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4.
Fam Med ; 55(6): 405-410, 2023 06.
Artigo em Inglês | MEDLINE | ID: mdl-37307393

RESUMO

BACKGROUND: While the Association of American Medical Colleges (AAMC) designated cross-disciplinary telemedicine competencies, curricular implementation is at disparate stages across medical schools and with significant curricular gaps. We investigated factors associated with the presence of telemedicine curriculum in family medicine clerkships. METHODS: Data were evaluated as part of the 2022 CERA survey of family medicine clerkship directors (CD). Participants answered questions about telemedicine curriculum in their clerkship, including whether it was required or optional, whether telemedicine competencies were assessed, the availability of faculty expertise, volume of visits, student autonomy in visits, CD's attitude about the importance of telemedicine education, and awareness of the Society of Teachers of Family Medicine's (STFM) Telemedicine Curriculum. RESULTS: Ninety-four of 159 CDs (59.1%) responded to the survey. Over one-third of FM clerkships (38, 41.3%) did not teach telemedicine and most CDs (59, 62.8%) did not assess competencies. The presence of telemedicine curriculum was positively associated with CDs' awareness of STFM's Telemedicine Curriculum (P=.032), attitude of CDs toward importance of telemedicine teaching (P=.007), higher level of learner autonomy in telemedicine visits (P=.035), and private medical schools (P=.020). CONCLUSIONS: Almost two-thirds of clerkships (62.8%) did not assess telemedicine competencies, and fewer than one-third of CDs (28.6%) considered telemedicine education as important as other clerkship topics. CDs' attitudes were a significant determinant of whether teaching of telemedicine skills occurred. Awareness of telemedicine education resources and higher learner autonomy in telemedicine encounters may promote integration into clerkship curriculum.


Assuntos
Medicina de Família e Comunidade , Telemedicina , Humanos , Currículo , Escolaridade , Docentes
5.
JMIR Med Educ ; 9: e43190, 2023 May 08.
Artigo em Inglês | MEDLINE | ID: mdl-37155241

RESUMO

BACKGROUND: Telemedicine use increased as a response to health care delivery changes necessitated by the COVID-19 pandemic. However, lack of standardized curricular content creates gaps and inconsistencies in effectively integrating telemedicine training at both the undergraduate medical education and graduate medical education levels. OBJECTIVE: This study evaluated the feasibility and acceptability of a web-based national telemedicine curriculum developed by the Society of Teachers of Family Medicine for medical students and family medicine (FM) residents. Based on the Association of American Medical Colleges telehealth competencies, the asynchronous curriculum featured 5 self-paced modules; covered topics include evidence-based telehealth uses, best practices in communication and remote physical examinations, technology requirements and documentation, access and equity in telehealth delivery, and the promise and potential perils of emerging technologies. METHODS: A total of 17 medical schools and 17 FM residency programs implemented the curriculum between September 1 and December 31, 2021. Participating sites represented 25 states in all 4 US census regions with balanced urban, suburban, and rural settings. A total of 1203 learners, including 844 (70%) medical students and 359 (30%) FM residents, participated. Outcomes were measured through self-reported 5-point Likert scale responses. RESULTS: A total of 92% (1101/1203) of learners completed the entire curriculum. Across the modules, 78% (SD 3%) of participants agreed or strongly agreed that they gained new knowledge, skills, or attitudes that will help them in their training or career; 87% (SD 4%) reported that the information presented was at the right level for them; 80% (SD 2%) reported that the structure of the modules was effective; and 78% (SD 3%) agreed or strongly agreed that they were satisfied. Overall experience using the national telemedicine curriculum did not differ significantly between medical students and FM residents on binary analysis. No consistent statistically significant relationships were found between participants' responses and their institution's geographic region, setting, or previous experience with a telemedicine curriculum. CONCLUSIONS: Both undergraduate medical education and graduate medical education learners, represented by diverse geographic regions and institutions, indicated that the curriculum was broadly acceptable and effective.

8.
PRiMER ; 6: 7, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35481231

RESUMO

Background and Objectives: This study examined changes over time in the shortage and quality of clinical training sites for students. The surveys provided baseline and milestone measurements for the Society of Teachers of Family Medicine's (STFM) Preceptor Expansion Initiative. Methods: Data were gathered in 2016 and again in 2020, through the Council of Academic Family Medicine's (CAFM) Educational Research Alliance (CERA) survey of family medicine clerkship directors. Clerkship directors answered questions concerning number of students requiring placement, number of precepting sites used, frequency of negative comments about family medicine as a specialty, and about opportunities for students to experience comprehensive care, patient-centered care, and document in electronic health records. Results: The number of students who annually required placement at family medicine preceptor sites increased slightly from 2016 to 2020, but the number of sites utilized per family medicine department did not. There were no changes in the percentage of sites having Patient-Centered Medical Home or similar recognition or providing comprehensive care with or without obstetrics. However, more students were allowed to enter data and write patient encounter notes in 2020 than in 2016. Conclusions: Clerkship directors continue to struggle to find high-quality family medicine training sites for students. STFM's Preceptor Expansion Initiative has made strides to help students become active, productive members of care teams, to reduce the administrative burden of teaching, and to promote the precepting of multiple students at once.1 These efforts to incentivize precepting are ongoing, but won't be enough to compensate for the rapid growth in the number of students and the increasing demands on physicians for high-volume patient care.

11.
PRiMER ; 5: 18, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34286221

RESUMO

BACKGROUND AND OBJECTIVES: Residents have been thrust onto the front lines of the US medical response to COVID-19. This study aimed to quantify and describe the experiences of family medicine residents nationally during the early phases of the pandemic. Specific areas of interest included training received and the residents' personal sense of safety. The purpose of this study was to look for differences among residents based on geographic location. METHOD: This May 2020 survey was conducted by the Council of Academic Family Medicine Educational Research Alliance (CERA) of a random sample of 5,000 resident members of the American Academy of Family Physicians (AAFP). RESULTS: The overall response rate for the survey was 5.66% (283/5,000). More than 40% of residents reported having felt in moderate to significant personal danger during the COVID-19 pandemic. Fewer than 20% had been tested for COVID-19 themselves. Among all respondents, 176 (65.7%) of the residents had provided direct patient care for COVID-19-positive patients. Most had been trained on personal protective equipment and the medical aspects of COVID-19, but 16.2% reported no training on how to care for COVID-19 patients. Minority residents, and residents in larger urban areas were less likely to receive timely training. CONCLUSIONS: The COVID-19 pandemic has had a major impact on family medicine residents' medical education and their sense of safety. Regional variations in residents' educational experiences during the pandemic exist. Training prior to COVID-19 exposure was not universal. In our sample, minority residents were less likely to receive timely training than White residents.

13.
Fam Med ; 53(6): 443-452, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34077963

RESUMO

BACKGROUND AND OBJECTIVES: Family medicine faculty face increasing expectations for clinical productivity. These expectations impinge on academic and education time and make it difficult to pursue research or scholarly activities. A task force convened by the Society of Teachers of Family Medicine created national guidelines to protect nonclinical time for family medicine faculty. METHODS: The task force reviewed existing guidelines for protected time, as well as data on current and past distribution of time for faculty in academic medicine, including a specific look at family medicine. Based on the evidence and expert opinion from task force members and leaders of family medicine organizations, the task force developed eight consensus recommendations. RESULTS: The guidelines include recommendations for allocation of protected time for program directors, associate program directors, and core faculty. These represent best practices to ensure programs have appropriate time to devote to the nonclinical duties of training and educating residents, while also promoting innovation in education, faculty well-being, and faculty retention. DISCUSSION: Faculty require nonclinical time for resident development, curriculum creation and maintenance, program assessment, and scholarship. Without these functions, programs can't meet accreditation requirements or fulfill their responsibility to develop strong family physicians. Residency programs, sponsoring institutions, universities, health care systems, and accrediting bodies should use these recommendations to develop budgets that provide appropriate time allocation to enhance faculty wellness, reduce turnover, and meet organizational missions and objectives around education and providing care for communities.


Assuntos
Internato e Residência , Acreditação , Currículo , Docentes de Medicina , Medicina de Família e Comunidade/educação , Humanos
14.
PRiMER ; 5: 45, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-35178507

RESUMO

INTRODUCTION: Recent changes to the Accreditation Council for Graduate Medical Education (ACGME) requirements eliminated minimum standards for protected nonclinical time for core faculty. Faculty perform many nonclinical tasks to maintain family medicine residencies. The objective of this study is to describe the landscape of nonclinical time for family medicine residency faculty. METHODS: Program directors at ACGME-accredited family medicine residencies were electronically surveyed in August 2019 to describe nonclinical time of their faculty. Survey information requested included program demographics, the amount of nonclinical time allocated, and the estimated amount of nonclinical time spent per year completing their faculty duties. RESULTS: A total 156 of 635 program directors (24.6%) returned the survey and 58 (9.1%) completed the entire survey for analysis inclusion. An average of 3,394 hours per year, per program were estimated to be spent on nonclinical activities. The greatest amount of time was spent on program administration (39%) and the least amount of time on curriculum development (5%). There was variation in the use of nonphysician faculty to complete these tasks. Allocated faculty time was comparable to estimated time spent performing nonclinical tasks. On average, a 24-resident program devoted 1.9 full-time equivalent faculty salary support to complete nonclinical activities. CONCLUSIONS: Family medicine residency faculty spend significant time completing nonclinical tasks required to meet ACGME requirements and need the protected time to complete these necessary tasks. Direct data on the use of faculty nonclinical time is needed to more accurately define its use.

16.
Fam Med ; 51(2): 159-165, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30736041

RESUMO

In late 2015, the Society of Teachers of Family Medicine (STFM) was charged with Family Medicine for America's Health's (FMAHealth) Workforce Education and Development Core Team's task of identifying, developing, and disseminating resources for community preceptors. The charge from FMAHealth came at a time when STFM was discussing strategies to address the critical shortage of clinical training sites for medical students. STFM hosted a summit to identify the most significant reasons for the shortage of community preceptors and shape the priorities, leadership, and investments needed to ensure the ongoing education of the primary care workforce. Summit participants were asked to propose solutions to achieve the following aims: (1) decrease the percentage of primary care clerkship directors who report difficulty finding clinical preceptor sites, and (2) increase the percentage of students completing clerkships at high-functioning sites. The outcome of the summit was an action plan with five tactics that are being implemented now: Tactic 1: Work with the Centers for Medicare and Medicaid Services (CMS) to revise student documentation guidelines. Tactic 2: Integrate interprofessional/interdisciplinary education into ambulatory primary care settings through integrated clinical clerkships. Tactic 3: Develop a standardized onboarding process for students and preceptors and integrate students into the work of ambulatory primary care settings in useful and authentic ways. Tactic 4: Develop educational collaboratives across departments, specialties, professions, and institutions to improve administrative efficiencies for preceptors. Tactic 5: Promote productivity incentive plans that include teaching and develop a culture of teaching in clinical settings.


Assuntos
Estágio Clínico , Medicina de Família e Comunidade/organização & administração , Preceptoria/organização & administração , Medicina de Família e Comunidade/educação , Humanos , Estudantes de Medicina
20.
J Am Osteopath Assoc ; 114(3): 172-8, 2014 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-24567270

RESUMO

CONTEXT: Individuals with vestibular dysfunction are at increased risk for falling. In addition, vestibular dysfunction is associated with chronic pain, which could present a serious public health concern as approximately 43% of US adults have chronic pain. OBJECTIVE: To assess the incidence of vestibular dysfunction in patients receiving medication for chronic, noncancer pain or other underlying neurologic disorders and to determine associated follow-up therapeutic and diagnostic recommendations. METHODS: The authors conducted a retrospective medical record review of consecutive patients who were treated in their private neuroscience practice with medications for chronic pain or underlying neurologic disorders in 2011. All patients underwent a series of tests using videonystagmography for the assessment of vestibular function. Test results and recommendations for therapy and additional testing were obtained. RESULTS: Medical records of 124 patients (78 women, 46 men) were reviewed. Vestibular deficits were detected in 83 patients (66.9%). Patient ages ranged from 29 through 72 years, with a mean age of 50.7 years for women and 52.5 years for men. Physician-recommended therapy and follow-up testing were as follows: 32 patients (38.6%), neurologic examination and possible magnetic resonance (MR) imaging or computed tomography (CT) of the brain; 26 patients (31.3%), vestibular rehabilitation therapy only; 22 patients (26.5%), vestibular and related balance-function rehabilitation therapy, further neurologic examination, and possible MR imaging or CT; 2 patients (2.4%), balance-function rehabilitation therapy and specialized internal auditory canal high-magnification MR imaging or CT to assess for acoustic neuroma; and 1 patient (1.2%), specialized internal auditory canal high-magnification MR imaging or CT to evaluate for possible intracanalicular acoustic neuroma. CONCLUSION: Patients being treated with medications for chronic, noncancer pain or other underlying neurologic disorders may have a higher-than-average incidence of vestibular dysfunction. Baseline assessment and monitoring of the vestibular apparatus may be indicated for these patients.


Assuntos
Dor Crônica/complicações , Osteopatia/métodos , Doenças do Sistema Nervoso/complicações , Doenças Vestibulares/etiologia , Adulto , Idoso , Dor Crônica/diagnóstico , Feminino , Seguimentos , Humanos , Incidência , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Doenças do Sistema Nervoso/diagnóstico , Equilíbrio Postural , Estudos Retrospectivos , Tomografia Computadorizada por Raios X , Estados Unidos/epidemiologia , Doenças Vestibulares/epidemiologia , Doenças Vestibulares/terapia
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