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 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 Impact of Proposed Institute of Medicine Duty Hours: Family Medicine Residency Directors' Perspective

2009 ◽  
Vol 1 (2) ◽  
pp. 195-200 ◽  
Author(s):  
Peter J. Carek ◽  
Joseph W. Gravel ◽  
Stanley Kozakowski ◽  
Perry A. Pugno ◽  
Gerald Fetter ◽  
...  
Keyword(s):  
Family Medicine ◽  
Patient Care ◽  
Residency Program ◽  
Detrimental Effect ◽  
Resident Education ◽  
Program Directors ◽  
Institute Of Medicine ◽  
Family Medicine Residency ◽  
Potential Impact ◽  
Residency Program Directors

Abstract Purpose To examine the opinions of family medicine residency program directors concerning the potential impact of the Institute of Medicine (IOM) resident duty hour recommendations on patient care and resident education. Methods A survey was mailed to 455 family medicine residency program directors. Data were summarized and analyzed using Epi Info statistical software. Significance was set at the P < .01 level. Results A total of 265 surveys were completed (60.9% response rate). A majority of family medicine residency program directors disagreed or strongly disagreed that the recent IOM duty hour recommendations will, in general, result in improved patient safety and resident education. Further, a majority of respondents disagreed or strongly disagreed that the proposed IOM rules would result in residents becoming more compassionate, more effective family physicians. Conclusion A majority of family medicine residency program directors believe that the proposed IOM duty hour recommendations would have a primarily detrimental effect on both patient care and resident education.

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.

scholarly journals The Outpatient Training Gap: A Pilot Study

2020 ◽  
Vol 52 (2) ◽  
pp. 131-134
Author(s):  
Raphaela Lipinski DeGette ◽  
Margae Knox ◽  
Thomas Bodenheimer
Keyword(s):  
Pilot Study ◽  
Family Medicine ◽  
Residency Program ◽  
Program Directors ◽  
Curriculum Planning ◽  
Direct Role ◽  
Educational Value ◽  
Family Medicine Residency ◽  
Primary Care Clinicians ◽  
Residency Program Directors

Background and Objectives: Most family medicine residency training takes place in hospitals, which is not reflective of the outpatient care practiced by most primary care clinicians. This pilot study is an initial exploration of family medicine residency directors’ opinions regarding this outpatient training gap. Methods: The authors surveyed 11 California family medicine residency program directors in 2017-2018 about factors that influence decisions regarding allocation of residents’ inpatient and outpatient time. Nine of the 11 program directors agreed to be interviewed. We analyzed the interviews for common themes. Results: The participating program directors were generally satisfied with inpatient and outpatient balance in their residents’ schedules. Factors identified as promoting inpatient training included the need for resident staffing of hospital services, the educational value of inpatient rotations, and a lack of capacity in continuity clinics. From the program directors’ perspective, residency funding played no direct role in curriculum planning. Program directors also felt that the ACGME requirements prescribing 1,650 continuity clinic visits throughout residency inhibited the development of creative outpatient training opportunities. Conclusions: Family medicine residency program directors participating in this exploratory study did not feel that their programs overly emphasized inpatient care and training.

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 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 Training Residents in Maternal Depression Care to Improve Child Health: A CERA Study

2019 ◽  
Vol 51 (9) ◽  
pp. 756-759
Author(s):  
Nicola A. Conners Edge ◽  
Shashank Kraleti ◽  
Lorraine McKelvey ◽  
Diane M. Jarrett ◽  
Jackie D. Sublett ◽  
...  
Keyword(s):  
Family Medicine ◽  
Maternal Depression ◽  
Current Knowledge ◽  
Well Being ◽  
Program Directors ◽  
Resident Training ◽  
Health And Development ◽  
Research Alliance ◽  
Residency Program Directors ◽  
The Impact

Background and Objectives: Untreated maternal depression negatively impacts both the mother and her children’s health and development. We sought to assess family medicine program directors’ (PDs) knowledge and attitudes regarding maternal depression management as well as resident training and clinical experience with this disorder. Methods: Data were gathered through the Council of Academic Family Medicine’s (CAFM) Educational Research Alliance (CERA) national survey of family medicine PDs in US and Canadian programs, from January through February, 2018. Results: Surveys were completed by 298 PDs (57.1% response rate) who were majority male (58.9%) and white (83.8%). Nearly all (90.2%) PDs agreed that family physicians should lead efforts to minimize the impact of maternal depression on child well-being. According to PD report, in the family medicine clinics where residents train, most (77.3%) have a clinic process that ensures that routine screening for depression occurs, and 54.4% do some screening of mothers during pediatric visits. Only 18.2% report routinely taking steps to minimize the impact of the mothers’ depression on child well-being. Finally, 41.3% of PDs reported being familiar with the literature on the impact of maternal depression on children; self-reported familiarity was significantly associated with more comprehensive resident training on this topic. Conclusions: Family medicine residency program directors are supportive of training in maternal depression, though their current knowledge is variable and there are opportunities to enhance care of mothers and children impacted by this common and serious disorder.

scholarly journals Family Medicine Residency Program Directors Attitudes and Knowledge of Family Medicine CAM Competencies

EXPLORE ◽  
2013 ◽  
Vol 9 (5) ◽  
pp. 299-307 ◽  
Author(s):  
Paula Gardiner ◽  
Amanda C. Filippelli ◽  
Patricia Lebensohn ◽  
Robert Bonakdar
Keyword(s):  
Family Medicine ◽  
Residency Program ◽  
Program Directors ◽  
Family Medicine Residency ◽  
Attitudes And Knowledge ◽  
Residency Program Directors
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