Family Medicine最新文献_第9页

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":null,"pages":null},"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

Departmental Metrics to Guide Equity, Diversity, and Inclusion for Academic Family Medicine Departments. 指导全科医学学术部门实现公平、多样性和包容性的部门指标。

IF 1.9 4区医学

Family Medicine Pub Date : 2024-04-16 DOI: 10.22454/fammed.2024.865619

Shalina Nair, José E Rodríguez, Samantha Elwood, Elisabeth Wilson, Annamalai Ramanathan, Debra Stulberg, Belinda Vail, Kristen Rundell, C. J. Peek

{"title":"Departmental Metrics to Guide Equity, Diversity, and Inclusion for Academic Family Medicine Departments.","authors":"Shalina Nair, José E Rodríguez, Samantha Elwood, Elisabeth Wilson, Annamalai Ramanathan, Debra Stulberg, Belinda Vail, Kristen Rundell, C. J. Peek","doi":"10.22454/fammed.2024.865619","DOIUrl":"https://doi.org/10.22454/fammed.2024.865619","url":null,"abstract":"PROBLEM\u0000Equity, diversity, and inclusion (EDI) efforts have accelerated over the past several years, without a traditional guidebook that other missions often have. To evaluate progress over time, departments of family medicine are seeking ways to measure their current EDI state. Across the specialty, unity regarding which EDI metrics are meaningful is absent, and discordance even exists about what should be measured.\u0000\u0000\u0000APPROACH\u0000This paper provides a general metrics framework, including a wide array of possibilities to consider measuring, for assessing individual departmental progress in this broad space. These measures are designed to be general enough to provide common language and can be customized to align with strategic priorities of individual family medicine departments.\u0000\u0000\u0000OUTCOMES\u0000The Diversity, Equity, and Inclusion Committee of the Association of Departments of Family Medicine has produced a common framework to facilitate measurement of EDI outcomes in the following areas: care delivery and health, workforce recruitment and retention, learner recruitment and training, and research participation. This framework allows departments to monitor progress across these domains that impact the tripartite mission, providing opportunities to capitalize on measured gains in EDI.\u0000\u0000\u0000NEXT STEPS\u0000Departments can review this framework and consider which metrics are applicable or develop their own metrics to align with their strategic priorities. In the future, collective departments could compare notes and measure aggregate progress together. Evaluating progress is a step in the journey toward the goal of ensuring that departments are operating from inclusive and just academic systems.","PeriodicalId":50456,"journal":{"name":"Family Medicine","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140698132","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}

引用次数: 0

Climate Change Curricula in Family Medicine Residency Programs: Program Directors' Perspectives From a CERA Survey. 全科医学住院医师培训项目中的气候变化课程：来自 CERA 调查的项目主任观点。

IF 1.9 4区医学

Family Medicine Pub Date : 2024-04-16 DOI: 10.22454/fammed.2024.548752

Frank Müller, Akhilesh Munagala, M. Bouthillier, Jesse I. Skok, Harland Holman

{"title":"Climate Change Curricula in Family Medicine Residency Programs: Program Directors' Perspectives From a CERA Survey.","authors":"Frank Müller, Akhilesh Munagala, M. Bouthillier, Jesse I. Skok, Harland Holman","doi":"10.22454/fammed.2024.548752","DOIUrl":"https://doi.org/10.22454/fammed.2024.548752","url":null,"abstract":"BACKGROUND AND OBJECTIVES\u0000Climate change is a major threat to the health of people worldwide. The health care system deals with the immediate health-related effects of climate change and, at the same time, is a major emitter of greenhouse gas. This study aimed to investigate (a) the awareness and perception of climate change among family medicine residency program directors, and (b) the state of climate change education in family medicine residency programs.\u0000\u0000\u0000METHODS\u0000The Council of Academic Family Medicine Educational Research Alliance (CERA) conducted a cross-sectional survey of family medicine program directors in the United States in April 2023. We analyzed anonymous data using descriptive and bivariate statistics.\u0000\u0000\u0000RESULTS\u0000We analyzed responses from 284 family medicine residency program directors (response rate 41.1%). Of these, 56.8% indicated not having any lectures/seminars dedicated to climate change and no plans to introduce such curricula, with considerably higher rates in East South Central United States (92.8%). A majority considered principles of climate change, carbon emissions emitted by the health care system, and discussion of climate change with patients of lesser importance for residency program education.\u0000\u0000\u0000CONCLUSIONS\u0000While climate change is an emerging topic affecting health and the provision of health care worldwide, our study suggests that many family medicine residency programs do not teach about it. Family medicine trainees may not always receive sufficient education about the risks posed to their patients by climate change, which could lead to them having limited knowledge and skills when discussing this topic with their patients in the future.","PeriodicalId":50456,"journal":{"name":"Family Medicine","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140697914","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}

引用次数: 0

Authors' Response to Letter About "URiMs and Imposter Syndrome" Commentary. 作者对有关 "URiMs 和冒名顶替综合症 "评论的回信。

IF 1.9 4区医学

Family Medicine Pub Date : 2024-04-16 DOI: 10.22454/fammed.2024.336789

Diana N. Carvajal, Ruth Enid Zambrana

引用次数: 0

Virtual Care: Perspectives From Family Physicians. 虚拟医疗：家庭医生的观点。

IF 1.9 4区医学

Family Medicine Pub Date : 2024-04-15 DOI: 10.22454/fammed.2024.592756

Olivia Ritchie, Emily Koptyra, Liz B Marquis, Reema Kadri, Anna R. Laurie, V. G. V. Vydiswaran, Jiazhao Li, Lindsay K. Brown, Tiffany C. Veinot, Lorraine R. Buis, T. Guetterman

{"title":"Virtual Care: Perspectives From Family Physicians.","authors":"Olivia Ritchie, Emily Koptyra, Liz B Marquis, Reema Kadri, Anna R. Laurie, V. G. V. Vydiswaran, Jiazhao Li, Lindsay K. Brown, Tiffany C. Veinot, Lorraine R. Buis, T. Guetterman","doi":"10.22454/fammed.2024.592756","DOIUrl":"https://doi.org/10.22454/fammed.2024.592756","url":null,"abstract":"BACKGROUND\u0000During the COVID-19 pandemic, virtual care expanded rapidly at Michigan Medicine and other health systems. From family physicians' perspectives, this shift to virtual care has the potential to affect workflow, job satisfaction, and patient communication. As clinics reopened and care delivery models shifted to a combination of in-person and virtual care, the need to understand physician experiences with virtual care arose in order to improve both patient and provider experiences. This study investigated Michigan Medicine family medicine physicians' perceptions of virtual care through qualitative interviews to better understand how to improve the quality and effectiveness of virtual care for both patients and physicians.\u0000\u0000\u0000METHODS\u0000We employed a qualitative descriptive design to examine physician perspectives through semistructured interviews. We coded and analyzed transcripts using thematic analysis, facilitated by MAXQDA (VERBI) software.\u0000\u0000\u0000RESULTS\u0000The results of the analysis identified four major themes: (a) chief concerns that are appropriate for virtual evaluation, (b) physician perceptions of patient benefits, (c) focused but contextually enriched patient-physician communication, and (d) structural support needed for high-quality virtual care.\u0000\u0000\u0000CONCLUSIONS\u0000These findings can help further direct the discussion of how to make use of resources to improve the quality and effectiveness of virtual care.","PeriodicalId":50456,"journal":{"name":"Family Medicine","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140704093","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}

引用次数: 0

Holistic Review in Family Medicine Residency Programs: A CERA Study. 全科医学住院医师培训项目中的整体审查：CERA 研究。

IF 1.9 4区医学

Family Medicine Pub Date : 2024-04-15 DOI: 10.22454/fammed.2024.515525

Oanh H. Truong, Jenny Y. Wang, Peter F. Cronholm

{"title":"Holistic Review in Family Medicine Residency Programs: A CERA Study.","authors":"Oanh H. Truong, Jenny Y. Wang, Peter F. Cronholm","doi":"10.22454/fammed.2024.515525","DOIUrl":"https://doi.org/10.22454/fammed.2024.515525","url":null,"abstract":"BACKGROUND AND OBJECTIVES\u0000Interest in using holistic review for residency recruitment as a strategy to improve the diversity of the physician workforce has increased. However, no data are published on the prevalence of holistic review in the selection process for family medicine residency programs. We designed this study to assess programs' knowledge, skills, and attitudes; prevalence; barriers to implementation; and program characteristics associated with the use of holistic review.\u0000\u0000\u0000METHODS\u0000Data for this study were elicited as part of a 2023 survey conducted by the Council of Academic Family Medicine Educational Research Alliance. The nationwide, web-based survey was sent to 739 family medicine residency program directors.\u0000\u0000\u0000RESULTS\u0000A total of 309 program directors completed the holistic review portion of the survey. Programs that understood and agreed with holistic review used it more in their selection process. Holistic review was more common in programs with higher rates of residents, faculty, and patients that are underrepresented in medicine. Barriers to holistic review utilization were increased number of applicants, increased resources associated with holistic review, and lack of consensus on the holistic review approach.\u0000\u0000\u0000CONCLUSIONS\u0000The holistic review process is an area of growing interest to diversify the physician workforce, especially among residencies caring for underresourced communities. Further discussions on the specific scoring rubrics of family medicine residency programs that use holistic review are needed and could help programs that are facing barriers. Widespread use of holistic review to diversify the physician workforce has the potential to improve patient care access and health.","PeriodicalId":50456,"journal":{"name":"Family Medicine","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140700829","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}

引用次数: 0

Still Undiagnosed: When Health Care Remains a Privilege, Not a Right. 仍未确诊：当医疗保健仍是特权而非权利时。

IF 1.9 4区医学

Family Medicine Pub Date : 2024-04-15 DOI: 10.22454/fammed.2024.696888

Carmelle Kuizon

引用次数: 0

A Longitudinal Assessment of Resident and New Graduate Well-Being According to Length of Training: A Report From the Length of Training Pilot in Family Medicine. 根据培训时间长短对住院医师和新毕业生幸福感的纵向评估：全科医学培训时间试验报告》。

IF 1.9 4区医学

Family Medicine Pub Date : 2024-04-15 DOI: 10.22454/fammed.2024.990826

Mark A. Johnson, Patricia A. Carney, Annie Ericson, Briana Money, Suki Tepperberg, Nicholas Weida, Jennifer Somers, Jennifer Romeu

{"title":"A Longitudinal Assessment of Resident and New Graduate Well-Being According to Length of Training: A Report From the Length of Training Pilot in Family Medicine.","authors":"Mark A. Johnson, Patricia A. Carney, Annie Ericson, Briana Money, Suki Tepperberg, Nicholas Weida, Jennifer Somers, Jennifer Romeu","doi":"10.22454/fammed.2024.990826","DOIUrl":"https://doi.org/10.22454/fammed.2024.990826","url":null,"abstract":"Background & Objectives: No prior studies have examined how length of training may influence wellness. As part of the Length of Training Pilot (LoTP), we explored resident and new graduate well-being according to program year and length of training in 3- and 4-year family medicine residency training programs.\u0000\u0000\u0000METHODS\u0000Two surveys captured data included in these analyses. One was a resident survey that included the Mayo Clinic physician-expanded Well-Being Index (eWBI) administered annually during the In-Training Examination (2014-2019). The second was administered to graduates 1 year after completion of training between 2016 and 2022 and included the same well-being questions. Response rates ranged between 77.7% and 96.8%.\u0000\u0000\u0000RESULTS\u0000The eWBI summary scores for burnout were highest in postgraduate year 1 (PGY1) and did not differ statistically according to length of training (PGY1: 2.02 in 3-year [3YR] programs vs 1.93 in 4-year [4YR] programs, P=.55; postgraduate year 2 [PGY2]: 2.42 in 3YR programs vs 2.38 in 4YR programs, P=.83; postgraduate year 3 [PGY3]: 2.18 in 3YR programs vs 2.28 in 4YR programs, P=.59; and 2.34 in postgraduate year 4 [PGY4] for those in 4YR programs), though some statistical differences were noted for three items. New graduates' eWBI summary scores before the COVID-19 pandemic were 1.77 among 3YR graduates and 1.66 among 4YR graduates (P=.59). These scores were higher during COVID-19 at 1.89 for 3YR graduates and 2.02 for 4YR graduates (P=.62). Length of training was not associated with differences in well-being before or during COVID-19.\u0000\u0000\u0000CONCLUSIONS\u0000We found no associations between length of training and physician well-being during training or among new graduates before or during COVID-19.","PeriodicalId":50456,"journal":{"name":"Family Medicine","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140702198","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}

引用次数: 0

Postresidency Practice Setting and Clinical Care Features According to 3 Versus 4 Years of Training in Family Medicine: A Length of Training Pilot Study. 全科医学 3 年与 4 年培训后的实习环境和临床护理特点：培训期限试点研究。

IF 1.9 4区医学

Family Medicine Pub Date : 2024-04-12 DOI: 10.22454/fammed.2024.699625

M. P. Eiff, Annie Ericson, Dang H. Dinh, Steele Valenzuela, C. Conry, Alan B. Douglass, W. P. Dickinson, Stephanie E. Rosener, Patricia A. Carney

{"title":"Postresidency Practice Setting and Clinical Care Features According to 3 Versus 4 Years of Training in Family Medicine: A Length of Training Pilot Study.","authors":"M. P. Eiff, Annie Ericson, Dang H. Dinh, Steele Valenzuela, C. Conry, Alan B. Douglass, W. P. Dickinson, Stephanie E. Rosener, Patricia A. Carney","doi":"10.22454/fammed.2024.699625","DOIUrl":"https://doi.org/10.22454/fammed.2024.699625","url":null,"abstract":"BACKGROUND AND OBJECTIVES\u0000Factors associated with physician practice choice include residency location, training experiences, and financial incentives. How length of training affects practice setting and clinical care features postgraduation is unknown.\u0000\u0000\u0000METHODS\u0000In this Length of Training Pilot (LoTP) study, we surveyed 366 graduates of 3-year (3YR) and 434 graduates of 4-year (4YR) programs 1 year after completion of training between 2013 and 2021. Variables assessed included reasons for practice setting choice, practice type, location, practice and community size, specialty mix, and clinical care delivery features (eg, integrated behavioral health, risk stratified care management). We compared different length of training models using χ2 or Fisher's exact tests for categorical variables and independent samples, and t test (unequal variances) for continuous variables.\u0000\u0000\u0000RESULTS\u0000Response rates ranged from 50% to 88% for 3YR graduates and 68% to 95% for 4YR graduates. Scope of practice was a predominant reason for graduates choosing their eventual practice, and salary was a less likely reason for those completing 4 years versus 3 years of training (scope, 72% vs 55%, P=.001; salary, 15% vs 22%, P=.028). Community size, practice size, practice type, specialty mix, and practice in a federally designated underserved site did not differ between the two groups. We found no differences in patient-centered medical home features when comparing the practices of 3YR to 4YR graduates.\u0000\u0000\u0000CONCLUSIONS\u0000Training length did not affect practice setting or practice features for graduates of LoTP programs. Future LoTP analyses will examine how length of training affects scope of practice and clinical preparedness, which may elucidate other elements associated with practice choice.","PeriodicalId":50456,"journal":{"name":"Family Medicine","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140710099","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}

引用次数: 0

Use of Signaling in Family Medicine Residency Interviewing. 在全科住院医生面试中使用信号。

IF 1.9 4区医学

Family Medicine Pub Date : 2024-04-12 DOI: 10.22454/fammed.2024.678799

Gretchen Irwin, Kari Nilsen, Tessa Rohrberg, Miranda A. Moore

{"title":"Use of Signaling in Family Medicine Residency Interviewing.","authors":"Gretchen Irwin, Kari Nilsen, Tessa Rohrberg, Miranda A. Moore","doi":"10.22454/fammed.2024.678799","DOIUrl":"https://doi.org/10.22454/fammed.2024.678799","url":null,"abstract":"BACKGROUND AND OBJECTIVES\u0000Although signals have been used in the residency application process by other specialties, family medicine residency directors have not previously participated. With applicant signal information available for the first time in the 2023-2024 application cycle, the current study describes family medicine residency program directors' intended use of signals and provides benchmarking descriptive data that may help inform best practices and future studies.\u0000\u0000\u0000METHODS\u0000A total of 691 of the 745 family medicine program directors in US family medicine residency programs accredited by the Accreditation Council for Graduate Medical Education were surveyed. We used ꭓ2 and Pearson correlation analyses to examine how program directors of family medicine residency programs intended to use signaling and their perceived impact of signaling on the residency interviewing process.\u0000\u0000\u0000RESULTS\u0000Most program directors indicated that applicant signals would assist them in deciding who to invite for an interview and would be a positive factor in a holistic review process. However, program directors also noted that rotation experience or geographic ties would be more powerful inducements to interview or rank a specific candidate. Program directors did not indicate a belief that signals would decrease interview season stress or workload.\u0000\u0000\u0000CONCLUSIONS\u0000Signals may play an important role in the residency application process for family medicine in 2023-2024. While signals are not anticipated to decrease application workload or stress, a signal may be an important mechanism for a specific applicant to distinguish themselves with a program.","PeriodicalId":50456,"journal":{"name":"Family Medicine","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140710048","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}

引用次数: 0