Murto

{"title":"Novel Performance Rating Instruments for Gynecological Procedures in Primary Care: A Pilot Study.","authors":"Parisa Rezaiefar, Nisha Waqas, Douglas Archibald, Susan Humphrey-Murto","doi":"10.22454/FamMed.2023.261011","DOIUrl":"10.22454/FamMed.2023.261011","url":null,"abstract":"Background and objectives: Improving training and confirming the acquisition of gynecological procedure skills for family physicians (FPs) is crucial for safe health care delivery. The objectives of this study were to (a) develop performance rating instruments for four gynecological procedures, and (b) pilot them to provide preliminary validity evidence using modern validity theory.Methods: Sixteen academic FPs and gynecologists participated in a modified Delphi technique to develop procedure-specific checklists (PSCs) for four procedures: intrauterine device insertion, endometrial biopsy, punch biopsy of the vulva, and routine pessary care. We modified a previously validated global rating scale (GRS) for ambulatory settings. Using prerecorded videos, 19 academic FPs piloted instruments to rate one first-year and one second-year family medicine resident's performance. They were blinded to the level of training. We compared the mean scores for PSCs and GRS for each procedure using paired samples t tests and Cohen's d to estimate effect sizes.Results: Consensus on items for the final PSCs was reached after two Delphi rounds. PSC and GRS scores were numerically higher for the second-year resident than the first-year resident for every procedure, with statistically significant differences for six of eight comparisons (P<.05). All comparisons demonstrated large effect sizes (Cohen's d>0.8). Both instruments received high scores for ease of use by raters.Conclusions: We developed novel performance rating instruments for four gynecological procedures and provided preliminary validity evidence for their use for formative feedback in a simulation setting. This pilot study suggests that these instruments may facilitate the training and documentation of family medicine trainees' skills in gynecological procedures.","PeriodicalId":50456,"journal":{"name":"Family Medicine","volume":" ","pages":"234-241"},"PeriodicalIF":1.8,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11189117/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41173058","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Family Medicine Residents Desperate for Abortion Education. 渴望堕胎教育的家庭医学院居民。

IF 1.8 4区医学

Family Medicine Pub Date : 2024-04-01 Epub Date: 2023-10-17 DOI: 10.22454/FamMed.2023.220499

Nick DeVetter, Jack Westfall, Erin C Westfall

引用次数: 0

Authors' Response to "Transitioning From AFMRD Entrustable Professional Activities to ABFM Core Outcomes to Measure Clinical Preparedness". 作者对 "从 AFMRD 委托专业活动过渡到 ABFM 核心成果以衡量临床准备情况 "的回应。

IF 1.8 4区医学

Family Medicine Pub Date : 2024-04-01 Epub Date: 2024-02-21 DOI: 10.22454/FamMed.2024.657114

Patricia A Carney, M Patrice Eiff

引用次数: 0

Organizing Primary Care Clinicians to Expand Reproductive Health Access: A Qualitative Program Evaluation. 组织初级保健临床医生扩大生殖健康服务：定性项目评估。

IF 1.8 4区医学

Family Medicine Pub Date : 2024-04-01 Epub Date: 2024-02-21 DOI: 10.22454/FamMed.2024.589091

Hayley V McMahon, Laura Riker, Hailey Broughton-Jones, Lily Trotta, Silpa Srinivasulu

{"title":"Organizing Primary Care Clinicians to Expand Reproductive Health Access: A Qualitative Program Evaluation.","authors":"Hayley V McMahon, Laura Riker, Hailey Broughton-Jones, Lily Trotta, Silpa Srinivasulu","doi":"10.22454/FamMed.2024.589091","DOIUrl":"10.22454/FamMed.2024.589091","url":null,"abstract":"Background and objectives: Comprehensive sexual reproductive health care (SRH) in the United States, including abortion, is siloed from primary care, making it more difficult to access. The crisis in access has drastically worsened following the overturning of Roe v Wade, 410 US 113 (1973). Primary care clinicians (PCC) are well-positioned to protect and expand SRH access but do not receive sufficient training or support. The Reproductive Health Access Network (\"Network\") was created to connect like-minded clinicians to engage in advocacy, training, and peer support to enhance access to SRH in their communities and practices. This evaluation explores PCC leaders' experiences within this SRH organizing network.Methods: In 2021, we conducted 34 semistructured phone interviews with a purposive sample of current (n=27) and former (n=7) PCC leaders in the Network (N=87). The program's theory of change and network evaluation framework guided reflexive thematic analysis.Results: Participants viewed Network support as critical to ending isolation through three mechanisms: connecting to a supportive community of like-minded peers, empowering leadership, and providing infrastructure for local organizing. They viewed mentorship as critical in building a sustainable and equitable pipeline of PCC leaders. Participants identified challenges to engaging fully, such as burnout and discrimination experienced both within and outside the Network.Conclusions: Community-building, peer support, and mentorship are critical to building and sustaining PCC leadership in SRH-organizing communities. Efforts are needed to mitigate burnout, support SRH education and mentorship for PCCs, and transform into a truly inclusive community. The Network structure is promising for amplifying efforts to enhance SRH access through clinician leadership.","PeriodicalId":50456,"journal":{"name":"Family Medicine","volume":" ","pages":"250-258"},"PeriodicalIF":1.8,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11189127/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140177541","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Quantifying the Educational Value of a Student-Run Free Clinic. 量化学生开办的免费诊所的教育价值。

IF 1.8 4区医学

Family Medicine Pub Date : 2024-03-01 Epub Date: 2024-01-16 DOI: 10.22454/FamMed.2024.568265

Megan Mazander, Joseph Rumenapp, Derek Lee, Charmaine Ong, Emily Floramo, Maureen Benjamins, Melissa Chen

{"title":"Quantifying the Educational Value of a Student-Run Free Clinic.","authors":"Megan Mazander, Joseph Rumenapp, Derek Lee, Charmaine Ong, Emily Floramo, Maureen Benjamins, Melissa Chen","doi":"10.22454/FamMed.2024.568265","DOIUrl":"10.22454/FamMed.2024.568265","url":null,"abstract":"Background and objectives: Student-run free clinics (SRFCs) are settings in which students in health professions gain clinical experience, often while providing free or reduced-cost health care to the surrounding community. The current literature quantifies the many benefits these clinics provide to their patients and the impact they have on students' future careers; but few previous studies have assessed the financial impact of the education provided at an SRFC. We report on a net educational benefit, an educational benefit to educational cost ratio, and a net educational benefit to educational cost ratio of one SRFC from the perspective of the university.Methods: We calculated the value of education by multiplying all student hours worked in the clinic by the associated value of 1 hour in the typical tuition-based curriculum. Clinic educational costs and student hours were obtained from clinic records from August 1, 2021 through July 31, 2022.Results: We found the total educational value students received to be $73,571 over one academic year. The educational operating expenses of the clinic totaled $9,053, resulting in a benefit-cost ratio of 8.13.Conclusions: This analysis demonstrated a potential financial advantage of operating an SRFC when assessing clinic education expenses in relation to the value of university-generated education. Our research may serve as a starting point to showcase the economic benefit of SRFCs to their parent institutions and encourage further analysis of other benefits SRFCs may provide to institutions of higher education.","PeriodicalId":50456,"journal":{"name":"Family Medicine","volume":" ","pages":"176-179"},"PeriodicalIF":1.8,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11136632/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139503055","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0