Interprofessional education: A nurse practitioner impacts family medicine residents' smoking cessation counselling experiences

Background and Objectives: Caring for geriatrics and palliative care patients requires integrated interprofessional care. Studies regarding interprofessional education in family medicine reveal concerns by residents regarding applicability in future practice. Our study objective was to determine the effectiveness of teaching multispecialty geriatric and palliative care skills to family medicine residents using an interprofessional clinic curriculum. Methods: We evaluated an interprofessional geriatric and palliative care outpatient curriculum from March 2014 to June 2015. The interprofessional team included pharmacists, psychologists, and family medicine geriatricians and palliative care providers. Family medicine residents in a 3-year residency program completed pre- and postassessments evaluating their confidence and knowledge in specific areas of geriatric and palliative care. These assessments covered their abilities in starting advanced care planning and setting goals in care discussions, as well as fall and depression assessment and elderly medication review. The subsequent resident perception of teaching effectiveness was also assessed. Qualitative comments were evaluated for themes. Patient perceptions were also surveyed. Results: Family medicine residents completed 52 surveys (51%). Improvements in all areas were significant (P<0.05). Postevaluation mean scores by year and by session demonstrated significant improvements in palliative care tools and teaching effectiveness. Qualitative comments revealed three themes: overall positive or negative educational value and understanding of assessments, reflection on interprofessional collaboration and team experience value, and improvements in logistics and collaboration. Patient satisfaction surveys reported improved satisfaction with their PCMH. Conclusions: The use of an interprofessional and multispecialty clinic curriculum to teach geriatric and palliative care improved resident self-assessed knowledge and confidence as well as teaching effectiveness. Further studies evaluating resident exposure to such visits could substantiate the long-term influence of this educational endeavor.

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Stress Management and Resiliency Training (SMART) for Family Medicine Residents at Eglin AFB

Case Medical Research ◽

10.31525/ct1-nct03936114 ◽

2019 ◽

Author(s):

Keyword(s):

Family Medicine ◽

Stress Management ◽

Resiliency Training ◽

Family Medicine Residents

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Perceived knowledge of psychiatry and family medicine residents regarding medical management of schizophrenia, hypertension, diabetes mellitus, and dyslipidemia: opportunities to refine the residency training

BMC Medical Education ◽

10.1186/s12909-021-02658-z ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Jiangbo Ying ◽

Jinhui Wan ◽

Kang Sim ◽

Ee-Jin Darren Seah ◽

Mythily Subramaniam

Keyword(s):

Diabetes Mellitus ◽

Family Medicine ◽

Residency Training ◽

Medical Management ◽

Demographic Data ◽

Significant Proportion ◽

Psychiatry Residents ◽

Training Curriculum ◽

Cross Sectional Survey ◽

Family Medicine Residents

Abstract Background Psychiatry and Family Medicine residents frequently see patients with comorbid mental and physical disorders. Little is known about the difference in knowledge of Psychiatry residents and Family Medicine residents regarding management of common conditions they encounter. This study aimed to assess the knowledge of Psychiatry and Family Medicine residents regarding medical management of schizophrenia, hypertension, diabetes mellitus, and dyslipidemia, as the findings could help to refine the training curriculum for residency training. Methods A cross-sectional survey design was used. Psychiatry and Family Medicine residents pursuing their residency in Singapore were recruited from November 2019 to June 2020. The survey questionnaire consisted of questions which assessed the knowledge regarding medical management of schizophrenia, hypertension, diabetes mellitus, and dyslipidemia. Descriptive statistics were used to describe the demographic data; T-tests or Mann-Whitney U tests to compare the differences between groups; and multiple regression analyses to assess the factors associated with Psychiatry residents’ knowledge of hypertension, diabetes mellitus, and dyslipidemia. Results Fifty-seven out of 70 (81.4%) Psychiatry residents and 58 out of 61 (95.1%) Family Medicine residents participated in the study. The majority of Psychiatry residents encountered patients with hypertension (93.0%), diabetes mellitus (87.7%) and dyslipidemia (91.2%) on a daily to weekly basis. Psychiatry residents had higher scores on questions about schizophrenia versus Family Medicine residents (mean 50.70 versus 43.28, p < 0.001). However, Psychiatry residents scored lower on questions about hypertension (mean 33.86 versus 40.98, p < 0.001), diabetes mellitus (mean 45.68 versus 49.79, p = 0.005) and dyslipidemia (mean 37.04 versus 44.31, p < 0.001). Receiving undergraduate medical education locally, compared to receiving it overseas, was associated with better knowledge of hypertension (beta = 0.515, p = 0.009) and dyslipidemia (beta = 0.559, p = 0.005); while younger age (26–30 versus > 35 and 31–35 versus > 35) was associated with better knowledge of hypertension (beta = 1.361, p = 0.002 and beta = 1.225, p = 0.003). A significant proportion of Psychiatry residents (61.4%) did not agree that the training provided to manage hypertension, diabetes mellitus, and dyslipidemia was adequate. Similarly, majority of Family Medicine residents (62.1%) did not agree that they had adequate training to manage schizophrenia. Conclusions This study raises the awareness of Psychiatry residents’ sense of discomfort in managing hypertension, diabetes mellitus, or dyslipidemia and conversely Family Medicine residents in management of schizophrenia, which can be further addressed during the training postings within the residency programs. Future studies are needed to look at local (such as training curriculum) and systemic factors (such as practice trends and culture) in order to better align residency selection criteria and training foci with real world practice factors over time.

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P016: Feasibility of a nurse-led smoking cessation intervention in the emergency department

CJEM ◽

10.1017/cem.2020.224 ◽

2020 ◽

Vol 22 (S1) ◽

pp. S70-S70

Author(s):

A. Tolmie ◽

R. Erker ◽

A. Donauer ◽

E. Sullivan ◽

T. Graham ◽

...

Keyword(s):

Emergency Department ◽

Smoking Cessation ◽

Cigarette Smoking ◽

Thematic Analysis ◽

Smoking Prevalence ◽

Community Support ◽

Support Programs ◽

Written Responses ◽

Smoking Cessation Counselling ◽

Community Support Programs

Introduction: Cigarette smoking is a leading global cause of morbidity and mortality. Multiple studies internationally have established that cigarette smoking prevalence is higher in emergency department (ED) patients than their respective communities. Previously, we demonstrated the smoking prevalence among Saskatoon ED patients (19.6%) is significantly higher than the provincial average (15.1%), and over 50% of smoking patients would be receptive to ED-specific cessation support. The purpose of this project was to identify nurses’ beliefs regarding smoking cessation in the ED, and barriers to implementing it in the department. Methods: A questionnaire was administered to all nurses employed at St. Paul's Hospital ED in Saskatoon assessing attitudes towards ED cessations, as well as the benefit and feasibility of three potential interventions: brief cessation counselling, referral to community support programs, and distributing educational resources. The questionnaire included Likert scale numerical ratings, and written responses for thematic analysis. Thematic analysis was performed by creating definitions of identified themes, followed by independent review of the data by researchers. Results: 83% of eligible nurses completed the survey (n = 63). Based on Likert scores, ED nurses rarely attempt to provide cessation support, and would be minimally comfortable with personally providing this service. Barriers identified through thematic analysis included time constraints (68.3%), lack of patient readiness (19%), and lack of resources/follow-up (15.9%). Referral to community support programs was deemed most feasible and likely to be beneficial, while counselling within the ED was believed to be least feasible and beneficial. Overall, 93.3% of nurses indicated time and workload as barriers to providing ED cessation support during the survey. Conclusion: Although the ED is a critical location for providing cessation support, the proposed interventions were viewed as a low priority task outside the scope of the ED. Previous literature has demonstrated that multifaceted ED interventions using counselling, handouts, and referrals are more efficacious than a singular approach. While introduction of a referral program has some merit, having professionals dedicated to ED cessation support would be most effective. At minimum, staff education regarding importance of providing smoking cessation therapy, and simple ways to incorporate smoking cessation counselling into routine nursing care could be beneficial.

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