PRiMER (Leawood, Kan.)最新文献_第2页

National Family Medicine Residency Outcomes Project Methodology. 国家全科住院医师培训成果项目方法。

PRiMER (Leawood, Kan.) Pub Date : 2024-09-24 eCollection Date: 2024-01-01 DOI: 10.22454/PRiMER.2024.588860

Wendy B Barr, Lars E Peterson, Sarah Fleischer, Dean A Seehusen

{"title":"National Family Medicine Residency Outcomes Project Methodology.","authors":"Wendy B Barr, Lars E Peterson, Sarah Fleischer, Dean A Seehusen","doi":"10.22454/PRiMER.2024.588860","DOIUrl":"10.22454/PRiMER.2024.588860","url":null,"abstract":"Introduction: Multiple specialties including family medicine are engaging in a robust re-envisioning of residency training that culminates with new program requirements. No large-scale prospective studies linking curriculum to graduate outcomes have been available to guide the new standards. This report describes the methodology including representativeness and response rates of the Council of Academic Family Medicine Education Research Alliance (CERA) and American Board of Family Medicine (ABFM) National Family Medicine Residency Outcomes Project (FM-ROP).Methods: FM-ROP is a prospective cohort study that followed ABFM diplomates who graduated in 2018 into practice. A CERA survey conducted in 2018 measured residency exposures as reported by program directors. We measured graduate outcomes through the 2021 National Graduate Survey (NGS). We compared participant demographics to available demographics of the sample frame using bivariate analysis.Results: The response rate for the 2018 CERA program director survey was 43.3% (254/587). The response rate to the 2021 NGS was 45.1% (1,623/3,596). After merging the two data sets, our final analytic sample included 779 graduates from 211 residencies. Graduates from larger programs and those with an MD degree were more likely to be included in the matched data set.Conclusion: This study is the first national cohort study in any specialty that follows residency graduates by assessing program director perspectives on their training, including program structures and processes, and then linking this to graduate data on practice patterns and outcomes. The methodology of this project could be used in other specialties to help guide residency redesign.","PeriodicalId":74494,"journal":{"name":"PRiMER (Leawood, Kan.)","volume":"8 ","pages":"52"},"PeriodicalIF":0.0,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11578397/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142683818","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Artificial Intelligence-Prompted Explanations of Common Primary Care Diagnoses. 人工智能提示的常见初级保健诊断解释。

PRiMER (Leawood, Kan.) Pub Date : 2024-09-17 eCollection Date: 2024-01-01 DOI: 10.22454/PRiMER.2024.916089

Mafaz Kattih, Max Bressler, Logan R Smith, Anthony Schinelli, Rahul Mhaskar, Karim Hanna

{"title":"Artificial Intelligence-Prompted Explanations of Common Primary Care Diagnoses.","authors":"Mafaz Kattih, Max Bressler, Logan R Smith, Anthony Schinelli, Rahul Mhaskar, Karim Hanna","doi":"10.22454/PRiMER.2024.916089","DOIUrl":"10.22454/PRiMER.2024.916089","url":null,"abstract":"Background: Artificial intelligence (AI)-generated explanations about medical topics may be clearer and more accessible than traditional evidence-based sources, enhancing patient understanding and autonomy. We evaluated different AI explanations for patients about common diagnoses to aid in patient care.Methods: We prompted ChatGPT 3.5, Google Bard, HuggingChat, and Claude 2 separately to generate a short patient education paragraph about seven common diagnoses. We used the Flesch Reading Ease (FRE) and Flesch-Kincaid Grade Level (FKGL) to evaluate the readability and grade level of the responses. We used the Agency for Healthcare Research and Quality's Patient Education Materials Assessment Tool (PEMAT) grading rubric to evaluate the understandability and actionability of responses.Results: Claude 2 demonstrated scores of FRE (67.0), FKGL (7.4), and PEMAT, 69% for understandability, and 34% for actionability. ChatGPT scores were FRE (58.5), FKGL (9.3), PEMAT (69% and 31%, respectively). Google Bard scores were FRE (50.1), FKGL (9.9), PEMAT (52% and 23%). HuggingChat scores were FRE (48.7) and FKGL (11.6), PEMAT (57% and 29%).Conclusion: Claude 2 and ChatGPT demonstrated superior readability and understandability, but practical application and patient outcomes need further exploration. This study is limited by the rapid development of these tools with newer improved models replacing the older ones. Additionally, the accuracy and clarity of AI responses is based on that of the user-generated response. The PEMAT grading rubric is also mainly used for patient information leaflets that include visual aids and may contain subjective evaluations.","PeriodicalId":74494,"journal":{"name":"PRiMER (Leawood, Kan.)","volume":"8 ","pages":"51"},"PeriodicalIF":0.0,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11578395/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142683766","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","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 Clerkship Directors' Remediation of Faculty With Mistreatment Concerns: Results From a CERA Clerkship Directors Survey. 全科实习主任对存在虐待问题的教师的补救措施：来自 CERA 实习主任调查的结果。

PRiMER (Leawood, Kan.) Pub Date : 2024-09-05 eCollection Date: 2024-01-01 DOI: 10.22454/PRiMER.2024.989728

William Y Huang, Yuanyuan Zhou, Jonnae Atkinson, Kenneth Barning, Misbah Keen, Joel Purkiss

{"title":"Family Medicine Clerkship Directors' Remediation of Faculty With Mistreatment Concerns: Results From a CERA Clerkship Directors Survey.","authors":"William Y Huang, Yuanyuan Zhou, Jonnae Atkinson, Kenneth Barning, Misbah Keen, Joel Purkiss","doi":"10.22454/PRiMER.2024.989728","DOIUrl":"10.22454/PRiMER.2024.989728","url":null,"abstract":"Introduction: Little is known about how frequently family medicine (FM) clerkship directors remediate faculty with student mistreatment concerns and their comfort level in performing the remediations. In this exploratory study, we investigated factors associated with the number of faculty remediated for student mistreatment concerns by FM clerkship directors and the comfort level of FM clerkship directors in remediating these faculty.Methods: Data were collected as part of the 2022 Council of Academic Family Medicine Educational Research Alliance (CERA) survey of FM clerkship directors. FM clerkship directors provided responses on how frequently they remediated faculty with mistreatment concerns and their comfort level in performing remediations.Results: Ninety-four of 159 FM clerkship directors (59.1%) responded to the survey. FM clerkship directors remediated more community faculty than employed faculty (P<.001). FM clerkship directors at schools where a larger percentage of students spent at least half of their rotation with a community faculty (P=.002) or where there were a higher percentage of paid community faculty (P=.004) were more likely to have remediated community faculty. FM clerkship directors reported more comfort in remediating employed faculty compared to community faculty (P=.048). FM clerkship directors with access to a formal mechanism for remediation (P=.016) or having a better adequacy in number of precepting sites (P=.041) reported higher comfort levels in remediating community faculty.Conclusions: Our study identified factors associated with remediating family medicine clerkship faculty with mistreatment concerns. Additional research is needed to determine the most effective strategies to remediate faculty with mistreatment concerns.","PeriodicalId":74494,"journal":{"name":"PRiMER (Leawood, Kan.)","volume":"8 ","pages":"48"},"PeriodicalIF":0.0,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11578396/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142683770","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A Student-Led Patient Navigation Program: Assessing the Goals of Individuals Experiencing Homelessness. 学生主导的病人导航计划：评估无家可归者的目标。

PRiMER (Leawood, Kan.) Pub Date : 2024-09-05 eCollection Date: 2024-01-01 DOI: 10.22454/PRiMER.2024.408604

Shannon Teaw, Drupad Annapureddy, Ethan Wang, Shelley Speed, Nora Gimpel

{"title":"A Student-Led Patient Navigation Program: Assessing the Goals of Individuals Experiencing Homelessness.","authors":"Shannon Teaw, Drupad Annapureddy, Ethan Wang, Shelley Speed, Nora Gimpel","doi":"10.22454/PRiMER.2024.408604","DOIUrl":"10.22454/PRiMER.2024.408604","url":null,"abstract":"Introduction: Homeless populations face higher barriers to health care access. A student-led patient navigation program (PNP) was established pairing groups of trained medical students, who serve as patient navigators, together with an individual experiencing homelessness (IEH) to develop goals tailored to each IEH's needs. The purpose of this study was to collect data pertaining to the goals of IEH centered on the social determinants of health (SDH) domains.Methods: IEH were invited to voluntarily participate in the program and patient navigators met with IEH weekly for a 12-week period to guide and connect patients with resources to accomplish the patients' goals. Manual review of each IEH's goals was performed and categorized according to SDH domains and further categorized into subdomains using qualitative content analysis.Results: A total of 86 goals were categorized for 19 participants, with an average of 4.5 goals per IEH. The most common goals were related to \"economic stability\" (n=34), followed by \"health care access\" (n=25), \"neighborhood and built environment\" (n=11), \"social and community context\" (n=10), and lastly \"education access\" (n=6). The most common goals based on subcategories were related to \"housing\" (n=13) and \"employment and career development\" (n=10).Conclusion: \"Economic stability\" and \"health care access-related\" goals were the most common among IEH participants. Subcategorization analyses revealed that \"obtaining identification documentation (ID)\" was a common goal that did not easily fit into the Centers for Disease Control and Prevention's (CDC)-defined categories but provided insight into necessary services. Characterizing the goals of IEH permits the development of targeted resources to assist IEH and bridge health care accessibility gaps.","PeriodicalId":74494,"journal":{"name":"PRiMER (Leawood, Kan.)","volume":"8 ","pages":"50"},"PeriodicalIF":0.0,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11578398/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142683748","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Leveraging Social Media for Recruiting Community Preceptors in Medical Education. 在医学教育中利用社交媒体招募社区实习生。

PRiMER (Leawood, Kan.) Pub Date : 2024-08-23 eCollection Date: 2024-01-01 DOI: 10.22454/PRiMER.2024.345198

Kamna Bansal, Shruti Varadarajan

引用次数: 0

Primary Care in Correctional Medicine: Redefining Medical Education for Incarcerated Patients. 矫正医学中的初级保健：重新定义针对被监禁病人的医学教育。

PRiMER (Leawood, Kan.) Pub Date : 2024-08-22 eCollection Date: 2024-01-01 DOI: 10.22454/PRiMER.2024.254255

Manasicha Wongpaiboon, Jackson L Shelton

引用次数: 0

Departure Decisions: Exit Survey of Family Medicine Residency Directors. 离职决定：全科住院医生主任离职调查。

PRiMER (Leawood, Kan.) Pub Date : 2024-08-21 eCollection Date: 2024-01-01 DOI: 10.22454/PRiMER.2024.770282

Douglas H Fernald, Christina M Hester, Steven R Brown

{"title":"Departure Decisions: Exit Survey of Family Medicine Residency Directors.","authors":"Douglas H Fernald, Christina M Hester, Steven R Brown","doi":"10.22454/PRiMER.2024.770282","DOIUrl":"10.22454/PRiMER.2024.770282","url":null,"abstract":"Background and objectives: Program director (PD) tenure, continuity, and stability may enhance residency program quality, yet many PDs do not stay long in their positions. No prior study has taken a comprehensive census of departing PDs to determine reasons for leaving the role. This study aimed to survey all exiting family medicine (FM) PDs to identify decision factors contributing to their departure.Methods: From October 2021 to October 2022, we sent a web-based exit survey to all departing FM PDs. The survey asked departing PDs to rate the strength of 36 factors in the decision to exit the PD role in terms of job satisfaction, accomplishments, career choices, workload, preparation, expectations, and support. We used the Fisher exact test to assess all 36 decision factors and PD characteristics for significant associations with shorter or longer PD tenures.Results: PDs submitted 73 surveys out of 109 invitations (67.0% response). We analyzed 68 with complete data. The median PD tenure was 5.6 years (mean 6.9 years). Most respondents (66/68, 97.1%) identified three or more strong factors in their decision to leave. The strongest factors reflected stable residency programs, an established succession plan, a desire for more personal/family time, and a sense that the time was right. PDs with tenures longer than 3 years were more likely to have completed the National Institute for Program Director Development (P=.001).Conclusions: PDs leave the position for multiple reasons, often positive, and not necessarily due to lack of support and preparation. Further exploration of decision factors may inform strategies to support PDs in their positions.","PeriodicalId":74494,"journal":{"name":"PRiMER (Leawood, Kan.)","volume":"8 ","pages":"46"},"PeriodicalIF":0.0,"publicationDate":"2024-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11377080/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142141956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Epley Maneuver Skills in Primary Care: 3D Semicircular Canal Models for Self-Learning. 初级保健中的 Epley 操作技能：用于自学的 3D 半规管模型。

PRiMER (Leawood, Kan.) Pub Date : 2024-08-14 eCollection Date: 2024-01-01 DOI: 10.22454/PRiMER.2024.576211

Keiichiro Kita, Kazuhiro Watanabe, Mayuko Saito, Maiko Kuroiwa

{"title":"Epley Maneuver Skills in Primary Care: 3D Semicircular Canal Models for Self-Learning.","authors":"Keiichiro Kita, Kazuhiro Watanabe, Mayuko Saito, Maiko Kuroiwa","doi":"10.22454/PRiMER.2024.576211","DOIUrl":"10.22454/PRiMER.2024.576211","url":null,"abstract":"Introduction: Posterior canal-type benign paroxysmal positional vertigo (BPPV) is commonly treated using the Epley maneuver; however, the maneuver's use in primary care is limited by insufficient expertise. Therefore, this study aimed to evaluate the efficacy of a three-dimensional (3D) semicircular canal model as a self-learning tool for primary care physicians to improve their Epley maneuver technique.Methods: Thirty-one participants (18 family physicians, seven residents, and six medical students) performed the Dix-Hallpike maneuver on a nursing manikin, followed by the Epley maneuver on the covered 3D models before and after a 5-minute self-study period with the uncovered 3D model. We measured the number of moved beads from posterior canal into the utricle of the 3D model, time spent on the Epley maneuver, and head suspension angle of the Dix-Hallpike maneuver.Results: Preintervention performance was divided into a skilled group (n=7) that could move almost all the beads and an unskilled group (n=24) that could move a few beads. Postintervention, the unskilled group members significantly improved their skill: The average moved beads increased from 0.35 to 8.00, maneuver time from 26.1 to 35.8 seconds, and head suspension angle from 10.3° to 16.4°. Most participants recognized the importance of correct positioning and spent adequate time.Conclusions: The 3D model was effective as a self-learning tool for improving Epley maneuver performance, particularly for less experienced practitioners. This approach could bridge the gap between evidence and practice in primary care for BPPV treatment, enhancing patient outcomes and reducing the need for specialist referrals.","PeriodicalId":74494,"journal":{"name":"PRiMER (Leawood, Kan.)","volume":"8 ","pages":"45"},"PeriodicalIF":0.0,"publicationDate":"2024-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11377077/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142141959","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Emergency Department Versus Primary Care Use: A Patient Perspective. 急诊科与初级保健的使用：患者视角。

PRiMER (Leawood, Kan.) Pub Date : 2024-08-12 eCollection Date: 2024-01-01 DOI: 10.22454/PRiMER.2024.526921

Natasha Wu, Jason R Woloski

{"title":"Emergency Department Versus Primary Care Use: A Patient Perspective.","authors":"Natasha Wu, Jason R Woloski","doi":"10.22454/PRiMER.2024.526921","DOIUrl":"10.22454/PRiMER.2024.526921","url":null,"abstract":"Introduction: When faced with an acute illness, patients routinely make the decision of whether to present to their primary care physician (PCP) or the emergency department (ED). While the ED is known to be a high-cost component of the health care system, many ED visits include nonurgent ailments that could easily be treated within the medical home/primary care office. Particularly for patients who have an established PCP, the factors driving a preference for ED use remain poorly understood. The purpose of this study was to better understand patient motivation for visiting the ED rather than the PCP office.Methods: This observational study aimed to take a qualitative look at the patient population using a health system ED in the city of Wilkes Barre, PA, from December 2021 to March 2022. We conducted 30 interviews of patients who recently visited the ED and analyzed the responses for recurring themes.Results: Major themes included the benefit of the PCP-patient relationship, patients' preference for multiple sources of medical guidance, patients' subjectively justifying their symptoms as emergent, seeking emergent care despite perception of higher cost, and factoring in time spent at a health care facility waiting for answers.Conclusions: This study contributes to further understanding of the values that drive ED use by using patient voice as a powerful tool to understand communities and local trends, which will allow health care systems to adapt and personalize protocols to their specific population.","PeriodicalId":74494,"journal":{"name":"PRiMER (Leawood, Kan.)","volume":"8 ","pages":"44"},"PeriodicalIF":0.0,"publicationDate":"2024-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11377075/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142141958","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Efforts to Reduce Bias in Clerkship Evaluations: A CERA Study. 努力减少实习评估中的偏见：CERA 研究。

PRiMER (Leawood, Kan.) Pub Date : 2024-08-05 eCollection Date: 2024-01-01 DOI: 10.22454/PRiMER.2024.662375

Nina Piazza, Mechelle Sanders, Gerardo Moreno, Elizabeth Brown

{"title":"Efforts to Reduce Bias in Clerkship Evaluations: A CERA Study.","authors":"Nina Piazza, Mechelle Sanders, Gerardo Moreno, Elizabeth Brown","doi":"10.22454/PRiMER.2024.662375","DOIUrl":"10.22454/PRiMER.2024.662375","url":null,"abstract":"Introduction: As the number of medical students who identify as underrepresented in medicine (URiM) increases, the disparities related to gender and URiM status persist. This study examines the current initiatives within family medicine clerkships to reduce bias in evaluations.Methods: Our 10-item survey was included as a module in the 2022 Council of Academic Family Medicine Educational Research Alliance national survey of family medicine clerkship directors. Our survey questions asked about whether programs had strategies to reduce bias in student evaluations, antiracism initiatives, perceptions on effectiveness of the initiatives, and type and cadence of faculty development on evaluations for preceptors.Results: The overall response rate for the survey was 59.12% (94/159); all respondents completed our module. Seventy percent said they had implemented strategies to reduce bias in evaluations, 60% felt these were effective, and 80% felt that reducing bias in evaluations was a priority. The majority, 89/91(95%), indicated that their medical schools had a current social justice, diversity, or antiracism initiative. We identified a positive association between specific antibias medical school initiatives and clerkship directors undertaking practices to reduce bias in evaluations (P=.005).Conclusions: Most programs had implemented strategies to reduce bias and felt that doing so was a priority. Community-based preceptors were less likely to have faculty development around reducing bias compared to those in academics. Further improvements may need to prioritize including community preceptors in educational efforts to reduce bias.","PeriodicalId":74494,"journal":{"name":"PRiMER (Leawood, Kan.)","volume":"8 ","pages":"43"},"PeriodicalIF":0.0,"publicationDate":"2024-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11377076/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142141957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0