PRiMER (Leawood, Kan.)最新文献

{"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}

{"title":"Impact of an Interprofessional HIV Quality Improvement Team on Patient Care and Resident Learning Opportunities.","authors":"Marilyn K Sauk,&nbsp;Kento Sonoda,&nbsp;Carly T Gabriel,&nbsp;Akruti Patel,&nbsp;Cynthia L Salter,&nbsp;Cara R McAnaney,&nbsp;Stephanie L Ballard","doi":"10.22454/PRiMER.2023.691851","DOIUrl":"https://doi.org/10.22454/PRiMER.2023.691851","url":null,"abstract":"<p><strong>Introduction: </strong>Although human immunodeficiency virus (HIV) care is a recommended competency for family medicine training, many programs report a lack of HIV expertise among faculty. After the departure of faculty with HIV care experience, an interprofessional HIV quality improvement team (HIV-QIT) of physicians and pharmacists aimed to maintain on-site HIV care and retain learning opportunities for residents, using process improvement and panel reviews with a remote HIV specialist faculty member.</p><p><strong>Methods: </strong>This study reports on a multicycle quality improvement pilot project with pre- and postintervention chart reviews between December 2019 and May 2021. All patients received primary care and HIV-QIT chart reviews on-site. We compared patients with integrated HIV care on-site to those receiving external HIV specialty care. Primary outcomes included virologic suppression, CD4 count ≥200 cells/mm³, and adherence to guideline-recommended HIV care. In cycle 1 (January-June 2020), the HIV-QIT reviewed patient charts and sent guideline-based recommendations to physicians. In cycle 2 (July 2020-May 2021), the HIV-QIT implemented several HIV-specific processes, including decision support updates, note templates, order sets, and reference materials. Sustained process improvements included HIV panel chart audits every 3 to 6 months and subsequent provider education.</p><p><strong>Results: </strong>Of 29 patients, more than half (55%, n=16) received integrated HIV care at the primary care site. We found no significant difference in care quality measures between primary and specialty care. Barriers to care completion included missed or canceled follow-up visits, on-site phlebotomy service closures, and declined HIV services.</p><p><strong>Conclusions: </strong>The HIV-QIT maintained on-site HIV treatment and retained experiential learning opportunities through process improvement and specialist-supported care recommendations to primary care physicians.</p>","PeriodicalId":74494,"journal":{"name":"PRiMER (Leawood, Kan.)","volume":"7 ","pages":"32"},"PeriodicalIF":0.0,"publicationDate":"2023-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10544635/pdf/primer-7-32.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41159519","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":"Implementation of a Multidisciplinary Medication Refill Protocol.","authors":"Samia Khan,&nbsp;Jessica J F Kram,&nbsp;Dennis J Baumgardner,&nbsp;Amanda G Sessions,&nbsp;Patrick Foss,&nbsp;Carl Bellinger,&nbsp;Fabiana Kotovicz","doi":"10.22454/PRiMER.2023.418724","DOIUrl":"https://doi.org/10.22454/PRiMER.2023.418724","url":null,"abstract":"<p><strong>Introduction: </strong>Primary care clinicians spend significant time managing nonvisit activities, including processing of requests for prescription renewal. Delays in processing refills may lead to patient dissatisfaction and impact provider productivity. Having nonclinicians process refills can be more efficient and time-saving. We aimed to evaluate the use of a multidisciplinary medication refill protocol to decrease the time to complete refill requests.</p><p><strong>Methods: </strong>We implemented nursing<b>-</b>driven management of refill requests within two family medicine residency clinics in Milwaukee, Wisconsin (Phase 1: single clinic implementation [March 2017-June 2019]; Phase 2: added second clinic prepandemic [June 2019-March 2020] and postpandemic [April 2020-December 2020]). The multidisciplinary refill protocol was created by faculty, residents, pharmacy, and nursing. Data were collected using electronic health record time stamps to determine when refill requests were initiated and filled by faculty, residents, and nurses. We used Mood's median test to compare the median time for medication refill completion. We used Levene's test to test for equal variance surrounding the median of each caregiver group. We used Fisher's exact test or χ² test with Yates' correction for 2×2 contingency tables.</p><p><strong>Results: </strong>In both phases, we identified a significant reduction in median time to refill completion ( <i>P</i><.001) and variability of time to refill completion ( <i>P</i><.001). Notably, in Phase 1, reduction in median refill time was most apparent among residents (383 vs 79 min postimplementation); and in Phase 2, the percentage of refills completed within 48 hours significantly increased between the pre-COVID-19 and COVID-19 pandemic among faculty and nursing in Clinic 1 and residents and faculty in Clinic 2 (all <i>P</i>'s<.001).</p><p><strong>Conclusions: </strong>Implementation of a multidisciplinary refill protocol significantly improved time and predictability of refill completion in both phases.</p>","PeriodicalId":74494,"journal":{"name":"PRiMER (Leawood, Kan.)","volume":"7 ","pages":"31"},"PeriodicalIF":0.0,"publicationDate":"2023-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10544644/pdf/primer-7-31.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41107789","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":"Protocol for the 2023 CERA Clerkship Director Survey.","authors":"Amanda Kost,&nbsp;Miranda A Moore,&nbsp;Tiffany Ho,&nbsp;Ray Biggs","doi":"10.22454/PRiMER.2023.238868","DOIUrl":"https://doi.org/10.22454/PRiMER.2023.238868","url":null,"abstract":"<p><strong>Introduction: </strong>CERA, the Council of Academic Family Medicine Educational Research Alliance, is a unique collaboration between multiple family medicine organizations to conduct omnibus surveys of distinct groups within family medicine. CERA's vision is to support excellence in family medicine educational research and improve research skills in family medicine. This paper describes the methods of the 2023 Clerkship Directory Survey and presents the demographic results of survey respondents.</p><p><strong>Methods: </strong>CERA's call for proposals for the annual Clerkship Directory Survey opened from January 2023 to February 2023. Five topics were selected, and authors of the selected proposals had a mentor assigned to their project. The survey was sent to Clerkship Directors via SurveyMonkey (Momentive, Inc) on May 30, 2023 and responses were collected through June 30, 2023. χ² tests were used for descriptive analysis.</p><p><strong>Results: </strong>The survey was initially sent to 179 potential respondents but after receiving updated clerkship information, the final pool size was 169 (163 United States, 16 Canada). Ninety-six clerkship directors completed the survey, with a response rate of 56.80% (96/169). The demographic data of potential clerkship director respondents were compared with the demographic data of actual respondents. There were no significant difference in demographic data including location, gender, race/ethnicity and underrepresented in medicine status.</p><p><strong>Discussion: </strong>This paper describes the methods of the 2023 CERA Clerkship Directory Survey and shows that survey respondents are representative of clerkship directors. Authors of the five accepted survey topics are responsible for publishing their study findings.</p>","PeriodicalId":74494,"journal":{"name":"PRiMER (Leawood, Kan.)","volume":"7 ","pages":"30"},"PeriodicalIF":0.0,"publicationDate":"2023-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10544638/pdf/primer-7-30.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41159573","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}