Intention to provide abortion upon completing family medicine residency and subsequent abortion provision: a 5-year follow-up survey

Contraception ◽  
2019 ◽  
Vol 100 (3) ◽  
pp. 188-192 ◽  
Author(s):  
Silpa Srinivasulu ◽  
Lisa Maldonado ◽  
Linda Prine ◽  
Susan E. Rubin
Keyword(s):  
Family Medicine ◽  
Family Medicine Residency

scholarly journals Evaluation of Resident and Faculty Performance in Routinely Addressing Unmet Reproductive Health Needs in a Teaching Health Center

2018 ◽  
Vol 50 (4) ◽  
pp. 291-295
Author(s):  
Elizabeth Kvach ◽  
Hayley Marcus ◽  
Lucy Loomis
Keyword(s):  
Family Medicine ◽  
Reproductive Health ◽  
Health Center ◽  
Unintended Pregnancy ◽  
Chart Review ◽  
Preconception Care ◽  
Health Needs ◽  
Screening Methods ◽  
Family Medicine Residency

Background and Objectives: High rates of unintended pregnancy and poor pregnancy outcomes can be ameliorated by improved access to contraceptive and preconception care. Little data exists regarding application of routine pregnancy intention (PI) screening to reduce unintended pregnancy and optimize preconception health in family medicine residency education. This quality improvement (QI) project evaluated the rate at which family medicine residents and providers (attending physicians and nurse practitioners) addressed women’s unmet reproductive health needs identified through PI screening. Methods: In April 2015 routine PI screening was implemented at a teaching health center. From April through July chart review was performed of patient encounters for eligible women age 12 to 45 to assess the rate of addressing unmet reproductive health needs, including contraception and/or preconception care, based on provider documentation. Individual resident and provider performance feedback was given monthly. Follow-up chart review was performed in February 2016 to evaluate postintervention performance. Results: Residents and providers had 1,676 eligible patient visits, and respectively increased their rates of addressing unmet reproductive health care needs from 47% to 48% in April to 66% to 67% in July 2015. Residents had a sustained increased rate of 62% in February 2016 (P=0.0139), while providers did not. Conclusions: Resident and provider rates of addressing women’s unmet reproductive health needs increased with a simple QI intervention. Residents, but not providers, sustained these rates at 6-month follow-up. Routine PI screening combined with performance evaluation is a promising approach to promote preventive reproductive health education in family medicine residency teaching clinics, but requires further study of long-term outcomes.

scholarly journals Promoting Documentation of Suicidality in a Family Medicine Residency Clinic

2018 ◽  
Vol 50 (2) ◽  
pp. 138-141
Author(s):  
Michelle D. Sherman ◽  
Kathryn Justesen ◽  
Eneniziaogochukwu A. Okocha
Keyword(s):  
Family Medicine ◽  
Treatment Plan ◽  
Educational Interventions ◽  
Baseline Period ◽  
Clinic Visit ◽  
Family Medicine Residency ◽  
Patient Reported ◽  
Patient Health ◽  
The Impact

Background and Objectives: Careful assessment of depression and suicidality are important given their prevalence and consequences for quality of life. Our study evaluated the impact of an educational intervention in a family medicine residency clinic on rates of provider documentation regarding suicidality. Methods: We offered two brief workshops to our clinic staff and created two standardized charting templates to empower and educate providers. One template used with the patient during the clinic visit elicited key factors (eg, plan, intent, barriers) and offered treatment plan options. The second template included supportive text and resources to include in the after-visit summary. A chart review was completed, examining 350 patient records in which the patient reported thoughts of death or suicide in the preceding 2 weeks on the Patient Health Questionnaire-9 ([PHQ-9], 150 over a 5-month baseline period, 150 in months 1 through 4 immediately following the workshops and template development, and 50 at follow-up months 7 through 8 following the intervention). We examined use of the templates and changes in rates of documentation of suicidality. Results: Rates of provider documentation of suicidality for patients who had expressed suicidal ideation on the PHQ-9 increased significantly from 57% at baseline to 78% in the postintervention phase; the rise persisted at follow-up. Rates of use of the assessment template were 58% (postintervention) and 49% (follow-up). Anecdotal provider feedback reflected appreciation of the templates for assessing and documenting challenging issues. Conclusions: Brief educational interventions were associated with improved rates of provider documentation of suicidality. The longer-term impact of the workshops and templates warrant further investigation.

scholarly journals Effect of diabetes self-management education on glycaemic control among type 2 diabetic patients at a family medicine clinic in Kenya: A randomised controlled trial

2018 ◽  
Vol 10 (1) ◽  
Author(s):  
Catherine W. Gathu ◽  
Jacob Shabani ◽  
Nancy Kunyiha ◽  
Riaz Ratansi
Keyword(s):  
Family Medicine ◽  
Usual Care ◽  
Primary Outcome ◽  
Self Management ◽  
Diabetic Patients ◽  
Educational Approach ◽  
Medicine Clinic ◽  
The Family

Background: Diabetes self-management education (DSME) is a key component of diabetes care aimed at delaying complications. Unlike usual care, DSME is a more structured educational approach provided by trained, certified diabetes educators (CDE). In Kenya, many diabetic patients are yet to receive this integral component of care. At the family medicine clinic of the Aga Khan University Hospital (AKUH), Nairobi, the case is no different; most patients lack education by CDE.Aim: This study sought to assess effects of DSME in comparison to usual diabetes care by family physicians.Setting: Family Medicine Clinic, AKUH, Nairobi.Methods: Non-blinded randomised clinical trial among sub-optimally controlled (glycated haemoglobin (HbA1c) ≥ 8%) type 2 diabetes patients. The intervention was DSME by CDE plus usual care versus usual care from family physicians. Primary outcome was mean difference in HbA1c after six months of follow-up. Secondary outcomes included blood pressure and body mass index.Results: A total of 220 diabetes patients were screened out of which 140 met the eligibility criteria and were randomised. Around 96 patients (69%) completed the study; 55 (79%) in the DSME group and 41 (59%) in the usual care group. The baseline mean age and HbA1c of all patients were 48.8 (standard deviation [SD]: 9.8) years and 9.9% (SD: 1.76%), respectively. After a 6-month follow-up, no significant difference was noted in the primary outcome (HbA1c) between the two groups, with a mean difference of 0.37 (95% confidence interval: -0.45 to 1.19; p = 0.37). DSME also made no remarkable change in any of the secondary outcome measures.Conclusion: From this study, short-term biomedical benefits of a structured educational approach seemed to be limited. This suggested that offering a short, intensified education programme might have limited additional benefit above and beyond the family physicians’ comprehensive approach in managing chronic conditions like diabetes.

scholarly journals Burnout and Job Satisfaction Among Family Medicine Residency Coordinators:

2018 ◽  
Vol 50 (9) ◽  
pp. 679-684 ◽  
Author(s):  
Samuel Ofei-Dodoo ◽  
Cassie Scripter ◽  
Rick Kellerman ◽  
Cheryl Haynes ◽  
Maria Eliza Marquise ◽  
...  
Keyword(s):  
Job Satisfaction ◽  
Family Medicine ◽  
Negative Relationship ◽  
Multiple Roles ◽  
Chi Square ◽  
Family Medicine Residency ◽  
Work Related ◽  
Quality Of Life Scale ◽  
Life Scale ◽  
High Degree

Background and Objectives: Research into rates of burnout and job satisfaction among family medicine residency coordinators is nonexistent. Coordinators play a pivotal role in medical education, sometimes have multiple roles and titles, and often work in stressful environments. The goals of this study were to explore the prevalence of, and relationship between, burnout and job satisfaction among family medicine residency coordinators. Methods: This national wellness study involved 307 family medicine residency coordinators. Modified questions of the Professional Quality of Life Scale, Version 5 were used to measure participants’ burnout and job satisfaction rates. The authors used chi-square tests, Pearson’s r correlations, and multiple linear regression to analyze the data. Results: The response rate was 72% (307/429), with 24% of family medicine residency coordinators reporting high, 51% reporting moderate, and 26% reporting low rates of work-related burnout. Twenty-eight percent of the family medicine residency coordinators reported high, 46% moderate, and 26% low job satisfaction. There was a significantly negative relationship between job satisfaction and work-related burnout, r (306)=-.638, P<0.001. Regression explained 42% of variance in job satisfaction, and showed that burnout (β=-.62) and years on the job (β=.15) were significant predictors of job satisfaction (R=0.64; F [5, 277]=40.28, P<.001). Conclusions: The results demonstrate that family medicine residency coordinators are generally satisfied with their work and reported moderate to high degree of burnout rates.

scholarly journals Maternity Care Tracks at US Family Medicine Residency Programs

2021 ◽  
Vol 53 (10) ◽  
pp. 857-863
Author(s):  
Steven E. Roskos ◽  
Tyler W. Barreto ◽  
Julie P. Phillips ◽  
Valerie J. King ◽  
W. Suzanne Eidson-Ton ◽  
...  
Keyword(s):  
Family Medicine ◽  
Maternity Care ◽  
Underserved Populations ◽  
Residency Programs ◽  
Family Medicine Residency ◽  
Survey Response Rate ◽  
Care Training ◽  
Practice Methods ◽  
Residency Program Directors ◽  
The Relationship

Background and Objectives: The number of family physicians providing maternity care continues to decline, jeopardizing access to needed care for underserved populations. Accreditation changes in 2014 provided an opportunity to create family medicine residency maternity care tracks, providing comprehensive maternity care training only for interested residents. We examined the relationship between maternity care tracks and residents’ educational experiences and postgraduate practice. Methods: We included questions on maternity care tracks in an omnibus survey of family medicine residency program directors (PDs). We divided respondent programs into three categories: “Track,” “No Track Needed,” and “No Track.” We compared these program types by their characteristics, number of resident deliveries, and number of graduates practicing maternity care. Results: The survey response rate was 40%. Of the responding PDs, 79 (32%) represented Track programs, 55 (22%) No Track Needed programs, and 94 (38%) No Track programs. Residents in a track attended more deliveries than those not in a track (at Track programs) and those at No Track Needed and No Track programs. No Track Needed programs reported the highest proportion of graduates accepting positions providing inpatient maternity care in 2019 (21%), followed by Track programs (17%) and No Track programs (5%; P<.001). Conclusions: Where universal robust maternity care education is not feasible, maternity care tracks are an excellent alternative to provide maternity care training and produce graduates who will practice maternity care. Programs that cannot offer adequate experience to achieve competence in inpatient maternity care may consider instituting a maternity care track.

scholarly journals Flexible Nasal Endoscopic Procedures in Family Medicine: Indications and Effectiveness

2021 ◽  
Vol 53 (10) ◽  
pp. 886-889
Author(s):  
John Malaty ◽  
Dongyuan Wu ◽  
Susmita Datta
Keyword(s):  
Family Medicine ◽  
Laryngopharyngeal Reflux ◽  
Upper Airway ◽  
Retrospective Chart Review ◽  
True Vocal Cord ◽  
Endoscopic Procedures ◽  
Specialist Referral ◽  
Postnasal Drip ◽  
The University

Background and Objectives: Most literature about flexible nasolaryngoscopy comes from specialty clinics, making it unclear if these indications can be effectively managed without referral. This study evaluated effectiveness of diagnosis and management of upper airway complaints, utilizing flexible nasal endoscopic procedures, in a family medicine center. Methods: We performed retrospective chart review for all patients who had nasal endoscopy, nasopharyngoscopy, and nasolaryngoscopy performed at the University of Florida Family Medicine Center over 3 years (n=89) with 5 additional years of follow up. We used descriptive statistics to evaluate indications, diagnoses, effectiveness of management by family medicine, and referral rate. Results: The most common primary indications were hoarseness (n=33, 37%), chronic cough (n=20, 22%), nasal obstruction (n=9, 10%), and unilateral ear dysfunction (n=6, 7%). The most common primary diagnoses found were allergic rhinitis/postnasal drip (n=41, 46%), laryngopharyngeal reflux (LPR)/gastroesophageal reflux disease (GERD; n=24, 27%), masses concerning for malignancy (n=4, 4.5%), true vocal cord (TVC) polyp (n=3, 3%), TVC nodules (n=3, 3%), and epistaxis (n=3, 3%). Of the four concerning masses, two were confirmed cancers (2%). In addition, there was one case (1%) of erythroleukoplakia with dysplasia of the TVC. Most patients had documented improvement with family medicine management (n=57, 64%) and another six (7%) had follow up without documentation of status and no need for referral. Thus, a total of 71% (n=64) did not require referral and 20% (n=18) needed specialist referral. Conclusions: Flexible nasal endoscopic procedures are effective in the care of patients in a family medicine residency center and can be safely performed and taught to residents.

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