scholarly journals Benchmarking of provider competencies and current training for prevention and management of obesity among family medicine residency programs: a cross-sectional survey

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Manuela Orjuela-Grimm ◽  
W. Scott Butsch ◽  
Silvia Bhatt-Carreño ◽  
B. Gabriel Smolarz ◽  
Goutham Rao

Abstract Background U.S. physicians lack training in caring for patients with obesity. For family medicine, the newly developed Obesity Medicine Education Collaborative (OMEC) competencies provide an opportunity to compare current training with widely accepted standards. We aimed to evaluate the current state of obesity training in family medicine residency programs. Methods We conducted a study consisting of a cross-sectional survey of U.S. family medicine residency program leaders. A total of 735 directors (including associate/assistant directors) from 472 family medicine residency programs identified from the American Academy of Family Physicians public directory were invited via postal mail to complete an online survey in 2018. Results Seventy-seven program leaders completed surveys (16% response rate). Sixty-four percent of programs offered training on prevention of obesity and 83% provided training on management of patients with obesity; however, 39% of programs surveyed reported not teaching an approach to obesity management that integrates clinical and community systems as partners, or doing so very little. Topics such as behavioral aspects of obesity (52%), physical activity (44%), and nutritional aspects of obesity (36%) were the most widely covered (to a great extent) by residency programs. In contrast, very few programs extensively covered pharmacological treatment of obesity (10%) and weight stigma and discrimination (14%). Most respondents perceived obesity-related training as very important; 65% of the respondents indicated that expanding obesity education was a high or medium priority for their programs. Lack of room in the curriculum and lack of faculty expertise were reported as the greatest barriers to obesity education during residency. Only 21% of the respondents perceived their residents as very prepared to manage patients with obesity at the end of the residency training. Conclusion Family medicine residency programs are currently incorporating recommended teaching to address OMEC competencies to a variable degree, with some topic areas moderately well represented and others poorly represented such as pharmacotherapy and weight stigma. Very few program directors report their family medicine residents are adequately prepared to manage patients with obesity at the completion of their training. The OMEC competencies could serve as a basis for systematic obesity training in family medicine residency programs.


PRiMER ◽  
2021 ◽  
Vol 5 ◽  
Author(s):  
Ying Zhang ◽  
Sonali Sheth ◽  
Amanda K.H. Weidner ◽  
Patricia Egwuatu ◽  
Lauren Webb ◽  
...  

Background and Objective: Immediate postpartum placement of intrauterine devices (PPIUD) offers important benefits to patients. Little is known about PPIUD training or knowledge within family medicine residency programs. We evaluated PPIUD experience and prior training among family medicine residents and faculty. Methods: We conducted a cross-sectional survey of residents and faculty in 24 regional family medicine residency programs in 2018. Survey questions focused on reception of PPIUD training and experience with PPIUD counseling and placement. Results: The final survey sample included 203 residents and 100 faculty with an overall response rate of 39%. About 26% (n=79) of all participants reported receiving prior training for counseling and placement of PPIUDs, while 16% (n=48) of participants had ever placed a PPIUD. Twenty-six percent (n=78) of participants reported that their residency programs offered PPIUD training. Residents and faculty who reported past PPIUD training and/or placement experience were more likely to have ever counseled patients about PPIUD (P<.001) and report that their primary training hospital offered PPIUD to patients (P<.001) and their residency programs offered PPIUD training (P<.001). Conclusions: Few programs offer routine PPIUD training opportunities for family medicine residents and faculty, which may contribute to limited availability of PPIUD to patients. There is a need to improve PPIUD training and placement opportunities for both family medicine residents and faculty.



2021 ◽  
Vol 53 (3) ◽  
pp. 189-194
Author(s):  
Gretchen Irwin ◽  
Kari Nilsen ◽  
Raghuveer Vedala ◽  
Rick Kellerman

Background and Objectives: Faculty shortages are a significant concern in family medicine education. Many family medicine residency programs need to recruit faculty in the coming years. As a result, family medicine faculty and resident physicians will be interviewing candidates to fill these vacancies. Little is known about the characteristics valued in a family medicine residency faculty candidate. Methods: Using a cross-sectional survey of family medicine faculty and resident physicians in family medicine residency programs in Kansas, we attempted to define which characteristics are most valued by current faculty members and resident physicians in family medicine residency programs during the faculty hiring process. Results: Of 187 invited respondents, 93 completed the survey (49.7% response rate). Twenty-five characteristics, grouped into five domains of relationship building, clinical, teaching, research and administrative skills, were rated as either not important, important, or very important. Building and maintaining healthy relationships was the most important characteristic for faculty, residents, males, and females. Administrative characteristics were the lowest ranked domain in our survey. Discussion: These results provide an important snapshot of the characteristics valued in faculty candidates for family medicine residency programs. Understanding the paradigm used by existing faculty and resident physicians in family medicine residency programs when considering new faculty hires has an important impact on faculty recruitment and faculty development programs.



Author(s):  
Christopher Daniel Gelston ◽  
Jennifer Landrigan Patnaik

Purpose: To evaluate ophthalmic educational training and confidence in caring for patients with ophthalmic complaints among internal, emergency, and family medicine residents in the United States.Methods: A 41-item cross-sectional survey was sent to the directors of 529 internal medicine, 237 emergency medicine, and 629 family medicine residency programs, who distributed it to residents in those programs. The survey included the number of ophthalmic education hours residents received. Respondents were asked to rate their confidence in performing an ophthalmic exam and treating patients with ocular conditions using a 5-point Likert scale ranging from “not confident” to “very confident.”Results: In total, 92.5% of internal medicine, 66.8% of emergency medicine, and 74.5% of family medicine residents received less than 10 hours of ophthalmic education during residency. Most respondents (internal medicine, 59.1%; emergency medicine, 76.0%; family medicine, 65.7%) reported that patients with ocular complaints constituted 1%–5% of visits. Mean±standard deviation confidence levels in performing an eye exam and treating patients with ophthalmic conditions were highest in emergency medicine residency programs (2.9±0.7), followed by family medicine (2.3±0.6) and internal medicine (2.2±0.6). A higher reported number of ophthalmic education hours in residency was associated with greater confidence among emergency (P<0.001), family (P<0.001), and internal (P=0.005) medicine residents.Conclusion: Internal, emergency, and family medicine residents receive limited ophthalmic education, as reflected by their overall low confidence levels in performing an ophthalmic exam and treating patients with ocular complaints. An increase in ophthalmic educational hours during their residencies is recommended to improve upon this knowledge gap.



2018 ◽  
Vol 50 (6) ◽  
pp. 437-443 ◽  
Author(s):  
Hugh Silk ◽  
Judith A. Savageau ◽  
Kate Sullivan ◽  
Gail Sawosik ◽  
Min Wang

Background and Objectives: National initiatives have encouraged oral health training for family physicians and other nondental providers for almost 2 decades. Our national survey assesses progress of family medicine residency programs on this important health topic since our last survey in 2011. Methods: Family medicine residency program directors (PDs) completed an online survey covering various themes including number of hours of oral health (OH) teaching, topics covered, barriers, evaluation, positive influences, and program demographics. Results: Compared to 2011, more PDs feel OH should be addressed by physicians (86% in 2017 vs 79% in 2011), yet fewer programs are teaching OH (81% vs 96%) with fewer hours overall (31% vs 45% with 4 or more hours). Satisfaction with the competence of graduating residents in OH significantly decreased (17% in 2017 vs 32% in 2011). Program directors who report graduates being well prepared to answer board questions on oral health topics are more likely to have an oral health champion (P&lt;0.001) and report satisfaction with the graduates’ level of oral health competency (P&lt;0.001). Programs with an oral health champion, or having a relationship with a state or national oral health coalition, or having routine teaching from a dental professional are significantly more likely to have more hours of oral health curriculum (P&lt;0.001). Conclusions: Family medicine PDs are more aware of the importance of oral health, yet less oral health is being taught in residency programs. Developing more faculty oral health champions and connecting programs to dental faculty and coalitions may help reduce this educational void.



2013 ◽  
Vol 5 (1) ◽  
pp. 31-35 ◽  
Author(s):  
Lars E. Peterson ◽  
Vanessa Diaz ◽  
Lori M. Dickerson ◽  
Marty S. Player ◽  
Peter J. Carek

Abstract Background Resident duty hour limits, new requirements for supervision, and an enhanced focus on patient safety have shown mixed effects on resident quality of life, patient safety, and resident competency. Few studies have assessed how recent graduates feel these changes have affected their education. Objective We assessed recent graduates' perceptions about the effects of duty hour and supervision requirements on their education. Methods We conducted a cross-sectional survey of graduates from South Carolina Area Health Education Consortium-affiliated family medicine residency programs from 2005 to 2009 by using logistic regression to determine associations between participant characteristics and survey responses. Results Graduates (N  =  136) completed the survey with a 51.3% response rate. Nearly all (96%) reported that residency prepared them for their current work hours; 97% reported they felt adequately supervised; 81% worked fewer hours in practice than in residency; 20% believed the limits had restricted their clinical experience; and 3% felt duty hour limits were more important than supervision. Graduates who practiced in a mid-sized communities were more likely to report duty hour limits restricted their clinical experience than individuals practicing in communities of &lt;10 000 (OR  =  6.30; 95% CI, 1.38–28.72). Conclusions Most graduates who responded to the survey felt supervision was equally or more important than limits on resident duty hours. However, 20% of respondents felt that the duty hour standards limited their education. The duty hour and supervision requirements challenge educators to ensure quality education.



2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Hüsna Çevik ◽  
Mehmet Ungan

Abstract Background The COVID-19 pandemic has had a negative impact on resident training in different branches and affected the physical and mental health of frontline residents adversely. This nationwide cross-sectional survey aimed to investigate the effects of the COVID-19 pandemic on family medicine residents in Turkey, including the levels of depression and burnout. Methods An anonymous online survey was distributed to all family medicine residents via e-mail and a web link between 28.11.2020 and 12.12.2020. Information on sociodemographic data and the residency programme were evaluated, and factors associated with depression and burnout were examined using the Patient Health Questionnaire-9 (PHQ-9) and the Burnout Measure-Short Version (BMS) respectively. Results Although the weekly average working hours of the 477 respondents increased significantly during the pandemic (p < 0.05), the average weekly working time in the Family Medicine (FM) outpatient clinic decreased. The greatest concern of 58.3% of the residents was fear of transmitting COVID-19 to their family members. 90.2% of the residents stated that training programmes were negatively or very negatively affected. According to PHQ-9 scores, 15.7% of residents had moderately severe, and 14.9% severe depression. The BMS scores of the residents demonstrated that 24.1% had a very severe burnout problem, and 23.3% should seek professional help as soon as possible. Being single, having no children, female gender, lack of personal protective equipments and increased contact time with COVID-19 patients were associated with higher scores in the depression and burnout scales (p < 0.05). Conclusions The COVID-19 pandemic has had a negative impact on training programmes for FM residents, who are at the forefront of the pandemic in Turkey, and this situation is closely related to depression and burnout. Due to the unpredictability of the pandemic, long-term plans should be made for the training needs of residents in order to protect their physical and mental health.



2020 ◽  
Vol 7 ◽  
pp. 238212052097320
Author(s):  
W Scott Butsch ◽  
Kathryn Robison ◽  
Ranita Sharma ◽  
Julianne Knecht ◽  
B. Gabriel Smolarz

Background: In an obesity epidemic, physicians are unprepared to treat patients with obesity. The objective of this study was to understand how obesity is currently addressed in United States (U.S.) Internal Medicine (IM) residency programs and benchmark the degree to which curricula incorporate topics pertaining to the recently developed Obesity Medicine Education Collaborative (OMEC) competencies. Methods: Invitations to complete an online survey were sent via postal mail to U.S IM residency programs in 2018. Descriptive analyzes were performed. Results: Directors/associate directors from 81 IM residencies completed the online survey out of 501 programs (16.2%). Although obesity was an intentional educational objective for most programs (66.7%), only 2.5% of respondents believed their residents are “very prepared” to manage obesity. Formal rotation opportunities in obesity are limited, and at best, only one-third (34.6%) of programs reported any one of the core obesity competencies are covered to “a great extent.” Many programs reported psychosocial components of obesity (40.7%), weight stigma (44.4%), etiological aspects of obesity (64.2%) and pharmacological treatment of obesity (43.2%) were covered to “very little extent” or “not at all.” Lack of room in the curriculum and lack of faculty expertise are the greatest barriers to integrating obesity education; only 39.5% of residency programs have discussed incorporating or expanding formal obesity education. Conclusions: Our study found the current obesity curricula within U.S. IM residency programs do not adequately cover important aspects that address the growing obesity epidemic, suggesting that obesity education is not enough of a priority for IM residency programs to formalize and implement within their curricula.



2020 ◽  
Vol 52 (8) ◽  
pp. 581-585
Author(s):  
Lauren A. Cafferty ◽  
Paul F. Crawford ◽  
Jeremy T. Jackson ◽  
Christy J.W. Ledford

Background and Objectives: Research shows that limited time, lack of funding, difficulty identifying mentors, and lack of technical support limit resident and faculty ability to fully participate in scholarly activity. Most research to date focuses on medical student and resident attitudes toward research. This study aimed to understand the underlying attitudes of family medicine residency (FMR) leaders toward scholarship. Methods: Two focus groups of family medicine residency leaders were conducted in March 2018. The sample (N=19) was recruited through the membership directory of the Family Physicians Inquiry Network. Results: Leaders shared positive attitudes toward scholarship; however, motivation to engage residents and residency faculty in scholarship diverged. Motivations for promoting scholarly activity among participants were either extrinsic (through ACGME, program graduation, or promotion requirements) or intrinsic (through personal interest and natural drive). Conclusions: Emerging themes illustrate differences in how FMR program leaders perceive the role of scholarship in residency programs. As programs aim to increase research and scholarship, more attention must be paid to the motivating messages communicated by the program’s leadership.



2020 ◽  
Vol 12 (02) ◽  
pp. e188-e194
Author(s):  
Shazia Dharssi ◽  
Fasika A. Woreta ◽  
Michael V. Boland

Abstract Purpose Given ophthalmology residency programs are transitioning to include the internship year, either through “joint” or “integrated” 4-year programs, we set out to identify applicant preferences regarding the match and their experiences with two residency application systems: (1) the Central Application Service (CAS) and (2) the Electronic Residency Application Service (ERAS). Design This study is designed as a retrospective repeated cross-sectional survey. Methods A 15-question online survey was sent to 196 and 461 applicants to the 2019 and 2020 ophthalmology match cycles, respectively. Questions from the survey assessed user experiences with specific components of both application services and evaluated preferences regarding the future of the ophthalmology match. Results Responses were received from 208 (32%) applicants. A majority of users had positive experiences with both application services; for CAS, 162 (78%) applicants had a positive experience, compared with 111 (53%) for ERAS. When compared directly, applicants favored the CAS (60%) to ERAS (21%). Furthermore, 108 (52%) respondents stated that they would prefer ophthalmology continue to use both the CAS and ERAS, while 47 (23%) respondents indicated a desire for the CAS to become the only application system for both matches. Conclusion Although half of all respondents prefer that both the CAS and ERAS systems are utilized for the match process, many express a desire for a single matching program. As ophthalmology residency programs move to joint and integrated 4-year programs, the complexity of matching will increase. Further evaluation of applicant preferences during this transition phase is needed as applicants are required to apply to a variety of different joint and integrated internship and ophthalmology programs.



2018 ◽  
Vol 50 (6) ◽  
pp. 450-454
Author(s):  
Alicia Ludden-Schlatter ◽  
Jack Wells ◽  
Robin L. Kruse

Background and Objectives: Procedural training is integral to family medicine residencies. Although accreditation bodies require that family medicine residency programs train residents in procedures relevant to their practices, there are no standards defining the scope of family medicine. We compared the perceived importance of 31 procedures by faculty, residents, and recent graduates of one institution. Methods: An online survey was sent to current residents and faculty of a large academic family medicine residency, as well as community practitioners who had graduated from that residency within the past 5 years. The survey asked participants to rate how important 31 procedures are for family medicine practices. Results: The overall response rate was 37%. Most respondents provided outpatient care, and few provided or intended to provide obstetric care. Dermatologic and musculoskeletal procedures were rated as having high importance by all groups, whereas obstetric and inpatient procedures received lower ratings. Residents ascribed higher importance than faculty or recent graduates for nearly all procedures. Conclusions: Most residents, faculty, and community practitioners provided outpatient care and rated dermatologic and musculoskeletal procedures as important. Inpatient and obstetric care are less common career paths, and related procedures were rated as less important. Resident physicians ascribed greater importance than community practitioners for many procedures, which may be due misperceptions of their future practice needs or imposed requirements for graduation.



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