Effectiveness of an Advanced Airway Training “Boot Camp” for Family Medicine Physician Trainees

2020 ◽  
Vol 163 (2) ◽  
pp. 204-208 ◽  
Author(s):  
Kastley Marvin ◽  
Paige Bowman ◽  
Matthew W. Keller ◽  
Art A. Ambrosio
Keyword(s):  
Family Medicine ◽  
Airway Management ◽  
Family Medicine Residency ◽  
Training Course ◽  
Intubation Difficulty ◽  
Advanced Airway ◽  
Medicine Physician ◽  
Hands On ◽  
Difficulty Scale ◽  
The Impact

Objective This course was designed to characterize the impact of a curriculum for training family medicine physicians in advanced airway techniques with respect to intubation performance and learner confidence. Methods A training course was introduced into the curriculum in a single-group pretest-posttest model at a community family medicine residency program. Training consisted of a didactic teaching session on airway management and hands-on skill session with direct laryngoscopy (DL) and video-assisted laryngoscopy (VAL) on normal and difficult airway simulators. Participants were scored with the Intubation Difficulty Scale and completed surveys before and after the training. Results Twenty-eight residents of all levels participated. The mean time to successful intubation was significantly decreased after training from 51.96 to 23.71 seconds for DL and from 27.89 to 17.07 seconds for VAL. Participant scores with the Intubation Difficulty Scale were also significantly improved for DL and VAL. All participants rated their comfort levels with both techniques as high following training. Discussion Advanced airway management is a critical skill for any physician involved in caring for critically ill patients, though few trainees receive formal training. Addition of an airway training course with simulation and hands-on experience can improve trainee proficiency and comfort with advanced airway techniques. Implications for Practice Training on airway management should be included in the curriculum for trainees who require the requisite skills and knowledge necessary for advanced airway interventions. This introductory project demonstrates the efficacy and feasibility of a relatively brief training as part of a family medicine residency curriculum.

scholarly journals The Impact of Tobacco Smoking on One Year Patient Outcomes at a Family Medicine Residency Clinic

2016 ◽  
Vol 2 (3) ◽  
Author(s):  
Scott A. Fields ◽  
◽  
Satyakant Chitturi ◽  
Anoop Kumar ◽  
Jennifer Rose ◽  
...  
Keyword(s):  
Family Medicine ◽  
Patient Outcomes ◽  
Tobacco Smoking ◽  
Family Medicine Residency ◽  
One Year ◽  
The Impact

scholarly journals A Survey of Regional Anesthesia Use In Greece And The Impact of A Structured Regional Anesthesia Course On Regional Techniques Knowledge And Practice

2021 ◽  
Author(s):  
Kassiani Theodoraki ◽  
Eleni Moka ◽  
Alexandros Makris ◽  
Evmorfia Stavropoulou
Keyword(s):  
Regional Anesthesia ◽  
Ultrasound Guidance ◽  
Electronic Database ◽  
Nerve Blocks ◽  
Training Course ◽  
Hands On ◽  
Lower Limb Surgery ◽  
Knowledge And Attitude ◽  
Ra Training ◽  
The Impact

Abstract Background: Due to the growing interest in regional anesthesia (RA) techniques and the realization of the need for formalized education in them, the Greek Chapter of the European Society of Regional Anesthesia and Pain Therapy (ESRA-Hellas) has established a structured hands-on training Course held annually since 2009, which is quite popular in the community of Greek anesthesiologists. The aim of the current survey was two-fold: first to provide an overview about the current practice of RA in Greece and secondly to evaluate the effect the aforementioned training Course has on participants’ knowledge and attitude towards RA.Methods: An electronic questionnaire was uploaded on SurveyMonkey and a link giving access to the questionnaire was forwarded via email to an electronic database of 825 practicing Greek anesthesiologists held in the electronic database of ESRA Hellas. The survey was totally anonymous and no identifying information was collected throughout. It contained questions relating to the anesthesiologists’ demographic characteristics, their RA practice and information pertaining to the RA training Course.Results: A total of 424 fully completed questionnaires were received, representing an overall response rate of 51.4%. Attendants of the Course are more familiar with the performance of peripheral nerve blocks with neurostimulation and/or ultrasound guidance as compared to non-attendants (p<0.001). Attendants are also less likely to practice exclusively general anesthesia, more likely to use peripheral blocks for lower limb surgery and more likely to consider taking the European Diploma of RA in comparison to non-attendants (p<0.001, p=0.018 and p=0,002, respectively). Both cohorts consider the Course of value and agree that the main reason to use regional techniques is to ensure optimal postoperative analgesia while the main hindrance to RA practice is the lack of relevant education in the techniques, especially those under ultrasound guidance. Regarding improvement of the Course, most participants suggested devoting ampler time in ultrasound hands-on practice and application.Conclusion: Greek anesthesiologists seek educational activities in the field of RA and the Course seems to fulfil the majority of attendants’ expectations. There will be further effort by the organizers to improve weaknesses of the current Course and undertake further educational initiatives in the field of RA according to international recommendations.

Patient loneliness in an urban, underserved family medicine residency clinic: prevalence and relationship to health care utilization

2020 ◽  
Vol 37 (6) ◽  
pp. 751-758
Author(s):  
Stephanie A Hooker ◽  
Paul Stadem ◽  
Michelle D Sherman ◽  
Jason Ricco
Keyword(s):  
Primary Care ◽  
Health Care ◽  
African American ◽  
Family Medicine ◽  
Health Care Utilization ◽  
Care Utilization ◽  
Care Clinic ◽  
Family Medicine Residency ◽  
Ed Visits ◽  
The Impact

Abstract Background Mounting evidence suggests that loneliness increases the risk of poor health outcomes, including cardiovascular disease and premature mortality.Objective: This study examined the prevalence of loneliness in an urban, underserved family medicine residency clinic and the association of loneliness with health care utilization. Methods Adult patients (N = 330; M age = 42.1 years, SD = 14.9; 63% female; 58% African American) completed the 3-item UCLA Loneliness screener at their primary care visits between November 2018 and January 2019. A retrospective case–control study design was used to compare health care utilization [hospitalizations, emergency department (ED) visits, primary care visits, no-shows and referrals] in the prior 2 years between patients who identified as lonely versus those who did not. Covariates included demographics and clinical characteristics. Results Nearly half (44%) of patients exceeded the cut-off for loneliness. Patients who were lonely were more likely to identify as African American, have depression and have a substance use disorder. Patients in the lonely group had significantly longer hospital stays and more primary care visits, no-shows and referrals than patients in the non-lonely group; there were no differences in number of hospitalizations or ED visits. Conclusions The prevalence of loneliness in an urban, underserved primary care clinic was much higher than prior prevalence estimates in primary care. Patients who are lonely may use more health care resources than patients who are not lonely. Primary care may be an ideal setting in which to identify patients who are lonely to further understand the impact of loneliness on health care outcomes.

scholarly journals Education in Quality Improvement for Practice in Primary Care During Residency Training and Subsequent Activities in Practice

2014 ◽  
Vol 6 (1) ◽  
pp. 50-54 ◽  
Author(s):  
Peter J. Carek ◽  
Lori M. Dickerson ◽  
Michele Stanek ◽  
Charles Carter ◽  
Mark T. Godenick ◽  
...  
Keyword(s):  
South Carolina ◽  
Quality Improvement ◽  
Family Medicine ◽  
Patient Care ◽  
Patient Centered ◽  
Residency Programs ◽  
Family Medicine Residency ◽  
The Family ◽  
The Impact ◽  
Standardized Curriculum

Abstract Background Quality improvement (QI) is an integral aspect of graduate medical education and an important competence for physicians. Objective We examined the QI activities of recent family medicine residency graduates and whether a standardized curriculum in QI during residency resulted in greater self-reported participation in QI activities in practice after graduation. Methods The family medicine residency programs affiliated with the South Carolina Area Health Education Consortium (N  =  7) were invited to participate in this study. Following completion of introductory educational activities, each site implemented regularly occurring (at least monthly) educational and patient care activities using QI principles and tools. Semiannually, representatives from each participating site met to review project aims and to provide updates regarding the QI activities in their program. To examine the impact of this project on QI activities, we surveyed graduates from participating programs from the year prior to and 2 years after the implementation of the curriculum. Results Graduates in the preimplementation and postimplementation cohorts reported participating in periodic patient care data review, patient care registries, QI projects, and disease-specific activities (57%–71% and 54%–63%, respectively). There were no significant differences in QI activities between the 2 groups except in activities associated with status of their practice as a patient-centered medical home. Conclusions Most but not all family medicine graduates reported they were actively involved in QI activities within their practices, independent of their exposure to a QI curriculum during training.

scholarly journals A structured curriculum and procedure clinic to help family medicine residents diagnose and treat skin cancer

2021 ◽  
Author(s):  
Christine Rivet ◽  
Farhad Motamedi ◽  
Joseph Burns ◽  
Douglas Archibald
Keyword(s):  
Skin Cancer ◽  
Family Medicine ◽  
Family Physicians ◽  
Residency Programs ◽  
Family Medicine Residency ◽  
Diagnosis And Management ◽  
Skin Cancers ◽  
Ideal Situation ◽  
Hands On ◽  
Family Medicine Residents

Implication Statement Melanoma is a potentially deadly type of skin cancer that has been increasing in incidence but is curable if found in the early stages. Family physicians are in an ideal situation to examine the skin during routine visits, but studies indicate they are not well trained to detect or treat skin cancers. We piloted a structured, longitudinal, hands-on procedural curriculum to improve family medicine residents’ ability to identify and manage skin cancers. Family medicine residency programs wishing to improve the diagnosis and management of skin cancer by family physicians might consider trialing our structured curriculum and procedure clinic.

scholarly journals Associations Between Program-Level Abortion Training and Graduate Preparation for and Provision of Reproductive Care

2019 ◽  
Vol 51 (9) ◽  
pp. 750-755 ◽  
Author(s):  
Amanda Weidner ◽  
Nancy Stevens ◽  
Grace Shih
Keyword(s):  
Family Medicine ◽  
Reproductive Health ◽  
Secondary Analysis ◽  
Family Physicians ◽  
Bivariate Analysis ◽  
Full Spectrum ◽  
Individual Level ◽  
Family Medicine Residency ◽  
Abortion Care ◽  
The Impact

Background and Objectives: The role of training in the declining rate of family physicians’ provision of women’s reproductive health care is unclear. No requirements for abortion training exist, and curricula vary widely. This study assessed the impact of program-level abortion training availability on graduates’ feelings of training adequacy and their postgraduate practice in reproductive health. Methods: We conducted secondary analysis of graduate survey data from 18 family medicine residency programs in the Northwest categorized by whether or not their program routinely offered abortion training (opt out or elective rotation). We used bivariate analyses and logistic regression to compare groups on preparation for training and current clinical practice of women’s health procedures. Results: Six of 18 programs included in the study had routinely available abortion training for graduates (N=408). In bivariate analysis, these programs with routine abortion training had significantly more graduates who report feeling prepared to perform abortions (19% vs 10%; P=.01), but no difference in likelihood to provide abortion care postresidency compared to programs without routine abortion training. In adjusted analyses, graduates of programs with routine abortion training were significantly less likely to feel prepared for performing colposcopies (OR=0.45, 95% CI, 0.26-0.78; P&lt;.01) and to actually perform them in practice (OR=0.32, 95% CI, 0.18-0.57; P&lt;.001); all other differences are attenuated. Conclusions: Program-level abortion training alone is not enough to overcome the systems- and individual-level barriers to increasing the numbers of trained family medicine residency graduates who provide abortion care and other reproductive care in practice. More must be done to create opportunities for family physicians interested in providing full-spectrum care in their postgraduate practices to be able to do so.

scholarly journals Point-of-Care Ultrasound for Family Medicine Residents: Attitudes and Confidence

2021 ◽  
Vol 53 (6) ◽  
pp. 457-460
Author(s):  
Jerica Johnson ◽  
David Stromberg ◽  
Byrch Willims ◽  
Nina Greenberg ◽  
Orrin Myers
Keyword(s):  
Family Medicine ◽  
Point Of Care ◽  
Point Of Care Ultrasound ◽  
Family Medicine Residency ◽  
University Of New Mexico ◽  
Confidence Levels ◽  
Significant Difference ◽  
Hands On ◽  
Before And After ◽  
Family Medicine Residents

Background and Objectives: Point-of-care ultrasound (POCUS) is increasingly being incorporated into family medicine residency training. Attitudes towards POCUS among family medicine residents (FMRs) are largely unknown, and confidence levels with performing and interpreting POCUS exams are also unknown among this group of learners. Our aim was to evaluate FMRs’ attitudes and confidence levels before and after the implementation of a new POCUS curriculum. Methods: Study participants included FMRs in all postgraduate years (ie, PGY1-PGY3) at the University of New Mexico (UNM) Family Medicine Residency Program. Our intervention was a yearlong implementation of a new POCUS curriculum based on the American Academy of Family Physicians POCUS curriculum guidelines. Our interventions included hands-on training sessions for both FMRs and faculty along with a resource website. We assessed attitudes and confidence levels with various POCUS exams using a pre- and postintervention survey. Results: Overall, FMRs felt significantly more confident in their ability to perform and interpret a point-of-care ultrasound after the implementation of POCUS curriculum. There was no significant difference in participants’ expectations of their use of POCUS during or after residency. Conclusions: Overall, this study provides evidence that the implementation of a POCUS curriculum that includes hands-on and didactic training is associated with increased confidence in utilizing POCUS among FMRs.

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.

PP27 An exploration of the experiences of paramedics taking part in a large randomised trial of airway management, and the impact on their views and practice

2019 ◽  
Vol 36 (10) ◽  
pp. e12.1-e12
Author(s):  
K Kirby ◽  
J Brandling ◽  
M Robinson ◽  
S Voss ◽  
J Benger
Keyword(s):  
Airway Management ◽  
Online Survey ◽  
Randomised Trial ◽  
Barriers And Facilitators ◽  
Trial Participation ◽  
List Type ◽  
Online Questionnaire ◽  
Advanced Airway ◽  
The Impact

BackgroundThe participation of over 1500 study paramedics in AIRWAYS-2 provides a unique opportunity for an in depth exploration of how the views and practice of study paramedics, in advanced airway management, may have developed as a result of their participation in AIRWAYS-2, and how their experiences can inform future trials in out-of-hospital cardiac arrest (OHCA). Future prehospital guidelines and practice will not only be shaped by the results of large trials such as AIRWAYS-2, but also by the views and attitudes of UK paramedics towards OHCA, airway management and research. This study allows an opportunity to add depth and understanding to the results of AIRWAYS-2.Study aimsTo explore paramedics’ experiences of participating in a large cluster randomized trial of airway management during OHCA, specifically:The challenges of enrolling patients who are critically unwell and unable to consent;Barriers and facilitators to successful research in OHCA patients;The impact on paramedics’ clinical practice and airway management during and after the trial;The role of advanced airway management during OHCA.MethodsContent analysis of an online survey of 1500 study paramedics to assess their experiences of participating in the trial and to establish any changes in their views and practice.Thematic analysis of telephone interviews with study paramedic to explore the findings of the online questionnaire. Exploring any changes in views and practice around advanced airway management as a result of participating in the trial; assessing experiences of trial training and enrolling critically unwell patients without consent, and exploring the barriers and facilitators for trial participation and the views of paramedics on the future role of advanced airway management during OHCA.Results and conclusionsThe study is in the analysis phase and is due to complete and report by the 31st January 2019.

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