scholarly journals Family Medicine Residents’ Attitudes About Training in Ethiopia and the United States

2019 ◽  
Vol 51 (5) ◽  
pp. 424-429 ◽  
Author(s):  
Weyinshet Gossa ◽  
Christine Jones ◽  
Sorana Raiculescu ◽  
Mesfin Melaku ◽  
Elnathan Kebebew ◽  
...  
Keyword(s):  
Family Medicine ◽  
Patient Care ◽  
Family Physicians ◽  
Residency Education ◽  
The United States ◽  
Personal Life ◽  
Women's Issues ◽  
The Impact ◽  
Residents Attitudes ◽  
Family Medicine Residents

Background and Objectives: In Ethiopia, family medicine began in 2013. The objective of this study was to compare family medicine residents’ attitudes about training in Ethiopia with those at a program in the United States. Methods: Family medicine residents at Addis Ababa University in Addis Ababa, Ethiopia and the University of Maryland in Baltimore, Maryland completed a 43-item Likert scale survey in 2017. The survey assessed residents’ attitudes about residency education, patient care, independence as family physicians, finances, impact of residency on personal life, and women’s issues. We calculated descriptive statistics on the demographics data and analyzed survey responses using a two-sample t-test. Results: A total of 18 (75%) Ethiopian residents and 18 (60%) US residents completed the survey (n=36). The Ethiopian residents had a wider age distribution (25-50 years) than the US residents (25-34 years). More US residents were female (72%) compared to the Ethiopian cohort (50%), while more Ethiopian residents were married (72%) compared to the US cohort (47%). There were statistically significant differences in attitudes toward patient care (P=0.005) and finances (P<0.001), differences approaching significance in attitudes toward residency education, and no significant differences in independence as family physicians, the impact of residency on personal life, and women’s issues in family medicine. Conclusions: Across two very different cultures, resident attitudes about independence as family physicians, the impact of residency on personal life and women’s issues, were largely similar, while cross-national differences in attitudes were found relative to residency education, patient care, and finances.

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 Pilot Study to Address Tolerance of Uncertainty Among Family Medicine Residents

2018 ◽  
Vol 50 (7) ◽  
pp. 531-538 ◽  
Author(s):  
Deborah Taylor ◽  
Bethany Picker ◽  
Donald Woolever ◽  
Erin K. Thayer ◽  
Patricia A. Carney ◽  
...  
Keyword(s):  
Family Medicine ◽  
Family Physicians ◽  
Medical Problems ◽  
Sustained Improvement ◽  
Tolerance Of Ambiguity ◽  
New Curriculum ◽  
Quasi Experimental ◽  
Tolerance Of Uncertainty ◽  
The Impact ◽  
Family Medicine Residents

Background and Objectives: Because patients often present to their family physicians with undifferentiated medical problems, uncertainty is common. Family medicine residents must manage both the ambiguity inherent in the field as well as the very real uncertainty of learning to become a skilled physician with little experience to serve as a guide. The purpose of this analysis was to assess the impact of a new curriculum on family medicine residents’ tolerance of ambiguity. Methods: We conducted an exploratory quasi-experimental study to assess the impact of a novel curriculum designed to improve family medicine residents’ tolerance of ambiguity. Four different surveys were administered to 25 family medicine residents at different stages in their training prior to and immediately and 6 months after the new curriculum. Results: Although many constructs remained unchanged with the intervention, one important construct, namely perceived threats of ambiguity, showed significant and sustained improvement relative to before undertaking this curriculum (score of 26.2 prior to the intervention, 22.1 immediately after, and 22.0 6 months after the intervention). Conclusions: A new curriculum designed to improve tolerance to ambiguity appears to reduce the perceived threats of ambiguity in this small exploratory study.

Moral Injury during the COVID-19 pandemic: A delphi model survey of family medicine residents

2021 ◽  
pp. 009121742110543
Author(s):  
Sean B Ngo ◽  
Payson J Clark ◽  
Sarah E Parr ◽  
Abel R Thomas ◽  
Akshat Dayal ◽  
...  
Keyword(s):  
Family Medicine ◽  
Family Relationships ◽  
The United States ◽  
Moral Injury ◽  
Professional Relationships ◽  
Major Barrier ◽  
Model Study ◽  
Seeking Help ◽  
Patient Relationships ◽  
Family Medicine Residents

Objectives The objective is to investigate the primary factors that created experiences leading to moral injury in family medicine residents during the COVID-19 pandemic and also to identify any barriers keeping these residents from seeking or receiving help when they experienced moral injury. Method A DELPHI model study utilizing three rounds of surveys was conducted at four family medicine residency programs in the United States. Resident responses to Survey 1 generated factors perceived to be causing them moral injury or constituting barriers to their seeking help. Thematic analysis identified common themes which were presented to residents in Survey 2 for rating and justification. Results and feedback from Survey 2 were shared with residents in Survey 3, where residents were prompted to reevaluate their ratings for factors and barriers for the purpose of generating consensus among themselves. A ranked list of factors and barriers was thereby created for the participating sites. Results Residents shared several stories about the factors that most pressured them to violate their moral values. The most severe and frequent factors contributing to moral injury involved disruptions to doctor–patient relationships, patient–family relationships, and relationships with other healthcare professionals. Time was the major barrier to residents seeking help. Conclusion During times of crisis, moral injury among residents may be minimized by protecting and promoting important clinical and professional relationships with patients, colleagues, and other medical professionals. While residents report that lack of time was the most significant barrier to seeking help, it is unclear how this complicated and ubiquitous problem would be resolved or mitigated.

pology) should help the student acquire a holistic approach to health and disease and to recognize the interrelationships of cultural, social, psychologi-cal, and environmental factors with the psysiological and biochemical pro-cesses of the body" (Willard Report, 1966, p. 27). Evaluation of the Mandate The important potential role of sociology in the curriculum of the family physician programs has been endorsed repeatedly before, during, and since the publication of the above-mentioned blue-ribbon commission reports (Silver, 1963, p. 74-77; GP, 1966, p. 225-246; Harrell, 1970, p. 61-64). That potential role has been greatly enhanced by the passage of the Health Educa-tion and Manpower Act in 1976, which mandated that by 1980, 50% of all medical students graduating from medical school should be entering residen-cies in the three designated primary care specialties—internal medicine, pediatrics, and family practice. An additional aspect of this act was the allocation of some $40,000,000 for the expansion and improvement of existing family medicine residencies and for the creation of additional resi-dency programs. The question at hand—almost 12 years after these recommendations were submitted to medical educators-is whether a new breed of physicians is being produced by training in family medicine. Is there a new type of physi-cian who is "aware not only of his patient's physicial illness, but also of interrelations of family members and of family and community and socio-economic factors affecting the health of family members?" (Silver, 1965, p. 188-189). There are clearly two elements that must be distinguished in evaluating this mandate to train family physicians—one quantitative and the other qualitative. As far as quantitative changes in the attention paid to training family physicians, there can be no doubt that significant shifts have occurred in the past decade. In 1967, there were only three family medicine training programs in the United States, at the Universities of Miami (Florida), Roches-ter, and Oklahoma. By 1970 there were 49 programs, in 1975 there were 233, and in 1977 there were well over 300. In 1970 family practice became a

2014 ◽  
pp. 126-132
Keyword(s):  
Family Medicine ◽  
Family Practice ◽  
Potential Role ◽  
Family Members ◽  
Family Physicians ◽  
Holistic Approach ◽  
The United States ◽  
Factors Affecting ◽  
Blue Ribbon ◽  
Quantitative Changes

scholarly journals Implementation, Evolution and Impact of ICU Telepharmacy Services Across a Health care System

2019 ◽  
Vol 54 (4) ◽  
pp. 232-240 ◽  
Author(s):  
Desiree E. Kosmisky ◽  
Sonia S. Everhart ◽  
Carrie L. Griffiths
Keyword(s):  
Critical Care ◽  
Patient Care ◽  
Healthcare System ◽  
Improve Patient Care ◽  
The United States ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Use Of Technology ◽  
American Society ◽  
The Impact

Purpose: A review of the implementation and development of telepharmacy services that ensure access to a critical care-trained pharmacist across a healthcare system. Summary: Teleintensive care unit (tele-ICU) services use audio, video, and electronic databases to assist bedside caregivers. Telepharmacy, as defined by the American Society of Health-System Pharmacists, is a method in which a pharmacist uses telecommunication technology to oversee aspects of pharmacy operations or provide patient care services. Telepharmacists can ensure accurate and timely order verification, recommend interventions to improve patient care, provide drug information to clinicians, assist in standardization of care, and promote medication safety. This tele-ICU pharmacy team is one of the only entirely clinical-based tele-ICU pharmacy models among the tele-ICU programs across the United States. The use of technology for customized alert generation and intervention proposal with medication orders and chart notation are unique. In a 34-month period from September 2015 to July 2018, more than 110 000 alerts were generated and 13 000 interventions were performed by telepharmacists. Conclusions: Tele-ICU pharmacists employ limited resources to provide critical care pharmacy expertise to multiple sites within a healthcare system during nontraditional hours with documented clinical and financial benefits. Further study is needed to determine the impact of tele-ICU pharmacists on ICU and hospital length of stay, morbidity, and mortality.

scholarly journals The Associations Between Preceptor Team Lead Relationships and Resident Wellness in an Academic Medicine Setting: An Exploratory Study

PRiMER ◽  
2017 ◽  
Vol 1 ◽  
Author(s):  
Cesar A. Gonzalez ◽  
Natalie E Gentile ◽  
Kurt B Angstman ◽  
Julia R Craner ◽  
Robert P. Bonacci
Keyword(s):  
Family Medicine ◽  
Self Care ◽  
Well Being ◽  
Increased Risk ◽  
Resident Wellness ◽  
Team Based Care ◽  
Perception Of Support ◽  
The Impact ◽  
The Relationship ◽  
Family Medicine Residents

Background: Lack of wellness among physicians has been associated with increased risk for physical and mental illness, interpersonal discord, and occupational liability. In academic primary care practices, physician wellness and self-care behaviors have been associated with improved patient outcomes. With the increase in team-based care structures in primary care clinics and residencies there may be opportunities to promote wellness among primary clinicians, particularly among resident physicians who are at increased risk for decreased well being. The primary objective of the study was to test an a priori hypothesis that family medicine residents’ perception of support from preceptor team leads would be associated with wellbeing. A secondary objective of the study was to test a post hoc hypothesis that examined whether the relationship between residents’ perception of support from their preceptor team leads would be associated with residents’ well being, while controlling for self-care behaviors. Methods: Our study utilized a prospective cross-sectional design with purposive sampling to survey family medicine residents. Data were collected in February 2016. The survey was sent out to 58 family medicine residents across three family medicine residencies at Mayo Clinic. The survey response rate was 55% (n=32); Ten (31.3%) residents reported being in their PGY-1, 11 (34.4%) in PGY-2; and 11 (34.4%) in PGY-3; participants included 19 (59.4%) women and 13 (40.6%) men. The Brief Resident Wellness Profile (BRWP) was utilized to assess family medicine residents’ perceived sense of professional accomplishment and mood in the past week. Results: In bivariate correlational analyses, increased perception of support from preceptor team leads (r=.40, P<.01) and reporting a male gender (r=.43, P<.01) was associated with increased resident wellness. In exploratory multivariate analysis, results suggested that while controlling for gender, frequency of self-care behaviors, and perceived preceptor team lead support, a one-point change on rating of perceived team leader support is associated with a 1.69 increase in resident wellness score on the BRWP. Conclusions: Our results provide preliminary evidence to support the relationship between preceptor team lead support and resident wellness in team-based care, above and beyond the impact that self-behaviors have on wellness. Our findings suggest evidence for the subsequent study of the impact of preceptor team lead relationship quality on resident wellness. 

scholarly journals Seven tips for clinical supervision in the time of COVID 19

2020 ◽  
Author(s):  
Karen Schultz ◽  
Alexander Singer ◽  
Ivy Oadansan
Keyword(s):  
Family Medicine ◽  
Clinical Supervision ◽  
Family Physicians ◽  
Care Model ◽  
Virtual Care ◽  
Virtual Supervision ◽  
Family Medicine Residents

Virtual care (VC) rapidly has become the preferred care model in family medicine settings during the COVID-19 pandemic.  Both residents and preceptors must rapidly adapt and develop new skills to provide and supervise virtual care. The College of Family Physicians of Canada (CFPC) created a VC supervision guide for family medicine residents and preceptors by quickly mobilizing a consensus driven approach leveraging existing CFPC educational committees, representing a broad range of teachers and residents in the country. The guide can be adapted to other settings and is provided in the hopes of being helpful to all preceptors providing VC and (virtual) supervision during the pandemic. 

scholarly journals Pilot Study: Evaluating the Impact of Pharmacist Patient-Specific Medication Recommendations for Diabetes Mellitus Therapy to Family Medicine Residents

Pharmacy ◽  
2020 ◽  
Vol 8 (3) ◽  
pp. 158
Author(s):  
Camlyn Masuda ◽  
Rachel Randall ◽  
Marina Ortiz
Keyword(s):  
Diabetes Mellitus ◽  
Pilot Study ◽  
Family Medicine ◽  
Statistical Significance ◽  
Diabetes Education ◽  
Office Visit ◽  
Patient Specific ◽  
Patients With Diabetes ◽  
The Impact ◽  
Family Medicine Residents

Pharmacists have demonstrated effectiveness in managing diabetes mellitus (DM) and lowering hemoglobin A1C (A1C) through direct patient management. Often patients with diabetes and elevated A1C may not be able to come into the clinic for separate appointments with a pharmacist or for diabetes education classes. A novel way that pharmacists can assist in improving the control of patients’ diabetes and improve prescriber understanding and the use of medications for diabetes is by providing medication recommendations to medical residents prior to the patient’s appointment with the medical resident. The results of this pilot study indicate that the recommendations provided to family medicine residents and implemented at the patient’s office visit helped to lower A1C levels, although the population size was too small to show statistical significance. This pilot study’s results support performing a larger study to determine if the pharmacist’s recommendation not only improves patient care by lowering A1C levels but if it also helps improve medical resident’s understanding and use of medications for diabetes.

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