Teaching Humanities in Medicine: The University of Massachusetts Family Medicine Residency Program Experience

Abstract Background Field notes (FNs) are used in Family Medicine residency programs to foster reflective learning and facilitate formative assessment. Residents assess their strengths and weaknesses and develop action plans for further improvement. This study explored the use of FNs in the University of Manitoba’s Family Medicine residency program 5 years after their implementation. Methods This multi-method study examined 520 FNs from 16 recent graduates from the University of Manitoba Family Medicine residency program. Quantitative analysis (frequencies and means) enabled descriptions and comparisons between training sites. Four themes emerged from inductive content analysis highlighting common ideas reflected upon. Results Residents displayed cyclical variation in the FN generation over 2 years. Eight of the 99 Priority Topics (addressing complex psychosocial issues) were not captured in this data set. The domains of Care of First Nations, Inuit, and Metis; Care of the Vulnerable and Underserved; and Behavioural Medicine and the CanMEDS-FM roles of FM – Procedural Skill, Leader/Manager, and Professional were less frequently reflected upon. Four themes (Patient-Centered Care, Patient Safety, Achieving Balance, and Confidence) were identified from qualitative analysis of residents’ narrative notes. Conclusions Vygotsky’s Sociocultural Theory of Cognitive Development was proposed as a lens through which to examine factors influencing resident learning. Residents’ discomfort with certain topics may lead to avoidance in reflecting upon certain competencies in FNs, impacting skill acquisition. Further research should explore factors influencing residents’ perceptions FNs and how to best assist residents in becoming competent, confident practitioners.

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A Longitudinal Curriculum for Quality Improvement, Leadership Experience, and Scholarship in a Family Medicine Residency Program

Family Medicine ◽

10.22454/fammed.2020.679626 ◽

2020 ◽

Vol 52 (8) ◽

pp. 570-575

Author(s):

Susan D. Pohl ◽

Sonja Van Hala ◽

Dominik Ose ◽

Benjamin Tingey ◽

Jennifer P. Leiser

Keyword(s):

Quality Improvement ◽

Family Medicine ◽

Residency Program ◽

Leadership Skills ◽

Family Medicine Residency ◽

University Of Utah ◽

Leadership Experience ◽

High Level ◽

The University ◽

Scholarly Projects

Background and Objectives: The Accreditation Council for Graduate Medical Education (ACGME) requires all residents be trained in quality improvement (QI), and that they produce scholarly projects. While not an ACGME requirement, residents need leadership skills to apply QI knowledge. We developed the Skills-based Experiential Embedded Quality Improvement (SEE-QI) curriculum to integrate training in QI, leadership, and scholarship. Methods: The University of Utah Family Medicine Residency Program began using the novel curriculum in 2012. The aim of the curriculum is to tie didactic teaching in quality improvement, leadership, and scholarship with skills application on multidisciplinary QI teams. Coaching for resident leaders is provided by faculty. Third-year resident leaders prepare academic presentations. Results of the ACGME Practice-Based Learning and Improvement (PBLI) 3 scores and number of scholarship presentations are described as a measure of efficacy. Results: Two cohorts of residents completed the curriculum and all competency assessments. The average initial and final competency scores for competency PBLI-3 showed improvement and the average final competency for each cohort was above the proficient level. The residency requirements for QI scholarship did not change with introduction of the curriculum, but the amount of optional curricular QI scholarship and independent QI scholarship increased. Conclusions: The SEE-QI curriculum resulted in a high level of resident QI competency, opportunity for leadership training, and an increase in scholarship. We studied the results of this curriculum at one institution. Efforts to tie QI, leadership, and scholarship training should be evaluated at other programs.

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Implementing an enhanced long-acting reversible contraception (LARC) curriculum and training for residents into a family medicine residency program

Contraception ◽

10.1016/j.contraception.2018.07.131 ◽

2018 ◽

Vol 98 (4) ◽

pp. 372

Author(s):

J Dalby ◽

M Dettmann ◽

M Gold

Keyword(s):

Family Medicine ◽

Residency Program ◽

Family Medicine Residency ◽

Long Acting ◽

And Training

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Residency Setting Association With Resident Substance Use Disorder Training: A CERA Secondary Data Analysis

Family Medicine ◽

10.22454/fammed.2020.373152 ◽

2020 ◽

Vol 52 (3) ◽

pp. 198-201

Author(s):

Joshua St. Louis ◽

Emma Worringer ◽

Wendy B. Barr

Keyword(s):

Substance Use ◽

Family Medicine ◽

Residency Program ◽

Secondary Analysis ◽

Secondary Data ◽

The United States ◽

Resident Training ◽

Addiction Medicine ◽

Residency Programs ◽

Family Medicine Residency

Background and Objectives: As the opioid crisis worsens across the United States, the factors that impact physician training in management of substance use disorders become more relevant. A thorough understanding of these factors is necessary for family medicine residency programs to inform their own residency curricula. The objective of our study was to identify factors that correlate with increased residency training in addiction medicine across a broad sample of family medicine residencies. Methods: We performed secondary analysis of a national family medicine residency program director survey conducted in 2015-2016 (CERA Survey PD-8). We obtained data from the Council of Academic Family Medicine Educational Research Alliance (CERA) Data Clearinghouse. We analyzed residency clinic site designation as a patient-centered medical home (PCMH), federally-qualified health center (FQHC), or both, for their correlation with faculty member possession of DEA-X buprenorphine waiver license, as well as required residency curriculum in addiction medicine. Results: Residency programs situated in an FQHC were more likely to have faculty members who possessed DEA-X buprenorphine waiver licenses (P=.025). Residency clinics that were both a PCMH as well as an FQHC also correlated strongly (P=.001). Furthermore, residencies with faculty who possessed a DEA-X license were significantly more likely to have a required curriculum in addiction medicine (P=.002). Conclusions: Our quantitative secondary analysis of CERA survey data of family medicine residency program directors revealed that resident training in addiction medicine is strongly correlated with both residency clinic setting (FQHC or FQHC/PCMH) as well as residency faculty possession of DEA-X licenses.

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Impact of Proposed Institute of Medicine Duty Hours: Family Medicine Residency Directors' Perspective

Journal of Graduate Medical Education ◽

10.4300/jgme-d-09-00003.1 ◽

2009 ◽

Vol 1 (2) ◽

pp. 195-200 ◽

Cited By ~ 5

Author(s):

Peter J. Carek ◽

Joseph W. Gravel ◽

Stanley Kozakowski ◽

Perry A. Pugno ◽

Gerald Fetter ◽

...

Keyword(s):

Family Medicine ◽

Patient Care ◽

Residency Program ◽

Detrimental Effect ◽

Resident Education ◽

Program Directors ◽

Institute Of Medicine ◽

Family Medicine Residency ◽

Potential Impact ◽

Residency Program Directors

Abstract Purpose To examine the opinions of family medicine residency program directors concerning the potential impact of the Institute of Medicine (IOM) resident duty hour recommendations on patient care and resident education. Methods A survey was mailed to 455 family medicine residency program directors. Data were summarized and analyzed using Epi Info statistical software. Significance was set at the P < .01 level. Results A total of 265 surveys were completed (60.9% response rate). A majority of family medicine residency program directors disagreed or strongly disagreed that the recent IOM duty hour recommendations will, in general, result in improved patient safety and resident education. Further, a majority of respondents disagreed or strongly disagreed that the proposed IOM rules would result in residents becoming more compassionate, more effective family physicians. Conclusion A majority of family medicine residency program directors believe that the proposed IOM duty hour recommendations would have a primarily detrimental effect on both patient care and resident education.

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