scholarly journals Resident Remediation in Family Medicine Residency Programs: A CERA Survey of Program Directors

2021 ◽  
Vol 53 (9) ◽  
pp. 773-778
Author(s):  
Winfred Frazier ◽  
Stephen A. Wilson ◽  
Frank D'Amico ◽  
George R. Bergus
Keyword(s):  
Family Medicine ◽  
Program Directors ◽  
Residency Programs ◽  
Family Medicine Residency ◽  
Faculty Knowledge ◽  
Remediation Strategies ◽  
Research Alliance ◽  
And Training ◽  
Remediation Process ◽  
Faculty Responsibility

Background and Objectives: Identifying underperforming residents and helping them become fully competent physicians is an important faculty responsibility. The process to identify and remediate these learners varies greatly between programs. The objective of this study was to evaluate the remediation landscape in family medicine residency programs by investigating resident remediation characteristics, tools to improve the process, and remediation challenges. Methods: This study analyzed responses from the Council of Academic Family Medicine Educational Research Alliance (CERA) national survey of family medicine program directors in 2017. Survey questions included topics on faculty remediation training, remediation prevalence, tools for remediation, and barriers to remediation. Results: Two hundred sixty-seven of 503 program directors completed our survey (53% response rate). Most residency programs (245/264, 93%) had at least one resident undergoing remediation in the last 3 years. A majority (242/265, 91%) of residents undergoing remediation were successful within 12 months. The three most important tools to improve remediation were an accessible remediation toolkit (50%), formal remediation recommendations from national family medicine organizations (20%), and on-site faculty development and training (19%). The top-two challenges to the remediation process were a lack of documented evaluations to trigger remediation and a lack of faculty knowledge and skills with effective remediation strategies. Conclusions: Residents needing remediation are common, but most were successfully remediated within 12 months. Program directors wanted access to a standardized toolkit to help guide the remediation process.

scholarly journals Point-of-Care Ultrasound in Family Medicine Residencies 5-Year Update: A CERA Study

2020 ◽  
Vol 52 (7) ◽  
pp. 505-511
Author(s):  
Jeffrey W. W. Hall ◽  
Harland Holman ◽  
Tyler W. Barreto ◽  
Paul Bornemann ◽  
Andrew Vaughan ◽  
...  
Keyword(s):  
Family Medicine ◽  
Core Curriculum ◽  
Point Of Care ◽  
Program Directors ◽  
Point Of Care Ultrasound ◽  
Residency Programs ◽  
Family Medicine Residency ◽  
Survey Results ◽  
Research Alliance ◽  
Residency Program Directors

Background and Objectives: In 2014, family medicine residency programs began to integrate point-of-care ultrasound (POCUS) into training, although very few had an established POCUS curriculum. This study aimed to evaluate the resources, barriers, and scope of POCUS training in family medicine residencies 5 years after its inception. Methods: Questions regarding current training and use of POCUS were included in the 2019 Council of Academic Family Medicine Educational Research Alliance (CERA) survey of family medicine residency program directors, and results compared to similar questions on the 2014 CERA survey. Results: POCUS is becoming a core component of family medicine training programs, with 53% of program directors reporting establishing or an established core curriculum. Only 11% of program directors have no current plans to add POCUS training to their program, compared to 41% in 2014. Despite this increase in training, the reported clinical use of POCUS remains uncommon. Only 27% of programs use six of the eight surveyed POCUS modalities more than once per year. The top three barriers to including POCUS in residency training in 2019 have not changed since 2014, and are (1) a lack of trained faculty, (2) limited access to equipment, and (3) discomfort with interpreting images without radiologist review. Conclusions: Training in POCUS has increased in family medicine residencies over the last 5 years, although practical use of this technology in the clinical setting may be lagging behind. Further research should explore how POCUS can improve outcomes and reduce costs in the primary care setting to better inform training for this technology.

scholarly journals An Update of Oral Health Curricula in US Family Medicine Residency Programs

2018 ◽  
Vol 50 (6) ◽  
pp. 437-443 ◽  
Author(s):  
Hugh Silk ◽  
Judith A. Savageau ◽  
Kate Sullivan ◽  
Gail Sawosik ◽  
Min Wang
Keyword(s):  
Oral Health ◽  
Family Medicine ◽  
Online Survey ◽  
Program Directors ◽  
Residency Programs ◽  
Health Curriculum ◽  
Family Medicine Residency ◽  
Important Health ◽  
Dental Professional ◽  
Residency Program Directors

Background and Objectives: National initiatives have encouraged oral health training for family physicians and other nondental providers for almost 2 decades. Our national survey assesses progress of family medicine residency programs on this important health topic since our last survey in 2011. Methods: Family medicine residency program directors (PDs) completed an online survey covering various themes including number of hours of oral health (OH) teaching, topics covered, barriers, evaluation, positive influences, and program demographics. Results: Compared to 2011, more PDs feel OH should be addressed by physicians (86% in 2017 vs 79% in 2011), yet fewer programs are teaching OH (81% vs 96%) with fewer hours overall (31% vs 45% with 4 or more hours). Satisfaction with the competence of graduating residents in OH significantly decreased (17% in 2017 vs 32% in 2011). Program directors who report graduates being well prepared to answer board questions on oral health topics are more likely to have an oral health champion (P<0.001) and report satisfaction with the graduates’ level of oral health competency (P<0.001). Programs with an oral health champion, or having a relationship with a state or national oral health coalition, or having routine teaching from a dental professional are significantly more likely to have more hours of oral health curriculum (P<0.001). Conclusions: Family medicine PDs are more aware of the importance of oral health, yet less oral health is being taught in residency programs. Developing more faculty oral health champions and connecting programs to dental faculty and coalitions may help reduce this educational void.

Assessing Family Medicine Residency Programs’ Training on Human Trafficking: A National Survey of Program Directors

2020 ◽  
pp. 1-13
Author(s):  
Ranit Mishori ◽  
Katherine Stolarz ◽  
Anita Ravi ◽  
Valeriy R. Korostyshevskiy ◽  
Ronald Chambers ◽  
...  
Keyword(s):  
Family Medicine ◽  
Human Trafficking ◽  
National Survey ◽  
Program Directors ◽  
Residency Programs ◽  
Family Medicine Residency

scholarly journals Training Family Medicine Residents to Perform Home Visits: A CERA Survey

2017 ◽  
Vol 9 (1) ◽  
pp. 90-96 ◽  
Author(s):  
Tomoko Sairenji ◽  
Stephen A. Wilson ◽  
Frank D'Amico ◽  
Lars E. Peterson
Keyword(s):  
Family Medicine ◽  
Primary Care Physicians ◽  
Home Visit ◽  
Home Visits ◽  
Program Directors ◽  
Family Medicine Residency ◽  
Resident Time ◽  
Faculty Time ◽  
Research Alliance ◽  
Residency Program Directors

ABSTRACT Background  Home visits have been shown to improve quality of care, save money, and improve outcomes. Primary care physicians are in an ideal position to provide these visits; of note, the Accreditation Council for Graduate Medical Education no longer requires home visits as a component of family medicine residency training. Objective  To investigate changes in home visit numbers and expectations, attitudes, and approaches to training among family medicine residency program directors. Methods  This research used the Council of Academic Family Medicine Educational Research Alliance (CERA) national survey of family medicine program directors in 2015. Questions addressed home visit practices, teaching and evaluation methods, common types of patient and visit categories, and barriers. Results  There were 252 responses from 455 possible respondents, representing a response rate of 55%. At most programs, residents performed 2 to 5 home visits by graduation in both 2014 (69% of programs, 174 of 252) and 2015 (68%, 172 of 252). The vast majority (68%, 172 of 252) of program directors expect less than one-third of their graduates to provide home visits after graduation. Scheduling difficulties, lack of faculty time, and lack of resident time were the top 3 barriers to residents performing home visits. Conclusions  There appeared to be no decline in resident-performed home visits in family medicine residencies 1 year after they were no longer required. Family medicine program directors may recognize the value of home visits despite a lack of few formal curricula.

scholarly journals Education and Attitudes on Medical Cannabis in Family Medicine Residency Programs

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.

scholarly journals Diversity and Facing Discrimination in Family Medicine Residencies: A CERA Survey of Program Directors

2021 ◽  
Vol 53 (10) ◽  
pp. 871-877
Author(s):  
Stacy E. Potts ◽  
Ivonne McLean ◽  
George W. Saba ◽  
Gerardo Moreno ◽  
Jennifer Edgoose ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Family Medicine ◽  
Residency Program ◽  
Underserved Populations ◽  
Program Directors ◽  
Workforce Diversity ◽  
Residency Programs ◽  
Family Medicine Residency ◽  
Residency Program Directors

Background and Objectives: Increasing the number of underrepresented minorities in medicine (URM) has the potential to improve access and quality of care and reduce health inequities for diverse populations. Having a diverse workforce in residency programs necessitates structures in place for support, training, and addressing racism and discrimination. This study examines reports of discrimination and training initiatives to increase diversity and address discrimination and unconscious bias in family medicine residency programs nationally. Methods: This survey was part of the Council of Academic Family Medicine Educational Research Alliance (CERA) 2018 national survey of family medicine residency program directors. Questions addressed the presence of reported discrimination, residency program training about discrimination and bias, and admissions practices concerning physician workforce diversity. We performed univariate and bivariate analyses on CERA survey response data. Results: We received 272 responses to the diversity survey items within the CERA program director survey from 522 possible residency director respondents, yielding a response rate of 52.1%. The majority of residency programs (78%) offer training for faculty and/or residents in unconscious/implicit bias and systemic/institutional racism. A minority of program directors report discrimination in the residency environment, most often reported by patients (13.2%) and staff (7.2%) and least often by faculty (3.3%), with most common reasons for discrimination noted as language or race/skin color. Conclusions: Most family medicine residency program directors report initiatives to address diversity in the workforce. Research is needed to develop best practices to ensure continued improvement in workforce diversity and racial climate that will enhance the quality of care and access for underserved populations.

scholarly journals What Will It Take to Recruit and Train More Underrepresented Minority Physicians in Family Medicine? A CERA Survey Analysis

2020 ◽  
Vol 52 (9) ◽  
pp. 661-664
Author(s):  
Julia P. Roulier ◽  
Jaeyun Sung
Keyword(s):  
Family Medicine ◽  
Family Physicians ◽  
Program Directors ◽  
The United States ◽  
Recruitment Strategies ◽  
Underrepresented Minority ◽  
Survey Analysis ◽  
Residency Programs ◽  
Family Medicine Residency ◽  
Diverse Patient Population

Background and Objectives: Both the Society of Teachers of Family Medicine (STFM) and the American Academy of Family Physicians have developed strategic plans to increase the training of underrepresented minority in medicine (URMM) family physicians to meet the needs of an increasingly diverse patient population in the United States. This study examines data from the 2017 Council of Academic Family Medicine (CAFM) Educational Research Alliance (CERA) Program Directors (PD12) Survey to assess whether recruitment strategies increase the diversity of underrepresented minority physicians in family medicine. Methods: Data were collected from an online electronic survey administered by the CERA of family medicine program directors in 2018. The data included specific questions about the diversity of URMM residents in family medicine programs and about initiatives that were used in their recruitment. We analyzed the data using the Pearson χ2 criteria for cause and effect of two variables. Results: Family medicine residency programs that have initiatives dedicated to increasing resident diversity have a higher percentage of URMM residents. Specifically, residency programs that have URMM recruitment strategies are 2.5 to 4 times more likely to have a diverse residency population than those programs without strategies (P<.001-.015). Conclusions: Striving to improve diversity in family medicine residency training in accordance with the ideals of STFM will require programs to design and implement initiatives to increase recruitment of URM residents.

scholarly journals Maternity Care Tracks at US Family Medicine Residency Programs

2021 ◽  
Vol 53 (10) ◽  
pp. 857-863
Author(s):  
Steven E. Roskos ◽  
Tyler W. Barreto ◽  
Julie P. Phillips ◽  
Valerie J. King ◽  
W. Suzanne Eidson-Ton ◽  
...  
Keyword(s):  
Family Medicine ◽  
Maternity Care ◽  
Underserved Populations ◽  
Residency Programs ◽  
Family Medicine Residency ◽  
Survey Response Rate ◽  
Care Training ◽  
Practice Methods ◽  
Residency Program Directors ◽  
The Relationship

Background and Objectives: The number of family physicians providing maternity care continues to decline, jeopardizing access to needed care for underserved populations. Accreditation changes in 2014 provided an opportunity to create family medicine residency maternity care tracks, providing comprehensive maternity care training only for interested residents. We examined the relationship between maternity care tracks and residents’ educational experiences and postgraduate practice. Methods: We included questions on maternity care tracks in an omnibus survey of family medicine residency program directors (PDs). We divided respondent programs into three categories: “Track,” “No Track Needed,” and “No Track.” We compared these program types by their characteristics, number of resident deliveries, and number of graduates practicing maternity care. Results: The survey response rate was 40%. Of the responding PDs, 79 (32%) represented Track programs, 55 (22%) No Track Needed programs, and 94 (38%) No Track programs. Residents in a track attended more deliveries than those not in a track (at Track programs) and those at No Track Needed and No Track programs. No Track Needed programs reported the highest proportion of graduates accepting positions providing inpatient maternity care in 2019 (21%), followed by Track programs (17%) and No Track programs (5%; P<.001). Conclusions: Where universal robust maternity care education is not feasible, maternity care tracks are an excellent alternative to provide maternity care training and produce graduates who will practice maternity care. Programs that cannot offer adequate experience to achieve competence in inpatient maternity care may consider instituting a maternity care track.

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