scholarly journals Development and Validation of the Foundational Healthcare Leadership Self-assessment

2018 ◽  
Vol 50 (4) ◽  
pp. 262-268
Author(s):  
Sonja Van Hala ◽  
Susan Cochella ◽  
Rachel Jaggi ◽  
Caren J. Frost ◽  
Bernadette Kiraly ◽  
...  
Keyword(s):  
Family Medicine ◽  
Leadership Skills ◽  
Principal Component ◽  
Early Career ◽  
The Self ◽  
Self Assessment ◽  
Healthcare Leadership ◽  
Residency Programs ◽  
Development And Validation ◽  
Family Medicine Residents

Background and Objectives: We sought to develop and validate a self-assessment of foundational leadership skills for early-career physicians. Methods: We developed a leadership self-assessment from a compilation of materials on health care leadership skills. A sequential exploratory study was conducted using qualitative and quantitative analysis for face, content, and construct validity of the self-assessment. First, two focus groups were conducted with leaders in medicine and family medicine residents, to refine the pilot self-assessment. The self-assessment pilot was then tested with family medicine residents across the country, and the results were quantitatively evaluated with principal component analysis. This data was used to reduce and group the statements into leadership domains for the final self-assessment. Results: Twenty-two invited family medicine residency programs agreed to distribute the survey. A total of 163 family medicine residents completed the survey, representing 16 to 20 residency programs from 12 states (response rate 28.9% to 34.8%). Analysis showed important differences by residency year, with more advanced residents scoring higher. The analysis reduced the number of items from 33 on the pilot assessment to 21 on the final assessment, which the authors titled the Foundational Healthcare Leadership Self-assessment (FHLS). The 21 items were grouped into five leadership domains: accountability, collaboration, communication, team management, and self-management. Conclusions: The FHLS is a validated 21-item self-assessment of foundational leadership skills for early career physicians. It takes less than 5 minutes to complete, and quantifies skill within five domains of foundational leadership. The FHLS is a first step in developing educational and evaluative assessments for training medical residents as clinician leaders.

scholarly journals Utilizing Practice-Based Research Networks to Teach and Implement Quality Improvement in Academic Medicine

2020 ◽  
Vol 52 (9) ◽  
pp. 642-646
Author(s):  
Clarissa Hoff ◽  
Luisito Caleon ◽  
Grace Lee ◽  
Mathew Quan
Keyword(s):  
Quality Improvement ◽  
Family Medicine ◽  
Leadership Skills ◽  
Research Network ◽  
Improvement Project ◽  
Residency Programs ◽  
Before And After ◽  
Practice Based Research ◽  
Attending Physicians ◽  
Family Medicine Residents

Background and Objectives: A 2019 study found that between 2014 and 2017, family medicine residents had little improvement in self-assessed preparedness to lead quality improvement projects. This study explored the effectiveness of leveraging a practice-based research network (PBRN) across multiple family medicine residencies not only for implementing quality improvement projects, but also as a teaching tool designed to improve knowledge, attitudes, beliefs, and leadership skills in family medicine faculty and residents. Methods: Residents in family medicine residency programs and one community internal medicine program and family medicine teaching faculty participated in a PBRN-led quality improvement project (QIP) to improve colon cancer screening in their clinic. Of 101 participants, 79 (78%) were residents and 22 (22%) were faculty or attending physicians. Questions surveying participants’ knowledge and confidence related to QIP before and after the QIP were given. Results: Overall, participants reported an improvement in their basic understanding of QI concepts (P=.004). They also reported having sufficient staff and ancillary support to meaningfully participate (P=.033). Participants indicated they had more confidence in their ability to participate in a QI project (P=.002), initiate, design, and lead such a project (P=.001), and teach their peers and staff basic QI concepts (P<.001). Conclusions: PBRNs appear to be a unique way to subjectively improve residents’ confidence in their quality improvement skills. PBRNs should be further explored as a method for educating family medicine residents in quality improvement.

scholarly journals Competencies to Guide a Leadership Curriculum for Family Medicine Chief Residents

2018 ◽  
Vol 50 (9) ◽  
pp. 694-697 ◽  
Author(s):  
M. Kim Marvel ◽  
Janell Wozniak ◽  
Alex J. Reed
Keyword(s):  
Family Medicine ◽  
Assessment Tool ◽  
Leadership Skills ◽  
Chief Resident ◽  
Leadership Competencies ◽  
The Self ◽  
Assessment Instrument ◽  
Self Assessment ◽  
Leadership Curriculum ◽  
Further Development

Background and Objectives: Chief resident leadership competencies are neither clear nor standardized. The goal of this project was to identify specific leadership skills for chief residents and to develop a self-assessment tool. Methods: Chief residents from 10 family medicine residencies participated in focus groups to identify leadership skills required to be an effective chief resident. The ideas generated by participants were grouped into 10 competencies and a self-assessment tool was developed. The tool has been used to help chief residents self-assess their leadership strengths and weaknesses, and to identify teaching priorities for biannual leadership workshops. Results: The self-assessment instrument was completed by 83 chief residents over 5 years. Mean ratings range from 3.19 to 3.57 on a 5-point scale (low to high competency). The self-ratings of residents starting their chief year compared to residents at the end of their chief year showed an increase in 9 of the 10 competencies. Conclusions: The leadership competencies are a useful tool to identify training priorities and to help chief residents or other leaders within a residency program identify skills for further development.

scholarly journals Improving Family Medicine Residents’ Written Communication

2012 ◽  
Vol 3 (1) ◽  
pp. e64-e68 ◽  
Author(s):  
José Francois
Keyword(s):  
Family Medicine ◽  
Assessment Tool ◽  
Pearson Correlation ◽  
The Self ◽  
Assessment Process ◽  
Written Communication ◽  
Self Assessment ◽  
Core Skill ◽  
The Difference ◽  
Family Medicine Residents

Background: Although competency in written communication is a core skill, written communication is seldom the focus of formal instruction in medical education. The objective of this intervention was to implement a self-assessment strategy to assist learners in improving their letter writing skills and then to evaluate its feasibility, reliability and potential educational value. Methods: Eight first-year family medicine residents from two teaching sites completing a six month family medicine rotation used a self-assessment process which included a self-study module and an assessment tool for letters. Each resident applied the self-assessment tool to eight to ten consecutive consult/referral request letters. Participants submitted initial and redrafted letters for independent rating. Results: Analysis of the content, style and global ratings of the initial 77 draft letters showed multiple deficiencies in the content of their letters. It was confirmed that by using the self-assessment tool, residents were able to reliably assess the quality of their letters. Residents’ assessments and those of the expert closely correlated (Pearson correlation 0.861, p < 0.0001). Over the course of the study the residents’ overall performance improved and the difference in total scores between the initial drafts and the rewritten letters narrowed. Conclusion: A self-assessment process of written communication significantly improves the quality and completeness of routine consult/referral request letters.

Revisiting the canons of psychiatry: Teaching the fundamentals of CATIE, STAR*D, and STEP-BD to family medicine residents

2018 ◽  
Vol 53 (5-6) ◽  
pp. 455-463
Author(s):  
Kevin P Brazill ◽  
Stephen Warnick ◽  
Christopher White
Keyword(s):  
Bipolar Disorder ◽  
Mental Illness ◽  
Family Medicine ◽  
Care Setting ◽  
Behavioral Science ◽  
Mental Illnesses ◽  
Residency Programs ◽  
Home Residency ◽  
Treatment Alternatives ◽  
Family Medicine Residents

Family medicine physicians are often the first providers to encounter and identify mental illness in their patients. Having a solid understanding of three landmark studies—Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE), Sequenced Treatment Alternatives to Relieve Depression (STAR*D), and Systemic Treatment Enhancement Program for Bipolar Disorder (STEP-BD)—can significantly improve a family medicine physician’s approach to mental illness and treatment choices, ultimately improving patient outcomes. Each of these studies has generated dozens of publications and consolidating the fundamentals of each one is essential for a resident to retain and implement findings in a real-world setting when treating patients with schizophrenia, depression, and bipolar disorder. When presented at the 38th Forum for Behavioral Science in Family Medicine in Chicago, IL, in September 2017, learners answered pre- and post-presentation questions about the treatment and guidelines pertaining to the three studies. Discussion leaders—physicians double-boarded in family medicine and psychiatry—presented key findings, clinical guidelines generated from each study, and updates since their respective publications. At the conclusion of the talk, participants received access to a slide deck and one-page summary for use in teaching at their home residency programs. Here, we present a framework for teaching family medicine residents three important canons of psychiatry with the goal of better management of three commonly encountered mental illnesses in the primary care setting.

scholarly journals Ophthalmology training and competency levels in caring for patients with ophthalmic complaints among United States internal medicine, emergency medicine, and family medicine residents

2019 ◽  
Vol 16 ◽  
pp. 25 ◽  
Author(s):  
Christopher Daniel Gelston ◽  
Jennifer Landrigan Patnaik
Keyword(s):  
Internal Medicine ◽  
United States ◽  
Emergency Medicine ◽  
Family Medicine ◽  
Educational Training ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Residency Programs ◽  
Confidence Levels ◽  
Family Medicine Residents

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.

scholarly journals The Impact of Practicing Obstetrics on Burnout Among Early-Career Family Physicians

2020 ◽  
Vol 52 (6) ◽  
pp. 408-413
Author(s):  
Tyler W. Barreto ◽  
Aimee Eden ◽  
Audrey Brock
Keyword(s):  
Family Medicine ◽  
Family Physicians ◽  
The United States ◽  
Early Career ◽  
Residency Programs ◽  
Complex Patients ◽  
Semistructured Interviews ◽  
Administrative Tasks ◽  
The Impact ◽  
The Relationship

Background and Objectives: According to a previous study, obstetric deliveries may be protective against burnout for family physicians. Analyses of interviews conducted during a larger qualitative study about the experiences of early-career family physicians who intended to include obstetric deliveries in their practice revealed that many interviewees discussed burnout. This study aimed to understand the relationship between practicing obstetrics and burnout based on an analysis of these emerging data on burnout. Methods: We conducted semistructured interviews with physicians who graduated from family medicine residency programs in the United States between 2013 and 2016. We applied an immersion-crystallization approach to analyze transcribed interviews. Results: Fifty-six early-career family physicians participated in interviews. Burnout was an emerging theme. Physicians described how practicing obstetrics can protect from burnout (eg, brings joy to practice, diversity in practice), how it can contribute to burnout (eg, time demands, increased stress), how it can do both simultaneously and the importance of professional agency (ie, the capacity to make own free choices), and other sources of burnout (eg, administrative tasks, complex patients). Conclusions: This study identifies a family medicine-obstetric paradox wherein obstetrics can simultaneously protect from and contribute to burnout for family physicians. Professional agency may partially explain this paradox.

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 Immediate Postpartum IUD Training Within a Regional Network of Family Medicine Residencies

PRiMER ◽  
2021 ◽  
Vol 5 ◽  
Author(s):  
Ying Zhang ◽  
Sonali Sheth ◽  
Amanda K.H. Weidner ◽  
Patricia Egwuatu ◽  
Lauren Webb ◽  
...  
Keyword(s):  
Family Medicine ◽  
Overall Response Rate ◽  
Prior Training ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Residency Programs ◽  
Family Medicine Residency ◽  
Survey Sample ◽  
Training Opportunities ◽  
Family Medicine Residents

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&lt;.001) and report that their primary training hospital offered PPIUD to patients (P&lt;.001) and their residency programs offered PPIUD training (P&lt;.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.

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