Resident Outcomes and Perspectives Over 2 Years of a New Scholarship Curriculum

Background and Objectives: Scholarship is recognized as a challenge in many family medicine residency programs. Among evaluations of scholarship curricula, few describe resident experiences of such interventions. To bridge this gap in knowledge, we measured resident confidence, satisfaction, and participation before and after implementing a new scholarship curriculum. Methods: The redesigned curriculum included a structured project timeline, resident research in progress meetings, faculty mentorship, scholarly skills workshops, and mentored journal clubs. We conducted a curriculum evaluation via surveys of residents prior to implementation and after years 1 and 2, measuring satisfaction with the scholarly environment and opportunities, and confidence and participation in specific scholarly activities using Likert scales from 1 (least confidence) to 5. Results: Compared to baseline (n=28), after 2 years (n=27) of the curriculum, residents reported increased mean confidence in critical appraisal of scientific articles (2.6±1.1 to 3.3±0.7, P=.007), carrying out a scholarly project (2.5±0.8 to 3.4±1.0, P=.005), and writing an abstract (3.0±0.8 to 3.8±0.7, P=.002). As compared to the first year, more residents in the second year participated in quality improvement projects (7.1% vs 29.6%, P=.031) and wrote conference abstracts (10.7% vs 37.0%, P=.022). Over the same period, those very satisfied with the scholarly environment increased from 0 (0%) to 8 (29.6%, P=.017). The June 2020 survey identified increased interest in scholarship because of the antiracism movement (51.9%) and COVID-19 pandemic (40.7%). Conclusions: Implementation of a redesigned scholarship curriculum was associated with increases in family medicine resident scholarship confidence and satisfaction.

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

Family Medicine ◽

10.22454/fammed.2020.411271 ◽

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.

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The Residency Performance Index: An Effort at Residency Quality Assessment and Improvement in Family Medicine

Journal of Graduate Medical Education ◽

10.4300/jgme-d-13-00355.1 ◽

2014 ◽

Vol 6 (4) ◽

pp. 756-759 ◽

Cited By ~ 4

Author(s):

Grant S. Hoekzema ◽

Lisa Maxwell ◽

Joseph W. Gravel ◽

Walter W. Mills ◽

William Geiger

Keyword(s):

Quality Improvement ◽

Family Medicine ◽

Performance Index ◽

Program Improvement ◽

First Year ◽

Clinical Experiences ◽

Residency Programs ◽

Family Medicine Residency ◽

Lack Of Information ◽

Quality Improvement Tool

Abstract Background Residency programs are increasingly being asked to defend their quality, and that of the residents they produce. Yet “residency quality” is a construct that has not been well defined, with no accepted standards other than meeting accreditation standards. In 2009, the Association of Family Medicine Residency Directors developed a strategic plan that included the goal of raising the quality of family medicine training. Objective We describe the development of this quality improvement tool, which we called the residency performance index (RPI), and its first year of use by family medicine residency programs. We describe the use of the tool as a “dashboard” to facilitate program self-improvement. Intervention Using program metrics specific to family medicine training, and benchmark criteria for these metrics, the RPI was launched in 2012 to help programs identify strengths and areas for improvement in their educational activities and resident clinical experiences that could be tracked and reviewed as part of the annual program evaluation. Results Approximately 100 program directors began using the tool and 70 finished the process, and were provided aggregate data. Initial review of this experience revealed difficulties with collecting data, and lack of information on graduates' scope of practice. It also showed the potential usefulness of the tool as a program improvement mechanism. Conclusions The RPI is a new quality improvement tool for family medicine residency programs. Although some initial challenges need to be addressed, it has the promise to aid family medicine residency in its internal improvement efforts.

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Cultivating person-centered medicine in future physicians

European Journal for Person Centered Healthcare ◽

10.5750/ejpch.v1i2.688 ◽

2013 ◽

Vol 1 (2) ◽

pp. 468 ◽

Cited By ~ 14

Author(s):

Kevin Garneau ◽

Thomas Hutchinson ◽

Qinyi Zhao ◽

Patricia Dobkin

Keyword(s):

Family Medicine ◽

Medical Practice ◽

Quantitative Data ◽

Systematic Approach ◽

Residency Programs ◽

Culture Of Medicine ◽

Time Stress ◽

Self Compassion ◽

Before And After ◽

Impact Patient Care

Person-centered medicine, while valued implicitly, is not always taught explicitly in medical schools or during residency programs. Threats to educating and practicing person-centered medicine include perceived lack of time, stress, burnout and a paucity of mentors with a systematic approach to modeling and teaching students how to relate to patients in a way that addresses them as whole persons. Herein we review how trainee stress and burnout negatively impact patient care and outline a program designed to teach mindful medical practice that may be an antidote to these problems. Moreover, we present quantitative data and a student’s narrative to highlight how to cultivate person-centered medicine in trainees.Fifty-eight 4th year medical students completed questionnaires pertaining to: depression, burnout, stress, wellbeing, self-compassion and mindfulness before and after taking a 4-week elective entitled, Mindful Medical Practice. Statistically significant improvements were found on emotional exhaustion, depression, self-compassion and mindfulness. One student’s experiences highlighted how what he learned in the elective guided him during his family medicine residency. We conclude with a discussion of how the culture of medicine and the training of future physicians in particular, need to take the whole persons of both the physician and patient into account in order for all to be satisfied with and benefit from medical care.

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Effect of the BASIC Examination on Knowledge Acquisition during Anesthesiology Residency

Anesthesiology ◽

10.1097/aln.0000000000002036 ◽

2018 ◽

Vol 128 (4) ◽

pp. 813-820 ◽

Cited By ~ 10

Author(s):

Yan Zhou ◽

Huaping Sun ◽

Cynthia A. Lien ◽

Mark T. Keegan ◽

Ting Wang ◽

...

Keyword(s):

Knowledge Acquisition ◽

Residency Training ◽

Educational Outcomes ◽

Mixed Effects ◽

Mixed Effects Models ◽

First Year ◽

Examination System ◽

Before And After ◽

Second Year ◽

Basic Examination

Abstract Background The American Board of Anesthesiology recently introduced the BASIC Examination, a component of its new staged examinations for primary certification, typically offered to residents at the end of their first year of clinical anesthesiology training. This analysis tested the hypothesis that the introduction of the BASIC Examination was associated with an acceleration of knowledge acquisition during the residency training period, as measured by increments in annual In-Training Examination scores. Methods In-Training Examination performance was compared longitudinally among four resident cohorts (n = 6,488) before and after the introduction of the staged system using mixed-effects models that accounted for possible covariates. Results Compared with previous cohorts in the traditional examination system, the first resident cohort in the staged system had a greater improvement in In-Training Examination scores between the first and second years of clinical anesthesiology training (by an estimated 2.0 points in scaled score on a scale of 1 to 50 [95% CI, 1.7 to 2.3]). By their second year, they had achieved a score similar to that of third-year clinical anesthesiology residents in previous cohorts. The second cohort to enter the staged system had a greater improvement of the scores between the clinical base year and the first clinical anesthesiology year, compared with the previous cohorts. Conclusions These results support the hypothesis that the introduction of the BASIC Examination is associated with accelerated knowledge acquisition in residency training and provides evidence for the value of the new staged system in promoting desired educational outcomes of anesthesiology training.

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Observation of Hermann’s Tortoise (Testudo hermanni) C Lutching without the Presence of Males and Eggshell Mortality on a Large Tortoise Farm in Slovenia Over a Three-Year Period

Acta veterinaria ◽

10.2478/acve-2020-0035 ◽

2020 ◽

Vol 0 (0) ◽

Author(s):

Stvarnik Mateja ◽

Lindtner-Knific Renata ◽

Štokar Žan ◽

Gregurić Gračner Gordana ◽

Mićunović Jasna ◽

...

Keyword(s):

Embryonic Development ◽

Reproductive Activity ◽

First Year ◽

Egg Weight ◽

The Third ◽

Before And After ◽

Testudo Hermanni ◽

Males And Females ◽

Second Year ◽

Second Clutch

AbstractThe aim of this study was to determine the percentage of hatched and fertilized eggs in female Hermann’s tortoises before and after the removal of males after breeding.A breeding group of Testudo hermanni boettgeri with 50 females and 12 males was included in the study. In the first year, all adults were together in the same habitat until reproductive activity was observed. After the end of May, the males and females were separated for the next two active seasons. The number of eggs and number of second clutches decreased gradually. In the first year, 76.0% of females laid eggs; in the second year, 24.0%; and in the third year, only 8.0%. Second clutches were observed in ten females (26.3%) in the first year, while in the next two years, one female had a second clutch. There was a small but significant correlation between the weight of a single tortoise and the number of eggs laid but no significant correlation between the weight of the tortoise and its average egg weight. The weight (15.1-16.8 g), length (33.9-36.1 mm) and width of each egg (27.5-28.0 mm) was measured.During the laying season, the eggs were put into incubators. The incubation length varied from 52 to 70 days. After the end of incubation, eggshell mortality and its causes (19.3-52.5%) were examined. In the first year, the viability rate of the incubated eggs was 80.7%; in the second year, 80.5%; and in the third year, 47.8%. Among the unhatched eggs in the first year, 62.5% were unfertilized, 53.1% were infected, 28.1% were dehydrated and 21.9% were found in various stages of embryonic development.

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Meaningful Partnerships: Stages of Development of a Patient and Family Advisory Council at a Family Medicine Residency Clinic (Preprint)

10.2196/preprints.12105 ◽

2018 ◽

Author(s):

Jeffrey D Schlaudecker ◽

Keesha Goodnow ◽

Anna Goroncy ◽

Reid Hartmann ◽

Saundra Regan ◽

...

Keyword(s):

Family Medicine ◽

Residency Training Program ◽

Lessons Learned ◽

Advisory Council ◽

First Year ◽

Residency Programs ◽

Family Medicine Residency ◽

Working Together ◽

The Creation ◽

Improve Health

BACKGROUND Partnering with patients and families is a crucial step in optimizing health. A patient and family advisory council (PFAC) is a group of patients and family members working together collaboratively with providers and staff to improve health care. OBJECTIVE This study aimed to describe the creation of a PFAC within a family medicine residency clinic. To understand the successful development of a PFAC, challenges, potential barriers, and positive outcomes of a meaningful partnership will be reported. METHODS The stages of PFAC development include leadership team formation and initial training, PFAC member recruitment, and meeting launch. Following a description of each stage, outcomes are outlined and lessons learned are discussed. PFAC members completed an open-ended survey and participated in a focus group interview at the completion of the first year. Interviewees provided feedback regarding (1) favorite aspects or experiences, (2) PFAC impact on a family medicine clinic, and (3) future projects to improve care. Common themes will be presented. RESULTS The composition of the PFAC consisted of 18 advisors, including 8 patient and family advisors, 4 staff advisors, 4 resident physician advisors, and 2 faculty physician advisors. The average meeting attendance was 12 members over 11 meetings in the span of the first year. A total of 13 out of 13 (100%) surveyed participants were satisfied with their experience serving on the PFAC. CONCLUSIONS PFACs provide a platform for patient engagement and an opportunity to drive home key concepts around collaboration within a residency training program. A framework for the creation of a PFAC, along with lessons learned, can be utilized to advise other residency programs in developing and evaluating meaningful PFACs.

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758 Online Surgical Journal Clubs: Are They Effective?

British Journal of Surgery ◽

10.1093/bjs/znab259.870 ◽

2021 ◽

Vol 108 (Supplement_6) ◽

Author(s):

K Michael ◽

B Clayton ◽

S Chiuta

Keyword(s):

Critical Appraisal ◽

Journal Club ◽

Learning Objectives ◽

Online Journal ◽

Journal Clubs ◽

Foundation Programme ◽

Before And After ◽

Online Format ◽

Surgical Journal ◽

Paired T Test

Abstract Aim Much of medical education has been abruptly forced online during the COVID-19 pandemic. Traditional journal clubs thrive on group interaction and debate. The aim of this project is to assess whether an online surgical journal club could replicate this experience and learning. Method A fortnightly, chat-based online surgical journal club with national reach was re-launched under SCALPEL (Manchester Medical School’s surgical society) with defined learning objectives, inclusion of studies from different surgical sub-specialities and a proforma to aid critical appraisal. Anonymous feedback forms were sent to participants to assess confidence in critically appraising the literature before and after attendance, and differences in means were analysed using paired t-test. Results 32 feedback forms from participants, the majority of whom were final year medical students (34.4%) were analysed. 28.1% had previously attended a journal club. 65.6% of attendees had prior involvement in a research project which led to a publication for 18.8%, while 59.4% were interested in applying for the Academic Foundation Programme (AFP). The self-reported confidence of participants to identify the study design, interpret the results and statistical analyses; and scrutinise the strengths and weaknesses of a study increased by 12.2%, 14.7% and 15.9% respectively (p = <0.001). Furthermore, 96.9% of attendees stated they would attend another online journal club in the future, with 59.4% favouring an online format. Conclusions Online surgical journal clubs are effective and are here to stay following the conclusion of social distancing. They have the advantage of further outreach and may encourage greater participation than traditional journal clubs.

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Global health training in Canadian family medicine residency programmes

Family Medicine and Community Health ◽

10.1136/fmch-2019-000250 ◽

2020 ◽

Vol 8 (1) ◽

pp. e000250

Author(s):

Divyanshi Jalan ◽

Helene Morakis ◽

Neil Arya ◽

Yassen Tcholakov ◽

Jennifer Carpenter ◽

...

Keyword(s):

Family Medicine ◽

Global Health ◽

Online Survey ◽

Response Rate ◽

First Year ◽

French Canada ◽

Health Training ◽

Resident Participation ◽

Family Medicine Residency ◽

Second Year

ObjectiveCanadian family medicine (FM) residency programmes are responding to the growing demand to provide global health (GH) education to their trainees; herein, we describe the various GH activities (GHAs) offered within Canadian FM programmes.DesignA bilingual online survey was sent out to all 17 Canadian FM program directors (PDs) and/or an appointed GH representative.SettingOnline survey via QualtricsParticipantsAll 17 Canadian FM PDs and/or an appointed GH representative.ResultsThe response rate was 100% and represented 3250 first-year and second-year FM residents across English and French Canada. All schools stated that they participate in some form of GHAs. There was variation in the level of organisation, participation and types of GHAs offered. Overall, most GHAs are optional, and there is a large amount of variation in terms of resident participation. Approximately one third of programmes receive dedicated funding for their GHAs, and two thirds wish to increase the scope/variety of GHAs.ConclusionThese results suggest nationwide interest in developing a workforce trained in GH, but show great discrepancies in training, implementation and education.

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Development of laparoscopic skills in Medical students naive to surgical training

Einstein (São Paulo) ◽

10.1590/s1679-45082014ao3237 ◽

2014 ◽

Vol 12 (4) ◽

pp. 467-472 ◽

Cited By ~ 6

Author(s):

Worens Luiz Pereira Cavalini ◽

Christiano Marlo Paggi Claus ◽

Daniellson Dimbarre ◽

Antonio Moris Cury Filho ◽

Eduardo Aimoré Bonin ◽

...

Keyword(s):

Medical Students ◽

Skill Acquisition ◽

Surgical Techniques ◽

First Year ◽

Laparoscopic Skills ◽

First Year Students ◽

Score Improvement ◽

Before And After ◽

Second Year ◽

Improved Performance

Objective To assess the acquisition of basic laparoscopic skills of Medical students trained on a surgical simulator.Methods First- and second-year Medical students participated on a laparoscopic training program on simulators. None of the students had previous classes of surgical technique, exposure to surgical practice nor training prior to the enrollment in to the study. Students´ time were collected before and after the 150-minute training. Skill acquisition was measured comparing time and scores of students and senior instructors of laparoscopic surgeryResults Sixty-eight students participated of the study, with a mean age of 20.4 years, with a predominance of first-year students (62%). All students improved performance in score and time, after training (p<0,001). Score improvement in the exercises ranged from 294.1 to 823%. Univariate and multivariate analyses identified that second-year Medical students have achieved higher performance after training.Conclusions Medical students who had never been exposed to surgical techniques can acquire basic laparoscopic skills after training in simulators. Second-year undergraduates had better performance than first-year students.

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Education and Attitudes on Medical Cannabis in Family Medicine Residency Programs

Family Medicine ◽

10.22454/fammed.2020.645274 ◽

2020 ◽

Vol 52 (10) ◽

pp. 730-735

Author(s):

Ann M. Philbrick ◽

Christine Danner ◽

Abayomi Oyenuga ◽

Chrystian Pereira ◽

Jason Ricco ◽

...

Keyword(s):

United States ◽

Family Medicine ◽

The United States ◽

Clinical Experiences ◽

Medical Cannabis ◽

Residency Programs ◽

Family Medicine Residency ◽

Medicine Resident ◽

Current State ◽

Research Alliance

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.

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