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4.
Educ Prim Care ; 27(5): 386-390, 2016 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-27538717

RESUMO

BACKGROUND: In 2013, the World Organisation of Family Doctors published training standards for post-graduate medical education (GME) in Family Medicine/General Practice (FP/GP). GME quality has not been well-defined, other than meeting accreditation standards. In 2009, the Association of Family Medicine Residency Directors (AFMRD) developed a tool that would aid in raising the quality of family medicine residency training in the USA. OBJECTIVE: We describe the development of this quality improvement tool, which we called the residency performance index (RPI), and its first three years of use by US family medicine residency (FMR) programmes. The RPI uses metrics specific to family medicine training in the USA to help programmes identify strengths and areas for improvement in their educational activities. Our review of three years of experience with the RPI revealed difficulties with collecting data, and lack of information on graduates' scope of practice. It also showed the potential usefulness of the tool as a programme improvement mechanism. CONCLUSIONS: The RPI is a nationwide, standardised, programme quality improvement tool for family medicine residency programmes in the USA, which was successfully launched as part of AFMRD's strategic plan. Although some initial challenges need to be addressed, it has the promise to aid family medicine residencies in their internal improvement efforts. This model could be adapted in other post-graduate training settings in FM/GP around the world.


Assuntos
Educação de Pós-Graduação em Medicina/normas , Medicina de Família e Comunidade/educação , Clínicos Gerais/educação , Internato e Residência/normas , Melhoria de Qualidade , Educação de Pós-Graduação em Medicina/organização & administração , Medicina de Família e Comunidade/normas , Clínicos Gerais/normas , Humanos , Internato e Residência/organização & administração , Estados Unidos
5.
J Grad Med Educ ; 6(4): 756-9, 2014 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-26140132

RESUMO

BACKGROUND: Residency programs are increasingly being asked to defend their quality, and that of the residents they produce. Yet "residency quality" is a construct that has not been well defined, with no accepted standards other than meeting accreditation standards. In 2009, the Association of Family Medicine Residency Directors developed a strategic plan that included the goal of raising the quality of family medicine training. OBJECTIVE: We describe the development of this quality improvement tool, which we called the residency performance index (RPI), and its first year of use by family medicine residency programs. We describe the use of the tool as a "dashboard" to facilitate program self-improvement. INTERVENTION: Using program metrics specific to family medicine training, and benchmark criteria for these metrics, the RPI was launched in 2012 to help programs identify strengths and areas for improvement in their educational activities and resident clinical experiences that could be tracked and reviewed as part of the annual program evaluation. RESULTS: Approximately 100 program directors began using the tool and 70 finished the process, and were provided aggregate data. Initial review of this experience revealed difficulties with collecting data, and lack of information on graduates' scope of practice. It also showed the potential usefulness of the tool as a program improvement mechanism. CONCLUSIONS: The RPI is a new quality improvement tool for family medicine residency programs. Although some initial challenges need to be addressed, it has the promise to aid family medicine residency in its internal improvement efforts.

10.
J Grad Med Educ ; 1(2): 195-200, 2009 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-21975978

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.

11.
Am Fam Physician ; 65(6): 1073-80, 2002 Mar 15.
Artigo em Inglês | MEDLINE | ID: mdl-11925083

RESUMO

Serum rheumatologic tests are generally most useful for confirming a clinically suspected diagnosis. Testing for rheumatoid factor is appropriate when rheumatoid arthritis, Sjögren's syndrome or cryoglobulinemia is suspected. Antinuclear antibody testing is highly sensitive for systemic lupus erythematosus and drug-induced lupus. Anti-double-stranded DNA antibodies correlate with lupus nephritis; the titer often corresponds with disease activity in systemic lupus erythematosus. Testing for anti-Ro (anti-SS-A) or anti-La (anti-SS-B) may help confirm the diagnosis of Sjögren's syndrome or systemic lupus erythematosus; these antibodies are associated with the extraglandular manifestations of Sjögren's syndrome. Cytoplasmic antineutrophil cytoplasmic antibody testing is highly sensitive and specific for Wegener's granulomatosis. Human leukocyte antigen-B27 is frequently present in ankylosing spondylitis and Reiter's syndrome, but the background presence of this antibody in white populations limits the value of testing. An elevated erythrocyte sedimentation rate (ESR) is a diagnostic criterion for polymyalgia rheumatica and temporal arteritis; however, specificity is quite low. ESR values tend to correlate with disease activity in rheumatoid arthritis and may be useful for monitoring therapeutic response.


Assuntos
Doenças Reumáticas/diagnóstico , Anticorpos Antinucleares/análise , Sedimentação Sanguínea , Doenças do Tecido Conjuntivo/diagnóstico , Humanos , Lúpus Eritematoso Sistêmico/diagnóstico , Fator Reumatoide/análise , Escleroderma Sistêmico/diagnóstico , Sensibilidade e Especificidade
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