Case simulations for permanent education in Primary Care – School of Patients DF

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
E Cubas-Rolim ◽  
F R Yung ◽  
M R Gripp ◽  
C L A Oliveira ◽  
L A Marques ◽  
...  
Keyword(s):  
Primary Care ◽  
Medical Students ◽  
Family Medicine ◽  
Physical Examination ◽  
Health Professional ◽  
The Other ◽  
Capital City ◽  
Technical Content ◽  
Regular Visit ◽  
Access Efficiency

Abstract Background In scenarios of vulnerability that include triple charge of diseases, permanent education in Primary Care and university is fundamental to allow greater access, efficiency and safety for users and health teams. Objectives The School of Patients DF was created as a tool for popular and technical health education, including case simulations for practice. It consists of standard technical content (Chapters), categorized by conditions and diseases, shared by Google Drive and used primarily in selected primary care units of Brazil's capital city. Results Technical simulations are performed in pairs, 1 participant acts as “patient” with script in hand (topics of the training) while the other acts as “health professional” as if in a regular visit. Simulations are timed for 10 minutes for consultation and 5 for feedback, boosting learning. Contents are based on guidelines and protocols from the Ministry of Health, Secretary of Health and Brazilian Community and Family Medicine Society. Since 2016 there have been realized over 1400 simulations, including weekly classes for last term medical students at the capital city federal university. Conclusions Simulations optimize the time necessary for permanent education (15 minutes blocks), avoiding limiting access for triage and consults, allowing smaller groups to train with greater focus and independent of computers or projectors. Key messages Standardizing training and practice bring benefit to patient care and safety. Simulations with structured physical examination are important both for professional as well as students.

scholarly journals Primary Care Tracks in Medical Schools

PRiMER ◽  
2019 ◽  
Vol 3 ◽  
Author(s):  
Maribeth P. Williams ◽  
Denny Fe Agana ◽  
Benjamin J. Rooks ◽  
Grant Harrell ◽  
Rosemary A. Klassen ◽  
...  
Keyword(s):  
Primary Care ◽  
Medical Students ◽  
Family Medicine ◽  
Primary Care Physicians ◽  
Response Rate ◽  
Positive Impact ◽  
Medical Schools ◽  
Clerkship Director ◽  
Medicine Clerkship ◽  
Faculty Mentorship

Introduction: With the estimated future shortage of primary care physicians there is a need to recruit more medical students into family medicine. Longitudinal programs or primary care tracks in medical schools have been shown to successfully recruit students into primary care. The aim of this study was to examine the characteristics of primary care tracks in departments of family medicine.  Methods: Data were collected as part of the 2016 CERA Family Medicine Clerkship Director Survey. The survey included questions regarding the presence and description of available primary care tracks as well as the clerkship director’s perception of impact. The survey was distributed via email to 125 US and 16 Canadian family medicine clerkship directors.  Results: The response rate was 86%. Thirty-five respondents (29%) reported offering a longitudinal primary care track. The majority of tracks select students on a competitive basis, are directed by family medicine educators, and include a wide variety of activities. Longitudinal experience in primary care ambulatory settings and primary care faculty mentorship were the most common activities. Almost 70% of clerkship directors believe there is a positive impact on students entering primary care.  Conclusions: The current tracks are diverse in what they offer and could be tailored to the missions of individual medical schools. The majority of clerkship directors reported that they do have a positive impact on students entering primary care.

scholarly journals Matching 25% of Medical Students in Family Medicine by 2030: Realistic or Beyond Our Reach?

2021 ◽  
Vol 53 (4) ◽  
pp. 252-255
Author(s):  
Alan K. David
Keyword(s):  
Primary Care ◽  
Medical Students ◽  
Family Medicine ◽  
Health System ◽  
National Health System ◽  
Family Doctors ◽  
Residency Programs ◽  
Primary Care Workforce ◽  
The Us ◽  
Physician Income

ABSTRACT: This article examines the America Needs More Family Doctors: 25x2030 Collaborative goal of “25x30”—that 25% of all medical students will enter family medicine residency programs by the year 2030. Filling 25% of all available postgraduate year-1 positions in the match is an important consideration in creating a strong primary care workforce. Data from the National Resident Matching Program (NRMP) matches for 2010 and 2020 are reviewed to examine trends not only in the US MD and DO categories, but also US international medical school graduates (IMGs) and non-US IMG categories over the last 10 years. If the total number of all programs and of all positions offered were held constant in 2030, what shifts in student choices would be required to reach the 25x30 goal in each applicant category as well as for all four categories combined? This discussion explores resources, power, physician income, and other factors that affect student numbers. Until a national health system is developed with national goals and priorities, it is unlikely that 25x30 will become a reality.

scholarly journals Medical Students’ Attitudes towards Careers in Primary Care in Singapore

2020 ◽  
Author(s):  
Humairah Zainal ◽  
Helen Elizabeth Smith
Keyword(s):  
Primary Care ◽  
General Practice ◽  
Medical Students ◽  
Family Medicine ◽  
Medical School ◽  
Medical Schools ◽  
School Experience ◽  
Ageing Population ◽  
Family Doctors ◽  
Students Attitudes

Abstract Background: Singapore needs more family doctors to care for its ageing population and their chronic conditions. To boost the recruitment of doctors within primary care, we need to better understand medical students’ attitudes and experience of General Practice and Family Medicine. While many studies have explored the facilitators and barriers to teaching undergraduate medical students in this field of medicine from the perspectives of GP teachers and trainers, few have examined students’ exposure to primary care in medical schools. Although there are works on factors influencing students’ attitudes towards primary care careers, the roles of medical schools, professional bodies and state institutions tend to be discussed independently of one another. This article explores medical students’ perceptions towards careers in primary care and how different stakeholders might collaborate in strengthening the medical school experience. Methods: Six focus groups involving 54 students from three medical schools in Singapore were conducted. Discussions focussed on their primary care experience, their professional and career aspirations, and perceptions towards the opportunities and challenges of primary care careers. Thematic analysis was used to interpret the qualitative data. Results: 15 key themes emerged from the discussions; 10 reflected key concerns of pursuing primary care careers whereas 5 others highlighted their positive aspects. The former include society’s perceptions of primary care professions as sub-standard, specialists’ negative attitudes towards family doctors, the emphasis on the lifestyle benefits of primary care careers rather than their professional characteristics, mundane case mix, limited professional opportunities, lack of continuity of care, limited consultation time, low remuneration, need for business acumen, and conflicts created by business in clinical care. However, the respondents also articulated positive views, including its lifestyle benefits, autonomy of private practice and better patient care, opportunities for entrepreneurialism and a portfolio career, breadth of clinical problems presented, and an improved future for General Practice and Family Medicine. Conclusion: The findings demonstrate that coordinated initiatives from multiple stakeholders would help to increase the attractiveness of primary care as a career choice among students. Improvements in the medical school experience will significantly enhance the prestige of General Practice and Family Medicine.

Life After a Disastrous Electronic Medical Record Implementation

2011 ◽  
pp. 153-168 ◽  
Author(s):  
Karen A. Wagner ◽  
Frances Wickham Lee ◽  
Andrea W. White
Keyword(s):  
United States ◽  
Primary Care ◽  
Family Medicine ◽  
Medical Record ◽  
Electronic Medical Record ◽  
The Other ◽  
Negative Experience ◽  
System Failures ◽  
The Impact ◽  
New System

The majority of users of an electronic medical record (EMR) at a family medicine clinic located in a small city in the western United States are currently quite dissatisfied with the system. The practice experienced a disastrous implementation of the EMR in 1994 and has not recovered. Although the level of dissatisfaction varies among the practice employees, several influential physicians are pushing to pull the plug and start over with a brand new system. The authors of this case studied this practice during a more comprehensive qualitative study of the impact of an EMR system on primary care. The practices negative experience was particularly noteworthy, because the other four practices in the larger study were satisfied with the EMR system. As with most system failures, there are multiple organizational and other factors that have contributed to the frustrations and dissatisfactions with the use of EMR within this practice.

scholarly journals Factors That Influence Student Choice in Family Medicine

2019 ◽  
Vol 51 (2) ◽  
pp. 143-148 ◽  
Author(s):  
Mustafa Alavi ◽  
Tiffany Ho ◽  
Chandler Stisher ◽  
Emma Richardson ◽  
Christina Kelly ◽  
...  
Keyword(s):  
Primary Care ◽  
Medical Students ◽  
Family Medicine ◽  
Focus Groups ◽  
Institutional Support ◽  
Medical Schools ◽  
Care Physician ◽  
Student Choice ◽  
Medicine Physician ◽  
Fourth Year Medical Students

Background and Objectives: The Family Medicine for America’s Health Workforce and Education Team aims to increase the number of medical students choosing family medicine to address the projected primary care physician shortage. This aim can be achieved by developing a well-trained primary care workforce. Our student- and resident-led FMAHealth work group aimed to identify factors that influenced fourth-year medical students’ choice to become family physicians. The secondary objective compared such factors between the 10 medical schools with the highest percentage of students matching into family medicine and non-top 10 medical schools. Methods: Fourth-year medical students nationwide participated in 90-minute virtual focus groups. Reviewers coded deidentified transcriptions and identified key themes and subthemes that were found to influence student choice. Results: Fifty-five medical students participated in focus groups over a 2-year period. Three key themes were found to influence students: perspective, choice, and exposure. Subthemes included: (1) the importance of high-quality preceptors practicing full-scope family medicine, (2) the value of a rural experience, and (3) institutional support to pursue family medicine. Physician compensation and loan repayment concerns were not major factors influencing student choice. Conclusions: Many factors influence student choice of family medicine including preceptors, clinical exposures, and institutional support. These factors varied by institution and many were found to be different between top 10 and non-top 10 schools. Addressing these factors will help increase students’ choice of family medicine and reduce the primary care shortage.

scholarly journals Attitudes Toward Family Medicine Among Students Choosing Other Primary Care Specialties

2020 ◽  
Vol 52 (7) ◽  
pp. 491-496
Author(s):  
Jacob Prunuske ◽  
Hana Kang ◽  
Andrea L. Wendling ◽  
Jennifer Edwards-Johnson ◽  
Julie P. Phillips
Keyword(s):  
Primary Care ◽  
Medical Students ◽  
Family Medicine ◽  
Secondary Data ◽  
Future Research ◽  
Curricular Development ◽  
Career Intention ◽  
Fourth Year Medical Students ◽  
Post Hoc ◽  
Career Advising

Background and Objectives: Little is known about how medical students choose between primary care specialties. We compared the attitudes toward family medicine of medical students intending to practice primary care but not family medicine (PCNFM), with students intending to practice family medicine (FM) and those intending nonprimary care (NPC) careers. Methods: The Family Medicine Attitudes Questionnaire (FMAQ) was distributed to 2,644 fourth-year medical students at 16 medical schools in spring 2017. Respondents were stratified by career intention. In this secondary data analysis, we used descriptive statistics to characterize responses to each questionnaire item and FMAQ total score, and analysis of variance with Bonferroni post hoc analyses to compare category and item mean responses. Results: Of 2,644 fourth-year medical students who received the FMAQ, 1,188 (41.8%) submitted usable responses. The 14-item FMAQ has a maximum score of 70. Mean total scores differed by category: 59.05 for FM, 52.88 for NPC, and 54.83 for PCNFM (F=108.96, P<.01); the differences between each possible pairing were significant (P<.05). Comparing the responses of students intending PCNFM careers with those of students intending NPC careers, there were no differences in mean responses for 8 of 14 FMAQ items. Responses of students intending PCNFM careers were similar to students intending FM for only 4 of 14 items (P<.05). Conclusions: Fourth-year students intending to match into PCNFM have attitudes toward FM that more closely approximate the attitudes of NPC students than the attitudes of FM students. Future research should explore implications for curricular development, student mentorship, and career advising.

Life After a Disastrous Electronic Medical Record Implementation

2011 ◽  
pp. 153-168
Author(s):  
Karen A. Wager ◽  
Frances Wickham Lee ◽  
Andrea W. White
Keyword(s):  
United States ◽  
Primary Care ◽  
Family Medicine ◽  
Medical Record ◽  
Electronic Medical Record ◽  
The Other ◽  
Negative Experience ◽  
System Failures ◽  
The Impact ◽  
New System

The majority of users of an Electronic Medical Record (EMR) at a family medicine clinic located in a small city in the western United States are currently quite dissatisfied with the system. The practice experienced a disastrous implementation of the EMR in 1994 and has not recovered. Although the level of dissatisfaction varies among the practice employees, several influential physicians are pushing to “pull the plug” and start over with a brand new system. The authors of this case studied this practice during a more comprehensive qualitative study of the impact of an EMR system on primary care. The practice’s negative experience was particularly noteworthy, because the other four practices in the larger study were satisfied with the EMR system. As with most system failures, there are multiple organizational and other factors that have contributed to the frustrations and dissatisfactions with the use of EMR within this practice.

scholarly journals The WRITE Stuff: A Rural Longitudinal Integrated Clerkship Addresses Workforce Needs

2019 ◽  
Vol 2 (5) ◽  
Author(s):  
Misbah Keen ◽  
Danielle Bienz ◽  
Toby Keys ◽  
Douglas Schaad ◽  
David Evans
Keyword(s):  
Primary Care ◽  
Medical Students ◽  
Family Medicine ◽  
Medical School ◽  
First Year ◽  
Key Word ◽  
Usmle Step 1 ◽  
Longitudinal Integrated Clerkship ◽  
Usmle Step ◽  
Workforce Needs

Introduction: The University of Washington School of Medicine has six campuses in the five state WWAMI (Washington, Wyoming, Alaska, Montana and Idaho) region. The WRITE (WWAMI Rural Integrated Training Experience) program is a 22 to 24 week long rural longitudinal integrated clerkship experience offered to medical students in their clinical phase (third year) of training. This program seeks to meet the rural workforce needs of the WWAMI region by increasing the number of medical students going into primary care. Critics of LIC’s have expressed concern about overall quality control of the more remote educational experience and the lack of specialty specific teaching.  The aim of this study was to compare medical school and PGY-1 performance of WRITE and Non-WRITE students while determining how well each cohort is meeting the regional workforce needs. Methods: The study group was all UWSOM students who matriculated from 2009 to 2013, advanced to graduation, and subsequently matched to a residency through the National Residency Match Program. WRITE and non-WRITE cohorts were compared for USMLE step 1 and 2 scores, MSPE (Medical Student Performance Evaluation) key word, and self and program director assessments in the first year of residency. The match results of the two cohorts were also compared to determine the proportions entering primary care residencies. Finally, for both cohorts the specialty choice at matriculation was compared with the match results. Descriptive statistics were used to test the comparisons. Results: The medical school performance of the WRITE and Non-WRITE cohorts was equivalent in all metrics (USMLE Step 1 and 2, MSPE key word, self and program director assessment of performance in the first year of residency). WRITE students were significantly more likely to match into primary care (67.6% vs 48.3%, p<0.001) overall and, in particular, Family Medicine as their specialty (40% vs 14.3%, p<0.001).  WRITE students were also more likely to match into the same specialty that they indicated on the UWSOM matriculation survey. For Family Medicine the loss of fidelity between matriculation and match among WRITE students was 3% (43.4 - 40.4) and among Non-WRITE students, it was 6.3% (20.6 - 14.3). Conclusions: Performance outcomes of the WRITE program are equivalent to a traditional block curriculum.  However, the WRITE cohort is significantly more likely to go into primary care fields, especially family medicine and is more likely to stay with the declared specialty at matriculation. Medical schools that seek to increase the number of students going into primary care may benefit from adopting a similar model.

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