RESUMO
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.
Assuntos
Internato e Residência/organização & administração , Diretores Médicos/educação , Médicos de Família/educação , Comportamento do Consumidor , Educação de Pós-Graduação em Medicina , Bolsas de Estudo , Humanos , Internato e Residência/normas , Liderança , Médicos de Família/normas , Estados UnidosAssuntos
Medicina de Família e Comunidade/educação , Financiamento Governamental/legislação & jurisprudência , Internato e Residência/economia , Apoio ao Desenvolvimento de Recursos Humanos/legislação & jurisprudência , Economia Hospitalar/legislação & jurisprudência , Medicina de Família e Comunidade/economia , Humanos , Faculdades de Medicina/economia , Faculdades de Medicina/legislação & jurisprudência , Estados Unidos , United States Health Resources and Services AdministrationRESUMO
Medical education curricula increasingly are incorporating courses on cultural competency and skills development in working with ethnically diverse patient populations as well as courses on genetics and genomics. The authors support these efforts and believe the next step is integration of genetics into cultural competency programs and similarly, cultural competency into genetics curricula. In this paper, the authors describe the work of the Genetics in Primary Care Faculty Development Working Group on Cultural Competency, a federally-funded initiative to prepare generalist faculty to teach genetics as part of ambulatory education. Over a 12-month period, this team wrote a module on cultural competency and nine new clinical cases, and developed the PRACTICE mnemonic (prevalence, risk, attitude, communication, testing, investigation, consent, empowerment) to help health care professionals integrate cultural competency skills in genetics into primary care. More specifically, the PRACTICE mnemonic integrates information emerging from experts in health disparities and doctor-patient communication to build a comprehensive model for addressing the relevance of culture and ethnicity in the delivery of genetic services. Lastly, this paper illustrates a systematic method of covering key areas of cultural competency through discussion of a patient with a genetic disorder as well as presents an argument as to why cultural competency is highly relevant to the delivery of genetic services especially as part of generalists' clinical practice.