scholarly journals The Impact of a Concussion Clinic on Family Medicine Resident Education

PRiMER ◽  
2019 ◽  
Vol 3 ◽  
Author(s):  
Theodore A. Ogren ◽  
Alexander C. Knobloch
Keyword(s):  
Primary Care ◽  
Family Medicine ◽  
Sports Medicine ◽  
Resident Education ◽  
Improvement Project ◽  
Medicine Resident ◽  
Point Of Entry ◽  
Personal Value ◽  
The Impact ◽  
Academic Year

Introduction: Given that primary care has been found to be the most likely point of entry into the health care system for concussion patients, diagnosis and management of concussions are vital to the education of family medicine physicians. Studies of primary care residencies reveal a self-perceived deficiency in sports medicine education. This project was designed to determine the effect of a concussion management clinic on family medicine residents’ confidence in and personal value placed on diagnosing and managing concussions.  Methods: This project was completed in a family medicine residency as a retrospective evaluation of an educational improvement project during the 2016-2017 academic year. The intervention involved implementation of a structured clinical experience focused on management of concussions. Residents were surveyed preintervention, as well as 5 and 11 months postintervention, measuring resident exposure to and confidence in diagnosing and managing concussions.  Results: Residents demonstrated significantly increased confidence in diagnosing concussions and managing complicated concussions following the intervention (both F [2, 84]=3.56, P=0.03). Post hoc analysis indicated the statistical difference was found between preintervention measures and 1 academic year later. The number of concussions seen positively correlated with resident confidence in both diagnosing and managing concussions while personal value remained high. Conclusions: This project is the first to evaluate the impact of a concussion clinic on resident education, demonstrating significant improvement in multiple areas of concussion education. Replicating the project in other family medicine residencies could be beneficial in determining if this clinic education model improves resident outcomes in other residencies. 

scholarly journals Does the Primary Care Experience Influence the Cancer Diagnostic Process?

2015 ◽  
Vol 2015 ◽  
pp. 1-12 ◽  
Author(s):  
Sylvie Provost ◽  
Raynald Pineault ◽  
Pierre Tousignant ◽  
Danièle Roberge ◽  
Dominique Tremblay ◽  
...  
Keyword(s):  
Primary Care ◽  
Metastatic Cancer ◽  
Diagnostic Process ◽  
Process Time ◽  
Care Experience ◽  
Usual Source ◽  
Point Of Entry ◽  
Experience Of Care ◽  
Time To Diagnosis ◽  
The Impact

Objective. To analyze the impact of patients’ experience of care at their usual source of primary care on their choice of point of entry into cancer investigation process, time to diagnosis, and presence of metastatic cancer at time of diagnosis. Method. A questionnaire was administered to 438 patients with cancer (breast, lung, and colorectal) between 2011 and 2013 in four oncology clinics of Quebec (Canada). Multiple regression analyses (logistic and Cox models) were conducted. Results. Among patients with symptoms leading to investigation of cancer (n=307), 47% used their usual source of primary care as the point of entry for investigation. Greater comprehensiveness of care was associated with the decision to use this source as point of entry (OR = 1.25; CI 90% = 1.06–1.46), as well as with shorter times between first symptoms and investigation (HR = 1.11; p=0.05), while greater accessibility was associated with shorter times between investigation and diagnosis (HR = 1.13; p<0.01).  Conclusion. Experience of care at the usual source of primary care has a slight influence on the choice of point of entry for cancer investigation and on time to diagnosis. This influence appears to be more related to patients’ perceptions of the accessibility and comprehensiveness of their usual source of primary care.

scholarly journals COVID-19 disruption to family medicine residency curriculum: results from a 2020 US programme directors survey

2021 ◽  
Vol 9 (3) ◽  
pp. e001144
Author(s):  
Julia Fashner ◽  
Anthony Espinoza ◽  
Arch G Mainous III
Keyword(s):  
Intensive Care Unit ◽  
Family Medicine ◽  
Resident Education ◽  
Point Scale ◽  
Community Size ◽  
Musculoskeletal Medicine ◽  
Medicine Resident ◽  
Residency Curriculum ◽  
The Usa ◽  
Research Alliance

ObjectiveThis research project examined the effects of the COVID-19 pandemic on the required curriculum in graduate medical education for family medicine residencies.DesignOur questions were part of a larger omnibus survey conducted by the Council of Academic Family Medicine Educational Research Alliance. Data were collected from 23 September to 16 October 2020.SettingThis study was set in the USA.ParticipantsEmails were sent to 664 family medicine programme directors in the USA. Of the 312 surveys returned, 35 did not answer our questions and were excluded, a total of 277 responses (44%) were analysed.ResultsThe level of disruption varied by discipline and region. Geriatrics had the highest reported disruption (median=4 on a 5-point scale) and intensive care unit had the lowest (median=1 on a 5-point scale). There were no significant differences for disruption by type of programme or community size.ConclusionProgramme directors reported moderate disruption in family medicine resident education in geriatrics, gynaecology, surgery, musculoskeletal medicine, paediatrics and family medicine site during the pandemic. We are limited in generalisations about how region, type of programme, community size or number of residents influenced the level of disruption, as less than 50% of programme directors completed the survey.

scholarly journals Outcomes of mental health pharmacist-managed electronic consults at a Veterans Affairs health care system

2017 ◽  
Vol 7 (3) ◽  
pp. 131-136 ◽  
Author(s):  
Christina Herbert ◽  
Holly Winkler ◽  
Troy A. Moore
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Health Care ◽  
Health Care System ◽  
Health Conditions ◽  
Veterans Health ◽  
Improvement Project ◽  
Mental Health Conditions ◽  
The Impact ◽  
Care System

Abstract Introduction: The demand for mental health services has increased as more veterans have been diagnosed with—and sought care for—one or more mental health conditions. Within the South Texas Veterans Health Care System (STVHCS), providers may submit electronic consults (e-consults) to mental health clinical pharmacy specialists for medication review and recommendations. These consults aim to manage veterans with uncomplicated mental health conditions in primary care, making specialty mental health providers more available for those who need such services. Pharmacists have improved outcomes and access to care for conditions such as diabetes and hypertension, but currently, there is limited evidence demonstrating the impact of pharmacists in mental health. Methods: This quality improvement project assessed the effectiveness of the e-consult service. Information was collected through a retrospective chart review of STVHCS veterans with the corresponding consult note placed in their chart from May 2014 through December 2015. Numbers of recommendations implemented and veterans maintained in primary care were analyzed as markers of effectiveness. Time and cost savings were secondarily explored. Results: A total of 361 consults were submitted for 353 unique patients. Of the 322 patients included in analyses, a total of 301 unique patients (93.5%) were maintained in primary care for at least 3 months. Of the 21 not maintained in primary care, 15 recommendations were implemented; of those maintained in primary care, 271 recommendations were implemented. Discussion: This service improves mental health care—and patient access—by promoting successful management and maintenance of less complicated patients in primary care.

Pharmacist Statin Prescribing Initiative in Diabetic Patients at an Internal Medicine Resident Clinic

2019 ◽  
Vol 33 (5) ◽  
pp. 598-604 ◽  
Author(s):  
Robert Vincent ◽  
Jennifer Kim ◽  
Tasrif Ahmed ◽  
Vishal Patel
Keyword(s):  
Internal Medicine ◽  
Primary Care ◽  
Adverse Effects ◽  
Statin Therapy ◽  
Internal Medicine Resident ◽  
The United States ◽  
Diabetic Patients ◽  
Post Intervention ◽  
Medicine Resident ◽  
The Impact

Background: Despite general increases in statin use in the United States, statin therapy may be underutilized in diabetic patients and vulnerable populations. Objective: To determine the impact of a collaborative pharmacist initiative on statin prescribing for diabetic patients in an internal medicine residency clinic. The primary outcome was the change in prevalence of patients on statin therapy before and after intervention implementation. Secondary outcomes included recommendation acceptance rates and reported adverse effects. Methods: This was a single-center, quasi-experimental pre–post intervention study. The study site was a hospital-based primary care residency clinic serving patients regardless of financial or insurance status. Diabetic patients 40 to 75 years old who were not on a statin and had an upcoming primary care physician appointment were included. Over 3 months, a clinical pharmacist and pharmacy resident evaluated clinical appropriateness and cost of statin therapy, provided recommendations to physicians, facilitated statin prescribing, and provided patient education. Results: Of 454 patients, 343 were on statin therapy (75.6%) prior to the initiative. The mean age was 58 years, 59.7% were female, 76.4% were black, and 90% had hypertension. After implementation, 375 (82.6%) patients were on statins ( P < .0001). Recommendations were well received (90.2% accepted) and no significant adverse effects were reported. Conclusion: Pharmacist implementation of a collaborative, patient-centered initiative increased statin prescribing in diabetic patients, most of which were black and had hypertension, in an internal medicine resident clinic.

scholarly journals Protocol for comparing two training approaches for primary care professionals implementing the Safe Environment for Every Kid (SEEK) model

2020 ◽  
Vol 1 (1) ◽  
Author(s):  
Howard Dubowitz ◽  
Lisa Saldana ◽  
Laurence A. Magder ◽  
Lawrence A. Palinkas ◽  
John A. Landsverk ◽  
...  
Keyword(s):  
Primary Care ◽  
Family Medicine ◽  
Medical Training ◽  
Scale Up ◽  
Public Health Problem ◽  
Pediatric Primary Care ◽  
Successful Implementation ◽  
Major Public Health Problem ◽  
Improvement Project ◽  
Safe Environment

Abstract Background Child maltreatment (CM) is a major public health problem, affecting many lives, in the short and long term, and costing individuals, families, and society dearly. There is a need for broad implementation of evidence-based preventive interventions, such as the Safe Environment for Every Kid (SEEK) model, developed for pediatric primary care. Primary care offers an excellent opportunity to help address prevalent psychosocial problems (e.g., parental depression) that are risk factors for CM. By addressing such problems, SEEK can strengthen families and support parents; promote children’s health, development, and safety; help prevent CM; and benefit the health of the US population. This study will examine intervention strategies for optimizing SEEK’s adoption, implementation, and sustainment, and its effectiveness in preventing CM. Despite strong evidence from two federally funded randomized controlled trials, SEEK has not been widely adopted. The goal of this study is to examine technology-driven implementation strategies to scale-up SEEK—in pediatric and family medicine primary care settings. The aims are to (1) evaluate the effectiveness of training strategies on SEEK’s implementation in primary care practices, (2) evaluate barriers and facilitators to successful implementation and sustainment of SEEK, and (3) examine the model’s effectiveness in preventing CM and the economic costs of implementing SEEK. Methods This randomized type III hybrid mixed methods design will examine how advances in medical training can bolster SEEK’s adoption and implementation in pediatric and family medicine practices in different regions of the USA. These are independent online training and in-depth structured training via a quality improvement project, approved by the American Boards of Pediatrics and of Family Medicine. We will also evaluate SEEKonline, software that assists primary care practitioners implement the model, and a “Traditional” paper and pencil strategy for their impact on implementation. The study uses the EPIS framework and the Universal Stages of Implementation Completion, quantitative measures, qualitative interviews, and data abstracted from electronic health records. Discussion The knowledge gained should improve pediatric primary care to better address prevalent social determinants of health, benefiting many children and families. The outcomes should enhance the field of implementation science and guide future interventions in primary care. Trial registration NCT03642327, Clinical Trials, registered August 21, 2018.

Sign in / Sign up

Export Citation Format

Share Document