Implementation and impact of an interprofessional education curriculum on medical, pharmacy, and social work students' attitudes, perceptions, and self-assessed teamwork skills.

Health professionals are actively contributing to interprofessional collaboration, yet implementation and assessment of interprofessional education (IPE) within Family Medicine is not well documented. From October 2014 to December 2018, social work, pharmacy, and medical students worked as an IP team involving inpatient, outpatient, and home visit experiences. Students completed two validated surveys pre- and post- their interprofessional education rotation: the Interdisciplinary Education Perception Scale (IEPS) and the Teams Skills Scale (TSS). Paired t-test analyses were conducted on individual pre- and post-survey scores. Twenty-seven (77%) of the 35 participating students completed pre- and post-surveys. Significant differences were found in mean change in pre-IEPS mean scores (4.95) and post-IEPS mean scores (5.29), with a mean difference in matched pairs of 0.31 (p < .001, p = 27). A significant difference was found in student pre-TSS mean scores (3.52) and post-TSS mean scores (4.31), with a mean difference in matched pairs of 0.79 (p < .0001, p = 27). Our findings demonstrate that the IPE curriculum had a positive impact on students' attitudes and self-assessed teamwork skills, with greater learning outcomes identified amongst pharmacy and social work students than medical students. Implementing IP curriculum into Family Medicine experiences is both feasible and worthy of further investigation.

Integrating Interprofessional Case Scenarios, Allied Embedded Actors, and Teaching Into Formative Observed Structured Clinical Exams.

BACKGROUND AND OBJECTIVES: Interprofessional education is a critical component of medical student training, yet it is often difficult to implement. Medical students who learn with, from, and about learners from other disciplines have been shown to create more effective and safe health care teams. The investigators wanted to know how participating in two interprofessional observed structured clinical exams (OSCEs) at Tufts University School of Medicine (TUSM) would affect changes in medical students' attitudes and values in interprofessional teamwork. METHODS: For the academic years 2017 and 2018, two interprofessional case scenarios were integrated into OSCEs for third-year medical students at TUSM, with an allied embedded actor (AEA) playing a social worker to an end-of-life scenario, and an AEA playing the role of a pharmacy student added to a chronic pain scenario. Students participated in didactic training about interprofessional teamwork and received structured feedback regarding interprofessional competencies following simulation cases. Changes in interprofessional knowledge and attitudes were assessed by comparing student pre- and postscenario mean scores on the Interprofessional Socialization and Valuing Scale (ISVS-21, a 21-item scale survey), with students rating themselves on a Likert scale from 1 (not at all) to 7 (to a very great extent). We performed paired t-test analysis on individual pre- and post-ISVS-21 means. RESULTS: Three hundred fifty-three of the 417 participating medical students fully completed pre- and postsurveys. Students reported significant changes in interprofessional knowledge and attitudes (mean change=1.3, P<.0001). Students and faculty regarded the interprofessional cases very highly. CONCLUSIONS: Placing interprofessional cases involving AEAs into OSCE events is easily replicated, and positively impacts students' attitudes and values in interprofessional knowledge.

Sailing smoothly across the cultural divide: Constructing effective behavioral science presentations for medical audiences.

Beginning behavioral science faculty, who are critical residency program contributors, face significant immediate challenges that often diminish their effectiveness and increase the time it takes to translate and reformat their expertise into relevant and meaningful educational presentations. Residency program culture and competency-based learning are quite different from the educational objectives and teaching environments found in most behavioral health training programs. The goal of this article is to provide beginning behavior science faculty, who are typically on their own and learning on the job, with a guide to the core educational perspectives and skills required as well as key resources that are available to them. Since a significant portion of behavioral science faculty's teaching time revolves around small and large group presentations, our guide focuses on how to incorporate key strategies and resources into relevant, evidenced-based and, most importantly, effective behavioral health presentations for the program's resident physicians. Specifically, our recommendations include selection of content, methods of content organization, techniques for actively engaging resident physicians in discussing the significance of the topics, and descriptions of numerous Internet resources for the primary mental health topics that concern family medicine trainees. Finally, it is emphasized that the relevant and effective use of these recommendations is dependent upon the behavioral science faculty educator's first understanding and appreciating how physicians' think, speak, and prioritize information while caring for their patients.

Family medicine training--the international experience.

Family medicine is undergoing dramatic transformation around the world. Its organisation, delivery, and funding are changing in profound ways. While the specifics of primary care reform vary, a common emerging strategy involves establishment of primary health care teams that provide improved access, use electronic records, are networked with other teams, and are paid using blended payment schemes. More family doctors are needed in all countries. New approaches beyond the traditional apprenticeships or residency programs will be required to meet global demand. Training of family doctors must change to prepare tomorrow's family physician for a different practice reality. Curricula are more competency-oriented, rather than time-focused. Today's trainees can anticipate a career that includes periodic reassessment of their knowledge base and competency. This article explores these trends and offers some strategies that have proved effective in various parts of the world for training increased numbers of qualified family doctors.

Creation of postgraduate training programs for family medicine in Vietnam.

BACKGROUND AND OBJECTIVES: The Vietnam Family Medicine Development Project has successfully created postgraduate training programs for family medicine in Vietnam. This paper's objective is to report on the project's progress and provide initial evaluation results. METHODS: A training network of medical schools in Vietnam partnered with family medicine departments in the United States to accomplish the goal of establishing family medicine as a specialty in Vietnam with assistance from the Ministry of Health. Together they created a curriculum and ambulatory training sites. Faculty development was accomplished, and training programs were implemented. RESULTS: A preliminary assessment of some of the graduates demonstrates that family physicians in Vietnam provide enhanced primary care with better patient satisfaction. A more-complete evaluation is underway. CONCLUSIONS: Initial establishment of the specialty of family medicine in Vietnam has been successful. Ongoing support for the development of this new primary care specialty has been garnered in each of the medical schools and at the ministerial level throughout the country.

Assessing communication competence: a review of current tools.

BACKGROUND: The assessment of communication competence has become a major priority of medical educational, policy, and licensing organizations in the United States and Canada. Multiple tools are available to assess communication competence, but there are few studies that compare the tools. METHODS: A consensus panel of six family medicine educators evaluated 15 instruments measuring the physician-patient interview. The primary evaluation criteria came from the Kalamazoo Consensus Statement (KCS), which derived from a multidisciplinary panel of experts that defined seven essential elements of physician-patient communication. We evaluated psychometric properties of the instruments and other assessment criteria felt to be important to family physicians (exploring family issues, interview efficiency, and usability/practicality). RESULTS: Instruments that received the highest ratings on KCS elements were designed for faculty raters and varied in their practicality/usability ratings and psychometric properties. Few instruments were rated high on psychometric properties or exploring family issues. CONCLUSIONS: The process successfully reviewed and provided a framework for assessing communication skills instruments. There is a need to expand the study, including use of a larger cohort of reviewers to provide more validity to the results and minimize potential biases.

An international consultation: the development of family medicine in Vietnam.

An effective international consultation on health system reform can be approached using the five-step process of establishing goals, conducting a needs assessment, defining objectives, developing methods, and designing evaluation strategies. This structure provided guidance to a consultation we provided to the Ministry of Health, Socialist Republic of Vietnam (SRV) to review its current health care delivery system. The consultation examined all levels of health care delivery and medical education. The SRV has an extensive, but poorly staffed, "commune health center" system. There is a widespread perception that the quality of medical care is low in these health centers. People leave their communities to obtain health care elsewhere at more-specialized levels and more-expensive sites. Our consultation included an analysis of the potential effect of creating a primary health care delivery system based on the model of family medicine. In addition to consulting, part of the time spent in Vietnam was used to advocate for changes in the system to allow for movement toward a primary health care delivery system. The consultation culminated in the creation of the specialty of family medicine and in the establishment of the medical education system to train family physicians.