scholarly journals Examining the Functioning and Reliability of the Family Medicine Milestones

2017 ◽  
Vol 9 (1) ◽  
pp. 46-53 ◽  
Author(s):  
Michael R. Peabody ◽  
Thomas R. O'Neill ◽  
Lars E. Peterson
Keyword(s):  
Family Medicine ◽  
Item Difficulty ◽  
High Reliability ◽  
Latent Trait ◽  
Training Sequence ◽  
Partial Credit Model ◽  
Residency Programs ◽  
Program Leaders ◽  
The Family ◽  
Key Dimensions

ABSTRACT Background  The Family Medicine (FM) Milestones are a framework designed to assess development of residents in key dimensions of physician competency. Residency programs use the milestones in semiannual reviews of resident performance from entry toward graduation. Objective  To examine the functioning and reliability of the FM Milestones and to determine whether they measure the amount of a latent trait (eg, knowledge or ability) possessed by a resident or simply indicate where a resident falls along the training sequence. Methods  This study utilized the Rasch Partial Credit model to examine academic year 2014–2015 ratings for 10 563 residents from 476 residency programs (postgraduate year [PGY] 1 = 3639; PGY-2 = 3562; PGY-3 = 3351; PGY-4 = 11). Results  Reliability was exceptionally high at 0.99. Mean scores were 3.2 (SD = 1.3) for PGY-1; 5.0 (SD = 1.3) for PGY-2; 6.7 (SD = 1.2) for PGY-3; and 7.4 (SD = 1.0) for PGY-4. Keyform analysis showed a rating on 1 item was likely to be similar for all other items. Conclusions  Our findings suggest that FM Milestones seem to largely function as intended. Lack of spread in item difficulty and lack of variation in category probabilities show that FM Milestones do not measure the amount of a latent trait possessed by a resident, but rather describe where a resident falls along the training sequence. High reliability indicates residents are being rated in a stable manner as they progress through residency, and individual residents deviating from this rating structure warrant consideration by program leaders.

scholarly journals Residency Leader Motivations to Engage Residents and Residency Faculty in Scholarship: A Qualitative Study

2020 ◽  
Vol 52 (8) ◽  
pp. 581-585
Author(s):  
Lauren A. Cafferty ◽  
Paul F. Crawford ◽  
Jeremy T. Jackson ◽  
Christy J.W. Ledford
Keyword(s):  
Family Medicine ◽  
Scholarly Activity ◽  
Resident Attitudes ◽  
Residency Programs ◽  
Program Leaders ◽  
Family Medicine Residency ◽  
Positive Attitudes ◽  
The Family ◽  
Emerging Themes

Background and Objectives: Research shows that limited time, lack of funding, difficulty identifying mentors, and lack of technical support limit resident and faculty ability to fully participate in scholarly activity. Most research to date focuses on medical student and resident attitudes toward research. This study aimed to understand the underlying attitudes of family medicine residency (FMR) leaders toward scholarship. Methods: Two focus groups of family medicine residency leaders were conducted in March 2018. The sample (N=19) was recruited through the membership directory of the Family Physicians Inquiry Network. Results: Leaders shared positive attitudes toward scholarship; however, motivation to engage residents and residency faculty in scholarship diverged. Motivations for promoting scholarly activity among participants were either extrinsic (through ACGME, program graduation, or promotion requirements) or intrinsic (through personal interest and natural drive). Conclusions: Emerging themes illustrate differences in how FMR program leaders perceive the role of scholarship in residency programs. As programs aim to increase research and scholarship, more attention must be paid to the motivating messages communicated by the program’s leadership.

scholarly journals Competency Assessment in Family Medicine Residency: Observations, Knowledge-Based Examinations, and Advancement

2017 ◽  
Vol 9 (6) ◽  
pp. 730-734 ◽  
Author(s):  
Arch G. Mainous ◽  
Bo Fang ◽  
Lars E. Peterson
Keyword(s):  
Family Medicine ◽  
Medical Knowledge ◽  
National Sample ◽  
Competency Assessment ◽  
Residency Programs ◽  
Knowledge Based ◽  
Competency Based ◽  
Key Dimensions ◽  
Relationship Of ◽  
The Relationship

ABSTRACT Background  The Family Medicine (FM) Milestones are competency-based assessments of residents in key dimensions relevant to practice in the specialty. Residency programs use the milestones in semiannual reviews of resident performance from the time of entry into the program to graduation. Objective  Using a national sample, we investigated the relationship of FM competency-based assessments to resident progress and the complementarity of milestones with knowledge-based assessments in FM residencies. Methods  We used midyear and end-of-year milestone ratings for all FM residents in Accreditation Council for Graduate Medical Education–accredited programs during academic years 2014–2015 and 2015–2016. The milestones contain 22 items across 6 competencies. We created a summative index across the milestones. The American Board of Family Medicine database provided resident demographics and in-training examination (ITE) scores. We linked information to the milestone data. Results  The sample encompassed 6630 FM residents. The summative milestone index increased, on average, for each cohort (postgraduate year 1 [PGY-1] to PGY-2 and PGY-2 to PGY-3) at each assessment. The correlation between the milestone index that excluded the medical knowledge milestone and ITE scores was r = .195 (P < .001) for PGY-1 to PGY-2 cohort and r = .254 (P < .001) for PGY-2 to PGY-3 cohort. For both cohorts, ITE scores and composite milestone assessments were higher for residents who advanced than for those who did not. Conclusions  Competency-based assessment using the milestones for FM residents seems to be a viable multidimensional tool to assess the successful progression of residents.

scholarly journals Education in Quality Improvement for Practice in Primary Care During Residency Training and Subsequent Activities in Practice

2014 ◽  
Vol 6 (1) ◽  
pp. 50-54 ◽  
Author(s):  
Peter J. Carek ◽  
Lori M. Dickerson ◽  
Michele Stanek ◽  
Charles Carter ◽  
Mark T. Godenick ◽  
...  
Keyword(s):  
South Carolina ◽  
Quality Improvement ◽  
Family Medicine ◽  
Patient Care ◽  
Patient Centered ◽  
Residency Programs ◽  
Family Medicine Residency ◽  
The Family ◽  
The Impact ◽  
Standardized Curriculum

Abstract Background Quality improvement (QI) is an integral aspect of graduate medical education and an important competence for physicians. Objective We examined the QI activities of recent family medicine residency graduates and whether a standardized curriculum in QI during residency resulted in greater self-reported participation in QI activities in practice after graduation. Methods The family medicine residency programs affiliated with the South Carolina Area Health Education Consortium (N  =  7) were invited to participate in this study. Following completion of introductory educational activities, each site implemented regularly occurring (at least monthly) educational and patient care activities using QI principles and tools. Semiannually, representatives from each participating site met to review project aims and to provide updates regarding the QI activities in their program. To examine the impact of this project on QI activities, we surveyed graduates from participating programs from the year prior to and 2 years after the implementation of the curriculum. Results Graduates in the preimplementation and postimplementation cohorts reported participating in periodic patient care data review, patient care registries, QI projects, and disease-specific activities (57%–71% and 54%–63%, respectively). There were no significant differences in QI activities between the 2 groups except in activities associated with status of their practice as a patient-centered medical home. Conclusions Most but not all family medicine graduates reported they were actively involved in QI activities within their practices, independent of their exposure to a QI curriculum during training.

scholarly journals Surveying Applicants to Improve the Family Medicine Residency Interview Day

PRiMER ◽  
2018 ◽  
Vol 2 ◽  
Author(s):  
Jason R. Woloski ◽  
Daniel Schlegel
Keyword(s):  
Family Medicine ◽  
Electronic Communication ◽  
Medical Center ◽  
Residency Programs ◽  
Family Medicine Residency ◽  
Program Support ◽  
The Family ◽  
Penn State ◽  
Communication Methods ◽  
A Current

Introduction: The diversity of family medicine residency programs across the country makes a generalized assessment of applicant preferences and experiences regarding the interview experience difficult. As such, there have been few publications in recent years relating to interview trail trends and modification of the interview day process to meet the needs of applicants. The purpose of this project was to identify applicant preferences and trends among applicants interviewing at Penn State Health’s Milton S. Hershey Medical Center during the 2014-2015 and 2015-2016 application cycles. Methods: Applicants completed a voluntary, anonymous, 16-question multiple-choice survey  during the interview day. Questions explored the preinterview dinner, interview day, and postinterview day communication methods. Results: In total, 67 surveys were collected from 68 eligible candidates (98.5%) in 2014-2015, and 65 surveys from 65 eligible candidates in 2015-2016 (100%) for a total of 132 participants. Applicant preferences focused on use of electronic communication and the importance of interviewing with both the program director and a current resident. Interview day trends experienced by those surveyed emphasized the inclusion of spouses/significant others, program support of hotel costs, frequency of applicant preinterview dinners, and the lack of emphasis on second-look visits.  Conclusion: This study highlights how the utilization of applicant surveys during the interview day may allow family medicine programs to identify trends occurring on the interview trail, while developing an interview day agenda that meets the desires of the applicants the program attracts.

scholarly journals Benchmarking of provider competencies and current training for prevention and management of obesity among family medicine residency programs: a cross-sectional survey

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Manuela Orjuela-Grimm ◽  
W. Scott Butsch ◽  
Silvia Bhatt-Carreño ◽  
B. Gabriel Smolarz ◽  
Goutham Rao
Keyword(s):  
Family Medicine ◽  
Online Survey ◽  
Weight Stigma ◽  
Variable Degree ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Residency Programs ◽  
Program Leaders ◽  
Family Medicine Residency ◽  
Treatment Of Obesity

Abstract Background U.S. physicians lack training in caring for patients with obesity. For family medicine, the newly developed Obesity Medicine Education Collaborative (OMEC) competencies provide an opportunity to compare current training with widely accepted standards. We aimed to evaluate the current state of obesity training in family medicine residency programs. Methods We conducted a study consisting of a cross-sectional survey of U.S. family medicine residency program leaders. A total of 735 directors (including associate/assistant directors) from 472 family medicine residency programs identified from the American Academy of Family Physicians public directory were invited via postal mail to complete an online survey in 2018. Results Seventy-seven program leaders completed surveys (16% response rate). Sixty-four percent of programs offered training on prevention of obesity and 83% provided training on management of patients with obesity; however, 39% of programs surveyed reported not teaching an approach to obesity management that integrates clinical and community systems as partners, or doing so very little. Topics such as behavioral aspects of obesity (52%), physical activity (44%), and nutritional aspects of obesity (36%) were the most widely covered (to a great extent) by residency programs. In contrast, very few programs extensively covered pharmacological treatment of obesity (10%) and weight stigma and discrimination (14%). Most respondents perceived obesity-related training as very important; 65% of the respondents indicated that expanding obesity education was a high or medium priority for their programs. Lack of room in the curriculum and lack of faculty expertise were reported as the greatest barriers to obesity education during residency. Only 21% of the respondents perceived their residents as very prepared to manage patients with obesity at the end of the residency training. Conclusion Family medicine residency programs are currently incorporating recommended teaching to address OMEC competencies to a variable degree, with some topic areas moderately well represented and others poorly represented such as pharmacotherapy and weight stigma. Very few program directors report their family medicine residents are adequately prepared to manage patients with obesity at the completion of their training. The OMEC competencies could serve as a basis for systematic obesity training in family medicine residency programs.

RETROSPECTIVE ANALYSIS OF THE MEDICAL DOCUMENTATION OF PATIENTS WHO APPLIED TO THE AMBULATORY OF GENERAL PRACTICE - FAMILY MEDICINE

2019 ◽  
Vol 72 (5) ◽  
pp. 938-941
Author(s):  
Оlexander Ye. Kononov ◽  
Liliana V. Klymenko ◽  
Ganna V. Batsiura ◽  
Larysa F. Matiukha ◽  
Olha V. Protsiuk ◽  
...  
Keyword(s):  
Family Medicine ◽  
Middle Ages ◽  
Risk Groups ◽  
Medical Documentation ◽  
Aged Patients ◽  
Family Doctors ◽  
Functional Changes ◽  
Medicine Clinic ◽  
Leading Role ◽  
The Family

Introduction: In today’s realities of health care reform in Ukraine family doctors play a leading role. The aim of our work was to analyze the medical cards of patients who applied for medical care to the family medicine clinic. Materials and methods: It was analyzed outpatient medical cards of 87 patients who applied to the family medicine clinic in the Khotov village, Kyiv region. The study included people aged 18 to 60 years, which corresponded to the groups of young and middle ages according to the WHO classification. Review: Our findings indicate the prevalence of functional changes among young people: somatoform dysfunction of the autonomic nervous system - 9 (37,5%) and the development of organic manifestations at middle-aged patients: arterial hypertension - 32 (62,7%) and coronary artery disease - 17 (33,3%). Conclusions: This study is important for determining the risk groups, early diagnosis and prevention of diseases.

scholarly journals Appraisal of the communication skills of residents in the Family Medicine Program in Central Saudi Arabia

2016 ◽  
Vol 37 (7) ◽  
pp. 804-808 ◽  
Author(s):  
Saad Alsaad ◽  
Sulaiman Alshammari ◽  
Turki Almogbel
Keyword(s):  
Saudi Arabia ◽  
Family Medicine ◽  
Communication Skills ◽  
The Family

scholarly journals Scale Alignment in the Between-Item Multidimensional Partial Credit Model

2021 ◽  
pp. 014662162110131
Author(s):  
Leah Feuerstahler ◽  
Mark Wilson
Keyword(s):  
Item Response ◽  
Kindergarten Readiness ◽  
Latent Trait ◽  
Individual Development ◽  
Partial Credit Model ◽  
Partial Credit ◽  
Response Models ◽  
Item Response Models ◽  
Item Parameters ◽  
Polytomous Item Response

In between-item multidimensional item response models, it is often desirable to compare individual latent trait estimates across dimensions. These comparisons are only justified if the model dimensions are scaled relative to each other. Traditionally, this scaling is done using approaches such as standardization—fixing the latent mean and standard deviation to 0 and 1 for all dimensions. However, approaches such as standardization do not guarantee that Rasch model properties hold across dimensions. Specifically, for between-item multidimensional Rasch family models, the unique ordering of items holds within dimensions, but not across dimensions. Previously, Feuerstahler and Wilson described the concept of scale alignment, which aims to enforce the unique ordering of items across dimensions by linearly transforming item parameters within dimensions. In this article, we extend the concept of scale alignment to the between-item multidimensional partial credit model and to models fit using incomplete data. We illustrate this method in the context of the Kindergarten Individual Development Survey (KIDS), a multidimensional survey of kindergarten readiness used in the state of Illinois. We also present simulation results that demonstrate the effectiveness of scale alignment in the context of polytomous item response models and missing data.

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