scholarly journals Entrustable Professional Activity Utilization: A CERA Study of Family Medicine Residency Program Directors

2019 ◽  
Vol 51 (6) ◽  
pp. 471-476
Author(s):  
Jennie B. Jarrett ◽  
Jumana Antoun ◽  
Memoona Hasnain

Background and Objectives: Entrustable professional activities (EPAs) is a novel assessment framework in competency-based medical education. While there are published pilot reports about utilization and validation of EPAs within undergraduate medical education (UME), there is a paucity of research within graduate medical education (GME). This study aimed to explore the landscape of EPAs within family medicine GME, particularly related to the understanding of EPAs, extent of utilization, and benefits and challenges of EPAs implementation as an assessment framework within family medicine residency programs (FMRPs) in the United States. Methods: A cross-sectional survey, as part of the 2017 Council of Academic Family Medicine (CAFM) Educational Research Alliance (CERA) Family Medicine Residency Program (FMRP) Director omnibus online survey was conducted in fall, 2017. ACGME-accredited FMRP directors were invited by email to participate. Results: The survey response rate was 53.1% (267/503). Overall, 90.1% (237/263) of FMRP directors were aware of EPAs as an assessment framework and 82.8% (197/238) understood the principles of EPAs, but 39.9% (95/238) were not confident in utilizing EPAs. Only 15.1% (36/238) of FMRP directors reported currently employing EPAs as an assessment tool. Identified benefits of EPAs use included increased transparency and congruence of expectations between learners and FRMP as well as facilitation for formative feedback. Identified barriers of EPA incorporation included difficulty integrating EPAs into the current assessment framework and faculty development. Conclusions: While EPAs are well recognized and understood by FMRP directors, there is significant lack of utilization of this assessment framework within FMRP in the United States.

2020 ◽  
Vol 52 (3) ◽  
pp. 198-201
Author(s):  
Joshua St. Louis ◽  
Emma Worringer ◽  
Wendy B. Barr

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.


Author(s):  
Nina Grace Ruedas ◽  
Terri Wall ◽  
Christopher Wainwright

Research shows that a growing number of people in the United States are identifying as LGBTQ+. Therefore, it is more important than ever that clinicians are trained to be knowledgeable, inclusive, and culturally aware. Unfortunately, there is a lack of LGBTQ+ health education requirements in graduate medical education. As a result, fewer clinicians are prepared to care for this growing population. The shortage of knowledgeable clinicians contributes to LGBTQ+ health disparities and barriers to care. One strategy to combat these deficiencies in health care is for Family Medicine residency programs to create and carry out an LGBTQ+ health curriculum. This article will review LGBTQ+ health topics, identify efforts that Family Medicine residency programs can make, and summarize curriculum developments made by the St. Vincent's Family Medicine Residency Program.


2020 ◽  
Vol 52 (10) ◽  
pp. 730-735
Author(s):  
Ann M. Philbrick ◽  
Christine Danner ◽  
Abayomi Oyenuga ◽  
Chrystian Pereira ◽  
Jason Ricco ◽  
...  

Background and Objectives: Medical cannabis has become increasingly prevalent in the United States, however the extent of family medicine resident education on this topic remains unknown. The objective of this study was to ascertain the current state of medical cannabis education across this population and identify patterns in education based on state legality and program director (PD) practices. Methods: Survey questions were part of the Council of Academic Family Medicine Educational Research Alliance (CERA) omnibus survey from May 2019 to July 2019. PDs from all Accreditation Council for Graduate Medical Education (ACGME)-accredited US family medicine residency programs received survey invitations by email. Results: A total of 251 (40.7%) PDs responded, with 209 (83.6% [209/250]) reporting at least 1 hour of didactic curriculum regarding cannabis. The most common context was substance misuse (mean 3.0±4.1 hours per 3 years), followed by pain management (2.7±3.4 hours), and management of other conditions (2.1±2.7 hours). Thirty-eight programs (15.2% [38/250]) offered clinical experiences related to medical cannabis, and PDs who had previously prescribed or recommended medical cannabis were more likely to offer this experience (P<.0001). Experiences peaked after 3 to 5 years of medical cannabis legality. PD confidence in resident counseling skills was low overall, but did increase among programs with clinical experiences (P=.0033). Conclusions: The current trajectory of medical cannabis use in the United States makes it likely that residents will care for patients interested in medical cannabis, therefore it is important residents be prepared to address this reality. Opportunities exist for improving medical cannabis education in family medicine residency programs.


2020 ◽  
Vol 12 (6) ◽  
pp. 717-726
Author(s):  
Peter Meyers ◽  
Elizabeth Wilkinson ◽  
Stephen Petterson ◽  
Davis G. Patterson ◽  
Randall Longenecker ◽  
...  

ABSTRACT Background Rural regions of the United States continue to experience a disproportionate shortage of physicians compared to urban regions despite decades of state and federal investments in workforce initiatives. The graduate medical education system effectively controls the size of the physician workforce but lacks effective mechanisms to equitably distribute those physicians. Objective We created a measurement tool called a “rural workforce year” to better understand the rural primary care workforce. It quantifies the rural workforce contributions of rurally trained family medicine residency program graduates and compares them to contributions of a geographically matched cohort of non-rurally trained graduates. Methods We identified graduates in both cohorts and tracked their practice locations from 2008–2018. We compared the average number of rural workforce years in 3 cross sections: 5, 8, and 10 years in practice after residency graduation. Results Rurally trained graduates practicing for contributed a higher number of rural workforce years in total and on average per graduate compared to a matched cohort of non-rural/rural training tack (RTT) graduates in the same practice intervals (P < .001 in all 3 comparison groups). In order to replace the rural workforce years produced by 1 graduate from the rural/RTT cohort, it would take 2.89 graduates from non-rural/RTT programs. Conclusions These findings suggest that rural/RTT-trained physicians devote substantially more service to rural communities than a matched cohort of non-rural/RTT graduates and highlight the importance of rural/RTT programs as a major contributor to the rural primary care workforce in the United States.


2011 ◽  
Vol 3 (3) ◽  
pp. 379-382 ◽  
Author(s):  
Peter J Carek ◽  
Lori M Dickerson ◽  
Vanessa A Diaz ◽  
Terrence E Steyer

Abstract Background Scholarly activity as a component of residency education is becoming increasingly emphasized by the Accreditation Council for Graduate Medical Education. “Limited or no evidence of resident or faculty scholarly activity” is a common citation given to family medicine residency programs by the Review Committee for Family Medicine. Objective The objective was to provide a model scholarly activity curriculum that has been successful in improving the quality of graduate medical education in a family medicine residency program, as evidenced by a record of resident academic presentations and publications. Methods We provide a description of the Clinical Scholars Program that has been implemented into the curriculum of the Trident/Medical University of South Carolina Family Medicine Residency Program. Results During the most recent 10-year academic period (2000–2010), a total of 111 residents completed training and participated in the Clinical Scholars Program. This program has produced more than 24 presentations during national and international meetings of medical societies and 15 publications in peer-reviewed medical journals. In addition, many of the projects have been presented during meetings of state and regional medical organizations. Conclusions This paper presents a model curriculum for teaching about scholarship to family medicine residents. The success of this program is evidenced by the numerous presentations and publications by participating residents.


Pharmacy ◽  
2020 ◽  
Vol 8 (3) ◽  
pp. 126
Author(s):  
Jennie B. Jarrett ◽  
Jody L. Lounsbery

(1) Objective: To determine the change in prevalence of clinical pharmacists as clinician educators within family medicine residency programs (FMRPs) in North America and to describe their clinical, educational and administrative scope over time. (2) Methods: A systematic review of the literature was performed starting with an electronic search of PubMed and Embase for articles published between January 1980 and December 2019. Studies were included if they surveyed clinical pharmacists regarding their clinical, educational, or other roles in FMRPs in the United States or Canada. The primary outcome was the change in prevalence of clinical pharmacists in North America. Secondary outcomes included: demographic information of clinical pharmacists, change in the prevalence in Canada and United States, and descriptions of clinical services, educational roles, and other activities of clinical pharmacists within FMRPs. (3) Results: Of the 65 articles identified, six articles met the inclusion criteria. The prevalence of clinical pharmacists as clinician educators in FMRPs in North America has grown from 24% to 53% in the United States (U.S.) and from 14% to 47% in Canada over the study period. The clinical and educational roles are similar including: the direct patient care, clinical education, and interprofessional education and practice. (4) Conclusion: The prevalence of clinical pharmacists in FMRPs is growing across North America. Clinical pharmacists are highly educated and trained to support these clinician educator positions. While educational roles are consistent, clinical pharmacists’ patient care roles are unique to their clinical site and growing.


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