scholarly journals Identifying and Remediating Quality Issues at Clinical Teaching Sites: A CERA Clerkship Directors Survey

2019 ◽  
Vol 51 (10) ◽  
pp. 811-816
Author(s):  
Joanna Drowos ◽  
Tomoko Sairenji ◽  
Kristen Hood Watson ◽  
Vanessa A. Diaz ◽  
Jasmine Pinckney ◽  
...  
Keyword(s):  
Family Medicine ◽  
Clinical Teaching ◽  
Medical Schools ◽  
Teaching Quality ◽  
Additional Time ◽  
Community Based ◽  
Medicine Clerkship ◽  
Education Leaders ◽  
Performance Challenges ◽  
Research Alliance

Background and Objectives: Family medicine clerkship directors must secure an adequate number of teaching sites while maintaining or improving the quality of teaching. This survey details how family medicine clerkship directors identify community-based clinical sites with performance challenges, types of challenges, and whether a remediation option exists for struggling clinical sites or preceptors. This study also investigates the relationship between clerkship structure and problems with maintaining high-quality teaching sites. Methods: Data were gathered and analyzed as part of the 2018 Council of Academic Family Medicine’s (CAFM) Educational Research Alliance (CERA) survey of family medicine clerkship directors. Results: There was a significant relationship between ease/difficulty of identifying clinical sites and paying preceptors (P=.032). A lower proportion of sites where a system is in place for remediation reported it being difficult to identify clinical sites (70.0% vs 92.2%, respectively, P=.011). Having a remediation system in place was also associated with less removal of sites (2.5% removed three or more sites vs 25% removed three or more sites, respectively, P=.005). Conclusions: Medical education leaders can explore payment to incentivize community-based preceptors in schools where identifying clinical sites is a challenge. Offering centralized preceptor development activities from medical schools, geared toward the importance of evaluations, balancing learners and opportunities for student engagement, may overcome some of the identified challenges. Medical schools may also consider providing additional time and support for clerkship directors to assist with tracking teaching quality at sites, and to assist struggling preceptors prior to removing them from teaching.

scholarly journals Changes in Family Medicine Clerkship Teaching Due to the COVID-19 Pandemic

2021 ◽  
Vol 53 (4) ◽  
pp. 282-284
Author(s):  
Kelly M. Everard ◽  
Kimberly Zoberi Schiel
Keyword(s):  
Family Medicine ◽  
Clinical Teaching ◽  
Rapid Development ◽  
Traditional Teaching ◽  
Frequent Change ◽  
Medicine Clerkship ◽  
Didactic Teaching ◽  
Traditional Teaching Methods ◽  
Clinical Changes ◽  
Research Alliance

Background and Objectives: On March 17, 2020, the Association of American Medical Colleges recommended temporary suspension of all medical student clinical activities due to the COVID-19 pandemic, which required a rapid development of alternatives to traditional teaching methods. This study examines education changes spurred by COVID-19. Methods: Data were collected via a Council of Academic Family Medicine Educational Research Alliance survey of family medicine clerkship directors. Participants answered questions about didactic and clinical changes made to clerkship teaching due to the COVID-19 pandemic, how positive the changes were, whether the changes would be made permanent, and how prepared clerkship directors were for the changes. Results: The response rate was 64%. The most frequent change made to didactic teaching was increasing online resources. The most frequent change made to clinical teaching was adding clinical simulation. Greater changes were made to clinical teaching than to didactic teaching. Changes made to didactic teaching were perceived as more positive for student learning than the changes made to clinical teaching. Clerkship directors felt more prepared for changes to didactic teaching than for clinical teaching, and were more likely to make the didactic teaching changes permanent than the clinical teaching changes. Conclusions: The COVID-19 pandemic caused nearly all clerkship directors to make changes to clerkship teaching, but few felt prepared to make these changes, particularly changes to clinical teaching. Clerkship directors made fewer changes to didactic teaching than clinical teaching, however, didactic changes were perceived as more positive than clinical changes and were more likely to be adopted long term.

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 Student Race and Gender and Patient Encounters in a Family Medicine Clerkship

2019 ◽  
Vol 51 (1) ◽  
pp. 14-21
Author(s):  
Joseph Hobbs ◽  
David L. Kriegel ◽  
Ashley Saucier ◽  
Denise M. Hodo ◽  
Stephen W. Looney
Keyword(s):  
Family Medicine ◽  
Clinical Teaching ◽  
Clinical Experiences ◽  
Medicine Clerkship ◽  
Race And Gender ◽  
Patient Demographics ◽  
Network Methods ◽  
Geographically Distributed ◽  
And Gender ◽  
Gender Specific

Background and Objectives: The purpose of this study was to determine the association of students’ race and gender with the race, gender, age, patient numbers, and problems encountered during a third-year family medicine clerkship across a geographically distributed clinical teaching network. Methods: Student patient experience logbook data from two separate but adjacent 3-year periods were analyzed. Mixed-effects regression models and generalized linear mixed models were used to determine the relationship between student race and gender on number and demographics of patients encountered and odds of encountering required conditions and gender-specific conditions at least once during the clerkship. Results: A total of 458 students documented 66,752 encounters during academic years 2008 through 2010, and 498 students documented 70,213 encounters during academic years 2011 through 2013. The first cohort averaged 145.8 (SD 24.0) encounters per student and the second cohort averaged 141.1 (SD 19.5) encounters per student. Females had more encounters during the first period, but no difference in the second. There was no difference in average encounters between white and nonwhite students during the first period, but during the second, nonwhite students had more encounters. A few differences were found in odds of encountering required conditions or gender-specific conditions, but none were consistent across time. Conclusions: Family medicine clerkship students in this geographically distributed network did not experience significant differences in patient demographics, conditions, or gender-specific diseases, based on their gender or race. The teaching sites in the study were monitored continuously to ensure consistent clinical experiences in volume and scope.

scholarly journals PROBLEM BASED LEARNING APPLIED TO PRACTICE IN MEDICAL SCHOOLS IN BRAZIL: A MINI-SYSTEMATIC REVIEW

2019 ◽  
Author(s):  
Frederico Alberto Bussolaro ◽  
Claudine Thereza-Bussolaro
Keyword(s):  
Systematic Review ◽  
Family Medicine ◽  
Literature Search ◽  
Clinical Teaching ◽  
Problem Based Learning ◽  
Medical Schools ◽  
Clinical Settings ◽  
Systematic Literature Search ◽  
Brazilian Students ◽  
Educational Methodology

ABSTRACTBackgroundActive learning is a well-established educational methodology in medical schools worldwide, although its implementation in Brazilian clinical settings is quite challenging. The objective of this study is to review the literature in a systematic manner to find and conduct a reflective analysis of how problem-based learning (PBL) has been applied to clinical teaching in medical schools in Brazil.Material & methodsA systematic literature search was conducted in three databases. A total of 250 papers related to PBL in Brazilian medical schools were identified through the database searches. Four studies were finally selected for the review.ResultsFour fields of medicine were explored on the four selected papers: gynecology/family medicine, medical semiology, psychiatry, and pediatrics. Overall, all the papers reported some level of strategic adaptability of the original PBL methodology to be applied in the Brazilian medical school’s curricula and to the peculiar characteristics specific to Brazil.ConclusionPBL application in Brazilian medical schools require some level of alteration from the original format, to better adapt to the characteristics of Brazilian students’ maturity, health system priorities and the medical labor market.

scholarly journals Impact of a Dedicated Teaching Attending Experience on a Required Emergency Medicine Clerkship

2019 ◽  
Vol 21 (1) ◽  
pp. 58-64
Author(s):  
Todd Guth ◽  
Michael Overbeck ◽  
Kelley Roswell ◽  
Tien Vu ◽  
Kayla Williamson ◽  
...  
Keyword(s):  
Emergency Medicine ◽  
Clinical Teaching ◽  
Multinomial Logistic Regression ◽  
Educational Innovation ◽  
High Volume ◽  
Teaching Quality ◽  
Medicine Clerkship ◽  
Clinical Educator ◽  
Sample Proportion ◽  
Rapid Pace

Introduction: One published strategy for improving educational experiences for medical students in the emergency department (ED) while maintaining patient care has been the implementation of dedicated teaching attending shifts. To leverage the advantages of the ED as an exceptional clinical educational environment and to address the challenges posed by the rapid pace and high volume of the ED, our institution developed a clerkship curriculum that incorporates a dedicated clinical educator role – the teaching attending – to deliver quality bedside teaching experiences for students in a required third-year clerkship. The purpose of this educational innovation was to determine whether a dedicated teaching attending experience on a third-year required emergency medicine (EM) clerkship would improve student-reported clinical teaching evaluations and student-reported satisfaction with the overall quality of the EM clerkship. Methods: Using a five-point Likert-type scale (1 - poor to 5 - excellent), student-reported evaluation ratings and the numbers of graduating students matching into EM were trended for 10 years retrospectively from the inception of the clerkship for the graduating class of 2009 through and including the graduating class of 2019. We used multinomial logistic regression to evaluate whether the presence of a teaching attending during the EM clerkship improved student-reported evaluation ratings for the EM clerkship. We used sample proportion tests to assess the differences between top-box (4 or 5 rating) proportions between years when the teaching attending experience was present and when it was not. Results: For clinical teaching quality, when the teaching attending is present the estimated odds of receiving a rating of 5 is 77.2 times greater (p <0.001) than when the teaching attending is not present and a rating of 4 is 27.5 times greater (p =0.0017). For overall clerkship quality, when the teaching attending is present, the estimated odds of receiving a rating of 5 is 13 times greater (p <0.001) and a rating of 4 is 5.2 times greater (p=0.0086) than when the teaching attending is not present. Conclusion: The use of a dedicated teaching attending shift is a successful educational innovation for improving student self-reported evaluation items in a third-year required EM clerkship.

scholarly journals Sexual Health Teaching in the Family Medicine Clerkship: Results of a CERA Survey

PRiMER ◽  
2021 ◽  
Vol 5 ◽  
Author(s):  
Sarah E. Stumbar ◽  
Nana Aisha Garba ◽  
Marisyl de la Cruz ◽  
Prasad Bhoite ◽  
Matthew Holley ◽  
...  
Keyword(s):  
Family Medicine ◽  
Sexual Health ◽  
Delivery Methods ◽  
Medicine Clerkship ◽  
Sexual Health Care ◽  
Curricular Development ◽  
The Family ◽  
Care Family ◽  
Research Alliance ◽  
Health Content

Introduction: With growing efforts to provide comprehensive and inclusive sexual health care, family medicine clerkships are well positioned to educate learners about a spectrum of related topics. This study investigated the current state of sexual health instruction in family medicine clerkships, including specific factors impacting its delivery. Methods: Questions about sexual health curricula were created and included as part of the 2020 Council of Academic Family Medicine’s Educational Research Alliance survey of family medicine clerkship directors. The survey was distributed via email to 163 recipients between June 1, 2020 and June 25, 2020. Results: One hundred five (64.42%) of 163 clerkship directors responded to the survey. Our results revealed that during family medicine clerkships, family planning, contraception, and pregnancy options counseling are covered significantly more often than topics related to sexual dysfunction and satisfaction and LGBTQ+ health. Most clerkship directors (91.5%) reported less than 5 hours of sexual health training in their curriculum. Those with more dedicated sexual health curricular hours were more likely to include simulation. Lack of time (41.7%) was the most frequently reported barrier to incorporating sexual health content into the clerkship.  Conclusions: Coverage of sexual health topics during the family medicine clerkship is limited in scope and delivery. To support curricular development and integration, future studies should more thoroughly examine the factors influencing the inclusion of sexual health content in family medicine clerkships as well as the development of assessment methods to determine competency.

scholarly journals Moving Toward a Standardized National Family Medicine Subinternship Curriculum:

2020 ◽  
Vol 52 (7) ◽  
pp. 523-527
Author(s):  
Tomoko Sairenji ◽  
Sarah E. Stumbar ◽  
Nana Aisha Garba ◽  
Prasad Bhoite ◽  
Maria Syl de la Cruz ◽  
...  
Keyword(s):  
Family Medicine ◽  
Potential Role ◽  
Positive Association ◽  
Online Program ◽  
Medicine Clerkship ◽  
Residency Programs ◽  
Variable Nature ◽  
P 16 ◽  
Research Alliance

Background and Objectives: Although the subinternship (sub-I) is considered integral in many medical schools’ curricula, family medicine does not have standardized course recommendations. Given the variable nature of this clinical experience, this study investigated the potential role of a standardized sub-I curriculum in family medicine. Methods: Questions about sub-Is were created and data were gathered and analyzed as part of the 2019 Council of Academic Family Medicine’s (CAFM) Educational Research Alliance (CERA) survey of family medicine clerkship directors. The survey was distributed via email to 126 US and 16 Canadian recipients between June 19, 2019 and August 2, 2019 through the online program SurveyMonkey. Results: A total of 101 (71.1%) of 142 clerkship directors responded to the survey. Most (84.2%) schools require sub-Is. There was a positive association between students matching into family medicine and having family medicine sub-Is at residency programs (P&lt;.001). There was no relationship between higher family medicine match rates and the presence of family medicine sub-Is at nonresidency sites (P=.48) or having an advanced ambulatory rotation requirement (P=.16). Conclusions: A sub-I is a way to further expose students to family medicine, and increasing sub-I positions at residency programs may influence the number who pursue the specialty. Creation of a standardized sub-I curriculum presents an opportunity to enhance a critical educational experience in family medicine.

scholarly journals The Effect of Teaching Family Medicine Clerkship Students on Preceptor Productivity

PRiMER ◽  
2020 ◽  
Vol 4 ◽  
Author(s):  
Tomoko Sairenji ◽  
Samuel Griffin ◽  
Misbah Keen
Keyword(s):  
Primary Care ◽  
Medical Student ◽  
Family Medicine ◽  
Student Teaching ◽  
Primary Care Physicians ◽  
Clinical Teaching ◽  
Medical Student Education ◽  
Billing Data ◽  
Medicine Clerkship ◽  
Number Of Patients

Introduction: High-quality, experiential learning in outpatient settings is indispensable for medical student education; however these settings are difficult to recruit and retain. The majority of primary care physicians are employed by organizations and are under pressure to increase their relative value unit (RVU) production. Although the common perception that teaching medical students decreases productivity is unproven, it is likely a barrier for primary care physicians pursuing clinical teaching. We sought to investigate whether medical student teaching affects clinical productivity. Methods: We recruited 15 family medicine (FM) clerkship sites to participate in our study via email and at an in-person meeting. For each preceptor, we collected billing data in the form of current procedural terminology (CPT) codes for all patient encounters and the number of patients seen per half-day for when the preceptor had a student and when they did not. We converted CPT codes to RVU data. We compared differences in productivity for each individual preceptor, and we used a paired t test to examine collective data with and without a student. Results: Ten preceptors at six FM clerkship sites provided reliable data. The average RVU per half-day without a student was 10.84, and it was slightly higher at 11.25 when a student was present (P=.74). The average number of patients seen per half-day without a student was 8.32 and it was slightly lower at 7.87 when a student was present (P=.58). Conclusion: This study shows promising data that teaching students in the outpatient setting does not decrease preceptor productivity. This pilot study can lead to a larger-scale exploration of family medicine preceptor productivity in different settings and institutions.

scholarly journals Teaching Chronic Pain in the Family Medicine Clerkship: Changes From 2014

2020 ◽  
Vol 52 (5) ◽  
pp. 361-363
Author(s):  
Kimberly Zoberi Schiel ◽  
Kelly M. Everard
Keyword(s):  
Chronic Pain ◽  
Family Medicine ◽  
Response Rate ◽  
Opioid Overdose ◽  
Medicine Clerkship ◽  
Overdose Death ◽  
The Family ◽  
Opioid Medications ◽  
Research Alliance ◽  
Nonpharmacological Treatments

Background and Objectives: The management of chronic pain is an important topic for training competent family physicians. The purpose of this study was to determine factors in teaching about chronic pain and whether state overdose death rates were associated with teaching chronic pain topics. Methods: Data were collected as part of the 2019 Council of Academic Family Medicine Educational Research Alliance (CERA) Clerkship Directors’ Survey. The response rate was 71%. Respondents answered questions about the amount of time spent teaching about chronic pain diagnoses, approach to chronic pain, opioid medications, nonopioid medications and nonpharmacologic treatments for chronic pain. Results: The most frequent topic was chronic pain diagnoses, taught by 64% of clerkships with an average of 92 minutes spent on the topic. Each chronic pain topic was taught by nearly 50% of clerkships, and 72.3% of clerkships taught at least one topic. More clerkships were teaching about opioids, nonopioids, and nonpharmacological treatments for chronic pain than in 2014. Time currently spent teaching about opioids was positively correlated with clerkships’ state 2014 drug overdose death rate. Conclusions: The majority of family medicine clerkships teach about chronic pain, and the amount of time dedicated to this topic has increased over the last 5 years. A state’s opioid overdose rate correlates with the amount of time spent teaching about opioids, but does not correlate with the amount of time teaching about other chronic pain subtopics. It is possible that the opioid crisis is causing a shift in the subtopics of chronic pain teaching.

scholarly journals Factors Associated With Successfully Filling Faculty Vacancies in Family Medicine

2019 ◽  
Vol 51 (6) ◽  
pp. 489-492
Author(s):  
Kelly M. Everard ◽  
Kimberly Zoberi ◽  
Christine Jacobs
Keyword(s):  
Family Medicine ◽  
Clinical Teaching ◽  
Department Chairs ◽  
Full Time ◽  
New Faculty ◽  
Full Time Equivalent ◽  
Protected Time ◽  
Signing Bonus ◽  
Signing Bonuses ◽  
Research Alliance

Background and Objectives: Faculty vacancies are a concern for chairs of academic family medicine departments who regularly face having to recruit new faculty. Faculty physicians who report lack of support for research and teaching or excessive time in activities that are not meaningful may experience burnout resulting in leaving academic medicine. Methods: Data were collected via a Council of Academic Family Medicine Educational Research Alliance (CERA) survey of US family medicine department chairs. To determine characteristics associated with success in hiring new physician faculty, chairs answered questions about the number of vacancies in the previous 12 months, the number of vacancies filled in the previous 12 months, the months the longest vacancy was open, starting salary, whether signing bonus was offered, and the full-time equivalent (FTE) for clinical, research, teaching, and administrative time. Results: The response rate was 52%. Chairs reported an average of 3.9 vacancies in the previous 12 months, and an average of 2.5 (66%) were filled. Chairs who didn’t offer protected time for teaching filled a higher percentage of their vacancies, but they did not fill them faster than departments that did offer teaching time. Higher salary and a signing bonus were associated with filling positions faster. Chairs who offered a signing bonus filled positions nearly 4 months sooner than those who didn’t. Conclusions: Offering protected time for teaching or research and FTE allocation for clinical, teaching, research, and administrative time were not associated with success in hiring new faculty. Chairs who offered higher salaries and signing bonuses were able to hire faculty more quickly than those who didn’t.

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