PRiMER (Leawood, Kan.)最新文献

{"title":"Evaluating Diabetes Group Medical Visits in a Family Medicine Residency Program.","authors":"Elfie Wegner,&nbsp;Adonis Cheng,&nbsp;Christina Johnson,&nbsp;Antonia Carbone,&nbsp;Nick Florio,&nbsp;Judy C Washington","doi":"10.22454/PRiMER.2023.128268","DOIUrl":"https://doi.org/10.22454/PRiMER.2023.128268","url":null,"abstract":"<p><strong>Background: </strong>Group medical visits (GMV) have been shown to improve metrics in patients with type 2 diabetes mellitus (DM). Overlook Family Medicine, a teaching residency program, anticipated that medical residents trained in the GMV model of care by interdisciplinary team members may improve cholesterol, HbA1C, BMI, and blood pressure in patients. The objective of this study was to compare metrics between group 1: GMV patients with DM whose primary care provider (PCP) was an attending physician/nurse practitioner (NP) and group 2: GMV patients with DM whose PCP was a family medicine (FM) medical resident receiving GMV training. We seek to provide guidance on implementation of GMV in residency teaching practices.</p><p><strong>Methods: </strong>We performed a retrospective analysis to evaluate total cholesterol, LDL, HDL, TG, BMI, HbA1C, and BP in GMV patients between 2015-2018. We used a <i>t</i> test to compare outcomes between the two groups. Diabetes training was provided to family medicine residents by an interdisciplinary team.</p><p><strong>Results: </strong>There were 113 patients enrolled in the study: 53 in group 1 and 60 in group 2. There was a statistically significant decrease in LDL and triglycerides, and an increase in HDL in group 2 (<i>P</i><.05). There was a clinically significant decrease in HbA1C in group 2 (-0.56, <i>P</i>=.0622).</p><p><strong>Conclusion: </strong>Sustainability of GMV can be achieved with a champion diabetes education specialist. Interdisciplinary team members are integral in training residents and addressing patients' barriers. GMV training should be incorporated into family medicine residency programs to improve metrics for patients with diabetes. FM residents who received interdisciplinary training had improved metrics in GMV patients compared to patients whose providers did not. Therefore, GMV training should be incorporated into family medicine residency programs to improve metrics for patients with diabetes.</p>","PeriodicalId":74494,"journal":{"name":"PRiMER (Leawood, Kan.)","volume":"7 ","pages":"128268"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9957450/pdf/primer-7-2.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10793420","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":"Virtual Recruitment Effects on Matched Residents in Family Medicine","authors":"Zakary Newberry, Karl Clebak, Joseph Wiedemer, Jessica Parascando, Alexis Reedy-Cooper, Robert Lennon, Huamei Dong","doi":"10.1370/afm.21.s1.4423","DOIUrl":"https://doi.org/10.1370/afm.21.s1.4423","url":null,"abstract":"","PeriodicalId":74494,"journal":{"name":"PRiMER (Leawood, Kan.)","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66697859","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":"Current Trends in Intra-articular Knee Injections Among Family Physicians.","authors":"Brittney J Warren,&nbsp;Jeremy L Fleeks,&nbsp;Namita Bhardwaj","doi":"10.22454/PRiMER.2023.286520","DOIUrl":"https://doi.org/10.22454/PRiMER.2023.286520","url":null,"abstract":"<p><strong>Introduction: </strong>Family physicians use a variety of medications and techniques to perform intra-articular knee injections in the treatment of knee osteoarthritis. Currently, there is no consensus in the literature among the various specialties that perform joint injections for osteoarthritis of the knee regarding frequency of injections and injectate. The purpose of this study is to examine (1) the types of intra-articular knee injections used by family physicians for arthritis, (2) the most commonly used injectate, (3) the procedural approach, and (4) the maximum number of times the majority of family physicians would inject a single knee. Our study provides a descriptive epidemiology of current knee injection practices in the United States among family physicians.</p><p><strong>Methods: </strong>Surveys were emailed to family physicians. We evaluated and analyzed responses.</p><p><strong>Results: </strong>We received 360 responses, of which 317 family physicians indicated using intra-articular knee injections for pain. The majority (99%) used intra-articular injection steroid therapy in the treatment of knee osteoarthritis. About half (57.4%) of the family physicians would inject the same knee between one to five times.</p><p><strong>Conclusion: </strong>This study provides an overview of current practices in intra-articular injections among family physicians in the United States and provides important information regarding injection practices. Given the lack of consensus and that current practice contradicts evidence in the literature, consideration should be given among all specialties who perform joint injections to create evidence-based clinical practice guidelines to optimize patient care.</p>","PeriodicalId":74494,"journal":{"name":"PRiMER (Leawood, Kan.)","volume":"7 ","pages":"9"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10121022/pdf/primer-7-9.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9387828","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":"A Novel Curricular Approach to Teach Quality Improvement and Health Disparities in a Family Medicine Clerkship.","authors":"Maria Syl de la Cruz, Allison R Casola, Kelsey Smith, Samantha Kelly, Eva Bernstein, Erin L Kelly","doi":"10.22454/PRiMER.2022.512327","DOIUrl":"10.22454/PRiMER.2022.512327","url":null,"abstract":"<p><strong>Background and objectives: </strong>Medical schools must integrate educational curricula that teach how to apply quality improvement principles to improve care for vulnerable populations. In this report, we describe the development, implementation, and evaluation of a combined quality improvement (QI) and health disparities curriculum for third-year family medicine clerkship students.</p><p><strong>Methods: </strong>After conducting an educational needs assessment, we developed a health disparities curriculum focused on QI principles for the family medicine clerkship. From November 2019 through August 2021, third-year medical students (N=395) completed the curriculum. The curriculum was delivered in an asynchronous online format, followed by a small group collaboration project to design and present a QI intervention through process mapping. Students also completed an individual reflection assignment that focused on care for vulnerable populations. Pre- and post assessment questions were administered on Qualtrics, after review by the clerkship director, research faculty and staff, and content experts for content and item validity. We analyzed quantitative data using SPSS version 27 software and used paired <i>t</i> tests for pre/post comparisons.</p><p><strong>Results: </strong>In total, 392 students completed the preassessment survey, 395 students completed the postassessment surveys, and 341 had matching study identifiers. Pre-to-post assessment survey evaluations showed statistically significant changes for nine out of nine QI knowledge questions (<i>P</i><.001), knowledge regarding a community health needs assessment (<i>P</i><.001), and knowledge about caring for vulnerable populations (homeless, veterans, immigrants/refugees; <i>P</i><.001).</p><p><strong>Conclusions: </strong>Preliminary evaluation of a combined QI and health disparities curriculum shows improvement in students' self-reported knowledge of use of a community health needs assessment, QI principles, and care for vulnerable populations.</p>","PeriodicalId":74494,"journal":{"name":"PRiMER (Leawood, Kan.)","volume":"6 ","pages":"512327"},"PeriodicalIF":0.0,"publicationDate":"2022-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9829005/pdf/primer-6-41.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9072684","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":"Assessing the Factors That Influence Medical Students' Attitudes Toward Working With Medically Underserved Populations.","authors":"Ashley Herrera,&nbsp;Courtney Johnson,&nbsp;Chelsea Anasi,&nbsp;Casey Ruoying Cai,&nbsp;Shivani Raman,&nbsp;Thanos Rossopoulos,&nbsp;Katherine Cantu,&nbsp;Chance Strenth,&nbsp;Philip G Day,&nbsp;Nora Gimpel","doi":"10.22454/PRiMER.2022.266345","DOIUrl":"https://doi.org/10.22454/PRiMER.2022.266345","url":null,"abstract":"<p><strong>Introduction: </strong>The needs of medically-underserved populations (MUPs) are consistently outpacing the number of physicians caring for them. Medical students' motivations toward working with MUPs consistently decline as they progress through medical school. Given the shortage of doctors caring for MUPs, the objective of our study was to further investigate factors that influence medical students' motivation to work with MUPs while they progress through their education. By identifying these elements, we hope to recommend identified factors within medical education that support the development of more physicians who care for MUPs.</p><p><strong>Methods: </strong>This cross-sectional study is an assessment of medical students at the University of Texas at Southwestern Medical School (UTSW). The study utilized the Medical Student Attitudes Toward the Underserved (MSATU), a validated survey that assesses medical student motivations toward the provision of medical care to MUPs. Surveys were administered at three time points selected to represent key transition points in medical education.</p><p><strong>Results: </strong>There was no significant difference between MSATU scores among the three time points. MSATU scores were higher among students who identified as female, had higher empathy, had higher value placed on teamwork, and had higher community-centeredness. MSATU scores were also higher among students planning to specialize in primary care compared to students planning to specialize in a non-primary care field (<i>P</i>=.239).</p><p><strong>Conclusion: </strong>This study identifies factors associated with high MSATU scores within UTSW medical education, including female identification, higher empathy score, higher emphasis on teamwork, higher community-centeredness, and plans to practice primary care. Additionally, the results support maintenance of MSATU scores across all three time points. Future research should examine individual-level data to determine whether individual students are maintaining their MSATU scores or if individual fluctuations are neutralized by group changes.</p>","PeriodicalId":74494,"journal":{"name":"PRiMER (Leawood, Kan.)","volume":" ","pages":"35"},"PeriodicalIF":0.0,"publicationDate":"2022-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9484529/pdf/primer-6-35.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33466183","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":"Are Medical Students Adequately Trained to Care for Persons With Disabilities?","authors":"Brianna A Marzolf,&nbsp;Melissa A Plegue,&nbsp;Oluwaferanmi Okanlami,&nbsp;Daniel Meyer,&nbsp;Diane M Harper","doi":"10.22454/PRiMER.2022.878147","DOIUrl":"https://doi.org/10.22454/PRiMER.2022.878147","url":null,"abstract":"<p><strong>Background and objectives: </strong>Insufficient provider training contributes to health care disparities for 61 million Americans with disabilities.2,4 This study examines medical students' perceptions of their disability training and the perceived effect training has on students' preparedness to care for people with disabilities (PWD) in future practice.</p><p><strong>Methods: </strong>Principles of the <i>Core Competencies on Disability for Health Care Education</i>5 generated 10 questions. The questions were included in a survey conducted by the Council of Academic Family Medicine Educational Research Alliance (CERA) and sent to medical student members of the American Academy of Family Physicians (AAFP). We compared responses using unadjusted χ² tests.</p><p><strong>Results: </strong>One hundred forty-seven surveys were returned, with 126 used for this analysis; 36% of students reported that their medical training provided them with the knowledge necessary to provide high-quality, comprehensive health care for PWD in their future practice and 97.6% agreed or strongly agreed that they needed to learn more. Six of the curricular exposures demonstrating variations of the health care needs of PWD were associated with higher percentages of medical students agreeing they are trained to perform high-quality health care for PWD in future practice.</p><p><strong>Conclusion: </strong>Medical students continue to report deficiencies in training, knowledge, and preparedness to care for PWD. Based on the <i>Core Competencies</i> framework, we have identified six curricular exposures that increase readiness to care for PWD. Therefore, we recommend the Liaison Committee on Medical Education formally integrate requirements for disability training in the standards of accreditation.7.</p>","PeriodicalId":74494,"journal":{"name":"PRiMER (Leawood, Kan.)","volume":" ","pages":"34"},"PeriodicalIF":0.0,"publicationDate":"2022-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9484532/pdf/primer-6-34.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33466184","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":"Faculty Competencies: An Exploration of Feasibility and Acceptance.","authors":"Priyanka Tulshian,&nbsp;Bharat Gopal,&nbsp;Tina Kenyon","doi":"10.22454/PRiMER.2022.111657","DOIUrl":"https://doi.org/10.22454/PRiMER.2022.111657","url":null,"abstract":"<p><strong>Introduction: </strong>A uniform method of iterative professional development for medical educators does not exist in the United States graduate medical education system. The Society of Teachers of Family Medicine Faculty Competencies Special Project Team, a subgroup of the Faculty Development Collaborative, sought to create a competency-based assessment framework for medical educators. This paper describes the feasibility and acceptance of a draft competencies resource using a survey.</p><p><strong>Methods: </strong>A mixed-methods, ten-question survey to assess the feasibility and acceptance of the draft competencies resource was created and distributed to medical educators through educational contacts from October 2019 to November 2019.</p><p><strong>Results: </strong>Eighty-six surveys were completed. Of the 86 respondents, 48 (55%) answered all the survey questions. Thematic analysis for acceptance of the draft yielded three groups, the accepting, neutral, and nonacceptance groups. Each group had distinct characteristics regarding the likelihood of accepting and using the draft competencies.</p><p><strong>Conclusions: </strong>The draft competencies are thought to be feasible, with overall acceptance in the current form. Further research will guide revisions of the competency resource before final distribution.</p>","PeriodicalId":74494,"journal":{"name":"PRiMER (Leawood, Kan.)","volume":" ","pages":"32"},"PeriodicalIF":0.0,"publicationDate":"2022-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9484531/pdf/primer-6-32.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33466185","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":"Creating Virtual Learning for 3-Year Accelerated MD Students During the COVID Pandemic.","authors":"Shou Ling Leong,&nbsp;Jessica A Parascando,&nbsp;Erika VanDyke,&nbsp;Alyssa Anderson,&nbsp;Lawrence Kass,&nbsp;Jennifer Grana,&nbsp;Eric Messner","doi":"10.22454/PRiMER.2022.422339","DOIUrl":"https://doi.org/10.22454/PRiMER.2022.422339","url":null,"abstract":"","PeriodicalId":74494,"journal":{"name":"PRiMER (Leawood, Kan.)","volume":" ","pages":"33"},"PeriodicalIF":0.0,"publicationDate":"2022-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9484530/pdf/primer-6-33.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33466186","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":"Rural Family Physician Perspectives on Wellness and the Role of Training in Supporting Physician Wellness.","authors":"Meredith L C Williamson,&nbsp;Jared Datzman,&nbsp;Rae Adams","doi":"10.22454/PRiMER.2022.528784","DOIUrl":"https://doi.org/10.22454/PRiMER.2022.528784","url":null,"abstract":"<p><strong>Purpose: </strong>Research evaluating the well-being of rural family physicians is limited, resulting in minimal understanding of how to prepare family medicine residents to succeed in rural practice postresidency. Our study aimed to investigate factors associated with maintaining wellness within rural family medicine practices and highlight interventions that rural family physicians identify as important to promote wellness among those seeking future employment in rural settings postresidency.</p><p><strong>Methods: </strong>Forty-eight rural family physicians completed an online survey with qualitative and multiple-choice items including the Mini-Z about physician demographics, burnout, and wellness. We conducted data analysis using NVivo 12 software for qualitative analyses and R 3.6.1 software for descriptive statistics.</p><p><strong>Results: </strong>The majority of participants reportedly maintained wellness in rural family practice (maintenance of wellness=79.17%; denied burnout=62.26%). Burnout rates were similar to the national burnout rates for family physicians (37.74% vs 46%). Participants identified multiple residency interventions that could be implemented to prepare rural family physicians to succeed.</p><p><strong>Conclusions: </strong>This study highlights factors that are associated with the maintenance of wellness among rural family physicians. This is the first study to investigate rural family physician perspectives on residency interventions that may have positive outcomes on wellness postresidency.</p>","PeriodicalId":74494,"journal":{"name":"PRiMER (Leawood, Kan.)","volume":" ","pages":"30"},"PeriodicalIF":0.0,"publicationDate":"2022-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9477720/pdf/primer-6-30.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40367909","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":"Improving Management of Opioid Use Disorder Training With Novel Resident Co-PCP Model.","authors":"Kristopher Azevedo,&nbsp;Rebecca E Cantone,&nbsp;Brian T Garvey","doi":"10.22454/PRiMER.2022.396130","DOIUrl":"https://doi.org/10.22454/PRiMER.2022.396130","url":null,"abstract":"<p><strong>Introduction: </strong>Multiple organizations have recommended primary care physicians (PCP) implement medication for opioid use disorder (MOUD) programs to address the opioid epidemic, but that has been hindered by residency graduates feeling unprepared to provide these services. This study describes a program innovation to increase exposure to MOUD in residents' own continuity practices.</p><p><strong>Methods: </strong>We designed, reviewed, and implemented a co-PCP model to increase resident MOUD visits at one rural health clinic in the Pacific Northwest that is part of a large academic health center. We then measured resident MOUD panels before and after to assess success of this novel program.</p><p><strong>Results: </strong>After implementation of the novel co-PCP model, the number of residents having at least three MOUD patients increased from two (25%) to eight (100%) over 8 months.</p><p><strong>Conclusions: </strong>The novel co-PCP model of care effectively increased exposure to MOUD care in one resident continuity practice. This may be a successful practice change for improving resident preparation to provide MOUD care after graduation and to expand access to these services for further progress on the opioid epidemic.</p>","PeriodicalId":74494,"journal":{"name":"PRiMER (Leawood, Kan.)","volume":" ","pages":"27"},"PeriodicalIF":0.0,"publicationDate":"2022-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9477700/pdf/primer-6-27.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40368484","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}