Impact of an Outpatient Psychiatry Rotation on Family Medicine Residents and Interns

1982 ◽  
Vol 27 (8) ◽  
pp. 644-647 ◽  
Author(s):  
Ronald J. Dyck ◽  
Hassan F.A. Azim
Keyword(s):  
Family Medicine ◽  
Training Program ◽  
Student Perceptions ◽  
Psychiatric Patients ◽  
Level Of Satisfaction ◽  
Outpatient Psychiatry ◽  
Assessment And Treatment ◽  
Students Satisfaction ◽  
Family Medicine Residents

The present study examined the relative impact of a training program for Family Medicine Residents and Rotating Interns located in a Psychiatric Walk-In Clinic. Specifically, it was of interest to assess students’ satisfaction with the orientation to the rotation, the degree of involvement in different activities and the amount of supervision received, as well as the skills acquired during the rotation. In addition to the information collected immediately following the rotation, student perceptions of the relative benefits of the rotation to their medical practice and their general attitude toward mental health facilities were obtained in a follow-up survey. The results indicated that students were generally satisfied with their rotation. In particular, their level of satisfaction was related to the exposure to a wide variety of psychiatric patients, the supervision received, and the fulfillment of their expectations of the rotation. The findings also indicated that the training program did not meet all the needs of the students, particularly in the area of the assessment and treatment of couples and families and the utilization of psychotropic medications.

scholarly journals The Interests of Family Medicine Residents in Future Faculty Positions Across the Senior Year

2021 ◽  
Vol 8 ◽  
pp. 238212052110596
Author(s):  
Amanda Weidner ◽  
Marcia McGuire ◽  
Kim Stutzman ◽  
Justin Glass ◽  
Nancy Gray Stevens
Keyword(s):  
Family Medicine ◽  
Senior Year ◽  
Faculty Role ◽  
Residency Programs ◽  
Teaching Role ◽  
Final Sample ◽  
Faculty Positions ◽  
Administrative Responsibilities ◽  
Family Medicine Residents

Background and Objectives The shortage of residency faculty in the pipeline is a growing concern to meet future workforce needs, though there is little research on attracting residents to be future faculty or what factors would influence their interest in this role. The objectives of this study were: (1) To assess the interest of third year residents (R3s) in faculty positions, and the various factors that might positively or negatively affect this decision; (2) to compare whether this changes across the R3 year; and (3) to compare between chief residents and other R3s. Methods Longitudinal survey at two points in time for each of three consecutive cohorts of R3s (2016-2018) from a regional network of family medicine residency programs. Results Among the final sample of R3s (176/545, 32% response), nearly half were interested in a residency faculty role. Strong positive influences on interest include the teaching role, advising/mentoring role, range of practice scope, and ability to perform procedures; salary and administrative responsibilities detract from interest. Among the matched sample of 96 R3s who also responded at Time 2 (55% response), non-chief residents had an increase in knowledge of and interest in the faculty role across the R3 year. Conclusions Nearly half of senior family medicine residents report positive interest in residency faculty positions and in most components of the role. Mentorship may encourage more residents to consider these positions upon graduation or shortly thereafter. More research on other specialties and with career follow up is recommended.

Le désintérêt progressif des résidents en médecine familiale à l’égard du suivi à domicile des personnes âgées

2014 ◽  
Vol 33 (2) ◽  
pp. 176-184
Author(s):  
François Aubry ◽  
Yves Couturier ◽  
Serge Dumont
Keyword(s):  
Family Medicine ◽  
The Elderly ◽  
Patient Centered ◽  
Medical Interventions ◽  
Short Period ◽  
Before And After ◽  
Centered Care ◽  
Administrative Tasks ◽  
Family Medicine Residents

ABSTRACTThis paper deals with the lack of interest shown by family medicine residents in Quebec (Canada) in home follow-up or monitoring of the elderly. By collecting and analyzing data from sixteen family medicine residents before and after their first experience of home follow-up, and from four medical supervisors, we found that residents experience a rapid loss of interest in this practice over a very short period. We show that this lack of interest stems first from the difficulty of applying the principle of patient-centered care, wherein medical interventions must meet the needs of the elderly in their entirety. Secondly, residents complain that they have to deal with many administrative tasks. They call for implementation of professional features to better integrate services such as case management.

scholarly journals Do Patients Follow-Up with Discharge Advice After Psychiatric Assessment and Discharge from Emergency Department?

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
H. Lari ◽  
M. Bullard ◽  
I. Colman ◽  
J.-M. Le Melledo ◽  
P. Tibbo
Keyword(s):  
Emergency Department ◽  
Mood Disorder ◽  
Psychotic Disorder ◽  
Psychiatric Patients ◽  
Family Doctor ◽  
Data Entry ◽  
Psychiatric Assessment ◽  
Addiction Services ◽  
Outpatient Psychiatry

Aims:To assess if patients follow-up with discharge advice after psychiatric assessment and discharge from Emergency Department (ED).Method:All patients with psychiatric complaint who presented at three ED's in Edmonton, Alberta, Canada were identified via ED Information System (EDIS). Patients presenting complaint were entered onto the EDIS by Triage Nurse along with demographic information. All charts were reviewed and clinical data was obtained. Patients who were assessed by Psychiatry and discharged home were contacted via telephone to determine if they followed-up with discharge advice of psychiatry team.Results:A total of 1420 patients have been identified during April and May 2008.Chart review has been completed. Data entry and follow-up is in progress. Preliminary data of 250 patients is presented here. 55% were male. Mean age 37 years (SD 12). 47% presented voluntarily. Psychiatry was consulted for 53% of patients. The presenting complaint was “Suicidal Ideation” in 29% and “Bizarre behaviour” in 24%. Primary diagnoses for those seen by Psychiatry were mood disorder (30%) and psychotic disorder (26%). Out of those seen by Psychiatry 36% were admitted. 44% of those admitted by psychiatry were diagnosed with psychotic disorder followed by mood disorder in 31%. The patients who were discharged home by Psychiatry were advised to follow up with their family doctor 7%, psychiatrist 15%, outpatient psychiatry services 16% and addiction services 16%.Conclusion:This is the first report of outcome of discharge advice and will help in developing and planning community follow-up system for psychiatric patients.

scholarly journals Long-term Effects of a Health Literacy Curriculum for Family Medicine Residents

PRiMER ◽  
2017 ◽  
Vol 1 ◽  
Author(s):  
Cliff Coleman ◽  
Sylvia Peterson-Perry ◽  
Bhavaya Sachdeva ◽  
Amy Kobus ◽  
Roger Garvin
Keyword(s):  
Health Literacy ◽  
Family Medicine ◽  
Health Care Professionals ◽  
Literacy Curriculum ◽  
Communication Behaviors ◽  
Literacy Knowledge ◽  
Clear Communication ◽  
Family Medicine Residents

Introduction: Improving education about health literacy for health care professionals has been recommended, and many US family medicine residency programs have developed such curricula. Few studies have evaluated the effectiveness of health literacy curricula for health care professionals. This pilot study aimed to determine whether a longitudinal health literacy curriculum for family medicine residents could achieve long-term sustained improvements in health literacy knowledge and clear communication practices. Methods: Self-reported pre- and postassessments were conducted for a series of four health literacy didactic and experiential trainings over 11 months with a cohort of 12 first-year family medicine residents (study adequately powered for cohort of 10 or more). Results: Five out of five health literacy knowledge items showed sustained significant improvement immediately after the initial didactic training. Two out of eight clear communication behaviors (eliciting patients’ questions through an open-ended approach, and using a teach-back method to check for patients’ understanding) showed sustained significant improvements in the 11-month follow-up period. The remaining six behaviors demonstrated a saw-tooth pattern, wherein each training session produced improvements in planned behaviors, which were, however, not maintained at subsequent follow-up assessments. Conclusions: These data suggest that residents learned the cognitive material related to health literacy and clear communication easily, but had difficulty integrating many trained skills into clinical practice, despite the use of experiential learning techniques. Future studies should use an observational design to assess clear communication behaviors, and should include assessment of potential barriers to implementing clear communication skills in clinical practice.

scholarly journals P046: The “Nightmares-FM” course: an effective simulation-based acute care training method for family medicine residents

CJEM ◽  
2016 ◽  
Vol 18 (S1) ◽  
pp. S94-S94
Author(s):  
F. Gilic ◽  
K. Schultz ◽  
I. Sempowski ◽  
A. Blagojevic
Keyword(s):  
Family Medicine ◽  
Acute Care ◽  
Therapeutic Interventions ◽  
Initial Assessment ◽  
Positive Pressure ◽  
Altered Level ◽  
Medicine Resident ◽  
Independent Expert ◽  
Family Medicine Residents

Introduction / Innovation Concept: Acute care skills are difficult to teach but can be improved using high-fidelity simulation training. We developed a comprehensive acute care “Nightmares-FM” simulation course (NM) for our Family Medicine residents and compared it to our standard simulation teaching- episodic Acute Care Rounds (ACR). Methods: NM course consisted of an initial 2 day session followed by 3 follow-on sessions interspersed throughout the PGY-1 year. ACR participants got access to 3 sessions interspersed throughout the PGY-1 year, each focusing on a different aspect of acute care. Both groups got access to the NM manual which covered the relevant topics: shock, arrhythmias, shortness of breath, altered level of consciousness and myocardial infarction. The manual is physiology-based and written specifically at the level that an average Family Medicine resident would be expected to perform at during on-call crises or emergency medicine rotations. 12 residents participating in the NM and 12 residents in time-matched ACR filled out questionnaires asking them to rate their level of knowledge of various aspects of acute care. Self-reported changes before and after each session, and at the end of the year, were analyzed using Wilcoxon matched pairs test. End of the year mean scores were compared using a two sided t-test. Finally, we developed a high-complexity acute care Objective Structured Clinical Examination (OSCE): COPD exacerbation with septic shock requiring use of positive pressure ventilation, fluids and vasopressors. The groups participated in the OSCE in February of their PGY-2 year and were graded using a validated scoring sheet marked by two independent expert video reviewers. Curriculum, Tool, or Material: NM initial 2-day session significantly improved the resident’s self-assessment scores on all 20 items of the questionnaire (p<0.05). Time matched ACR improved 11 out of 20 items (p<0.05) level. Follow-up NM sessions improved 5-8 out of 20 items, (p<0.05). Follow-up ACR sessions improved 1-5 out of 20 items, (p<0.05). End of the year means were higher for 13/20 items in the NM group (p>0.05) The NM group scored significantly higher on both the mean scores of OSCE individual categories: Initial assessment, Diagnostic workup, Therapeutic interventions and Communication and teamwork (p<0.05) and the Global Assessment Score (p<0.026). Conclusion: “Nightmares-FM” course is more effective than our standard curriculum at teaching acute care skills to Family Medicine residents.

Effects of a resiliency program on burnout and resiliency in family medicine residents

2019 ◽  
Vol 54 (4-5) ◽  
pp. 327-335 ◽  
Author(s):  
Julie Brennan ◽  
Angele McGrady ◽  
Jennifer Tripi ◽  
Archit Sahai ◽  
Megan Frame ◽  
...  
Keyword(s):  
Family Medicine ◽  
Intervention Group ◽  
Maslach Burnout Inventory ◽  
Assessment Tools ◽  
Controlled Study ◽  
Control Group ◽  
Post Intervention ◽  
Significant Difference ◽  
Family Medicine Residents

Research has highlighted the prevalence of burnout in medical residents and the relative rarity of evidence-based structured programs to build resiliency. This was a controlled study of an 8-h program designed to increase resiliency and decrease burnout that focused on personal awareness, improving coping skills, building social connection, and maintaining balance. The project was approved by the institutional review board. Thirty-two family medicine residents signed the consent form. Structured assessment tools were administered to the intervention group at pre-program, immediately post-program and at one- and two-year follow-up. The control group completed the same pre- and post-assessments. Post-intervention comparison of the two groups demonstrated that the intervention group showed significantly lower scores in depersonalization and emotional exhaustion on the Maslach Burnout Inventory immediately after the program. There was no significant difference in the outcomes in year1 and year 2 follow-up. Residents evaluated the program positively. Resiliency programs can be incorporated into a family medicine residency and participants benefit by lowering indicators of burnout.

scholarly journals Educational Intervention Reduced Family Medicine Residents’ Intention to Request Diagnostic Tests: Results of a Controlled Trial

2021 ◽  
Vol 41 (3) ◽  
pp. 329-339
Author(s):  
Antonius Schneider ◽  
Markus Bühner ◽  
Therese Herzog ◽  
Siona Laverty ◽  
Stefanie Ziehfreund ◽  
...  
Keyword(s):  
Family Medicine ◽  
Educational Intervention ◽  
Diagnostic Tests ◽  
Controlled Trial ◽  
Diagnostic Reasoning ◽  
Significant Group ◽  
Significant Group Difference ◽  
The Impact ◽  
Family Medicine Residents

Objective Dealing with uncertainty is a core competence for physicians. To evaluate the impact of an educational intervention on family medicine residents’ (FMRs’) intention to request diagnostic tests and their attitudes toward uncertainty. Methods Nonrandomized controlled trial. Intervention group (IG) FMRs participated in interactive “dealing with uncertainty” seminars comprising statistical lessons and diagnostic reasoning. Control group (CG) FMRs participated in seminars without in-depth diagnostic lessons. FMRs completed the Dealing with Uncertainty Questionnaire (DUQ), comprising the Diagnostic Action and Diagnostic Reasoning scales. The Physicians’ Reaction to Uncertainty (PRU) questionnaire, comprising 4 scales (Anxiety Due to Uncertainty, Concern about Bad Outcomes, Reluctance to Disclose Uncertainty to Patients, and Reluctance to Disclose Mistakes to Physicians) was also completed. Follow-up was performed 3 months later. Differences were calculated with repeated-measures analysis of variance. Results In total, 107 FMRs of the IG and 102 FMRs of the CG participated at baseline and follow-up. The mean (SD) Diagnostic Action scale score decreased from 24.0 (4.8) to 22.9 (5.1) in the IG and increased in the CG from 23.7 (5.4) to 24.1 (5.4), showing significant group difference ( P = 0.006). The Diagnostic Reasoning scale increased significantly ( P = 0.025) without a significant group difference ( P = 0.616), from 19.2 (2.6) to 19.7 (2.4) in the IG and from 18.1 (3.3) to 18.8 (3.2) in the CG. The PRU scale Anxiety Due to Uncertainty decreased significantly ( P = 0.029) without a significant group difference ( P = 0.116), from 20.5 (4.8) to 18.5 (5.5) in the IG and from 19.9 (5.5) to 19.0 (6.0) in the CG. Conclusion The structured seminar reduced self-rated diagnostic test requisition. The change in Anxiety Due to Uncertainty and Diagnostic Reasoning might be due to an unspecific accompanying effect of the extra-occupational seminars for residents.

52. Simulation based training improves resident competence in the performance of critical resuscitation procedures

2007 ◽  
Vol 30 (4) ◽  
pp. 56
Author(s):  
I. Rigby ◽  
I. Walker ◽  
T. Donnon ◽  
D. Howes ◽  
J. Lord
Keyword(s):  
Internal Medicine ◽  
Emergency Medicine ◽  
Medical Education ◽  
Family Medicine ◽  
Training Program ◽  
Correlation Coefficient ◽  
Training Programs ◽  
Self Assessment ◽  
Procedural Skills ◽  
Simulation Based

We sought to assess the impact of procedural skills simulation training on residents’ competence in performing critical resuscitation skills. Our study was a prospective, cross-sectional study of residents from three residency training programs (Family Medicine, Emergency Medicine and Internal Medicine) at the University of Calgary. Participants completed a survey measuring competence in the performance of the procedural skills required to manage hemodynamic instability. The study intervention was an 8 hour simulation based training program focused on resuscitation procedure psychomotor skill acquisition. Competence was criterion validated at the Right Internal Jugular Central Venous Catheter Insertion station by an expert observer using a standardized checklist (Observed Structured Clinical Examination (OSCE) format). At the completion of the simulation course participants repeated the self-assessment survey. Descriptive Statistics, Cronbach’s alpha, Pearson’s correlation coefficient and Paired Sample t-test statistical tools were applied to the analyze the data. Thirty-five of 37 residents (9 FRCPC Emergency Medicine, 4 CCFP-Emergency Medicine, 17 CCFP, and 5 Internal Medicine) completed both survey instruments and the eight hour course. Seventy-two percent of participants were PGY-1 or 2. Mean age was 30.7 years of age. Cronbach’s alpha for the survey instrument was 0.944. Pearson’s Correlation Coefficient was 0.69 (p < 0.001) for relationship between Expert Assessment and Self-Assessment. The mean improvement in competence score pre- to post-intervention was 6.77 (p < 0.01, 95% CI 5.23-8.32). Residents from a variety of training programs (Internal Medicine, Emergency Medicine and Family Medicine) demonstrated a statistically significant improvement in competence with critical resuscitation procedural skills following an intensive simulation based training program. Self-assessment of competence was validated using correlation data based on expert assessments. Dawson S. Procedural simulation: a primer. J Vasc Interv Radiol. 2006; 17(2.1):205-13. Vozenilek J, Huff JS, Reznek M, Gordon JA. See one, do one, teach one: advanced technology in medical education. Acad Emerg Med. 2004; 11(11):1149-54. Ziv A, Wolpe PR, Small SD, Glick S. Simulation-based medical education: an ethical imperative. Acad Med. 2003; 78(8):783-8.

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