FRONTLINE: DIABETES SUPPLEMENTING EDUCATION AND QUALITY IMPROVEMENT IN FAMILY MEDICINE RESIDENCY TRAINING

Abstract Background Residency programs are increasingly being asked to defend their quality, and that of the residents they produce. Yet “residency quality” is a construct that has not been well defined, with no accepted standards other than meeting accreditation standards. In 2009, the Association of Family Medicine Residency Directors developed a strategic plan that included the goal of raising the quality of family medicine training. Objective We describe the development of this quality improvement tool, which we called the residency performance index (RPI), and its first year of use by family medicine residency programs. We describe the use of the tool as a “dashboard” to facilitate program self-improvement. Intervention Using program metrics specific to family medicine training, and benchmark criteria for these metrics, the RPI was launched in 2012 to help programs identify strengths and areas for improvement in their educational activities and resident clinical experiences that could be tracked and reviewed as part of the annual program evaluation. Results Approximately 100 program directors began using the tool and 70 finished the process, and were provided aggregate data. Initial review of this experience revealed difficulties with collecting data, and lack of information on graduates' scope of practice. It also showed the potential usefulness of the tool as a program improvement mechanism. Conclusions The RPI is a new quality improvement tool for family medicine residency programs. Although some initial challenges need to be addressed, it has the promise to aid family medicine residency in its internal improvement efforts.

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A “Sense”-ational HPV Vaccination Quality Improvement Project in a Family Medicine Residency Practice

Journal of the National Medical Association ◽

10.1016/j.jnma.2019.06.004 ◽

2019 ◽

Vol 111 (6) ◽

pp. 588-599 ◽

Cited By ~ 1

Author(s):

Ann McGaffey ◽

Nicole Payette Lombardo ◽

Nathan Lamberton ◽

Patricia Klatt ◽

Jason Siegel ◽

...

Keyword(s):

Quality Improvement ◽

Family Medicine ◽

Hpv Vaccination ◽

Quality Improvement Project ◽

Improvement Project ◽

Family Medicine Residency

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

Journal of Graduate Medical Education ◽

10.4300/jgme-06-01-39.1 ◽

2014 ◽

Vol 6 (1) ◽

pp. 50-54 ◽

Cited By ~ 8

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.

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Intimidation, harassment, and discrimination during family medicine residency training: a mixed methods study

BMC Medical Education ◽

10.1186/s12909-021-02623-w ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Olga Szafran ◽

Wayne Woloschuk ◽

Jacqueline M. I. Torti ◽

Maria F. Palacios Mackay

Keyword(s):

Mixed Methods ◽

Family Medicine ◽

Residency Training ◽

Sleep Problems ◽

Phase 1 ◽

Qualitative Interviews ◽

Hospital Setting ◽

Mixed Methods Study ◽

Family Medicine Residency ◽

Negative Effect

Abstract Background The importance of wellbeing of family medicine residents is recognized in accreditation requirements which call for a supportive and respectful learning environment; however, concerns exist about learner mistreatment in the medical environment. The purpose of this study was to to describe family medicine graduates’ perceived experience with intimidation, harassment and discrimination (IHD) during residency training. Methods A mixed-methods study was conducted on a cohort of family medicine graduates who completed residency training during 2006–2011. Phase 1, the quantitative component, consisted of a retrospective survey of 651 graduates. Phase 2, the qualitative component, was comprised of 11 qualitative interviews. Both the survey and the interviews addressed graduates’ experience with IHD with respect to frequency and type, setting, perpetrator, perceived basis for IHD, and the effect of the IHD. Results The response rate to the survey was 47.2%, with 44.7% of respondents indicating that they experienced some form of mistreatment/IHD during residency training, and 69.9% noting that it occurred more than once. The primary sources of IHD were specialist physicians (75.7%), hospital nurses (47.8%), and family physicians (33.8%). Inappropriate verbal comments were the most frequent type of IHD (86.8%). Graduates perceived the basis of the IHD to be abuse of power (69.1%), personality conflict (36.8%), and family medicine as a career choice (30.1%), which interview participants also described. A significantly greater proportion IMGs than CMGs perceived the basis of IHD to be culture/ethnicity (47.2% vs 10.5%, respectively). The vast majority (77.3%) of graduates reported that the IHD experience had a negative effect on them, consisting of decreased self-esteem and confidence, increased anxiety, and sleep problems. As trainees, they felt angry, threatened, demoralized, discouraged, manipulated, and powerless. Some developed depression or burnout, took medication, or underwent counselling. Conclusions IHD continued to be prevalent during family medicine residency training, with it occurring most frequently in the hospital setting and specialty rotations. Educational institutions must work with hospital administrators to address issues of mistreatment in the workplace. Residency training programs and the medical establishment need to be cognizant that the effects of IHD are far-reaching and must continuously work to eradicate it.

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