Family Medicine最新文献

{"title":"Write LIFE: Start Writing Without a Research Project.","authors":"Sarah I Ramírez, Héctor Arreaza, Viviana Martinez-Bianchi, Donna Baluchi, José E Rodríguez","doi":"10.22454/FamMed.2025.162513","DOIUrl":"10.22454/FamMed.2025.162513","url":null,"abstract":"","PeriodicalId":50456,"journal":{"name":"Family Medicine","volume":" ","pages":"528"},"PeriodicalIF":1.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144318520","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Opioid Use Disorder Education in the Family Medicine Clerkships: A CERA Study.","authors":"Kento Sonoda, Kelly M Everard","doi":"10.22454/FamMed.2025.301169","DOIUrl":"10.22454/FamMed.2025.301169","url":null,"abstract":"<p><strong>Background and objectives: </strong>Opioid use disorder (OUD) education is crucial early in medical education in response to the overwhelming number of drug overdose deaths and the stigma attached to addiction among health care professionals. Our study aimed to examine factors associated with teaching about OUD and to determine whether OUD education has increased over the past several years.</p><p><strong>Methods: </strong>Data were collected through a cross-sectional survey of 173 US and Canadian family medicine clerkship directors in summer 2024. Survey items included clerkship directors' perceived importance, presence of current OUD education, and perceived barriers to OUD education.</p><p><strong>Results: </strong>The response rate was 52.6% (91/173). Nine participants did not complete the addiction medicine questions and were excluded from analyses. Nearly three-fourths of clerkship directors thought teaching OUD was important, but 45% of clerkships did not include any OUD education. Approximately one-third of clerkship didactics covered screening, brief intervention, and referral to treatment (SBIRT; 40.2%); diagnosis of OUD (42.7%); pharmacological treatment of OUD (37.8%); and opioid overdose prevention education (31.7%). Lack of time in the curriculum was the most commonly perceived barrier to OUD education in clerkship.</p><p><strong>Conclusions: </strong>Clerkships were more likely to include OUD education if clerkship directors perceived OUD education as important or had faculty with expertise to teach OUD. Our survey revealed an increase in the inclusion of OUD education in family medicine clerkships over the past several years. Designing the addiction medicine curricula specifically for medical student education may contribute to enhancing OUD education.</p>","PeriodicalId":50456,"journal":{"name":"Family Medicine","volume":" ","pages":"489-492"},"PeriodicalIF":1.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12306615/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144318517","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}

{"title":"Barriers to Implementing a Racial Justice Curriculum: CERA Comparison of Family Medicine Program Directors' and Residents' Perspectives.","authors":"Tiffany Ho, Andrew D Curtin, Eliza Taylor, Gerardo Moreno","doi":"10.22454/FamMed.2025.951379","DOIUrl":"10.22454/FamMed.2025.951379","url":null,"abstract":"<p><strong>Background and objectives: </strong>The 2023 Accreditation Council for Graduate Medical Education (ACGME) program requirements for family medicine residencies state that family physicians must have the competence to address racial and ethnic health disparities experienced by their patients. Racial justice curricula (RJC) or antiracism curricula can provide residencies with the tools faculty and residents need. This study explores the differences in perceived barriers between family medicine program directors (PDs) and residents.</p><p><strong>Methods: </strong>Survey questions on RJCs were included in the 2020 Council of Academic Family Medicine Educational Research (CERA) survey of PDs and 2021 CERA survey of residents. Participants' perceived top two barriers to implementing an RJC in their residency program were illustrated with Sankey diagrams. We used the χ2 test and logistic regression for analysis.</p><p><strong>Results: </strong>Of the 578 participants included, 312 (54%) were PDs and 266 (46%) were residents. Compared to PDs, residents were more likely to identify as female, less likely White, and more likely from community-based, nonuniversity-affiliated residency programs. PDs ranked lack of faculty training as the most important barrier, while residents ranked lack of time as the top barrier. Residents also were significantly more likely to rank lack of faculty interest and resident interest as barriers.</p><p><strong>Conclusions: </strong>Family medicine PDs and residents identified different barriers to implementing an RJC. Additional research is needed to investigate the impact of knowledge and culture on residency programs' receptiveness to addressing racial and ethnic health disparities.</p>","PeriodicalId":50456,"journal":{"name":"Family Medicine","volume":" ","pages":"471-482"},"PeriodicalIF":1.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12306607/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144318562","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}

{"title":"Inpatient Pediatric Training of Family Medicine Residents: A Pediatric Perspective.","authors":"Tina V Halley, Priti Bhansali, Katharine N Clouser, Gayatri B Madduri, Kamakshya Patra, Joy L Solano, Laura Nell Hodo","doi":"10.22454/FamMed.2025.431942","DOIUrl":"10.22454/FamMed.2025.431942","url":null,"abstract":"<p><strong>Background and objectives: </strong>Family physicians contribute significantly to the pediatric workforce, but little is known about their pediatric training during residency, specifically in the inpatient setting. Our objective was to gather data on the inpatient pediatric training of family medicine residents from the perspective of pediatric faculty.</p><p><strong>Methods: </strong>We created a survey about inpatient pediatric training of family medicine residents, including pediatric rotation characteristics, ward team structure, educational resources, and faculty involvement. The Association of Pediatric Program Directors (APPD) accepted the survey for distribution to pediatric residency associate program directors. Demographic data about respondents were provided by APPD. Data were collected between January and February 2024. We performed descriptive analysis of survey responses.</p><p><strong>Results: </strong>We received 74 responses from 190 institutions, for a response rate of 39%. Of the respondents, 81% provided training to family medicine residents. We found wide variability in the structure of this training. Only 7% of sites reported having curricula specific to training family medicine residents in inpatient pediatric care. Inpatient pediatricians (76%) are often tasked with creating rotation structure and curricula for training family medicine residents.</p><p><strong>Conclusions: </strong>In the view provided by our limited survey population, we found variability in the training structure and content of pediatric inpatient experiences; few family medicine-specific curricular tools are being used for this training, with little to no family medicine faculty involvement in this training. An opportunity may be available for collaboration between pediatric and family medicine faculty to establish a foundation for future curricula.</p>","PeriodicalId":50456,"journal":{"name":"Family Medicine","volume":" ","pages":"483-488"},"PeriodicalIF":1.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12306603/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144318564","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}

{"title":"The Forest and the Trees.","authors":"Sarina Schrager","doi":"10.22454/FamMed.2025.758338","DOIUrl":"10.22454/FamMed.2025.758338","url":null,"abstract":"","PeriodicalId":50456,"journal":{"name":"Family Medicine","volume":"57 7","pages":"463-464"},"PeriodicalIF":1.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12306605/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144644051","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}

{"title":"Noticing.","authors":"Minda Liu","doi":"10.22454/FamMed.2025.168307","DOIUrl":"10.22454/FamMed.2025.168307","url":null,"abstract":"","PeriodicalId":50456,"journal":{"name":"Family Medicine","volume":" ","pages":"517-518"},"PeriodicalIF":1.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12306606/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144318516","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}

{"title":"The Prevalence and Stress Impact of Decredentialing as a Form of Gender Microaggression: A CERA General Membership Study.","authors":"Katherine M Mahon, Thomas Yuen, Nicole Freund, Kari Nilsen","doi":"10.22454/FamMed.2025.650146","DOIUrl":"10.22454/FamMed.2025.650146","url":null,"abstract":"<p><strong>Background and objectives: </strong>This study sought to quantify the anecdotally reported experience of decredentialing in the profession of medicine, specifically as it applies to gender. Decredentialing is defined as the experience of being addressed by first name without permission or being mistaken as a nonphysician provider.</p><p><strong>Methods: </strong>Eight questions regarding decredentialing microaggressions and resultant stress reactions were submitted as part of the 2023 Council of Academic Family Medicine Educational Research Alliance general membership survey.</p><p><strong>Results: </strong>Women physicians reported significantly higher rates of unauthorized first name use by patients (15% vs 3% for men patients; 7% vs 3% for women patients). Women physicians also reported significantly higher rates of decredentialing by being mistaken as a nonphysician by patients (39.8% frequent vs 1.1%), clinical staff (13.0% frequent vs 0.7%), and other physicians (10.9% frequent vs 1.1%). Women respondents reported more substantial stress responses after unauthorized first-name use (36.9% more stressful vs 6.3%) and mistaken roles (47.7% more stressful vs 8.4%). Subgroup analysis of self-identified underrepresented in medicine (URiM) populations showed significantly higher rates of microaggressions among URiM women physicians compared to men physicians and in total URiM respondents versus non-URiM respondents.</p><p><strong>Conclusions: </strong>Women physicians experience the gender microaggression of decredentialing via unauthorized first-name use by patients and being mistaken for a nonphysician more frequently than men physicians. Women physicians also more frequently experience a stress response from these microaggressions. Decredentialing, long acknowledged anecdotally by women physicians, is a valid gender microaggression disproportionately affecting women physicians.</p>","PeriodicalId":50456,"journal":{"name":"Family Medicine","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144884218","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preparing the Heart.","authors":"Amy Odom","doi":"10.22454/FamMed.2025.524393","DOIUrl":"10.22454/FamMed.2025.524393","url":null,"abstract":"","PeriodicalId":50456,"journal":{"name":"Family Medicine","volume":" ","pages":"520"},"PeriodicalIF":1.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12306614/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144318518","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}

{"title":"Assessment of Emergency and Trauma Stabilization Training in Family Medicine Residency Programs: A CERA Study.","authors":"Joel Klas, Cole Puffer, Paul Klas, Joyce C Hollander-Rodriguez, Patricia A Carney","doi":"10.22454/FamMed.2025.459247","DOIUrl":"10.22454/FamMed.2025.459247","url":null,"abstract":"<p><strong>Background and objectives: </strong>Family physicians are central to the national emergency department workforce, especially in rural communities. However, the number of family physicians working in emergency departments is decreasing, perhaps due to lack of training.</p><p><strong>Methods: </strong>We assessed emergency medicine and trauma stabilization curricula in US family medicine residencies to identify barriers to training in these areas. Council on Academic Family Medicine Educational Research Alliance (CERA) program directors' surveys were administered between September 26, 2023 and October 30, 2023. We stratified data according to community size (&lt;30,000; 30,000-74,999; 75,000-149,999; 150,000-499,999; 500,000-1,000,000; and &gt;1,000,000) to explore whether training differed based on training program rurality.</p><p><strong>Results: </strong>Of the 715 program directors, 271 responded (37.9%). Of the program directors who responded, nearly 76% reported that residents spend 100 to 299 hours training in emergency rooms, and more than 86% reported that residents lead 0 to 5 trauma stabilizations by the time their training is complete, which did not differ according to rurality. Only 3.0% reported that all their graduates were prepared to work independently in emergency rooms, and 3.4% reported that all their graduates were prepared to lead trauma stabilizations, which also did not differ according to rurality. Barriers to training included Accreditation Council for Graduate Medical Education (ACGME) emphasis on other practice requirements (58.3%) and a lack of emphasis on trauma stabilization (69.7%).</p><p><strong>Conclusions: </strong>Most program directors reported that few of their residents were prepared to independently work in emergency departments. If ACGME wishes to increase family medicine graduates' entry into the emergency medicine workforce, system changes may be required to increase emphasis on emergency training and its core component of trauma stabilization.</p>","PeriodicalId":50456,"journal":{"name":"Family Medicine","volume":" ","pages":"465-470"},"PeriodicalIF":1.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12306610/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144318561","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}

{"title":"Knowledge Self-Assessment Engagement and Family Medicine Board Examination Outcomes.","authors":"Peter M Wingrove, Andrew W Bazemore, Ting Wang, Keith Stelter, David W Price","doi":"10.22454/FamMed.2025.200510","DOIUrl":"10.22454/FamMed.2025.200510","url":null,"abstract":"<p><strong>Background and objectives: </strong>Evidence on the relationship between formative assessment engagement and summative assessment outcomes in practicing physicians is sparse. We evaluated the relationship between engagement in the American Board of Family Medicine (ABFM) formative Continuous Knowledge Self-Assessment (CKSA) and performance on high-stakes summative assessments.</p><p><strong>Methods: </strong>This retrospective cohort study included 24,926 ABFM diplomates who completed CKSA modules and summative assessments between 2017 and 2023. We analyzed CKSA engagement metrics-such as the number of quarters completed, time of completion, and self-reported confidence-against performance on summative assessments, measured by z scores. Multivariable regression models controlled for demographic factors and prior assessment performance.</p><p><strong>Results: </strong>The overall cohort summative assessment pass rate during the study period was 90.3%. Greater CKSA engagement was strongly associated with higher summative assessment performance. Diplomates who completed all four CKSA quarters had significantly higher summative assessment z scores than those completing fewer quarters (P&lt;.001). Early CKSA completion and spending more time on low-confidence questions were also positively correlated with both CKSA and summative assessment scores (P&lt;.001). These effects were observed across different levels of prior exam performance.</p><p><strong>Conclusions: </strong>Engagement in formative assessments like CKSA, particularly early and consistent participation and reviewing incorrect or low-confidence questions, is linked to better outcomes on high-stakes assessments. Future research should explore the mechanisms underlying these associations and consider developing an index of engagement to identify physicians at risk of poor performance. Incorporating structured, longitudinal self-assessments like CKSA into certification requirements could enhance continuous learning and improve summative exam readiness.</p>","PeriodicalId":50456,"journal":{"name":"Family Medicine","volume":" ","pages":"500-507"},"PeriodicalIF":1.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12306612/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144318565","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}