scholarly journals Curricular Recommendations for a National Family Medicine Subinternship: A Qualitative Analysis From Multiple Stakeholders

2021 ◽  
Vol 53 (10) ◽  
pp. 835-842
Author(s):  
Maria Syl D. de la Cruz ◽  
Tomoko Sairenji ◽  
Sarah E. Stumbar ◽  
Dolapo Babalola ◽  
Alexander W. Chessman

Background and Objectives: The 2011 Alliance for Clinical Education panel recommended the development of a specialty-specific curriculum for all subinternships (sub-Is). A 2019 CERA survey found that 58% of family medicine clerkship directors agreed that a standardized curriculum would be helpful. The goal of this study was to explore attitudes and preferences regarding a national family medicine sub-I curriculum among a broad set of stakeholders. Methods: Focus groups were conducted with medical students, residents, residency faculty, and undergraduate medical education faculty at the 2020 STFM Conference on Medical Student Education. Focus groups were transcribed, and a qualitative analysis was conducted with participants’ responses about the benefits and characteristics of a family medicine sub-I, recommendations for core sub-I skills/objectives, likelihood of using a national curriculum, and preferred student and program evaluation methods. Results: There were four focus groups with a total of 24 participants. The following main themes emerged: the family medicine sub-I has distinctive characteristics from other sub-Is and provides unique benefits for students and residency programs, a standardized curriculum should allow for adaptability and flexibility, and the sub-I evaluation for the students and program should be specific and experience-focused. These themes were classified into specific subthemes. Conclusions: The stakeholder emphasis on themes of uniqueness, adaptability, and specificity within evaluation will help educators structure a comprehensive framework for national recommendations for the sub-I curriculum. A well-designed family medicine sub-I may provide rigorous educational training for students and may also encourage career commitment to the discipline.

PRiMER ◽  
2019 ◽  
Vol 3 ◽  
Author(s):  
Luyang Liu ◽  
Katherine Margo

The Society of Teachers of Family Medicine (STFM) is an organization made up of educators devoted to teaching family medicine to learners of all levels. This multidisciplinary group of physicians, behavioral scientists, researchers, and educators from other health professions works to further STFM’s mission of improving the health of all people through education, research, patient care, and advocacy. STFM held its 43rd Conference on Medical Student Education in Anaheim, California from February 9 to 12, 2017. Abstracts for conference sessions can be viewed online.1 The conference was held concurrently with the 2017 Society of Student-Run Free Clinics Annual Conference. This partnership empowered many passionate medical students to participate in STFM sessions and present their posters. A wide variety of topics were explored by STFM conference presenters and attendees. The plenary speakers addressed physician wellness (Dike Drummond, MD), family medicine as a career (Wanda Filer, MD), and the future of family medicine (Aaron Michelfelder, MD, and Michelle Byrne, MD). The STFM Education Committee reviewed and selected eight exemplary abstracts from 22 presented educational research papers. Criteria for selection included strength of contribution to medical student education, topic of interest within and beyond family medicine, and quality of study, including well-described rationale, appropriate methods, clear results, and thoughtful conclusions. The areas covered are related to new educational methods and tools, faculty development, and interprofessional learning and assessment.  Editor’s Note: Six of the eight selected presentation abstracts appear in this collection. Two2,3 of the eight selected abstracts have been published in the intervening time, and are not included below. Society of Teachers of Family Medicine. 2017 Conference on Medical Student Education Conference Sessions. https://www.stfm.org/conferences/generalinformation/msearchives/. Accessed December 23, 2018. Nguyen D, Servey JT, Scott LS. fmCASES national examination as a pretest in a family medicine clerkship. Fam Med. 2018;50(2):142-145. https://doi.org/10.22454/FamMed.2018.853841   Hoffman M, Cohen-Osher M. The one minute learner: evaluation of a new tool to promote discussion of medical student goals and expectations in clinical learning environments. Fam Med. 2016;48(3):222-225.


PRiMER ◽  
2020 ◽  
Vol 4 ◽  
Author(s):  
Tomoko Sairenji ◽  
Samuel Griffin ◽  
Misbah Keen

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.


2012 ◽  
Vol 10 (3) ◽  
pp. 275-276 ◽  
Author(s):  
◽  
H. Chumley ◽  
A. Chessman ◽  
J. Hobbs ◽  
D. Clements ◽  
...  

Author(s):  
Umayya Musharrafieh ◽  
Khalil Ashkar ◽  
Dima Dandashi ◽  
Maya Romani ◽  
Rana Houry ◽  
...  

Introduction: Objective Structured Clinical Examination (OSCE) is considered a useful method of assessing clinical skills besides Multiple Choice Questions (MCQs) and clinical evaluations. Aim: To explore the acceptance of medical students to this assessment tool in medical education and to determine whether the assessment results of MCQs and faculty clinical evaluations agree with the respective OSCE scores of 4th year medical students (Med IV). Methods: performance of a total of 223 Med IV students distributed on academic years 2006-2007, 2007-2008, and 2008-2009 in OSCE, MCQs and faculty evaluations were compared. Out of the total 93 students were asked randomly to fill a questionnaire about their attitudes and acceptance of this tool. The OSCE was conducted every two months for two different groups of medical students who had completed their family medicine rotation, while faculty evaluation based on observation by assessors was submitted on a monthly basis upon the completion of the rotation. The final exam for the family medicine clerkship was performed at the end of the 4thacademic year, and it consisted of MCQsResults: Students highly commended the OSCE as a tool of evaluation by faculty members as it provides a true measure of required clinical skills and communication skills compared to MCQs and faculty evaluation. The study showed a significant positive correlation between the OSCE scores and the clinical evaluation scores while there was no association between the OSCE score and the final exam scores.Conclusion: Student showed high appreciation and acceptance of this type of clinical skills testing. Despite the fact that OSCEs make them more stressed than other modalities of assessment, it remained the preferred one.


2018 ◽  
Vol 26 (0) ◽  
Author(s):  
Yolanda López-Benavente ◽  
José Arnau-Sánchez ◽  
Tania Ros-Sánchez ◽  
Mª Beatriz Lidón-Cerezuela ◽  
Araceli Serrano-Noguera ◽  
...  

ABSTRACT Objective: to identify difficulties and motivations for the practice of physical exercise in women older than 65 years. Method: qualitative study based on the phenomenological theory, with focus groups and in-depth interviews. The nursing staff selected 15 women by intentional sampling using the following criteria: age, time dedicated to physical exercise, independence, and absence of cognitive impairment and contraindication for this activity. Two focus groups were formed (one of them did physical exercise for less than 150 minutes per week and the other at least 150 minutes per week) in addition to conducting five in-depth interviews. Qualitative analysis of the data was performed through transcription, coding, categorization, and verification of results. Results: the difficulties to start and develop physical exercise were circumscribed to the perception of poor health and lack of free time; both circumstances result from care obligation, being represented as a gender imposition. However, the motivations are related to perception of strength, need for socialization, and perception of autonomy and freedom. Conclusions: the ideological representation of gender determines the women’s decision to exercise. Knowing the meaning and significance that women give to health and their role in the socio-family environment allows nurses to develop relationships and interventions to encourage the practice of physical exercise.


Pain Medicine ◽  
2017 ◽  
Vol 19 (11) ◽  
pp. 2138-2145 ◽  
Author(s):  
José G Luiggi-Hernandez ◽  
Jean Woo ◽  
Megan Hamm ◽  
Carol M Greco ◽  
Debra K Weiner ◽  
...  

Abstract Objective Mindfulness is a nonpharmacologic mind-body therapy that has been shown to be effective in older adults with chronic low back pain (cLBP). There are few first-person accounts in the literature that describe the older adult experience and perspective while learning mindfulness and meditation to treat pain. The objective of this study was to investigate dominant themes present in the experiences of older adults applying mindfulness and meditation to cope with cLBP. Design Qualitative analysis of four focus groups. Subject Twenty-five adults age 65 years or older who had completed an eight-week mindfulness program. Methods The focus groups met for a comprehensive discussion session about their experience with mindfulness and meditation. The audio for each session was recorded, and the discussions were transcribed. Codebook development, qualitative coding, and thematic analysis were performed. The coders each coded all four transcripts, following which they met to adjudicate all coding differences until they were in complete agreement on coding. Results Several key themes were brought up by older adults utilizing mindfulness as a means of coping with pain, which included overcoming fear of pain (“Before [learning mindfulness], I used to dread pain”), pain awareness (“You’re focusing more on being aware than the pain; now that’s what helps me”), and pain significance (“It becomes insignificant”). Conclusions The themes identify several ways mindfulness impacts older adults with cLBP, including decreased negative emotions related to chronic pain such as fear of pain, a different perspective or change in awareness about pain, and reducing the significance of pain.


PRiMER ◽  
2019 ◽  
Vol 3 ◽  
Author(s):  
Maribeth P. Williams ◽  
Denny Fe Agana ◽  
Benjamin J. Rooks ◽  
Grant Harrell ◽  
Rosemary A. Klassen ◽  
...  

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.


2020 ◽  
Vol 52 (2) ◽  
pp. 104-111 ◽  
Author(s):  
Catherine Coe ◽  
Cleveland Piggott ◽  
Ardis Davis ◽  
Mary N. Hall ◽  
Kristen Goodell ◽  
...  

Background and Objectives: Leadership positions in academic medicine lack racial and gender diversity. In 2016, the Council of Academic Family Medicine (CAFM) established a Leadership Development Task Force to specifically address the lack of diversity among leadership in academic family medicine, particularly for underrepresented minorities and women. approach: The task force was formed in August 2016 with members from each of the CAFM organizations representing diversity of race, gender, and academic position. The group met from August 2016 to December 2017. The task force reviewed available leadership development programming, and through consensus identified common pathways toward key leadership positions in academic family medicine—department chairs, program directors, medical student education directors, and research directors. consensus development: The task force developed a model that describes possible pathways to several leadership positions within academic family medicine. Additionally, we identified the intentional use of a multidimensional mentoring team as critically important for successfully navigating the path to leadership. Conclusions: There are ample opportunities available for leadership development both within family medicine organizations and outside. That said, individuals may require assistance in identifying and accessing appropriate opportunities. The path to leadership is not linear and leaders will likely hold more than one position in each of the domains of family medicine. Development as a leader is greatly enhanced by forming a multidimensional team of mentors.


2019 ◽  
Vol 51 (10) ◽  
pp. 811-816
Author(s):  
Joanna Drowos ◽  
Tomoko Sairenji ◽  
Kristen Hood Watson ◽  
Vanessa A. Diaz ◽  
Jasmine Pinckney ◽  
...  

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.


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