scholarly journals Institutional NIH Research Funding and a Culture of Support for Family Medicine—Their Relationship to Family Medicine Specialty Choice

2018 ◽  
Vol 50 (5) ◽  
pp. 369-371
Author(s):  
Arch G. Mainous ◽  
Maribeth Porter ◽  
Denny Fe Agana ◽  
Alexander W. Chessman
Keyword(s):  
Medical Students ◽  
Family Medicine ◽  
Medical School ◽  
School Environment ◽  
The United States ◽  
Specialty Choice ◽  
Medicine Clerkship ◽  
Educational Support ◽  
Negative Comments ◽  
Nih Funding

Background and Objectives: The United States suffers from a low proportion of medical students pursuing family medicine (FM). Our objective was to examine institutional characteristics consistent with a focus on National Institutes of Health (NIH) research, institutional support for FM education, and the proportion of medical students choosing FM. Methods: The 2015 CERA Survey of Family Medicine Clerkship Directors was merged with institutional NIH funding data from 2014 and medical student specialty choice in 2015. Institutional educational support was operationalized as (1) clerkship director’s perception of medical school environment toward FM, and (2) amount of negative comments about FM made by faculty in other departments. The outcome was the percentage of students selecting FM. Bivariate statistics were computed. Results: As NIH funding increases, the proportion of students entering FM decreases (r=-.22). Institutions with higher NIH funding had lower clerkship director perceptions of medical school support toward FM (r=-.38). Among private institutions, the negative correlation between NIH funding and the proportion of students entering FM strengthens to r=-.48, P=.001. As perceptions of support for FM increase, the proportion of students entering FM increase (r=.47). Among private schools, perceptions of support toward family medicine was strongly positively correlated with the proportion of students entering FM (r=.72, P=.001). Conclusions: Higher institutional NIH funding is associated with less support for FM and lower proportions of students choosing FM. These issues appear to be even more influential in private medical schools. Understanding how to integrate the goals of NIH-level research and increasing primary care workforce so that both can be achieved is the next challenge.

Medical schools, primary care and family medicine: clerkship directors’ perceptions of the current environment

2019 ◽  
Vol 36 (6) ◽  
pp. 680-684
Author(s):  
Maribeth Porter ◽  
Denny Fe Agana ◽  
Robert Hatch ◽  
Susmita Datta ◽  
Peter J Carek
Keyword(s):  
Primary Care ◽  
Family Medicine ◽  
Medical School ◽  
School Environment ◽  
Student Attitudes ◽  
Primary Care Physicians ◽  
Specialty Choice ◽  
Medicine Clerkship ◽  
Negative Comments ◽  
The Usa

Abstract Background The culture at a medical school and the positive experiences in primary care clerkships influence student specialty choice. This choice is significant if the demand for primary care physicians is to be met. The aim of this study was to examine family medicine clerkship directors’ perceptions of the medical school environment. Methods Data were collected as part of the 2015 Council of Academic Family Medicine Educational Research Alliance Family Medicine Clerkship Director survey. Questions asked included how clerkship directors perceived the environment of their medical school towards family medicine, has the environment towards family medicine changed between 2010 and 2015, do they take action to influence student attitudes towards family medicine and whether faculty members in other departments make negative comments about family medicine. Results The response rate was 79.4%. While most respondents indicated the environment of their medical school has become more positive towards family medicine, a majority of clerkship directors perceived the environment to be either very much against, slightly against or indifferent towards family medicine. Nearly one-half (41.4%) of the clerkship directors were notified more than once a year that a faculty member of another department made a negative comment about family medicine. Results varied among regions of the USA and between schools located in the USA and Canada. Conclusion Family medicine clerkship directors often perceived negativity towards family medicine, a finding that may limit the effectiveness of academic health centres in their mission to better serve their community and profession.

scholarly journals FMAQ-S: Development of a Short Form of the Family Medicine Attitudes Questionnaire

PRiMER ◽  
2021 ◽  
Vol 5 ◽  
Author(s):  
Hana Kang ◽  
Jacob Prunuske ◽  
Andrea L. Wendling ◽  
Jennifer Edwards-Johnson ◽  
Julie P. Phillips
Keyword(s):  
Medical Students ◽  
Family Medicine ◽  
Student Attitudes ◽  
Short Form ◽  
Item Analysis ◽  
The United States ◽  
Criterion Validity ◽  
Specialty Choice ◽  
Supporting Evidence ◽  
Item Discrimination

Introduction: Identifying and training students who choose family medicine careers is essential to meeting primary care workforce needs in the United States. Medical students’ positive attitudes toward family medicine are associated with students’ choice of family medicine as a specialty. This study sought to refine a previously tested questionnaire assessing US medical students’ attitudes toward family medicine by shortening the questionnaire to make it more useful in educational practice and research settings. Methods: We refined our existing 14-item questionnaire by item analysis and validation. We conducted item analysis using a graded response model approach after identifying the unidimensionality of the original scale. We selected items based on their item discrimination parameters and item information levels, and calculated the correlation between specialty choice and family medicine attitudes score to evaluate criterion validity. Results: Exploratory factor analyses indicated the questionnaire is unidimensional. Among the original 14 items, 10 items had high item discrimination parameters and low standard error of measurement. These 10 items contribute the most to distinguishing individuals’ differences in family medicine attitudes and were selected for inclusion in the short-form questionnaire (FMAQ-S). The point-biserial correlation between the short-form scale and students’ choice of family medicine was 0.378, which provides supporting evidence for criterion validity. Conclusion: The FMAQ-S is a concise and validated measure for assessing medical student attitudes toward family medicine. This abbreviated questionnaire can be used by medical educators to identify students for specific programming or interventions intended to support family medicine specialty choice.

scholarly journals Building a Successful, Socially-Distanced Family Medicine Clerkship in the COVID Crisis

PRiMER ◽  
2020 ◽  
Vol 4 ◽  
Author(s):  
John R. Hayes ◽  
Bryan Johnston ◽  
Rebecca Lundh
Keyword(s):  
Medical Education ◽  
Medical Students ◽  
Family Medicine ◽  
The United States ◽  
Learning Objectives ◽  
Direct Patient Care ◽  
Clinical Environment ◽  
Clinical Instruction ◽  
Medicine Clerkship ◽  
Illness Script

Introduction: In the wake of the COVID-19 pandemic, many family medicine clerkships across the United States are scrambling to provide meaningful medical education in a new clinical environment. Most medical schools have paused or severely limited the direct patient care that has been the core educational requirement of the clinical clerkships. The aim of this study was to develop and evaluate a curricular model that meets the family medicine clerkship learning objectives via telemedicine clinical instruction. Methods: We created a clerkship where all clinical encounters took place by phone or video visits. Students were required to have telemedicine encounters with at least 20 patients over a 4-week clerkship. We also created a telemedicine illness script-writing assignment to prepare students and faculty for these encounters. We evaluated our curriculum by surveying participating students and faculty members.   Results: Student surveys revealed that all learning objectives were met during the telemedicine clerkship experience. Students felt they made a difference during the COVID-19 pandemic. Faculty felt that the medical students were helpful and that they were able to provide meaningful clinical instruction. Conclusion: Our study reveals that a family medicine clerkship can be successfully delivered using telemedicine and remote learning techniques. Senior medical students are a valuable resource and can have a meaningful clinical impact while learning more about family medicine. If social distancing precautions continue, this model can be used by other clerkships to continue medical education and provide medical care. 

scholarly journals Association of Family Medicine Interest at Matriculation to Medical School and FMIG Participation With Eventual Practice as a Family Physician

2019 ◽  
Vol 51 (8) ◽  
pp. 682-686 ◽  
Author(s):  
Amanda Kost ◽  
Kimberly Kardonsky ◽  
Jeanne Cawse-Lucas ◽  
Tomoko Sairenji
Keyword(s):  
Family Medicine ◽  
Medical School ◽  
Family Physician ◽  
Family Physicians ◽  
The United States ◽  
Specialty Choice ◽  
Odds Ratios ◽  
Binary Logistic Regression Model ◽  
University Of Washington ◽  
Predicted Probability

Background and Objectives: An adequate family medicine workforce is needed to improve health and health care outcomes in the United States, yet few medical students in the US become family physicians. Indicators of family medicine interest upon medical school matriculation exist. Family medicine interest groups (FMIGs) may influence student choice. This study examines the association of FMIG participation with various matriculation interest indicators to predict which students go on to become family physicians. Methods: The American Medical Association Masterfile was used to identify the practice specialty of 601 graduates of the University of Washington School of Medicine who matriculated between 2003 and 2007. Graduates’ scores on the Family Medicine Interest Survey (FMIS) and whether a student listed family medicine as their top choice upon matriculation along with FMIG participation and demographic characteristics were used in a binary logistic regression model to predict eventual practice. The model output was used to calculate odds ratios and predicted probabilities of family medicine practice given initial family medicine interest and FMIG participation. Results: FMIG participation was associated with higher odds ratios and increased predicted probability of becoming a family physician regardless of initial interest although the magnitude of the difference varied. FMIG participants who listed family medicine as their top specialty had a 68% predicted probability of entering family medicine compared to 8% probability if they did not list family medicine first and did not participate in FMIG. FMIG participation was associated with odds ratios between 3.27-4.19 for entering family medicine regardless of FMIS score. Conclusions: Among University of Washington students with family medicine as their top specialty choice upon matriculation, FMIG participation was associated with higher odds of entering the specialty. The same was true, although to a lesser degree, for students who had a high score on the FMIS.

scholarly journals Students of Change: Health Policy in Action

2022 ◽  
Vol 54 (1) ◽  
pp. 38-43
Author(s):  
Amy Clithero-Eridon ◽  
Danielle Albright ◽  
Clint Brayfield ◽  
Nicole Abeyta ◽  
Karen Armitage
Keyword(s):  
Public Health ◽  
Health Policy ◽  
Medical Students ◽  
Family Medicine ◽  
Medical School ◽  
Medicine Clerkship ◽  
Health System Change ◽  
University Of New Mexico ◽  
Policy Tool ◽  
The Impact

Background and Objectives: Health policy is more impactful for public health than many other strategies as it can improve health outcomes for an entire population. Yet in the “see one, do one, teach one” environment of medical school, most students never get past the “see one” stage in learning about the powerful tools of health policy and advocacy. The University of New Mexico School of Medicine mandates health policy and advocacy education for all medical students during their family medicine clerkship rotation. The aim of this project is to describe a unique health policy and advocacy course within a family medicine clerkship. Methods: We analyzed policy briefs from 265 third-year medical students from April 2016 through April 2019. Each brief is categorized by the level of change targeted for policy reform: national, state, city, or university/school. Implemented policies are described. Results: Slightly less than one-third of the policies (30%) relate to education, 36% advocate for health system change by addressing cost, access, or quality issues, and 34% focus on public health issues. Fourteen policies have been initiated or successfully enacted. Conclusions: This curriculum gives each medical student a health policy tool kit with immediate opportunities to test their skills, learn from health policy and advocacy experts, and in some cases, implement health policies while still in medical school. A 1-week family medicine policy course can have impact beyond the classroom even during medical school, and other schools should consider this as a tool to increase the impact of their graduates.

Undergraduate performance assessment

2017 ◽  
Vol 5 (9) ◽  
pp. 1-7
Author(s):  
Umayya Musharrafieh ◽  
Khalil Ashkar ◽  
Dima Dandashi ◽  
Maya Romani ◽  
Rana Houry ◽  
...  
Keyword(s):  
Medical Students ◽  
Family Medicine ◽  
Assessment Tool ◽  
Clinical Skills ◽  
Faculty Evaluation ◽  
Multiple Choice Questions ◽  
Final Exam ◽  
Monthly Basis ◽  
Medicine Clerkship ◽  
Clinical Evaluations

Introduction: Objective Structured Clinical Examination (OSCE) is considered a useful method of assessing clinical skills besides Multiple Choice Questions (MCQs) and clinical evaluations. Aim: To explore the acceptance of medical students to this assessment tool in medical education and to determine whether the assessment results of MCQs and faculty clinical evaluations agree with the respective OSCE scores of 4th year medical students (Med IV). Methods: performance of a total of 223 Med IV students distributed on academic years 2006-2007, 2007-2008, and 2008-2009 in OSCE, MCQs and faculty evaluations were compared. Out of the total 93 students were asked randomly to fill a questionnaire about their attitudes and acceptance of this tool. The OSCE was conducted every two months for two different groups of medical students who had completed their family medicine rotation, while faculty evaluation based on observation by assessors was submitted on a monthly basis upon the completion of the rotation. The final exam for the family medicine clerkship was performed at the end of the 4thacademic year, and it consisted of MCQsResults: Students highly commended the OSCE as a tool of evaluation by faculty members as it provides a true measure of required clinical skills and communication skills compared to MCQs and faculty evaluation. The study showed a significant positive correlation between the OSCE scores and the clinical evaluation scores while there was no association between the OSCE score and the final exam scores.Conclusion: Student showed high appreciation and acceptance of this type of clinical skills testing. Despite the fact that OSCEs make them more stressed than other modalities of assessment, it remained the preferred one.

scholarly journals On Teaching the Sum While Paying Attention to the Parts: Whole Person Care through Ethnography in Medical Education

2015 ◽  
Vol 2 (2) ◽  
Author(s):  
Vasiliki Nataly Rahimzadeh ◽  
David Lessard ◽  
Peter Nugus
Keyword(s):  
Medical Students ◽  
Family Medicine ◽  
Medical School ◽  
Professional Identity ◽  
Identity Formation ◽  
Medical Training ◽  
Academic Discipline ◽  
Professional Identity Formation ◽  
Patient Centered ◽  
Whole Person

Objective—This article provides a reflection on medical teaching opportunities for whole person care based on our experiences mentoring 2nd-year medical students through an Ethnography Practicum at a Canadian university.                                                                  Background—The Ethnography Practicum is a new addition to the Family Medicine Transition to Clinical Practice (TCP) curriculum introduced in the second year of medical school at McGill University. It involves 30 hours of instruction (6 hours in lectures with an instructor, and 24 hours in small-group tutorials with the authors), and 9 hours of fieldwork observations in various community health settings across Montreal, QC. The primary aims of the Practicum converge with those of the TCP generally in two important ways: to inculcate in students the concepts of patient centered care, and to promote family medicine as both an academic discipline and career option.                    Results and Discussion— Our experiences illustrate two tensions that shape students’ expectations and experiences throughout their involvement in the Practicum and, in turn, highlight the implications for teaching whole-person care. First, ethnography as a combination of different methods has itself been the locus of tensions between positivist and critical traditions in the three last decades. Second, the Practicum is situated precisely at the crossroads of key moments on the professional identity formation continuum for our students. Such a crossroads is disruptive to the status quo of medical traineeship characteristic of the first two years in medical school, and thus reorients professional identity formation. The above tensions reveal how ethnography is not only a revered research tradition in the humanities, but can also be a conduit to whole person care-inspired clinical practice.Conclusion—As instructors and mentors involved in this Ethnography Practicum, we are continually forging a new relevance for organizational ethnography in medical training, where medical students can reflect and act on competencies beyond clinical ones. The Practicum provides a space for students to wrestle with alternative epistemologies to understanding the social world in which medicine is embedded. We lastly provide pragmatic ways to better address these tensions in an effort to support students as they proceed through the (multifaceted) development of their professional identities as future physicians.

scholarly journals Primary Care Tracks in Medical Schools

PRiMER ◽  
2019 ◽  
Vol 3 ◽  
Author(s):  
Maribeth P. Williams ◽  
Denny Fe Agana ◽  
Benjamin J. Rooks ◽  
Grant Harrell ◽  
Rosemary A. Klassen ◽  
...  
Keyword(s):  
Primary Care ◽  
Medical Students ◽  
Family Medicine ◽  
Primary Care Physicians ◽  
Response Rate ◽  
Positive Impact ◽  
Medical Schools ◽  
Clerkship Director ◽  
Medicine Clerkship ◽  
Faculty Mentorship

Introduction: With the estimated future shortage of primary care physicians there is a need to recruit more medical students into family medicine. Longitudinal programs or primary care tracks in medical schools have been shown to successfully recruit students into primary care. The aim of this study was to examine the characteristics of primary care tracks in departments of family medicine.  Methods: Data were collected as part of the 2016 CERA Family Medicine Clerkship Director Survey. The survey included questions regarding the presence and description of available primary care tracks as well as the clerkship director’s perception of impact. The survey was distributed via email to 125 US and 16 Canadian family medicine clerkship directors.  Results: The response rate was 86%. Thirty-five respondents (29%) reported offering a longitudinal primary care track. The majority of tracks select students on a competitive basis, are directed by family medicine educators, and include a wide variety of activities. Longitudinal experience in primary care ambulatory settings and primary care faculty mentorship were the most common activities. Almost 70% of clerkship directors believe there is a positive impact on students entering primary care.  Conclusions: The current tracks are diverse in what they offer and could be tailored to the missions of individual medical schools. The majority of clerkship directors reported that they do have a positive impact on students entering primary care.

scholarly journals BASH: badmouthing, attitudes and stigmatisation in healthcare as experienced by medical students

2016 ◽  
Vol 40 (2) ◽  
pp. 97-102 ◽  
Author(s):  
Ali Ajaz ◽  
Rhodri David ◽  
Damien Brown ◽  
Melanie Smuk ◽  
Ania Korszun
Keyword(s):  
Medical Students ◽  
Career Choice ◽  
Academic Staff ◽  
Medical Schools ◽  
Specialty Choice ◽  
Direct Result ◽  
Clinical Implications ◽  
Online Questionnaire ◽  
Medical Specialties ◽  
Negative Comments

Aims and methodWe used an online questionnaire to investigate medical students' perceptions of the apparent hierarchy between specialties, whether they have witnessed disparaging comments (‘badmouthing’ or ‘bashing’) against other specialists and whether this has had an effect on their career choice.ResultsIn total, 960 students from 13 medical schools completed the questionnaire; they ranked medical specialties according to the level of badmouthing and answered questions on their experience of specialty bashing. Psychiatry and general practice attracted the greatest number of negative comments, which were made by academic staff, doctors and students. Twenty-seven per cent of students had changed their career choice as a direct result of bashing and a further 25.5% stated they were more likely to change their specialty choice. Although 80.5% of students condemned badmouthing as unprofessional, 71.5% believed that it is a routine part of practising medicine.Clinical implicationsBashing of psychiatry represents another form of stigmatisation that needs to be challenged in medical schools. It not only has an impact on recruitment into the specialty, but also has the wider effect of stigmatising people with mental health disorders.

RURAL ORIGIN MEDICAL STUDENTS: HOW DO THEY COPE WITH THE MEDICAL SCHOOL ENVIRONMENT?

2003 ◽  
Vol 11 (2) ◽  
pp. 89-95 ◽  
Author(s):  
Shane R. Durkin ◽  
Angela Bascomb ◽  
Deborah Turnbull ◽  
John Marley
Keyword(s):  
Medical Students ◽  
Medical School ◽  
School Environment
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