PRiMER (Leawood, Kan.)最新文献

{"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":"<p><strong>Introduction: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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).</p><p><strong>Conclusion: </strong>\"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.</p>","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}

{"title":"Leveraging Social Media for Recruiting Community Preceptors in Medical Education.","authors":"Kamna Bansal, Shruti Varadarajan","doi":"10.22454/PRiMER.2024.345198","DOIUrl":"10.22454/PRiMER.2024.345198","url":null,"abstract":"","PeriodicalId":74494,"journal":{"name":"PRiMER (Leawood, Kan.)","volume":"8 ","pages":"49"},"PeriodicalIF":0.0,"publicationDate":"2024-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11377072/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142141960","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}

{"title":"Primary Care in Correctional Medicine: Redefining Medical Education for Incarcerated Patients.","authors":"Manasicha Wongpaiboon, Jackson L Shelton","doi":"10.22454/PRiMER.2024.254255","DOIUrl":"10.22454/PRiMER.2024.254255","url":null,"abstract":"","PeriodicalId":74494,"journal":{"name":"PRiMER (Leawood, Kan.)","volume":"8 ","pages":"47"},"PeriodicalIF":0.0,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11377071/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142141963","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}

{"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":"<p><strong>Background and objectives: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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 (<i>P</i>=.001).</p><p><strong>Conclusions: </strong>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.</p>","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}

{"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":"<p><strong>Introduction: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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.</p>","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}

{"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":"<p><strong>Introduction: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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.</p>","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}

{"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":"<p><strong>Introduction: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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 (<i>P</i>=.005).</p><p><strong>Conclusions: </strong>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.</p>","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}

{"title":"Peer Review Is Primary: Presentations, Publications, Promotions, and Practice.","authors":"Kendall M Campbell, Edgar Figueroa, Donna Baluchi, José E Rodríguez","doi":"10.22454/PRiMER.2024.148162","DOIUrl":"10.22454/PRiMER.2024.148162","url":null,"abstract":"<p><p>Peer review is primarily thought of as the process used to determine whether manuscripts are published in medical or other academic journals. While a publication may be one outcome of peer review, this article shares a model of 4 Ps to remind faculty of some important additional applications of peer review. The 4 Ps are publication, presentation, promotion, and practice. The medical literature offers few reasons why faculty should get involved in peer review. In this article, we define peer review, illustrate the role of peer review in four important processes, describe how the volume of material to review has changed over time, and share how participation in these processes promotes career advancement. Understanding the peer review process and its benefits can encourage professionals to participate in peer review in any of the four Ps as they recognize the benefits to their discipline and their career.</p>","PeriodicalId":74494,"journal":{"name":"PRiMER (Leawood, Kan.)","volume":"8 ","pages":"42"},"PeriodicalIF":0.0,"publicationDate":"2024-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11377078/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142141961","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}

{"title":"Results of a Needs Assessment for a DEI Workshop for GME Program Coordinators.","authors":"Kate Rowland, Lauren Anderson, Katherine M Wright, Megham Twiss, Jory Eaton, Khalilah Gates","doi":"10.22454/PRiMER.2024.209059","DOIUrl":"10.22454/PRiMER.2024.209059","url":null,"abstract":"<p><strong>Introduction: </strong>Competency in diversity, equity, and inclusion skills is critical for graduate medical education program coordinators. Coordinators contribute to high-level personnel and program management while also providing informal social support to residents. However, little has been reported about program coordinator learning needs, interest, and self-reported skills and attitudes regarding diversity, equity, and inclusion initiatives in graduate medical education. This study sought to describe the characteristics, job tasks, attitudes, and learning needs of program coordinators attending a professional development session about diversity, equity, and inclusion.</p><p><strong>Methods: </strong>Participants registered for a September 2022 program coordinator professional development workshop on diversity, equity, inclusion, and bias were invited to complete an electronic needs assessment prior to the workshop. Items were based on expert opinion and literature review. We performed descriptive and comparative analysis.</p><p><strong>Results: </strong>The response rate was 54% (106/198); 90% (94/104) of respondents identified as female; 42% (44/104) identified as an underrepresented minority. Fifty-seven percent (63/104) received mandatory training on bias while 13% (14/104) were previously trained on bias at a conference specific to the role of a coordinator. Eighty-nine percent (86/104) of coordinators reported having contact with applicants during recruiting; 67% (63/104) offer informal resident evaluations. Most participants agreed it is the coordinator's professional responsibility to confront colleagues who display signs of discrimination toward women (66%; 62/104) or based on cultural/ethnic identity (65%; 61/104).</p><p><strong>Conclusions: </strong>Program coordinators report visible and impactful roles in the residency leadership and management team. Few coordinators have received diversity, equity, and inclusion training related to their complex work in graduate medical education. Future graduate medical education diversity, equity, inclusion, and bias competency programs should specifically include program coordinators.</p>","PeriodicalId":74494,"journal":{"name":"PRiMER (Leawood, Kan.)","volume":"8 ","pages":"39"},"PeriodicalIF":0.0,"publicationDate":"2024-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11377079/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142141964","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}

{"title":"Point-of-Care Ultrasound Track in an Academic Family Medicine Department.","authors":"Benjamin Beduhn, Sebastian Schoneich, William Saunders, Marie Claire O'Dwyer, Scott Kelley, Ryan Tucker, Juana Nicoll Capizzano","doi":"10.22454/PRiMER.2024.363716","DOIUrl":"10.22454/PRiMER.2024.363716","url":null,"abstract":"<p><strong>Introduction: </strong>Point-of-care ultrasound (POCUS) is increasingly being employed in family medicine. Residency tracks can be an effective way to increase mastery in a specific subdiscipline for interested residents, but no studies exist on the implementation of a POCUS track in family medicine. We address this gap in the literature by assessing POCUS use by POCUS track residents compared to non-POCUS track residents and faculty in an academic family medicine department.</p><p><strong>Methods: </strong>We performed a retrospective review of all POCUS scans completed in the first year after implementation of a family medicine residency POCUS track. Scans were analyzed by two reviewers. We compared scan volume and type between POCUS track residents, non-POCUS track residents, and faculty. A blinded quality analysis was performed on each group of scans.</p><p><strong>Results: </strong>A total of 572 scans were completed on 536 patients over 1 year. POCUS track residents scanned significantly more than non-POCUS track residents (mean difference of 72.2, CI 59.1 to 85.4; <i>P</i><.0001). The most common scan types across groups were musculoskeletal and soft tissue. POCUS track residents showed statistically improved scan quality in all scan types, while non-POCUS track residents showed statistical improvement only in soft tissue, shoulder, and abdominal aortic aneurysm scans.</p><p><strong>Conclusions: </strong>This is the first longitudinal study of a novel academic family medicine residency POCUS track. Participation in a POCUS track can increase the number, variety, and quality of scans performed. Our curriculum can be a model for family medicine residency programs that wish to provide robust POCUS training.</p>","PeriodicalId":74494,"journal":{"name":"PRiMER (Leawood, Kan.)","volume":"8 ","pages":"41"},"PeriodicalIF":0.0,"publicationDate":"2024-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11377073/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142141962","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}