Family Medicine最新文献

{"title":"CBME-The Challenge Is in the Details.","authors":"Sarina Schrager","doi":"10.22454/FamMed.2025.990900","DOIUrl":"10.22454/FamMed.2025.990900","url":null,"abstract":"","PeriodicalId":50456,"journal":{"name":"Family Medicine","volume":"57 4","pages":"242-243"},"PeriodicalIF":1.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12147685/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144058912","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":"Value-Based Care Education in Family Medicine Residency Programs: A CERA Study of Program Directors.","authors":"Maria Syl de la Cruz, Ashley Chou, Deborah Edberg, William T Leach, Catherine Guariglia, Julie T Schultz, Anna Flattau","doi":"10.22454/FamMed.2025.502198","DOIUrl":"10.22454/FamMed.2025.502198","url":null,"abstract":"<p><strong>Background and objectives: </strong>Primary care is shifting to value-based care (VBC) payment models, which measure and prioritize quality outcomes and cost efficiency. These models include functions such as interdisciplinary teamwork, proactive panel management, and measurement of total cost of care, with the specific aim of improving quality and reducing health care costs. Graduating residents will require training in the key principles of VBC to succeed in many primary care settings. This research study explored current training practices in VBC within family medicine residency programs.</p><p><strong>Methods: </strong>A Council of Academic Family Medicine Educational Research Alliance study of family medicine program directors assessed the current state of VBC education. The survey questions assessed whether programs had a formal VBC curriculum, what elements of VBC are taught and how, and the present barriers and facilitators to VBC education.</p><p><strong>Results: </strong>The overall response rate for the survey was 45.39% (320/705). Most respondents (92.2%) agreed that teaching VBC within their residency curriculum was important, but only 26.9% of programs have established a formal VBC curriculum. The most frequently taught element is the \"evaluation and management of quality outcomes\" (80.9%), and VBC is mostly taught through didactics (79.7%). The most frequently reported barrier to teaching VBC was the lack of time within the curriculum and/or competing priorities (37.5%).</p><p><strong>Conclusions: </strong>Residency programs in primary care specialties would benefit from a formal VBC curriculum appropriate for graduate medical education. This curriculum should include assessment tools for residents that include objective measures for VBC skills and training.</p>","PeriodicalId":50456,"journal":{"name":"Family Medicine","volume":"57 4","pages":"298-302"},"PeriodicalIF":1.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12147695/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144037131","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":"\"Dad, What Do You Want My Role Here to Be?\"","authors":"Katherine M Mahon","doi":"10.22454/FamMed.2025.854157","DOIUrl":"10.22454/FamMed.2025.854157","url":null,"abstract":"","PeriodicalId":50456,"journal":{"name":"Family Medicine","volume":"57 4","pages":"305-306"},"PeriodicalIF":1.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12147694/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144057509","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":"Development and Validation of a Shave Biopsy Training Checklist.","authors":"Alicia Ludden-Schlatter, Stephanie Bunt, Kate DuChene Hanrahan","doi":"10.22454/FamMed.2025.615731","DOIUrl":"10.22454/FamMed.2025.615731","url":null,"abstract":"<p><strong>Background and objectives: </strong>Residencies train residents in procedures and assess their competency, but existing assessment tools have demonstrated poor reliability and have not been validated.</p><p><strong>Methods: </strong>This mixed-methods study validated a shave biopsy checklist with family medicine and dermatology faculty at two academic centers. In each phase of the study, teaching faculty scored a video-recorded simulated procedure using the checklist, and investigators assessed content validity, interrater reliability, and accuracy.</p><p><strong>Results: </strong>In focus groups of nine family medicine and dermatology faculty, 16 of 18 checklist items met or surpassed 80% interrater reliability. Overall checklist reliability was 74%. Focus group surveys initially revealed insufficient content validity. Lowest performing items were removed, and then the follow-up content validity index (0.76) surpassed the required threshold (0.62). Twenty-one of 70 family medicine faculty completed a final survey, which showed a content validity index of 0.63, surpassing the required threshold of 0.42. Twelve of 70 family medicine faculty viewed and scored a simulated video-recorded procedure. Overall interrater reliability was 91% (Cohen's d=1.36). Fourteen of 16 checklist items demonstrated greater than or equal to 90% interrater reliability. Accuracy analysis revealed 67.9% correct responses in focus groups and 84.9% in final testing (simple t test, P&lt;.001, Cohen's d=1.4).</p><p><strong>Conclusions: </strong>This rigorously validated checklist demonstrates appropriate content validity, interrater reliability, and accuracy. Findings support use of this shave biopsy checklist as an objective mastery standard for medical education and as a tool for formative assessment of procedural competency.</p>","PeriodicalId":50456,"journal":{"name":"Family Medicine","volume":"57 4","pages":"268-275"},"PeriodicalIF":1.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12147697/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144048979","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":"Is This Normal?","authors":"Brianna Moyer","doi":"10.22454/FamMed.2025.667617","DOIUrl":"10.22454/FamMed.2025.667617","url":null,"abstract":"","PeriodicalId":50456,"journal":{"name":"Family Medicine","volume":"57 4","pages":"303-304"},"PeriodicalIF":1.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12147689/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144056548","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":"Family Medicine Residency Faculty: Inpatient Staffing, Satisfaction, and Turnover.","authors":"Brandon Hidaka, Emily R Smith, Anthony J Furlano, Terri Nordin, Lindsey M Ruppel, Abdul Waheed","doi":"10.22454/FamMed.2025.822335","DOIUrl":"10.22454/FamMed.2025.822335","url":null,"abstract":"<p><strong>Background and objectives: </strong>Physician scheduling affects job satisfaction and retention. This study explores how family medicine residency inpatient staffing relates to core faculty retention and program director (PD) perception of faculty satisfaction with work-life integration.</p><p><strong>Methods: </strong>A total of 280 family medicine residency PDs responded to the 2023 Council of Academic Family Medicine Education Research Alliance survey. We used the ꭓ2 test to explore associations among program demographics, inpatient staffing characteristics, faculty retention, and PD-reported faculty satisfaction with work-life integration. We measured associations among pairs of ordinal variables with Spearman's correlation.</p><p><strong>Results: </strong>In two-thirds (66%) of programs, faculty cover the inpatient service at least every 8 weeks, with 40% of programs reporting averages of 70 or more hours per inpatient week; nevertheless, most programs' faculty were perceived to be satisfied with less than 10% turnover. The number of hours per week was inversely associated with PD-reported faculty satisfaction (r=-0.21, P=.001). Faculty turnover was directly associated with community size (r=0.17, P=.01). Faculty turnover was more likely to be greater than 10% if the number of hours per inpatient week was more than 89 (odds ratio 12.4, P=.02). Faculty turnover, PD-reported faculty dissatisfaction, and plans to change inpatient staffing were all correlated (r&gt;0.28, P&lt;.0001).</p><p><strong>Conclusions: </strong>Most family medicine residencies have core faculty cover the inpatient service at least once every 8 weeks, during which they work at least 60 hours per week. Longer hours are associated with lower perceived faculty satisfaction of work-life integration, with a threshold effect on faculty turnover. Family medicine residency programs must carefully balance the needs of residents, the community served, and faculty themselves.</p>","PeriodicalId":50456,"journal":{"name":"Family Medicine","volume":"57 4","pages":"276-285"},"PeriodicalIF":1.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12147692/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144046265","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":"Gender Parity in CERA Survey Submissions.","authors":"Katherine M Wright, Heather L Paladine, Miranda A Moore, Grace Shih, Santina J G Wheat","doi":"10.22454/FamMed.2025.925429","DOIUrl":"10.22454/FamMed.2025.925429","url":null,"abstract":"<p><strong>Background and objectives: </strong>The Council of Academic Family Medicine Educational Research Alliance (CERA) is a unique collaboration of academic family medicine organizations (Society of Teachers of Family Medicine [STFM], Association of Family Medicine Residency Directors, North American Primary Care Research Group, Association of Departments of Family Medicine) that facilitates and improves educational research in family medicine. CERA conducts approximately five surveys per year, including residency program directors, clerkship directors, department chairs, and general membership. Members of these organizations propose modules of 10 questions for these surveys. Proposals are peer-reviewed, and the top proposals are incorporated, along with standardized demographic questions, into an omnibus survey. We sought to determine the impact of self-reported gender of the primary submitter on survey module acceptance rates.</p><p><strong>Methods: </strong>We conducted a bibliometric analysis to explore author characteristics and quantify dissemination efforts. We conducted ꭓ2 analyses to determine gender differences in proposal acceptance. We used the exact binomial test to compare proportions of women authors to the benchmark proportion of women in STFM.</p><p><strong>Results: </strong>Overall, women submitted 66% (460/699) of CERA survey module proposals and authored 65% of accepted CERA modules (157/241) with the highest proportion concentrated among Clerkship Surveys (73%, 40/55). The acceptance rate did not differ significantly by gender (χ2=0.07, df=1, P=.80). A total of 73.4% (177/241) of module authors went on to present or publish their findings; we found no significant differences in scholarly output by gender (χ2=0.70, df=1, P=.41).</p><p><strong>Conclusions: </strong>These findings indicate that the CERA module submission process has been successful in achieving comparable acceptance rates for men and women submitters. Other specialties should consider a similar model as a means to support early career educational researchers, including women.</p>","PeriodicalId":50456,"journal":{"name":"Family Medicine","volume":"57 4","pages":"286-291"},"PeriodicalIF":1.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12147696/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144055410","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":"Clinical Questions Addressed by First-Year Medical Students in Primary Care: A Cross-Sectional Study.","authors":"Mary Roper, Peter R A Malik, Andrea Quaiattini, Roland Grad","doi":"10.22454/FamMed.2025.381934","DOIUrl":"10.22454/FamMed.2025.381934","url":null,"abstract":"<p><strong>Background and objectives: </strong>In the context of an evidence-based medicine theme, medical students in their first year at McGill University formulate a PICO (population, intervention, comparator, and outcome) question arising from a patient encounter in family medicine. We sought to analyze clinical questions addressed within PICO projects submitted by first-year medical students shadowing a family physician.</p><p><strong>Methods: </strong>A total of 180 student projects were split equally between two reviewers. Questions were then classified according to a three-component classification system: (a) type of question (screening, diagnosis, prognosis, treatment [including preventive treatment], etiology, and harm); (b) Ely's taxonomy; and (c) question topics based on the 105 priority topics of the College of Family Physicians of Canada.</p><p><strong>Results: </strong>The most frequent question type among the students was treatment/prevention (152, 84.0%), followed by etiology (7, 3.9%), screening (6, 3.3%), prognosis (6, 3.3%), harm (5, 2.8%), and diagnosis (4, 2.2%). Based on Ely's taxonomy, the most frequent question was \"How should I treat condition x (not limited to drug treatment)?\" (105, 58.3%). Of the 105 priority topics from the College of Family Physicians of Canada, in children (18, 10%), pain (16, 8.9%), pregnancy (12, 6.7%), depression (11, 6.1%), and behavioral problems (10, 5.6%) were most frequently represented.</p><p><strong>Conclusions: </strong>Clinical questions addressed by first-year medical students, of which the vast majority are about treatment and prevention, can be classified. Students did not commonly address questions related to diagnosis, indicating that additional teaching may be required to use the PICO format to address this question type.</p>","PeriodicalId":50456,"journal":{"name":"Family Medicine","volume":"57 4","pages":"261-267"},"PeriodicalIF":1.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12147699/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143990700","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 Value of Learning Collaboratives: Experiences From Several Residency Networks.","authors":"Molly Ormsby, Grace Shih, Amanda Weidner","doi":"10.22454/FamMed.2025.903495","DOIUrl":"10.22454/FamMed.2025.903495","url":null,"abstract":"<p><p>The 2023 Accreditation Council for Graduate Medical Education guidelines highlight learning collaboratives as the \"optimal way to facilitate [family medicine residency] programs' ability to attain their educational and community aims.\" As a result, many residency programs are seeking to develop, expand, or sustain learning collaboratives. This study aims to provide practical advice, examples, and encouragement for residency programs interested in creating or participating in a learning collaborative, based on lessons learned from the representatives' collective experiences. A purposive sampling of five learning collaboratives at various stages of development and growth was conducted to capture a representative range of models. Data were collected through participatory engagement and refined through iterative rounds of member checking. Despite differences in form and structure, learning collaboratives share commonalities in the support they provide their participants. They encounter common barriers and rely on similar strategies for success.</p>","PeriodicalId":50456,"journal":{"name":"Family Medicine","volume":"57 4","pages":"247-252"},"PeriodicalIF":1.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12147698/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144042430","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":"Coaching With the End in Mind: Developing Coaching Skills Toward Meaningful Individual Learning Plans.","authors":"Randolph Pearson, Tonya L Caylor","doi":"10.22454/FamMed.2024.678104","DOIUrl":"10.22454/FamMed.2024.678104","url":null,"abstract":"","PeriodicalId":50456,"journal":{"name":"Family Medicine","volume":" ","pages":"238"},"PeriodicalIF":1.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142958289","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}