PRiMER (Leawood, Kan.)最新文献

{"title":"Call to Action: A Faculty Survey to Inform Future Efforts at Student-Run Clinics.","authors":"Nina Piazza, Alyssa Bruehlman","doi":"10.22454/PRiMER.2024.950821","DOIUrl":"https://doi.org/10.22454/PRiMER.2024.950821","url":null,"abstract":"<p><strong>Introduction: </strong>Existing literature about student-run clinics (SRCs) often focuses on student rather than patient experiences. To begin to gather data on norms and practices at SRCs nationally, this pilot study surveyed faculty leaders from SRCs around the country about metrics such as clinic organization, patient demographics, and care services.</p><p><strong>Methods: </strong>A 38-question survey was distributed via email to members of the Student Run Free Clinic Faculty Association (SRFCFA) in October 2021. All responses were collected electronically via Qualtrics survey software.</p><p><strong>Results: </strong>Most SRCs are held at least once weekly in variable physical locations. All SRCs surveyed use an electronic medical record. Student leadership typically rotates annually. Preceptors skew towards generalists rather than specialists. Clinics have variable patient volumes but see majority uninsured and non-English-speaking patient populations. Responses about consistency of result communication, follow-up visits, referrals to specialty care, and management of high-risk patients were mixed. The majority of respondents did not feel that learner experience was prioritized over patient care.</p><p><strong>Conclusion: </strong>The design and operations of SRCs nationwide is variable and not standardized. There remains a limited understanding of patient experiences and patient-centered outcomes at SRCs, and thus it is difficult to guide best practices. Future efforts to collect patient perspectives and outcomes should be emphasized given the vulnerable populations these clinics serve.</p>","PeriodicalId":74494,"journal":{"name":"PRiMER (Leawood, Kan.)","volume":"8 ","pages":"6"},"PeriodicalIF":0.0,"publicationDate":"2024-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10887400/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139974914","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":"Think-Pair-Share: Promoting Equitable Participation and In-Depth Discussion.","authors":"Amy R Guenther, Cathleen M Abbott","doi":"10.22454/PRiMER.2024.444143","DOIUrl":"https://doi.org/10.22454/PRiMER.2024.444143","url":null,"abstract":"<p><strong>Introduction: </strong>Increasing student participation within the classroom can improve student engagement, the classroom environment, and student learning, and can provide for more diverse perspectives on the content. Think-pair-share (TPS) is an instructional strategy that can be used to promote and support student participation and enhance learning. Our study aimed to investigate the use of this strategy in early medical education.</p><p><strong>Methods: </strong>Using content analysis of video recordings, equity mapping software, and student surveys, we examined the implementation of TPS in three different small groups of first-year medical students. We looked for increased student participation, equity in the distribution of student participation, and quality of discussion as evidence of TPS's effectiveness in promoting student learning.</p><p><strong>Results: </strong>TPS increased student participation and improved the quality of discussion. Additionally, students indicated TPS positively affected their learning, with the \"thinking\" and \"pairing\" time being especially important.</p><p><strong>Conclusions: </strong>In utilizing TPS as an instructional strategy, medical educators can provide a structure that promotes a more equitable distribution of student participation, increased student interaction, and in-depth collaborative dialogue that enhance the overall learning experience.</p>","PeriodicalId":74494,"journal":{"name":"PRiMER (Leawood, Kan.)","volume":"8 ","pages":"7"},"PeriodicalIF":0.0,"publicationDate":"2024-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10887392/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139974917","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":"Longitudinal Antiracism Training for Family Medicine Residency Faculty.","authors":"Charity Lehn, Harriet Huang, Aline Hansen-Guzman, Amelia Challender, Heather Bleacher, Kimberly Wiggins, Cleveland Piggott, Elizabeth Kvach","doi":"10.22454/PRiMER.2023.351932","DOIUrl":"10.22454/PRiMER.2023.351932","url":null,"abstract":"<p><strong>Introduction: </strong>Medical educators have often perpetuated misunderstandings about race-based medicine and at times failed to create safe educational environments for diverse learners who frequently experience mistreatment. It is imperative that family medicine faculty be equipped to recognize and mitigate bias and inequities in our teaching, research, and clinical care.</p><p><strong>Methods: </strong>Our residency formed a diversity, equity, inclusion, and antiracism (DEIA) faculty work group to address the need for faculty training. We developed and administered a 32-item needs assessment survey in 2020 to determine gaps in antiracist knowledge and skills among our faculty members. Over the following year, faculty members designed and implemented a series of faculty training sessions including a half-day faculty retreat to address the highest need areas. We reassessed faculty confidence and skills using a follow-up survey in 2021.</p><p><strong>Results: </strong>Faculty respondents demonstrated increased confidence in their knowledge of various DEIA topics and ability to intervene when observing biased or culturally insensitive behaviors from colleagues. Participants also reported increased confidence in their ability to mitigate bias in their teaching and clinical work.</p><p><strong>Conclusions: </strong>Our longitudinal DEIA faculty training series, embedded into the existing structure of the residency, resulted in improvements in DEIA-related confidence and skills among faculty members. This training model could be adapted to a variety of residency settings as one step toward dismantling racism in medical education and clinical practice.</p>","PeriodicalId":74494,"journal":{"name":"PRiMER (Leawood, Kan.)","volume":"7 ","pages":"40"},"PeriodicalIF":0.0,"publicationDate":"2023-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10751100/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139041008","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":"Impact of Virtual Recruitment on Costs, Time Spent, and Applicant Perspectives Within a Family Medicine Residency Program.","authors":"Kara A Frame, Katherine T Fortenberry, Susan Cochella, Osman Sanyer, Eliza Taylor, Dominik Ose, Kirsten Stoesser","doi":"10.22454/PRiMER.2023.262017","DOIUrl":"10.22454/PRiMER.2023.262017","url":null,"abstract":"<p><strong>Background: </strong>Virtual recruitment for all residency programs was endorsed by the Accreditation Council for Graduate Medical Education (ACGME) for the 2021 and 2022 recruitment seasons. This study assesses the impact of virtual recruitment on cost and outcome in a family medicine residency program.</p><p><strong>Methods: </strong>We assessed program recruitment costs and interview-day time with applicants in one program for the 2019 to 2022 recruitment seasons, and we sent an anonymous survey to interviewed applicants (n=98) for the 2022 match year. In-person interviews were conducted in 2019 and 2020. Virtual interviews were conducted in 2021 and 2022.</p><p><strong>Results: </strong>Program recruitment costs decreased from over $70,000 annually for in-person interview seasons to between $10,000 and $20,000 annually for the virtual interview years. Applicant time with the program on interview days decreased from 515 minutes when held in-person, to 345 minutes when virtual. Applicants expressed that they were generally satisfied with the virtual interview format though their preference for the virtual format was only slightly greater than for in-person interviews (38.6% and 35.1%, respectively); 26.3% of the responding applicants had no preference for either format. During virtual interview years, applicants interviewed at an average of 16.6 programs with 80% indicating that virtual interviews allowed for consideration of more programs.</p><p><strong>Conclusion: </strong>The virtual interview format was associated with decreased interview-day costs for programs and interviewees, and decreased time on interview days for both groups. It allowed applicants to consider more programs.</p>","PeriodicalId":74494,"journal":{"name":"PRiMER (Leawood, Kan.)","volume":"7 ","pages":"38"},"PeriodicalIF":0.0,"publicationDate":"2023-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10751097/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139041007","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":"Using Ultrasound to Augment Exam Skills Among Clerkship Students.","authors":"David Embers, Nicole T Yedlinsky","doi":"10.22454/PRiMER.2023.183911","DOIUrl":"10.22454/PRiMER.2023.183911","url":null,"abstract":"<p><strong>Introduction: </strong>Point-of-care ultrasound (POCUS) is becoming more common as a diagnostic and clinical tool. Some medical schools have incorporated POCUS training in their curriculum. A family medicine clerkship during the third year of undergraduate medical education is appropriate for incorporating musculoskeletal (MSK) education. Musculoskeletal ultrasound (MSKUS) is a potential tool for augmenting this teaching.</p><p><strong>Methods: </strong>Third-year undergraduate family medicine clerkship students were given prework related to ultrasound physics, terminology, and sonographic appearance of MSK structures. This was followed by a 2-hour session in the first week of their clerkship covering the shoulder and knee MSK exams, and incorporated hands-on scanning. Students practiced MSK exams during their 8-week clerkship and POCUS was available in clinic. They were administered a postsession survey to rate the MSKUS curriculum. Objective, structured clinical exam (OSCE) testing, including performance evaluation of the knee examination during the final clerkship week, was compared to prior-year OSCE scores.</p><p><strong>Results: </strong>Third-year medical students felt the use of MSKUS was helpful and enhanced overall understanding of MSK exams. We did not see an improvement in OSCE scores. Students reported a desire for more POCUS training.</p><p><strong>Conclusion: </strong>POCUS is a powerful tool within the clinical and academic setting. We were able to develop a curriculum using MSKUS to augment teaching the shoulder and knee exams to third-year family medicine clerkship students. While we did not see an improvement in OSCE scores evaluating the performance of a knee exam, students reported greater understanding of the exams with the MSKUS instruction added. Students desire more POCUS training in the undergraduate medical curriculum.</p>","PeriodicalId":74494,"journal":{"name":"PRiMER (Leawood, Kan.)","volume":"7 ","pages":"39"},"PeriodicalIF":0.0,"publicationDate":"2023-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10751098/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139041009","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":"Medical Students’ Knowledge and Perceptions of Mpox in a High Incidence Region: Implications for Clinical Preparedness","authors":"Jake Nusynowitz, Lily Jamneshan, Nana Aisha Garba, Marquita Samuels, Prasad Bhoite, Sarah E. Stumbar","doi":"10.22454/primer.2023.120676","DOIUrl":"https://doi.org/10.22454/primer.2023.120676","url":null,"abstract":"Introduction: In August 2022, mpox (formerly “monkeypox”) was declared a public health emergency in the United States, yet there has been little published on medical providers’ knowledge or perceptions of the disease. With one of the highest incidence rates in the United States being in South Florida, our Miami-based medical school aimed to assess students' perceived levels of knowledge and attitudes regarding mpox. Methods: An optional, anonymous survey consisting of multiple choice and Likert-type questions was emailed to all medical students. The first survey was sent out September 1, 2022, after which students received reminders on October 3, 8, and 31, 2022. We analyzed respondents’ perceived knowledge and risk of contracting mpox by comparing responses between heterosexual and LGBTQ+ groups and preclinical and clinical groups. We used Mann-Whitney U or Kruskal Wallis tests for inferential statistical analysis. Results: Of 480 medical students, 168 (35.0%) responded to the survey. Most respondents (88.1%) were not concerned about mpox; 95.2% perceived their personal risk to be moderate or low. LGBTQ+ students were significantly more likely than others to report feeling at risk from mpox. The majority (72.0%) of respondents reported poor perceived knowledge of mpox. There was no significant difference between preclinical and clinical students' reported level of perceived knowledge (P=.0621); 76.2% of respondents were not confident in their ability to recognize mpox symptoms. LGBTQ+ students were significantly more confident in identifying symptoms than others (P=.0201). Conclusion: Medical students feel they lack critical knowledge of mpox and report being unprepared to recognize disease symptoms. The higher level of perceived risk and knowledge among LGBTQ+ students may stem from biases perpetuated by public messaging regarding mpox. These findings highlight the need for integrating education on emerging epidemics into undergraduate medical education to enable students to safely provide high-quality patient care.","PeriodicalId":74494,"journal":{"name":"PRiMER (Leawood, Kan.)","volume":"86 3","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135092589","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond Quality: Redesigning a Quality Conference With a Focus on Health Equity","authors":"Marie Claire O'Dwyer, Mercy Adetoye, Leigh Morrison, Anna McEvoy, Tim Tellez, Kartik Sidhar, Jean Wong, Laura Lee, Karl T. Rew, Thomas Bishop, Jenna B. Greenberg","doi":"10.22454/primer.2023.249832","DOIUrl":"https://doi.org/10.22454/primer.2023.249832","url":null,"abstract":"family physicians, we are uniquely positioned to optimize health outcomes by providing high-quality continuity of care for our patients. Health inequities, de[ned as systematic differences in health outcomes between populations that are “avoidable and unjust” are challenging to address with our patients. Health inequities are driven by both social determinants of health—the conditions in which people are born, grow, live ,work and age","PeriodicalId":74494,"journal":{"name":"PRiMER (Leawood, Kan.)","volume":"16 41","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135973624","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Conducting a Manuscript Peer Review","authors":"Christopher P. Morley, Jacob Prunuske","doi":"10.22454/primer.2023.674484","DOIUrl":"https://doi.org/10.22454/primer.2023.674484","url":null,"abstract":"","PeriodicalId":74494,"journal":{"name":"PRiMER (Leawood, Kan.)","volume":"77 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136012747","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Writing an External Letter of Review for Promotion","authors":"Suzanne Minor, Sarah E. Stumbar, Joanna Drowos, Jennifer Hartmark-Hill, Victoria Hayes, Jeanne Cawse-Lucas, Parvathi Perumareddi","doi":"10.22454/primer.2023.447836","DOIUrl":"https://doi.org/10.22454/primer.2023.447836","url":null,"abstract":"Academic promotion, representing achievement of a level of distinction in one’s body of work, is an honorable accomplishment in a faculty member’s career. External letters of review written by faculty at higher ranks are a critical component of the promotion portfolio. We discuss key considerations for writing external letters. These considerations can be used to mentor this skill for less experienced letter writers. We also highlight how professional societies can aid faculty in developing and strengthening writing and mentoring capabilities for this vital task.","PeriodicalId":74494,"journal":{"name":"PRiMER (Leawood, Kan.)","volume":"217 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136293438","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparing Resident and Program Director Perspectives on Wellness Curricula: A CERA Study.","authors":"Lauren Penwell-Waines, Ambar Kulshreshtha, Julie Brennan, Katherine Bergs, Lindsay Fazio, Aaron Grace, Mari Ricker, Amy Romain, Jill Schneiderhan, Peter F Cronholm","doi":"10.22454/PRiMER.2023.300982","DOIUrl":"10.22454/PRiMER.2023.300982","url":null,"abstract":"<p><strong>Introduction: </strong>Mitigating the stress of graduate medical education has been the focus of residency leadership in the United States. This study examined family medicine (FM) resident and program director (PD) satisfaction with current wellness curricula, including perceptions of availability of resources and emphasis on well-being.</p><p><strong>Methods: </strong>The Council of Academic Family Medicine Educational Research Alliance administered online surveys to PDs accredited by the Accreditation Council for Graduate Medical Education, US-based FM residencies, and resident American Academy of Family Physicians members from April to May 2021. The present study included an assessment of wellness curriculum implementation using the Wellness Element Count (WEC), a satisfaction rating with wellness programming, and a single question assessing perceived changes in emphasis on wellness during COVID-19.</p><p><strong>Results: </strong>A total of 242 residents (5% response rate) and 263 PDs (42% response rate) completed the survey. Residents reported lower WEC indicators compared to PDs (<i>P</i><.001). Overall, 67.8% of resident respondents were satisfied with their program's wellness efforts, compared to 89.3% of PDs ( <i>P</i><.001). Perceived emphasis on wellness curricula in the program was associated with greater resident satisfaction (OR=2.75, <i>P</i><.05); less emphasis on wellness was associated with less resident satisfaction (OR=0.15, <i>P</i><.001).</p><p><strong>Conclusions: </strong>Residents reported overall lower perceived availability and satisfaction with program wellness efforts compared to PDs, suggesting a disparity between perspectives. Ongoing efforts should be directed at encouraging use of available wellness resources and supporting a culture of well-being.</p>","PeriodicalId":74494,"journal":{"name":"PRiMER (Leawood, Kan.)","volume":"7 ","pages":"33"},"PeriodicalIF":0.0,"publicationDate":"2023-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10544636/pdf/primer-7-33.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41180654","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}