Moving on From Self-assessment.

Self-assessment of knowledge and confidence is common in medical education, and there are both philosophical and practical to justifications for it. However, many attempts to establish a correlation between self-assessments of knowledge or confidence and objective measures of knowledge or skill acquisition have failed. While in some circumstances the inclusion or reliance of self-assessment may be warranted, for example when a study is specifically measuring traits or outcomes that rely upon meta-cognition or increases in confidence, it is more often the case that self-assessment is used as a substitute for more objective measures. This is demonstrably flawed, and PRiMER as a journal will be moving away from publishing reports that inappropriately rely upon self-assessed knowledge or confidence as the only study outcomes.

Interconception care during well-child visits by family physicians in the United States: A cross-sectional study.

Background: Interconception care (ICC) by family physicians during well-child visits (WCVs) has been broadly advocated in principle but has not been widely implemented. We aimed to investigate ICC at WCVs by family physicians at our facility, focusing on four maternal risk factors, including maternal tobacco use, maternal depression, contraception, and folic acid supplementation. Methods: Mothers who visited WCVs with children up to the age of 24 months at our university-affiliated clinic were screened for the four maternal risks. Brief interventions were provided to mothers with positive screening results. We investigated mothers at WCVs from December 1, 2020, to November 30, 2022. We performed descriptive and binary logistic regression analyses to determine the maternal demographic factors associated with positive screenings. Results: Of 1143 WCVs, 205 mothers were evaluated. Screening was positive in the following rates: tobacco use 5.9%, depression 11.5%, contraception 73.6%, and folic acid supplementation 40.5%. Single marital status was associated with positive screening for smoking (odds ratio [OR] 8.689, p = 0.016) and maternal depression (OR 3.470, p = 0.035). Maternal education level lower than a high school diploma was associated with positive screening for folic acid intake (OR 4.975, p = 0.004). Conclusions: ICC conducted during WCVs by family physicians offers valuable opportunities to identify maternal risk factors and address modifiable factors that can influence future birth outcomes. Single marital status and educational level less than a high school diploma were more potent risk factors for maternal behavior in ICC. More research is needed to assess the outcomes of the interventions.

US Fourth-Year Medical Students: Diabetes Knowledge and Confidence Dissonance.

Introduction: Self-assessed confidence is not a reliable indicator of knowledge levels, as multiple studies have shown; however, it is often used as a measure of knowledge. The purpose of this study is to identify whether the confidence of graduating students in a US medical school to diagnose and treat diabetes is correlated with their diabetes-related knowledge. Methods: We developed a 38-question survey, targeting students' external experiences, knowledge, and confidence related to the diagnosis, treatment, and prevention of diabetes. The survey includes six self-reported confidence questions and 15 multiple choice-style questions, to test diabetes knowledge. The survey was administered electronically using REDCap to the graduating medical school class (n=176) at Upstate Medical University. We calculated mean knowledge scores and confidence scores were calculated. We used Pearson correlation and t tests to assess for correlations and differences in the collected data. We also reviewed diabetes content in the current curriculum. Results: The response rate was 38%. The mean confidence score was 19.97 out of 30 (SD=3.92) and the mean knowledge score was 9.63 out of 15 (SD=2.09). Total knowledge and confidence scores were not correlated. A positive correlation between confidence in prescribing/adjusting medications to treat patients with type 1 diabetes and knowledge levels was found (R=.325, P=.007). Academic electives, external experiences with diabetes, and demographics did not correlate with knowledge and confidence differences. Conclusions: Students overestimated their ability to adequately manage people with diabetes. Better approaches are needed to prepare future physicians to diagnose and treat diabetes.

Storylines of family medicine IV: perspectives on practice-lenses of appreciation.

Storylines of Family Medicine is a 12-part series of thematically linked mini-essays with accompanying illustrations that explore the many dimensions of family medicine, as interpreted by individual family physicians and medical educators in the USA and elsewhere around the world. In 'IV: perspectives on practice-lenses of appreciation', authors address the following themes: 'Relational connections in the doctor-patient partnership', 'Feminism and family medicine', 'Positive family medicine', 'Mindful practice', 'The new, old ethics of family medicine', 'Public health, prevention and populations', 'Information mastery in family medicine' and 'Clinical courage.' May readers nurture their curiosity through these essays.