Developing and implementing a faculty development curriculum for Japanese family medicine residency faculty.

BACKGROUND: Despite the increase in family medicine residency in Japan, there are only a few structured faculty development (FD) programs. The objective of this project was to construct a consensus on core competencies of faculty to develop a faculty development curriculum in a Japanese family medicine context. METHODS: In 2015, a private FD initiative in the Mie University initiated a curriculum development in collaboration with FD fellowship at the University of Pittsburgh. A literature review and subsequent Delphi process were conducted for core competency development. Based on the core competency list, we designed and implemented a 2-year part-time FD curriculum from 2016. A course evaluation using pre-post confidence level was held during March 2017. RESULTS: Twenty-eight objectives were defined in five core domains: 1) care management/family medicine principle, 2) leadership/professional development, 3) administrative/management, 4) teaching, and 5) research/scholarly activity. A pre-post survey at the end of an academic year revealed a significant increase in learner confidence for "care management/family medicine principle" (P = .03), "teaching" (P < .01), and "research/scholarly activity" (P < .01), as well as the total score (P = .03). CONCLUSIONS: A family medicine FD curriculum based on a faculty core competency list was developed by consensus in a Japanese family medicine context. The core competency was strongly context-oriented, and the relevance of the FD topics and opportunities to apply to the participants' current positions may be inevitable for learner engagement. Further curriculum refinements will be required to see whether the curriculum could be used for faculty development in other family medicine residencies.

Adequacy of initial evaluation of fever in long-term care facilities.

AIM: Febrile residents in long-term care facilities (LTCF) might be inadequately evaluated by caregivers. The present study aimed to examine the factors associated with inadequacy of initial fever evaluations by caregivers at night in LTCF. METHODS: We carried out a cross-sectional study among a convenience sample of caregivers employed at 11 LTCF in Japan using a vignette-based questionnaire. The respondents were randomly assigned to one of two scenarios describing a mild or severe febrile episode in an LTCF resident at night. The respondents' thinking patterns were classified based on influential factors in their fever evaluation. Associations between adequacy of evaluation and respondents' characteristics were evaluated using generalized linear mixed models. RESULTS: A total of 34% of fever evaluations among caregivers were considered to be inadequate regarding the necessity for examination by a physician, due in most cases to underestimating the severity of the fever. Respondents' thinking patterns in fever evaluation were significantly associated with the adequacy of the evaluation. Caregivers who placed particular importance on the preferences of residents and families versus other factors including the resident's febrile condition, were more likely to make an inadequate evaluation than those who did not. CONCLUSIONS: Our findings here suggest that eagerness to comply with residents' preference in fever evaluation could prompt caregivers not to call for an appropriate diagnostic procedure. Geriatr Gerontol Int 2017; 17: 1294-1299.