scholarly journals Mindsets of Early-Career Family Physicians Trained in Competency-Based Education

PRiMER ◽  
2021 ◽  
Vol 5 ◽  
Author(s):  
Mao Ding ◽  
Sudha Koppula ◽  
Olga Szafran ◽  
Lillian Au ◽  
Oksana Babenko

Introduction: The objective of this study was to examine the mindsets (mastery, performance approach, performance avoidance) of early-career family physicians following graduation from a competency-based education residency program. Methods: This was a longitudinal, cohort, survey study of family medicine residents at a large Canadian university. The 2015-2017 cohort of family medicine residents was surveyed at three time points: (1) at the end of residency training; (2) at 1 year in clinical practice; and (3) at 3 years in clinical practice. We used Baranik et al’s instrument to measure three types of mindsets. We performed descriptive and multivariate analyses using SPSS 26.0 software. Results: Irrespective of the time in practice, mean scores were the highest on the mastery mindset and the lowest on the performance avoidance mindset measures (P<.001). Over time, the mastery mindset scores tended to decrease (P=.04). Conclusion: Family physicians trained in competency-based education continued to be mastery-oriented in the first 3 years of clinical practice. This finding is reassuring given that the mastery mindset is associated with professional well-being and long-term success. Nonetheless, because mastery mindset scores appeared to decrease over time, residency programs need to ensure graduating residents are equipped with knowledge and tools to remain mastery-oriented throughout the course of their professional careers.

BMJ Open ◽  
2019 ◽  
Vol 9 (9) ◽  
pp. e030477
Author(s):  
M Ruth Lavergne ◽  
Laurie J Goldsmith ◽  
Agnes Grudniewicz ◽  
David Rudoler ◽  
Emily Gard Marshall ◽  
...  

IntroductionCanadians report persistent problems accessing primary care despite an increasing per-capita supply of primary care physicians (PCPs). There is speculation that PCPs, especially those early in their careers, may now be working less and/or choosing to practice in focused clinical areas rather than comprehensive family medicine, but little evidence to support or refute this. The goal of this study is to inform primary care planning by: (1) identifying values and preferences shaping the practice intentions and choices of family medicine residents and early career PCPs, (2) comparing practice patterns of early-career and established PCPs to determine if changes over time reflect cohort effects (attributes unique to the most recent cohort of PCPs) or period effects (changes over time across all PCPs) and (3) integrating findings to understand the dynamics among practice intentions, practice choices and practice patterns and to identify policy implications.Methods and analysisWe plan a mixed-methods study in the Canadian provinces of British Columbia, Ontario and Nova Scotia. We will conduct semi-structured in-depth interviews with family medicine residents and early-career PCPs and analyse survey data collected by the College of Family Physicians of Canada. We will also analyse linked administrative health data within each province. Mixed methods integration both within the study and as an end-of-study step will inform how practice intentions, choices and patterns are interrelated and inform policy recommendations.Ethics and disseminationThis study was approved by the Simon Fraser University Research Ethics Board with harmonised approval from partner institutions. This study will produce a framework to understand practice choices, new measures for comparing practice patterns across jurisdictions and information necessary for planners to ensure adequate provider supply and patient access to primary care.


2020 ◽  
Vol 52 (2) ◽  
pp. 135-137 ◽  
Author(s):  
Jacob Anderson ◽  
Jason Leubner ◽  
Steven R. Brown

Background and Objectives: Time spent in the electronic health record (EHR), away from direct patient care, is associated with physician burnout. Yet there is a lack of evidence quantifying EHR use among family physicians. The purpose of the study was to describe a method for quantifying habits and duration of use within the electronic health record in family medicine residents and faculty with particular attention paid to time spent after hours. Methods: We audited EHR time for family medicine residents and faculty using an EHR vendor-provided, web-based tracking system. We collected and analyzed the number of patient encounters, total time in the EHR per patient, total time in the EHR after hours by physicians for a 6-month time period. Results: Over the 6-month period reviewed, family medicine trainees and faculty saw between one and 164 patients monthly, spent between 17 and 217 minutes in the EHR per patient, and spent between 0 and 33 hours in the EHR after hours per month. Conclusions: Family medicine residents spend a significant amount of time completing EHR tasks after hours. Objective EHR data can be used by family medicine residency programs to devise interventions to decrease inefficient use of the EHR, decrease after-hours EHR use, and improve well-being.


2012 ◽  
Vol 35 (2) ◽  
pp. 115-119 ◽  
Author(s):  
Karl Iglar ◽  
Cynthia Whitehead ◽  
Susan Glover Takahashi

2015 ◽  
Vol 71 (1) ◽  
pp. 53-58
Author(s):  
Bonny Jung ◽  
Lorie Shimmell ◽  
Deb Stewart ◽  
Leah Gatti ◽  
Kyrsten Venasse ◽  
...  

2021 ◽  
Author(s):  
Jörg Matthes ◽  
Kevin Koban ◽  
Ariadne Neureiter ◽  
Anja Stevic

BACKGROUND Given that governmental prevention measures restricted most face-to-face communications, online self-disclosure via smartphones emerged as an alternative coping strategy that aimed at reducing the impact of the COVID-19 pandemic on people’s psychological health. Prepandemic research demonstrated that online self-disclosure benefits people’s psychological health by establishing meaningful relationships, obtaining social support, and achieving self-acceptance, particularly in times of crisis. However, it is unclear whether these dynamics transition well to lockdown conditions where online self-disclosure must stand almost entirely on its own. Longitudinal investigations are needed to gain insights into the psychological functionalities of online self-disclosure during the COVID-19 pandemic. OBJECTIVE This study aimed to determine the temporal associations between smartphone online self-disclosure (as a communicative behavior) and critical indicators of psychological health (including psychopathological, as well as hedonic and eudaimonic states) during the first COVID-19 lockdown in Austria. METHODS We conducted a representative 2-wave panel survey between late March/April 2020 and May 2020. A total of 416 participants completed both waves (43.1% attrition rate, given n=731 participants who completed the first wave). A partially metric measurement invariant overtime structural equation model was used to determine the temporal associations among online self-disclosure, fear of COVID-19, happiness, and psychological well-being. RESULTS The analysis revealed that fear of COVID-19 significantly predicted online self-disclosure over time (<i>b</i>=0.24, <i>P</i>=.003) and happiness over time (<i>b</i>=−0.14, <i>P</i>=.04), but not psychological well-being (<i>b</i>=0.03, <i>P</i>=.48), that is, stronger COVID-19 fears at T1 prompted more online self-disclosure and less happiness at T2. Online self-disclosure, on the other hand, significantly predicted happiness (<i>b</i>=0.09, <i>P</i>=.02), but neither fear of COVID-19 (<i>b</i>=−0.01, <i>P</i>=.57) nor psychological well-being (<i>b</i>=−0.01, <i>P</i>=.57) over time. Participants who engaged more strongly in online self-disclosure at T1 felt happier at T2, but they did not differ from less-disclosing participants concerning COVID-19 fears and psychological well-being at T2. Importantly, happiness and psychological well-being were significantly related over time (happiness T1 → psychological well-being T2: <i>b</i>=0.11, <i>P</i>&lt;.001; psychological well-being T1 → happiness T2: <i>b</i>=0.42, <i>P</i>&lt;.001). CONCLUSIONS Our findings suggest that online self-disclosure might play a pivotal role in coping with pandemic stressors. With restrictions on their options, individuals increasingly turn to their smartphones and social media to disclose their feelings, problems, and concerns during lockdown. While online self-disclosure might not alleviate fears or improve psychological well-being, our results demonstrate that it made people experience more happiness during this crisis. This psychological resource may help them withstand the severe psychological consequences of the COVID-19 crisis over longer timeframes.


2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S114-S115
Author(s):  
Jiaan Zhang

Abstract Previous research has shown the beneficial effects of positive psychological assets on health, but more research is needed to confirm the prospective effects on cognitive function. The purpose of this study is to examine the relationship between psychological well-being and the earliest onset of cognitive impairment among Chinese older adults. Data came from 2000 to 2014 waves of the Chinese Longitudinal Healthy Longevity Survey. Study sample consisted of 6,225 older adults who were free from cognitive impairment in 2000. Psychological well-being was measured based on seven items that assessed optimism, conscientiousness, self-determination, happiness, self-esteem, pessimism, and loneliness, with responses ranging from “always (1)” to never (5)”. Negative feelings items were reverse coded. Higher score indicated more positive psychological well-being. Cognitive impairment was measured by a Chinese version of the Mini-Mental State Examination. Respondents scored at or above 24 were regarded as having no cognitive impairment. A multi-category time-varying variable was used to capture four potential outcomes: (1) persistently free of cognitive impairment between waves, (2) onset of cognitive impairment, (3) death between waves, and (4) attrition. Socio-demographics, chronical diseases conditions, functional health status were served as controls. Multilevel multinomial logistic regression models that account for clustering of observations within a subject over time were employed for the study. Results show that more positive psychological well-being is significantly associated with reduced risk of cognitive impairment onset and death over time. Results suggest that developing more psychological resilience-based intervention programs among older adults may help them delay the onset of cognitive impairment.


2020 ◽  
Vol 52 (6) ◽  
pp. 408-413
Author(s):  
Tyler W. Barreto ◽  
Aimee Eden ◽  
Audrey Brock

Background and Objectives: According to a previous study, obstetric deliveries may be protective against burnout for family physicians. Analyses of interviews conducted during a larger qualitative study about the experiences of early-career family physicians who intended to include obstetric deliveries in their practice revealed that many interviewees discussed burnout. This study aimed to understand the relationship between practicing obstetrics and burnout based on an analysis of these emerging data on burnout. Methods: We conducted semistructured interviews with physicians who graduated from family medicine residency programs in the United States between 2013 and 2016. We applied an immersion-crystallization approach to analyze transcribed interviews. Results: Fifty-six early-career family physicians participated in interviews. Burnout was an emerging theme. Physicians described how practicing obstetrics can protect from burnout (eg, brings joy to practice, diversity in practice), how it can contribute to burnout (eg, time demands, increased stress), how it can do both simultaneously and the importance of professional agency (ie, the capacity to make own free choices), and other sources of burnout (eg, administrative tasks, complex patients). Conclusions: This study identifies a family medicine-obstetric paradox wherein obstetrics can simultaneously protect from and contribute to burnout for family physicians. Professional agency may partially explain this paradox.


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