WorldWideScience

Sample records for family medicine clerkship

  1. A Comparison of Students' Clinical Experience in Family Medicine and Traditional Clerkships.

    Science.gov (United States)

    Parkerson, George R., Jr.; And Others

    1984-01-01

    Experience on the traditional internal medicine, surgery, pediatrics, obstetrics-gynecology, and psychiatry clerkships was compared with the experience on a family medicine clerkship. The family medicine clerkship offered the most experience with circulatory, respiratory, digestive, neurological, musculoskeletal, and skin problems and with…

  2. A Third-Year Family Medicine Clerkship Based in an Academic Family Practice Center.

    Science.gov (United States)

    Taylor, Robert B; And Others

    1984-01-01

    A 5-week family medicine clerkship is described that uses several innovative techniques: problem-based learning focusing on patient management tutorials; consultation with specialists; supervised patient care and a nursing home inpatient teaching service; and workshops on topics such as office-surgical techniques, practice management, and…

  3. Relevance of clerkship characteristics in changing students' interest in family medicine: a questionnaire survey

    Science.gov (United States)

    Herwig, Anna; Viehmann, Anja; Thielmann, Anika; Gesenhues, Stefan; Weltermann, Birgitta

    2017-01-01

    Objectives Exposure to family medicine (FM) can serve to promote students' interest in this field. This study aimed at identifying clerkship characteristics which decrease or increase students' interest in FM. Design This cross-sectional questionnaire study analysed students' clerkship evaluations between the years 2004 and 2014. Descriptive statistics were used to compare four predefined groups: (1) high interest in FM before and after the clerkship (Remained high), (2) poor interest before and after the clerkship (Remained low), (3) poor interest before the clerkship which improved (Increased) and (4) high interest before the clerkship which decreased (Decreased). Setting Students' evaluations of FM clerkships in the fourth of 6 years of medical school. Participants All questionnaires with complete answers on students' interest in FM and its change as a result of the clerkship (2382 of 3963; 60.1%). The students' mean age was 26 years (± 3.9), 62.7% (n=1505) were female. Outcome measure The outcome was a change in students' interest in FM after completing the clerkship. Results Interest in FM after the clerkship was as follows: 40.1% (n=954) Remained high, 5.5% (n=134) Remained low, 42.1% (n=1002) Increased and 12.3% (n=292) Decreased. Students with decreased interest had performed a below-average number of learning activities (4 vs 6 activities). A total of 45.9% (n=134 of 292) of the students with decreased interest reported that the difficulty of the challenge was inadequate for their educational level: 81.3% (n=109) felt underchallenged and 18.7% (n=25) overchallenged. Conclusions In more than 50% of cases, the clerkship changed the students' interest in FM. Those with decreased interest were more frequently underchallenged. We observed an increase in FM if at least six learning activities were trained. Our findings stress the importance of well-designed FM clerkships. There is a need for standardised educational strategies which enable teaching

  4. Art-making in a family medicine clerkship: how does it affect medical student empathy?

    Science.gov (United States)

    Potash, Jordan S; Chen, Julie Y; Lam, Cindy L K; Chau, Vivian T W

    2014-11-28

    To provide patient-centred holistic care, doctors must possess good interpersonal and empathic skills. Medical schools traditionally adopt a skills-based approach to such training but creative engagement with the arts has also been effective. A novel arts-based approach may help medical students develop empathic understanding of patients and thus contribute to medical students' transformative process into compassionate doctors. This study aimed to evaluate the impact of an arts-making workshop on medical student empathy. This was a mixed-method quantitative-qualitative study. In the 2011-12 academic year, all 161 third year medical students at the University of Hong Kong were randomly allocated into either an arts-making workshop or a problem-solving workshop during the Family Medicine clerkship according to a centrally-set timetable. Students in the arts-making workshop wrote a poem, created artwork and completed a reflective essay while students in the conventional workshop problem-solved clinical cases and wrote a case commentary. All students who agreed to participate in the study completed a measure of empathy for medical students, the Jefferson Scale of Empathy (JSE) (student version), at the start and end of the clerkship. Quantitative data analysis: Paired t-test and repeated measures ANOVA was used to compare the change within and between groups respectively. Qualitative data analysis: Two researchers independently chose representational narratives based on criteria adapted from art therapy. The final 20 works were agreed upon by consensus and thematically analysed using a grounded theory approach. The level of empathy declined in both groups over time, but with no statistically significant differences between groups. For JSE items relating to emotional influence on medical decision making, participants in the arts-making workshop changed more than those in the problem-solving workshop. From the qualitative data, students perceived benefits in arts

  5. Emergency Medicine Clerkship Directors: Current Workforce

    Directory of Open Access Journals (Sweden)

    David A. Wald

    2014-07-01

    Full Text Available Introduction: The emergency medicine clerkship director serves an important role in the education of medical students. The authors sought to update the demographic and academic profile of the emergency medicine clerkship director. Methods: We developed and implemented a comprehensive questionnaire, and used it to survey all emergency medicine clerkship directors at United States allopathic medical schools accredited by the Liaison Committee on Medical Education. We analyzed and interpreted data using descriptive statistics. Results: One hundred seven of 133 (80.4% emergency medicine clerkship directors completed the survey. Clerkship Director’s mean age was 39.7 years (SD-7.2, they were more commonly male 68.2%, of Caucasian racial backgrounds and at the instructor or assistant professor (71.3% level. The mean number of years of experience as clerkship director was 5.5 (SD-4.5. The mean amount of protected time for clerkship administration reported by respondents was 7.3 hours weekly (SD-5.1, with the majority (53.8% reporting 6 or more hours of protected time per week. However, 32.7% of emergency medicine clerkship directors reported not having any protected time for clerkship administration. Most clerkship directors (91.6% held additional teaching responsibilities beyond their clerkship and many were involved in educational research (49.5%. The majority (79.8%, reported being somewhat or very satisfied with their job as clerkship director. Conclusion: Most clerkship directors were junior faculty at the instructor or assistant professor rank and were involved with a variety of educational endeavors beyond the clerkship. [West J Emerg Med. 2014;15(4:398–403.

  6. Teaching Prevention in Internal Medicine Clerkships.

    Science.gov (United States)

    Kinsinger, Linda

    2000-01-01

    Reviews the rationale for including prevention in the clinical medicine clerkship. Summarizes current guidelines, presents examples of curricula in several medical schools, and proposes a future direction that stresses integrating teaching preventive medicine into internal medicine clerkships and across the entire four-year medical curriculum. (DB)

  7. E-Learning in family medicine education: faculty support in a community clerkship

    Directory of Open Access Journals (Sweden)

    Gensichen, Jochen

    2005-04-01

    Full Text Available E-learning was planned as a test for medical students within their curriculum of family medicine. A multi-modular online-offer specific to the target group accompanies the 10th term medical students during their peripheral practical courses in family practices. Teaching objectives are as follows: (1 Introduction into e-learning, (2 clinical general medicine - online-module, (3 chronic care online-module, (4 online-application. The systematic evaluation shows that e-learning promotes the communication of students both among themselves and with the university during their practical courses. On the basis of the experiences from this pilot test the combination with more traditional teaching methods (blended learning seems to be a promising option for medical education.

  8. The internal medicine clerkship and ambulatory learning experiences: results of the 2010 clerkship directors in internal medicine survey.

    Science.gov (United States)

    Shaheen, Amy; Papp, Klara K; Torre, Dario

    2013-01-01

    Education in the ambulatory setting should be an integral part of undergraduate medical education. However, previous studies have shown education in this setting has been lacking in medical school. Ambulatory education occurs on some internal medicine clerkships. The extent of this education is unclear. The purpose of this survey was to assess the structure, curriculum, assessment methods, and barriers to implementation of ambulatory education on the internal medicine clerkship. An annual survey of institutional members of the Clerkship Directors in Internal Medicine (CDIM) was done in April 2010. The data were anonymous and descriptive statistics were used to summarize responses. Free text results were analyzed using qualitative techniques. The response rate was 75%. The majority of respondents had a required ambulatory component to the clerkship. Ambulatory experiences distinct from the inpatient internal medicine experience were common (46%). Integration with either the inpatient experiences or other departmental clerkships also occurred. The majority of ambulatory educational experiences were with generalists (74%) and/or subspecialists (45%). The most common assessment tool was the National Board of Medical Examiners (NBME) ambulatory shelf exam. Thematic analysis of the question about how practice based learning was taught elicited four major themes: Not taught; taught in the context of learning evidence based medicine; taught while learning chronic disease management with quality improvement; taught while learning about health care finance. Barriers to implementation included lack of faculty and financial resources. There have been significant increases in the amount of time dedicated to ambulatory internal medicine. The numbers of medical schools with ambulatory internal medicine education has increased. Integration of the ambulatory experiences with other clerkships such as family medicine occurs. Curriculum was varied but difficulties with dissemination

  9. Reflective writing in the internal medicine clerkship: a national survey of clerkship directors in internal medicine.

    Science.gov (United States)

    Chretien, Katherine C; Chheda, Shobhina G; Torre, Dario; Papp, Klara K

    2012-01-01

    Reflective writing programs have been implemented at many medical schools, but it is unclear to what extent and how they are structured. We surveyed the 107 Clerkship Directors of Internal Medicine member institutions on use of reflective writing assignments during the internal medicine clerkship. Eighty-six of 107 (80%) institutional members completed the survey. Thirty-five percent reported having a reflective writing assignment, 48% did not, and 6% did not but were considering starting one within the next 2 years. Of the 30 assignments, most were partially structured (60%), involved small-group discussion (57%), and provided individual student feedback (73%). A minority (30%) contributed to the students' grade. Respondents believed assignments contributed to students' learning in multiple domains, most often Professionalism (97%) and Communication (77%). Although reflective writing programs were common, variability existed in their structure. Further research is needed to determine how best to implement them.

  10. The association of students requiring remediation in the internal medicine clerkship with poor performance during internship.

    Science.gov (United States)

    Hemann, Brian A; Durning, Steven J; Kelly, William F; Dong, Ting; Pangaro, Louis N; Hemmer, Paul A

    2015-04-01

    To determine whether the Uniformed Services University (USU) system of workplace performance assessment for students in the internal medicine clerkship at the USU continues to be a sensitive predictor of subsequent poor performance during internship, when compared with assessments in other USU third year clerkships. Utilizing Program Director survey results from 2007 through 2011 and U.S. Medical Licensing Examination (USMLE) Step 3 examination results as the outcomes of interest, we compared performance during internship for students who had less than passing performance in the internal medicine clerkship and required remediation, against students whose performance in the internal medicine clerkship was successful. We further analyzed internship ratings for students who received less than passing grades during the same time period on other third year clerkships such as general surgery, pediatrics, obstetrics and gynecology, family medicine, and psychiatry to evaluate whether poor performance on other individual clerkships were associated with future poor performance at the internship level. Results for this recent cohort of graduates were compared with previously published findings. The overall survey response rate for this 5 year cohort was 81% (689/853). Students who received a less than passing grade in the internal medicine clerkship and required further remediation were 4.5 times more likely to be given poor ratings in the domain of medical expertise and 18.7 times more likely to demonstrate poor professionalism during internship. Further, students requiring internal medicine remediation were 8.5 times more likely to fail USMLE Step 3. No other individual clerkship showed any statistically significant associations with performance at the intern level. On the other hand, 40% of students who successfully remediated and did graduate were not identified during internship as having poor performance. Unsuccessful clinical performance which requires remediation in

  11. Improving clerkship preparedness: a hospital medicine elective for pre-clerkship students.

    Science.gov (United States)

    Connor, Denise M; Conlon, Paul J; O'Brien, Bridget C; Chou, Calvin L

    2017-01-01

    Medical students often struggle to apply their nascent clinical skills in clerkships. While transitional clerkships can orient students to new roles and logistics, students may benefit from developing clinical skills in inpatient environments earlier in their curriculum to improve readiness for clerkships. Our four- to six-session elective provides pre-clerkship students with individualized learning in the inpatient setting with the aim of improving clerkship preparedness. Students work one-on-one with faculty who facilitate individualized learning through mentoring, deliberate practice, and directed feedback. Second-year medical students are placed on an attending-only, traditionally 'non-teaching' service in the hospital medicine division of a Veterans Affairs (VA) hospital for half-day sessions. Most students self-select into the elective following a class-wide advertisement. The elective also accepts students who are referred for remediation of their clinical skills. In the elective's first two years, 25 students participated and 47 students were waitlisted. We compared participant and waitlisted (non-participant) students' self-efficacy in several clinical and professional domains during their first clerkship. Elective participants reported significantly higher clerkship preparedness compared to non-participants in the areas of physical exam, oral presentation, and formulation of assessments and plans. Students found the one-on-one feedback and personalized attention from attending physicians to be a particularly useful aspect of the course. This frequently cited benefit points to students' perceived needs and the value they place on individualized feedback. Our innovation harnesses an untapped resource - the hospital medicine 'non-teaching' service - and serves as an attainable option for schools interested in enhancing early clinical skill-building for all students, including those recommended for remediation. A&P: Assessment and plan; H&P: History and

  12. Death is not always a failure: outcomes from implementing an online virtual patient clinical case in palliative care for family medicine clerkship

    Directory of Open Access Journals (Sweden)

    Amy Tan

    2013-11-01

    Full Text Available Background: The dying patient is a reality of medicine. Medical students, however, feel unprepared to effectively manage the complex end-of-life (EOL management issues of the dying patient and want increased experiential learning in Palliative Care. Aims: To address the need for more formal curriculum in EOL care, we developed and implemented an online virtual patient (VP clinical case in Palliative Care into the 2010–2011 Year Three Family Medicine Clerkship rotation curriculum. Methods: A mixed-method design was used to measure the change in knowledge and perceived preparedness level in EOL care before and after completing the online VP case. A survey collected qualitative descriptions of the students’ educational experience of using this case. Results: Ninety five percent (130/137 of the students voluntarily consented to have their results analyzed. The group knowledge score (n=127 increased significantly from a pre-course average of 7.69/16±2.27, to a post-course average of 10.02/16±2.39 (p<0.001. The students’ self-assessed comfort level increased significantly with all aspects of EOL management from pre-course to post-course (p<0.001. Nearly, 91.1% of the students rated the VP realism as ‘Good to Excellent’, 86% rated the case as educationally beneficial. Nearly 59.3% of students felt emotionally engaged with the VP. Qualitative feedback found that the case content was very useful and realistic, but that the interface was sometimes awkward to navigate. Conclusions: The online VP case in Palliative Care is a useful teaching tool that may help to address the need for increased formal Palliative Care experience in medical school training programs.

  13. Factors associated with performance in an internal medicine clerkship

    Science.gov (United States)

    McNeal, Tresa; Lezama, Maybelline; Chandler, Martha; Forrester, Lisa; Metting, Austin; Mirkes, Curtis; Van Cleave, Holly; Win, Sonny; Myers, John D.

    2017-01-01

    The purpose of this retrospective study was to examine the relationship between demographic and educational variables and student performance on an internal medicine (IM) clerkship in order to target areas for educational intervention and potential early remediation. This study examined data associated with third-year medical student performance (N = 505) during the IM clerkship at Baylor Scott & White, Temple/Texas A&M Health Science Center College of Medicine from 2005 to 2011. Multiple regression analysis (N = 341) showed that a model containing the following variables was significantly associated with scores on the National Board of Medical Examiners (NBME) subject exam, accounting for 46.5% of the variance: Objective Structured Clinical Exam (OSCE), Medical College Admissions Test (MCAT), US Medical Licensing Exam (USMLE) Step 1, second-year grade point average (GPA), and clinical evaluation. A model containing USMLE Step 1, clinical evaluation, and NBME was significantly associated with OSCE score, accounting for 30% of the variance. Additionally, a model containing age, MCAT score, undergraduate GPA, NBME subject exam score, and OSCE was significantly associated with clinical evaluation score, accounting for 22% of score variance. Age accounted for the most unique variance in clinical evaluation score. Gender and IM interest group were not significantly associated with any outcome variable. In conclusion, in contrast to previous studies in the field, we did not find a significant association between undergraduate GPA and NBME score. Our findings supply further evidence that the OSCE, typically believed to be a clinical performance exam, actually assesses a broader set of domains. Interest group membership did not confer any academic benefit to medical students in IM clerkships in our study. PMID:28127127

  14. Factors associated with performance in an internal medicine clerkship.

    Science.gov (United States)

    Colbert, Colleen; McNeal, Tresa; Lezama, Maybelline; Chandler, Martha; Forrester, Lisa; Metting, Austin; Mirkes, Curtis; Van Cleave, Holly; Win, Sonny; Myers, John D

    2017-01-01

    The purpose of this retrospective study was to examine the relationship between demographic and educational variables and student performance on an internal medicine (IM) clerkship in order to target areas for educational intervention and potential early remediation. This study examined data associated with third-year medical student performance (N = 505) during the IM clerkship at Baylor Scott & White, Temple/Texas A&M Health Science Center College of Medicine from 2005 to 2011. Multiple regression analysis (N = 341) showed that a model containing the following variables was significantly associated with scores on the National Board of Medical Examiners (NBME) subject exam, accounting for 46.5% of the variance: Objective Structured Clinical Exam (OSCE), Medical College Admissions Test (MCAT), US Medical Licensing Exam (USMLE) Step 1, second-year grade point average (GPA), and clinical evaluation. A model containing USMLE Step 1, clinical evaluation, and NBME was significantly associated with OSCE score, accounting for 30% of the variance. Additionally, a model containing age, MCAT score, undergraduate GPA, NBME subject exam score, and OSCE was significantly associated with clinical evaluation score, accounting for 22% of score variance. Age accounted for the most unique variance in clinical evaluation score. Gender and IM interest group were not significantly associated with any outcome variable. In conclusion, in contrast to previous studies in the field, we did not find a significant association between undergraduate GPA and NBME score. Our findings supply further evidence that the OSCE, typically believed to be a clinical performance exam, actually assesses a broader set of domains. Interest group membership did not confer any academic benefit to medical students in IM clerkships in our study.

  15. A new emergency medicine clerkship program: students' perceptions of what works.

    Science.gov (United States)

    Yeung, Marianne; Beecker, Jennifer; Marks, Meridith; Nuth, Janet; Weitzman, Brian; Lee, A Curtis; Frank, Jason R

    2010-05-01

    Emergency medicine is an evolving discipline in Canadian medical schools. Little has been published regarding student preferences for emergency medicine training during the clerkship phase of MD programs. We assessed medical students' perceptions of a newly developed emergency medicine clerkship rotation involving multiple learning modalities. The evaluation process included assessment of the rotation's instructional elements and overall educational value. The first cohort of medical students to complete this new emergency medicine clerkship was invited to answer a questionnaire just before graduation. Students rated their preferences for components of the rotation using paired comparisons. Open ended questions explored students' satisfaction with the emergency medicine clerkship as well as perceptions of the rotation's impact on career development. Of the 94 students in the first clerkship cohort, 81 (86%) responded to the survey. Students found the emergency medicine clerkship highly valuable, citing the broad range of cases seen, close supervision, and opportunities to develop clinical assessment, decision making and procedural skills. Students' curricular preferences were for advanced cardiac life support (ACLS) (26.4%), clinical shifts (20.6%), supervised clinical shifts (17.8%), procedural skills laboratories (14.8%), tutorials (10.8%) and preceptor assisted learning sessions (9.8%). This new emergency medicine clerkship program incorporated multiple learning methods within a 4-week rotation and was highly rated by students. Although clinical shifts and ACLS were generally preferred activities, students had varying individual preferences for specific learning activities. Multiple learning methods allowed all students to benefit from the rotation. This study makes a compelling case for including an emergency medicine rotation with multiple learning modalities as a core element of clerkship at every medical school.

  16. Simulation in Medical Student Education: Survey of Clerkship Directors in Emergency Medicine

    OpenAIRE

    Heitz, Corey; Eyck, Raymond Ten; Smith, Michael; Fitch, Michael

    2011-01-01

    Introduction The objective of this study is to identify (1) the current role of simulation in medical student emergency medicine (EM) education; (2) the challenges to initiating and sustaining simulation-based programs; and (3) educational advances to meet these challenges. Methods We solicited members of the Clerkship Directors in Emergency Medicine (CDEM) e-mail list to complete a Web-based survey addressing the use of simulation in both EM clerkships and preclinical EM curricula. Survey el...

  17. Simulation in Medical Student Education: Survey of the Clerkship Directors in Emergency Medicine

    OpenAIRE

    Michael Fitch; Michael Smith; Raymond Ten Eyck; Corey Heitz

    2011-01-01

    Introduction: The objective of this study is to identify (1) the current role of simulation in medical student emergency medicine (EM) education; (2) the challenges to initiating and sustaining simulationbased programs; and (3) educational advances to meet these challenges. Methods: We solicited members of the Clerkship Directors in Emergency Medicine (CDEM) e-mail list to complete a Web-based survey addressing the use of simulation in both EM clerkships and preclinical EM curricula. Survey ...

  18. Development of emotional intelligence in a team-based learning internal medicine clerkship.

    Science.gov (United States)

    Borges, Nicole J; Kirkham, Karen; Deardorff, Adam S; Moore, Jeremy A

    2012-01-01

    Although increasing number of articles have been published on team-based learning (TBL), none has explored team emotional intelligence. We extend the literature by examining changes in team emotional intelligence during a third year clerkship where TBL is a primary instructional strategy. We hypothesized that team emotional intelligence will change in a positive direction (i.e., increase) during the clerkship. With IRB approval, during the 2009-2010 academic year third-year students in their internal medicine clerkship (N = 105, 100% response rate) completed the Workgroup Emotional Intelligence Profile - Short Version (WEIP-S) at the beginning and at the end of their 12-week clerkship. TBL is an instructional strategy utilized during the internal medicine clerkship. Paired t-tests showed that team emotional intelligence increased significantly pre to post clerkship for three of the four areas: awareness of own emotions (p = 0.018), recognizing emotions in others (p = 0.031), and ability to manage other's emotions (p = 0.013). There was no change for ability to control own emotions (p = 0.570). In an internal medicine clerkship, where TBL is utilized as an instructional strategy, team emotional intelligence increases. This supports TBL as an adjunctive tool to traditional medical education pedagogy.

  19. Structured Communication: Teaching Delivery of Difficult News with Simulated Resuscitations in an Emergency Medicine Clerkship

    Directory of Open Access Journals (Sweden)

    Lamba, Sangeeta

    2015-03-01

    Full Text Available Introduction: The objective is to describe the implementation and outcomes of a structured communication module used to supplement case-based simulated resuscitation training in an emergency medicine (EM clerkship. Methods: We supplemented two case-based simulated resuscitation scenarios (cardiac arrest and blunt trauma with role-play in order to teach medical students how to deliver news of death and poor prognosis to family of the critically ill or injured simulated patient. Quantitative outcomes were assessed with pre and post-clerkship surveys. Secondarily, students completed a written self-reflection (things that went well and why; things that did not go well and why to further explore learner experiences with communication around resuscitation. Qualitative analysis identified themes from written self-reflections. Results: A total of 120 medical students completed the pre and post-clerkship surveys. Majority of respondents reported that they had witnessed or role-played the delivery of difficult news, but only few had real-life experience of delivering news of death (20/120, 17% and poor prognosis (34/120, 29%. This communication module led to statistically significant increased scores for comfort, confidence, and knowledge with communicating difficult news of death and poor prognosis. Pre-post scores increased for those agreeing with statements (somewhat/very much for delivery of news of poor prognosis: comfort 69% to 81%, confidence 66% to 81% and knowledge 76% to 90% as well as for statements regarding delivery of news of death: comfort 52% to 68%, confidence 57% to 76% and knowledge 76% to 90%. Respondents report that patient resuscitations (simulated and/or real generated a variety of strong emotional responses such as anxiety, stress, grief and feelings of loss and failure. Conclusion: A structured communication module supplements simulated resuscitation training in an EM clerkship and leads to a self-reported increase in knowledge

  20. Simulation in Medical Student Education: Survey of the Clerkship Directors in Emergency Medicine

    Directory of Open Access Journals (Sweden)

    Michael Fitch

    2011-05-01

    Full Text Available Introduction: The objective of this study is to identify (1 the current role of simulation in medical student emergency medicine (EM education; (2 the challenges to initiating and sustaining simulationbased programs; and (3 educational advances to meet these challenges. Methods: We solicited members of the Clerkship Directors in Emergency Medicine (CDEM e-mail list to complete a Web-based survey addressing the use of simulation in both EM clerkships and preclinical EM curricula. Survey elements addressed the nature of the undergraduate EM clerkship and utilization of simulation, types of technology, and barriers to increased use in each setting. Results: CDEM members representing 60 EM programs on the list (80% responded. Sixty-seven percent of EM clerkships are in the fourth year of medical school only and 45% are required. Fewer than 25% of clerkship core curriculum hours incorporate simulation. The simulation modalities used most frequently were high-fidelity models (79%, task trainers (55%, and low-fidelity models (30%. Respondents identified limited faculty time (88.7% and clerkship hours (47.2% as the main barriers to implementing simulation training in EM clerkships. Financial resources, faculty time, and the volume of students were the main barriers to additional simulation in preclinical years. Conclusion: A focused, stepwise application of simulation to medical student EM curricula can help optimize the ratio of student benefit to faculty time. Limited time in the curriculum can be addressed by replacing existing material with simulation-based modules for those subjects better suited to simulation. Faculty can use hybrid approaches in the preclinical years to combine simulation with classroom settings for either small or large groups to more actively engage learners while minimizing identified barriers.

  1. Teaching medicine of the person to medical students during the beginning of their clerkships.

    NARCIS (Netherlands)

    Verhoeven, Anita; Dekker, Hanke

    2014-01-01

    This article describes how medicine of the person is taught to 4th year medical students in Groningen, The Netherlands, as part of the teaching programme ‘Professional Development’. In that year, the students start with their clerkships. In this transitional phase from medical student to young

  2. Teaching medicine of the person to medical students during the beginning of their clerkships.

    NARCIS (Netherlands)

    Verhoeven, Anita; Dekker, Hanke

    2014-01-01

    This article describes how medicine of the person is taught to 4th year medical students in Groningen, The Netherlands, as part of the teaching programme ‘Professional Development’. In that year, the students start with their clerkships. In this transitional phase from medical student to young docto

  3. A simulator-based curriculum to promote comparative and reflective analysis in an internal medicine clerkship.

    Science.gov (United States)

    McMahon, Graham T; Monaghan, Colleen; Falchuk, Kenneth; Gordon, James A; Alexander, Erik K

    2005-01-01

    To develop and evaluate a novel curricular framework using high-fidelity patient simulation in an internal medicine clerkship. Two 90-minute simulator-based modules of ischemic heart failure and hypoxemic respiratory failure were developed from adult and experiential learning principles. Three short simulated cases focused on each pathophysiologic concept were intermixed with two short teaching sessions and a period of comparative analysis. In 2002-03, the program was piloted among 90 third-year medical students at Harvard Medical School assigned to complete their core internal medicine clerk-ship. An entry and two follow-up questionnaires were used to assess the process. The instructors conducted quantitative and qualitative data analysis and directly observed students' performances. Instructors consistently noted students' ability to appropriately extract a history, perform a basic examination, and order appropriate tests. However, students demonstrated repeated errors in the application of knowledge to the clinical circumstance. A final comparative discussion was essential to new learning and students recognized this integrative analysis as the most critical component of the exercise. Every student reported the experience as useful. Ninety-four percent (n = 85) felt the simulator should become a routine part of the clerkship and 68% (n = 71) desired three or more sessions during their internal medicine clerkship. Simulator-based curricular modules are feasible in an internal medicine clerkship and can successfully complement existing curricula. By comparing similar cases in a compressed time frame, students may achieve enhanced efficiencies in reflective and meta-cognitive learning. As medical simulation is increasingly available, such a curriculum may represent valuable additions to the internal medicine educational environment.

  4. Re-demonstration without remediation – a missed opportunity? A national survey of internal medicine clerkship directors

    Directory of Open Access Journals (Sweden)

    Mary R. Hawthorne

    2014-12-01

    Full Text Available Background: Many different components factor into the final grade assigned for the internal medicine clerkship. Failure of one or more of these requires consideration of remedial measures. Purpose: To determine which assessment components are used to assign students a passing grade for the clerkship and what remediation measures are required when students do not pass a component. Methods: A national cross-sectional survey of Clerkship Directors in Internal Medicine (CDIM institutional members was conducted in April 2011. The survey included sections on remediation, grading practices, and demographics. The authors analyzed responses using descriptive and comparative statistics. Results: Response rate was 73% (86/113. Medicine clerkships required students to pass the following components: clinical evaluations 83 (97%, NBME subject exam 76 (88%, written assignments 40 (46%, OSCE 35 (41%, in-house written exam 23 (27%, and mini-CEX 19 (22%. When students failed a component of the clerkship for the first time, 55 schools (64% simply allowed students to make up the component, while only 16 (18% allowed a simple make-up for a second failure. Additional ward time was required by 24 schools (28% for a first-time failure of one component of the clerkship and by 49 (57% for a second failure. The presence or absence of true remedial measures in a school was not associated with clerkship director academic rank, grading scheme, or percent of students who failed the clerkship in the previous year. Conclusions: Most schools required passing clinical evaluations and NBME subject exam components to pass the medicine clerkship, but there was variability in other requirements. Most schools allowed students to simply re-take the component for a first-time failure. This study raises the question of whether true remediation is being undertaken before students are asked to re-demonstrate competence in a failed area of the clerkship to be ready for the subinternship

  5. Medical student self-assessment narratives: perceived educational needs during fourth-year emergency medicine clerkship.

    Science.gov (United States)

    Bernard, Aaron W; Balodis, Amanda; Kman, Nicholas E; Caterino, Jeffrey M; Khandelwal, Sorabh

    2013-01-01

    The educational needs of medical students in the 4th-year of training are not well defined in the literature. The specific aim of this investigation is to characterize the perceived educational needs of 4th-year medical students during an Emergency Medicine clerkship. This was a thematic analysis of informed self-assessment narratives. The writings were performed by medical students during an Emergency Medicine clerkship from July 2010 through May 2011. Themes and subthemes that emerged were assessed for frequency of occurrence. Qualitative analysis of 203 narratives revealed 13 themes and 55 subthemes. Patient care (50%), history taking (44%), and physical examination (29%) were the themes most commonly noted as strengths. Medical decision making/plan of care (44%), differential diagnosis (37%), presentation skills (32%), and knowledge base (27%) were the themes most commonly noted as weaknesses. All themes were described as strengths by some students and weaknesses by others; however, trends were apparent in the analysis. Fourth-year medical students rotating on an Emergency Medicine clerkship perceive an educational need to improve medical decision making/plan of care. Self-assessment narratives reveal trends in strengths and weaknesses but also highlight the importance of recognizing students as unique learners with individualized needs.

  6. Final year medical students’ understanding of family medicine

    Directory of Open Access Journals (Sweden)

    Marija Petek Šter

    2013-05-01

    Full Text Available Objective. The European Academy of Teachers in General Practice / Family Medicine (EURACT has developed an educational agenda, the key document for teaching family medicine in Europe. The aim of our study was to find out how final year medical students at the beginning of their family medicine clerkship understand the discipline of family medicine. Methods. The attitudes toward family medicine were paraphrased and developed into a 164-item questionnaire, which was administered to 335 final-year medical students at the beginning of their clerkship. Using combinatorial optimization with genetic algorithms we selected 30 items which yielded the highest Cronbach alpha reliability coefficient. Finally, we performed a factor analysis to find which dimensions of family medicine were recognised by the students and compared them with the domains defined in the EURACT definition. Results. The 30-item questionnaire had a Cronbach alpha reliability coefficient of 0.919. The differences between male and female students were not very significant (p=0.061. With the factor analysis we recognised seven factors, belonging to three out of six domains of the EURACT educational agenda: primary care management, personcenteredness and comprehensive approach. Conclusion. Final-year medical students at the beginning of their family medicine clerkship understand some of the dimensions of family medicine rather well, but they are not aware of some important competences of family doctors. There is a necessity to teach students about specific problem solving skills and the importance of balance between the health needs of an individual patient and the community.

  7. Does the Concept of the “Flipped Classroom” Extend to the Emergency Medicine Clinical Clerkship?

    Science.gov (United States)

    Heitz, Corey; Prusakowski, Melanie; Willis, George; Franck, Christopher

    2015-01-01

    Introduction Linking educational objectives and clinical learning during clerkships can be difficult. Clinical shifts during emergency medicine (EM) clerkships provide a wide variety of experiences, some of which may not be relevant to recommended educational objectives. Students can be directed to standardize their clinical experiences, and this improves performance on examinations. We hypothesized that applying a “flipped classroom” model to the clinical clerkship would improve performance on multiple-choice testing when compared to standard learning. Methods Students at two institutions were randomized to complete two of four selected EM clerkship topics in a “flipped fashion,” and two others in a standard fashion. For flipped topics, students were directed to complete chief complaint-based asynchronous modules prior to a shift, during which they were directed to focus on the chief complaint. For the other two topics, modules were to be performed at the students’ discretion, and shifts would not have a theme. At the end of the four-week clerkship, a 40-question multiple-choice examination was administered with 10 questions per topic. We compared performance on flipped topics with those performed in standard fashion. Students were surveyed on perceived effectiveness, ability to follow the protocol, and willingness of preceptors to allow a chief-complaint focus. Results Sixty-nine students participated; examination scores for 56 were available for analysis. For the primary outcome, no difference was seen between the flipped method and standard (p=0.494.) A mixed model approach showed no effect of flipped status, protocol adherence, or site of rotation on the primary outcome of exam scores. Students rated the concept of the flipped clerkship highly (3.48/5). Almost one third (31.1%) of students stated that they were unable to adhere to the protocol. Conclusion Preparation for a clinical shift with pre-assigned, web-based learning modules followed by an

  8. Does the Concept of the “Flipped Classroom” Extend to the Emergency Medicine Clinical Clerkship?

    Directory of Open Access Journals (Sweden)

    Corey Heitz

    2015-10-01

    Full Text Available Introduction: Linking educational objectives and clinical learning during clerkships can be difficult. Clinical shifts during emergency medicine (EM clerkships provide a wide variety of experiences, some of which may not be relevant to recommended educational objectives. Students can be directed to standardize their clinical experiences, and this improves performance on examinations. We hypothesized that applying a “flipped classroom” model to the clinical clerkship would improve performance on multiple-choice testing when compared to standard learning. Methods: Students at two institutions were randomized to complete two of four selected EM clerkship topics in a “flipped fashion,” and two others in a standard fashion. For flipped topics, students were directed to complete chief complaint-based asynchronous modules prior to a shift, during which they were directed to focus on the chief complaint. For the other two topics, modules were to be performed at the students’ discretion, and shifts would not have a theme. At the end of the four-week clerkship, a 40-question multiple-choice examination was administered with 10 questions per topic. We compared performance on flipped topics with those performed in standard fashion. Students were surveyed on perceived effectiveness, ability to follow the protocol, and willingness of preceptors to allow a chief-complaint focus. Results: Sixty-nine students participated; examination scores for 56 were available for analysis. For the primary outcome, no difference was seen between the flipped method and standard (p=0.494. A mixed model approach showed no effect of flipped status, protocol adherence, or site of rotation on the primary outcome of exam scores. Students rated the concept of the flipped clerkship highly (3.48/5. Almost one third (31.1% of students stated that they were unable to adhere to the protocol. Conclusion: Preparation for a clinical shift with pre-assigned, web-based learning

  9. Overnight Hospital Experiences for Medical Students: Results of the 2014 Clerkship Directors in Internal Medicine National Survey.

    Science.gov (United States)

    Goren, Eric N; Leizman, Debra S; La Rochelle, Jeffrey; Kogan, Jennifer R

    2015-09-01

    Since the 2011 Accreditation Council of Graduate Medical Education (ACGME) work hour rules for residents were implemented, 24-30 h call for interns has been replaced by shift work, including night-float. The impact of these changes on undergraduate medical education experiences in internal medicine has not been described. We aimed to determine the current status of medical students' overnight experiences in Internal Medicine clerkships and sub-internships, and to assess internal medicine educators' perceptions of the importance of overnight work during internal medicine rotations. In May 2014, the Clerkship Directors in Internal Medicine (CDIM) conducted its annual survey. Twenty-eight questions about student participation in overnight work and perceptions of the importance of overnight work (rated on 1-5 Likert scale, 1 = very unimportant and 5 =  ery important) were included. Descriptive statistics were used to summarize responses. Free text results were analyzed qualitatively. The response rate was 78 %. A minority of respondents reported students having any overnight experience during the clerkship (38.7 %) or the sub-internship (40.7 %). Only 5 % of respondents reported having students assigned to night-float rotations outside of clerkships or sub-internships. Respondents agreed that overnight experiences were more important during the sub-internship than the clerkship, 4.0 ± 1.1 vs. 3.2 ± 1.2, p rated as important overnight tasks for both clerkship and sub-internship students. Overnight experiences offer students additional educational opportunities. Clerkship directors felt that the overnight experience for the sub-intern in particular was an important chance to practice providing emergency cross coverage and other intern roles. In the era of ACGME duty hours, there is a need to further examine whether there is a role for increased overnight hospital experiences for medical students.

  10. CERA: Clerkships Need National Curricula on Care Delivery, Awareness of Their NCC Gaps.

    Science.gov (United States)

    Cochella, Susan; Liaw, Winston; Binienda, Juliann; Hustedde, Carol

    2016-06-01

    The Society of Teachers of Family Medicine's (STFM) National Clerkship Curriculum (NCC) was created to standardize and improve teaching of a minimum core curriculum in family medicine clerkships, promoting the Triple Aim of better care and population health at lower cost. It includes competencies all clerkships should teach and tools to support clerkship directors (CDs). This 2014 CERA survey of clerkship directors is one of several needs assessments that guide STFM's NCC Editorial Board in targeting improvements and peer-review processes. CERA's 2014 survey of CDs was sent to all 137 CDs at US and Canadian allopathic medical schools. Primary aims included: (1) Identify curricular topics of greatest need, (2) Inventory the percent of family medicine clerkships teaching each NCC topic, and (3) Determine if longitudinal or blended clerkship have unique needs. This survey also assessed use of NCC to advocate for teaching resources and collaborate with colleagues at other institutions. Ninety-one percent of CDs completed the survey. Sixty-four percent reported their clerkship covers all of the NCC minimum core, but on detailed analysis, only 1% teach all topics. CDs need curricula on care delivery topics (cost-effective approach to acute care, role of family medicine in the health care system, quality/safety, and comorbid substance abuse). Single-question assessments overestimate the percentage of clerkships teaching all of the NCC minimum core. Clerkships need national curricula on care delivery topics and tools to help them find their curricular gaps.

  11. Core competencies for emergency medicine clerkships: results of a Canadian consensus initiative.

    Science.gov (United States)

    Penciner, Rick; Woods, Robert A; McEwen, Jill; Lee, Richard; Langhan, Trevor; Bandiera, Glen

    2013-01-01

    There is no consensus on what constitutes the core competencies for emergency medicine (EM) clerkship rotations in Canada. Existing EM curricula have been developed through informal consensus and often focus on EM content to be known at the end of training rather than what is an appropriate focus for a time-limited rotation in EM. We sought to define the core competencies for EM clerkship in Canada through consensus among an expert panel of Canadian EM educators. We used a modified Delphi method and the CanMEDS 2005 Physician Competency Framework to develop a consensus among expert EM educators from across Canada. Thirty experts from nine different medical schools across Canada participated on the panel. The initial list consisted of 152 competencies organized in the seven domains of the CanMEDS 2005 Physician Competency Framework. After the second round of the Delphi process, the list of competencies was reduced to 62 (59% reduction). A complete list of competencies is provided. This study established a national consensus defining the core competencies for EM clerkship in Canada.

  12. Effectiveness of emergency medicine in longitudinal integrated clerkships

    OpenAIRE

    Banh, Kenny; Ramirez, Rene; Thabit, Christina

    2014-01-01

    Objective: This study investigated third-year students’ experience with the emergency medicine (EM) component in integrated longitudinal programs. The study aimed to see if EM could be integrated into third-year integrated longitudinal programs while addressing accreditation standards and increasing interest in EM.Methods: The authors surveyed students who participated in an integrated longitudinal program at University of California San Francisco School of Medicine (UCSF) from 2010 to 2012. ...

  13. Learning while evaluating: the use of an electronic evaluation portfolio in a geriatric medicine clerkship

    Directory of Open Access Journals (Sweden)

    Tabatabai Diana

    2006-01-01

    Full Text Available Abstract Background Electronic evaluation portfolios may play a role in learning and evaluation in clinical settings and may complement other traditional evaluation methods (bedside evaluations, written exams and tutor-led evaluations. Methods 133 third-year medical students used the McGill Electronic Evaluation Portfolio (MEEP during their one-month clerkship rotation in Geriatric Medicine between September 2002 and September 2003. Students were divided into two groups, one who received an introductory hands-on session about the electronic evaluation portfolio and one who did not. Students' marks in their portfolios were compared between both groups. Additionally, students self-evaluated their performance and received feedback using the electronic portfolio during their mandatory clerkship rotation. Students were surveyed immediately after the rotation and at the end of the clerkship year. Tutors' opinions about this method were surveyed once. Finally, the number of evaluations/month was quantified. In all surveys, Likert scales were used and were analyzed using Chi-square tests and t-tests to assess significant differences in the responses from surveyed subjects. Results The introductory session had a significant effect on students' portfolio marks as well as on their comfort using the system. Both tutors and students reported positive notions about the method. Remarkably, an average (± SD of 520 (± 70 evaluations/month was recorded with 30 (± 5 evaluations per student/month. Conclusion The MEEP showed a significant and positive effect on both students' self-evaluations and tutors' evaluations involving an important amount of self-reflection and feedback which may complement the more traditional evaluation methods.

  14. Long-term educational impact of a simulator curriculum on medical student education in an internal medicine clerkship.

    Science.gov (United States)

    Brim, Nancy M; Venkatan, Suresh K; Gordon, James A; Alexander, Erik K

    2010-04-01

    Medical simulation is frequently used in postgraduate medical training, but its value and sustainability in medical student education are less clear. We report the first long-term experience of mannequin simulation in an internal medicine clerkship. During a 6-year period (2002-2009), 327 Harvard medical students participated in a simulator-based teaching experience designed to expose students to the principles of myocardial infarction (MI). This experience was additive to a 12-week clerkship curriculum. Through blinded survey instruments, we sought to determine how the simulator exercise modified student exposure to a core curricular objective in the traditional clerkship. We also sought student and faculty perception of this educational tool and factors important to sustainability. Three hundred twenty-seven consecutive students were exposed to the simulation exercise and their experiences evaluated. Three hundred twenty-six students (99%) described the simulation experience as valuable, with >69% requesting multiple sessions be provided during each clerkship. Although a core objective, only 78% of students reported having a didactic teaching session on MI during the clerkship, and only 47% of students reported exposure to a live patient with MI. Furthermore, only 15% of students reported exposure to at least two different clinical presentations of MI, allowing comparison and reflection. Thus, the simulation exercise provided the only exposure to this topic for 22% of students and facilitated comparisons of different clinical presentations for 85% of students. When students participated in both the simulator and the didactic sessions, 74% favored the simulation exercise. Faculty cited small group size, once monthly delivery and focused curricula as key points for sustainability of this effort. Mannequin simulation is a valuable and sustainable addition to a third-year internal medicine clerkship. For some students, simulation provides otherwise unavailable

  15. Competency-Based Medical Education in the Internal Medicine Clerkship: A Report From the Alliance for Academic Internal Medicine Undergraduate Medical Education Task Force.

    Science.gov (United States)

    Fazio, Sara B; Ledford, Cynthia H; Aronowitz, Paul B; Chheda, Shobhina G; Choe, John H; Call, Stephanie A; Gitlin, Scott D; Muntz, Marty; Nixon, L James; Pereira, Anne G; Ragsdale, John W; Stewart, Emily A; Hauer, Karen E

    2017-09-14

    As medical educators continue to redefine learning and assessment across the continuum, implementation of competency-based medical education in the undergraduate setting has become a focus of many medical schools. While standards of competency have been defined for the graduating student, there is no uniform approach for defining competency expectations for students during their core clerkship year. The authors describe the process by which an Alliance for Academic Internal Medicine task force developed a paradigm for competency-based assessment of students during their inpatient internal medicine (IM) clerkship. Building on work at the resident and fellowship levels, the task force focused on the development of key learning outcomes as defined by entrustable professional activities (EPAs) that were specific to educational experiences on the IM clerkship, as well as identification of high-priority assessment domains. The work was informed by a national survey of clerkship directors.Six key EPAs emerged: generating a differential diagnosis, obtaining a complete and accurate history and physical exam, obtaining focused histories and clinically relevant physical exams, preparing an oral presentation, interpreting the results of basic diagnostic studies, and providing well-organized clinical documentation. A model for assessment was proposed, with descriptors aligned to the scale of supervision and mapped to Accreditation Council for Graduate Medical Education domains of competence. The proposed paradigm offers a standardized template that may be used across IM clerkships, and which would effectively bridge competency evaluation in the clerkship to fourth-year assessment as well as eventual postgraduate training.Written work prepared by employees of the Federal Government as part of their official duties is, under the U.S. Copyright Act, a "work of the United States Government" for which copyright protection under Title 17 of the United States Code is not available. As

  16. Development and validation of a questionnaire for evaluation of students' attitudes towards family medicine.

    Science.gov (United States)

    Šter, Marija Petek; Švab, Igor; Klemenc-Ketiš, Zalika; Kersnik, Janko

    2015-03-01

    The development of the EURACT (European Academy of Teachers in General Practice) Educational Agenda helped many family medicine departments in development of clerkship and the aims and objectives of family medicine teaching. Our aims were to develop and validate a tool for assessment of students' attitudes towards family medicine and to evaluate the impact of the clerkship on students' attitudes regarding the competences of family doctor. In the pilot study, experienced family doctors were asked to describe their attitudes towards family medicine by using the Educational Agenda as a template for brainstorming. The statements were paraphrased and developed into a 164-items questionnaire, which was administered to 176 final-year students in academic year 2007/08. The third phase consisted of development of a final tool using statistical analysis, which resulted in the 60-items questionnaire in six domains which was used for the evaluation of students' attitudes. At the beginning of the clerkship, person-centred care and holistic approach scored lower than the other competences. Students' attitudes regarding the competences at the end of 7 weeks clerkship in family medicine were more positive, with exception of the competence regarding primary care management. The students who named family medicine as his or her future career choice, found holistic approach as more important than the students who did not name it as their future career. With the decision tree, which included students' attitudes to the competences of family medicine, we can successfully predict the future career choice in family medicine in 93.5% of the students. This study reports on the first attempt to develop a valid and reliable tool for measuring attitudes towards family medicine based on EURACT Educational Agenda. The questionnaire could be used for evaluating changes of students' attitudes in undergraduate curricula and for prediction of students' preferences regarding their future professional

  17. Beyond diagnoses: family medicine core themes in student reflective writing.

    Science.gov (United States)

    Bradner, Melissa K; Crossman, Steven H; Gary, Judy; Vanderbilt, Allison A; VanderWielen, Lynn

    2015-03-01

    We share qualitative study results of third-year medical student writings during their family medicine clerkship utilizing a reflective writing exercise from 2005 and 2013. For this paper, 50 student writings were randomly selected from the 2005 cohort in addition to 50 student writings completed by the 2013 cohort. Deductive thematic analysis utilizing Atlas.ti software was completed utilizing the Future of Family Medicine core attributes of family physicians as the a priori coding template. Student writings actively reflect key attributes of family physicians as described by the Future of Family Medicine Report: a deep understanding of the dynamics of the whole person, a generative impact on patients' lives, a talent for humanizing the health care experience, and a natural command of complexity and multidimensional access to care. We discuss how to lead the writing exercise and provide suggestions for facilitating the discussion to bring out these important aspects of family medicine care.

  18. Correlation of the National Emergency Medicine M4 Clerkship Examination with USMLE Examination Performance

    Directory of Open Access Journals (Sweden)

    Luan E. Lawson

    2015-12-01

    Full Text Available Introduction: Assessment of medical students’ knowledge in clinical settings is complex yet essential to the learning process. Clinical clerkships use various types of written examinations to objectively test medical knowledge within a given discipline. Within emergency medicine (EM, a new national standardized exam was developed to test medical knowledge in this specialty. Evaluation of the psychometric properties of a new examination is an important issue to address during test development and use. Studies have shown that student performance on selected standardized exams will reveal students’ strengths and/or weaknesses, so that effective remedial efforts can be implemented. Our study sought to address these issues by examining the association of scores on the new EM national exam with other standardized exam scores. Methods: From August 2011 to April 2013, average National EM M4 examination scores of fourthyear medical students taken at the end of a required EM clerkship were compiled. We examined the correlation of the National EM M4 examination with the scores of initial attempts of the United States Medical Licensing Exam (USMLE Step 1 and Step 2 Clinical Knowledge (CK examinations. Correlation coefficients and 95% confidence intervals of correlation coefficients are reported. We also examined the association between the national EM M4 examination score, final grades for the EM rotation, and USMLE Step 1 and Step 2 CK scores. Results: 133 students were included in the study and achieved a mean score of 79.5 SD 8.0 on the National EM M4 exam compared to a national mean of 79.7 SD 3.89. The mean USMLE Step 1 score was 226.8 SD 19.3. The mean USMLE Step 2 CK score was 238.5 SD 18.9. National EM M4 examination scores showed moderate correlation with both USMLE Step 1 (mean score=226.8; correlation coefficient=0.50; 95% CI [0.28-0.67] and USMLE Step 2 CK (mean score=238.5; correlation coefficient=0.47; 95% CI [0.25-0.65]. Students scoring

  19. Design and implementation of a longitudinal ambulatory clerkship in the first-year curriculum at the Johns Hopkins School of Medicine

    Directory of Open Access Journals (Sweden)

    Rosalyn Stewart

    2011-05-01

    Full Text Available In response to calls for medical education reform we designed and implemented a new Longitudinal Ambulatory Clerkship (LAC at the Johns Hopkins University School of Medicine. The LAC provides first-year medical students with their initial exposure to clinical medicine during a 12-month experience consisting of weekly clinic sessions with a practicing physician-mentor (preceptor and longitudinal experience with a population of patients. The LAC allows students to experience firsthand many of the personal, professional, and organizational issues that impact the practice of medicine. This paper reviews the rationale, development, and challenges during implementation of this clerkship.

  20. Referral for competency committee review for poor performance on the internal medicine clerkship is associated with poor performance in internship.

    Science.gov (United States)

    Hemann, Brian A; Durning, Steven J; Kelly, William F; Dong, Ting; Pangaro, Louis N; Hemmer, Paul A

    2015-04-01

    To determine how students who are referred to a competency committee for concern over performance, and ultimately judged not to require remediation, perform during internship. Uniformed Services University of the Health Sciences' students who graduated between 2007 and 2011 were included in this study. We compared the performance during internship of three groups: students who were referred to the internal medicine competency committee for review who met passing criterion, students who were reviewed by the internal medicine competency committee who were determined not to have passed the clerkship and were prescribed remediation, and students who were never reviewed by this competency committee. Program Director survey results and United States Medical Licensing Examination (USMLE) Step 3 examination results were used as the outcomes of interest. The overall survey response rate for this 5-year cohort was 81% (689/853). 102 students were referred to this competency committee for review. 63/102 students were reviewed by this competency committee, given passing grades in the internal medicine clerkship, and were not required to do additional remediation. 39/102 students were given less than passing grades by this competency committee and required to perform additional clinical work in the department of medicine to remediate their performance. 751 students were never presented to this competency committee. Compared to students who were never presented for review, the group of reviewed students who did not require remediation was 5.6 times more likely to receive low internship survey ratings in the realm of professionalism, 8.6 times more likely to receive low ratings in the domain of medical expertise, and had a higher rate of USMLE Step 3 failure (9.4% vs. 2.8%). When comparing the reviewed group to students who were reviewed and also required remediation, the only significant difference between groups regarding professionalism ratings with 50% of the group requiring

  1. Development and assessment of a pediatric emergency medicine simulation and skills rotation: meeting the demands of a large pediatric clerkship

    Directory of Open Access Journals (Sweden)

    Elaine K. Fielder

    2015-11-01

    Full Text Available Objective: To implement a curriculum using simulation and skills training to augment a Pediatric Emergency Medicine (PEM rotation within a pediatric clerkship. Background: PEM faculty are often challenged with a high learner to teacher ratio in a chaotic clinical setting. This challenge was heightened when our pediatric clerkship's traditional 1-week PEM rotation (consisting of 4 students completing four 8-hour ED shifts/week expanded to 8 students every 2 weeks. We sought to meet this challenge by integrating simulation-based education into the rotation. Methods: Clerkship students from March to June 2012 completed our traditional rotation. Students between July and October 2012 completed the new PEM-SIM curriculum with 19 hours ED shifts/week and 16 hours/week of simulation/skills training. Pre/post-tests evaluated 1 medical management/procedural comfort (five-point Likert scale; and 2 PEM knowledge (15 multiple-choice questions. Results: One hundred and nine students completed the study (48 traditional, 61 PEM-SIM. Improvement in comfort was significantly higher for the PEM-SIM group than the traditional group for 6 of 8 (75% medical management items (p<0.05 and 3 of 7 (43% procedures, including fracture splinting, lumbar puncture, and abscess incision/drainage (p<0.05. PEM-SIM students had significantly more improvement in mean knowledge compared to the traditional group (p<0.001. Conclusions: We have successfully integrated 16 hours/week of faculty-facilitated simulation-based education into a PEM rotation within our clerkship. This curriculum is beneficial in clinical settings with high learner to teacher ratios and when patient care experiences alone are insufficient for all students to meet rotation objectives.

  2. Faculty Evaluations Correlate Poorly with Medical Student Examination Performance in a Fourth-Year Emergency Medicine Clerkship.

    Science.gov (United States)

    Dubosh, Nicole M; Fisher, Jonathan; Lewis, Jason; Ullman, Edward A

    2017-06-01

    Clerkship directors routinely evaluate medical students using multiple modalities, including faculty assessment of clinical performance and written examinations. Both forms of evaluation often play a prominent role in final clerkship grade. The degree to which these modalities correlate in an emergency medicine (EM) clerkship is unclear. We sought to correlate faculty clinical evaluations with medical student performance on a written, standardized EM examination of medical knowledge. This is a retrospective study of fourth-year medical students in a 4-week EM elective at one academic medical center. EM faculty performed end of shift evaluations of students via a blinded online system using a 5-point Likert scale for 8 domains: data acquisition, data interpretation, medical knowledge base, professionalism, patient care and communication, initiative/reliability/dependability, procedural skills, and overall evaluation. All students completed the National EM M4 Examination in EM. Means, medians, and standard deviations for end of shift evaluation scores were calculated, and correlations with examination scores were assessed using a Spearman's rank correlation coefficient. Thirty-nine medical students with 224 discrete faculty evaluations were included. The median number of evaluations completed per student was 6. The mean score (±SD) on the examination was 78.6% ± 6.1%. The examination score correlated poorly with faculty evaluations across all 8 domains (ρ 0.074-0.316). Faculty evaluations of medical students across multiple domains of competency correlate poorly with written examination performance during an EM clerkship. Educators need to consider the limitations of examination score in assessing students' ability to provide quality patient clinical care. Copyright © 2016 Elsevier Inc. All rights reserved.

  3. Family Medicine Curriculum Resource Project: the future.

    Science.gov (United States)

    Stearns, Jeffrey A; Stearns, Marjorie A; Paulman, Paul M; Chessman, Alexander W; Davis, Ardis K; Sherwood, Roger A; Sheets, Kent J; Steele, David J; Matson, Christine C

    2007-01-01

    Under contract to the Health Resources and Services Administration (HRSA), the Society of Teachers of Family Medicine (STFM) created an undergraduate medical education curricular resource designed to train physicians to practice in the 21st century. An interdisciplinary group of more than 35 educators worked for 4 years to create the Family Medicine Curriculum Resource (FMCR). By consensus, the Accreditation Council for Graduate Medical Education (ACGME) competencies were adopted as the theoretical framework for this project. The FMCR provides materials for the preclerkship years, the third-year family medicine clerkship, the postclerkship year, and faculty development, as well as guidance for integrating topics of special interest to the federal government (such as, geriatrics, Healthy People 2010, genetics, informatics) into a 4-year continuum of medical education. There are challenges inherent in implementing each component of the FMCR. For example, can the ACGME competency-based approach be adapted to undergraduate medical education? Can the densely packed preclerkship years be adapted to include more focused effort on developing these competencies, and whose job is it anyway? What is "core" to being a competent clinician, and what information can be obtained when needed from medical informatics sources? Will family medicine educators embrace the FMCR recommendations for their third-year clerkships? Will exit assessment of the competency levels of graduating medical students be achieved, and can it make them more capable residents? Can faculty in different clinical and educational settings integrate the teaching of "how to learn" into their repertoire? How will faculty development innovation progress in a time of increasing emphasis on clinical productivity? Developing a common language and adoption of core competencies for all levels of medical education is imperative in a society that is focusing on improving health care quality and outcomes. The FMCR Project

  4. Problem based learning (PBL) vs. Case based curriculum in clinical clerkship, Internal Medicine innovated Curriculum, Student prospective.

    Science.gov (United States)

    Aljarallah, Badr; Hassan, Mohammad Saleh

    2015-04-01

    The vast majority of PBL experience is in basic science courses. Application of classic Problem based learning in clerkship phase is challenging. Although the clinical case is considered a problem, yet solving this problem following the burrow's law has faced hurdles. The difficulties are facing the learner, the teacher and curricula. We implement innovative curriculum for the clerkship year in internal medicine course. We surveyed the student just before coming to an internal medicine course to ask them about continuing PBL or other types of learning in clinical years. A committee was created to study the possible ways to integrate PBL in the course. After multiple brainstorming meeting, an innovated curriculum was implemented. Student surveyed again after they completed their course. The survey is asking them about what is the effect of the implemented curriculum in their skills, attitude, and knowledge. 70% of Students, who finished their basic science in PBL, preferred not to have classical PBL, but more a clinical oriented case based curriculum in the clinical years. After this innovated curriculum, 50-60 % of students who completed it showed a positive response in all aspects of effects including skill, attitude, and knowledge. The Innovated curriculum includes daily morning report, 3 bedside teaching, investigation session, and clinical reasoning weekly, and Lectures up to twice a week. We suggest implementing a curriculum with PBL and case-based criteria in clinical phase are feasible, we are providing a framework with this innovated curriculum.

  5. Abstracts From the Proceedings of the 2015 Annual Meeting of the Clerkship Directors of Internal Medicine (CDIM).

    Science.gov (United States)

    Nixon, L James; Ryder, Hilary F; Alexandraki, Irene; Lyons, Maureen D; McEwen, Kelsey Angell; DeWaay, Deborah J; Warrier, Sarita; Lang, Valerie J; LaRochelle, Jeffrey

    2016-01-01

    Since its inception in 1989, Clerkship Directors in Internal Medicine (CDIM) has promoted excellence in medical student education. CDIM members move medical education forward by sharing innovations in curriculum and assessment and discoveries related to educating our students and administering our programs. The Alliance for Academic Internal Medicine, of which CDIM is a founding member, broadens the umbrella beyond student education to include five academically focused specialty organizations representing departments of medicine, teaching hospitals, and medical schools working together to advance learning, discovery, and caring. CDIM held its 2015 annual meeting at Academic Internal Medicine Week in Atlanta, Georgia. This year 36 innovation and research submissions were selected for either oral abstract or poster presentation. The quality of the presentations was outstanding this year and included many of the most important issues in medical education. The CDIM research committee selected the following seven abstracts as being of the highest quality, the most generalizable, and relevant to the readership of Teaching and Learning in Medicine. Two abstracts include information from the CDIM annual survey, which remains a rich source for answering questions about student education on a national level. Looking at trends in medical education, three of the seven selected abstracts mention entrustable professional activities. Three of the abstracts address how we assess student skill and provide them with appropriate feedback. These include two schools' approach to bringing milestones into the medical student realm, use of objective structured clinical exam for assessing clinical skill in clerkship, and what students want in terms of feedback. Four articles deal with curricular innovation. These include interprofessional education, high-value care, transitions of care, and internship preparation. We are pleased to share these abstracts, which represent the breadth and

  6. Shared Canadian Curriculum in Family Medicine (SHARC-FM)

    Science.gov (United States)

    Keegan, David A.; Scott, Ian; Sylvester, Michael; Tan, Amy; Horrey, Kathleen; Weston, W. Wayne

    2017-01-01

    Abstract Problem addressed In 2006, leaders of undergraduate family medicine education programs faced a series of increasing curriculum mandates in the context of limited time and financial resources. Additionally, it became apparent that a hidden curriculum against family medicine as a career choice was active in medical schools. Objective of program The Shared Canadian Curriculum in Family Medicine was developed by the Canadian Undergraduate Family Medicine Education Directors and supported by the College of Family Physicians of Canada as a national collaborative project to support medical student training in family medicine clerkship. Its key objective is to enable education leaders to meet their educational mandates, while at the same time countering the hidden curriculum and providing a route to scholarship. Program description The Shared Canadian Curriculum in Family Medicine is an open-access, shared, national curriculum (www.sharcfm.ca). It contains 23 core clinical topics (determined through a modified Delphi process) with demonstrable objectives for each. It also includes low- and medium-fidelity virtual patient cases, point-of-care learning resources (clinical cards), and assessment tools, all aligned with the core topics. French translation of the resources is ongoing. Conclusion The core topics, objectives, and educational resources have been adopted by medical schools across Canada, according to their needs. The lessons learned from mounting this multi-institutional collaborative project will help others develop their own collaborative curricula. PMID:28404720

  7. Construct Validity of Three Clerkship Performance Assessments

    Science.gov (United States)

    Lee, Ming; Wimmers, Paul F.

    2010-01-01

    This study examined construct validity of three commonly used clerkship performance assessments: preceptors' evaluations, OSCE-type clinical performance measures, and the NBME [National Board of Medical Examiners] medicine subject examination. Six hundred and eighty-six students taking the inpatient medicine clerkship from 2003 to 2007…

  8. Impact of a Revised Curriculum Focusing on Clinical Neurology and Musculoskeletal Care on a Required Fourth-Year Medical Student Physical Medicine and Rehabilitation Clerkship

    Directory of Open Access Journals (Sweden)

    John W. Norbury

    2016-01-01

    Full Text Available Background. A Required Fourth-Year Medical Student Physical Medicine and Rehabilitation (PM&R Clerkship was found to increase students’ knowledge of PM&R; however the students’ overall rotation evaluations were consistently lower than the other 8 required clerkships at the medical school. Objective. To describe the impact of a revised curriculum based upon Entrustable Professional Activities and focusing on basic pain management, musculoskeletal care, and neurology. Setting. Academic Medical Center. Participants. 73 fourth-year medical students. Methods. The curriculum changes included a shift in the required readings from rehabilitation specific topics toward more general content in the areas of clinical neurology and musculoskeletal care. Hands-on workshops on neurological and musculoskeletal physical examination techniques, small group case-based learning, an anatomy clinical correlation lecture, and a lecture on pain management were integrated into the curriculum. Main Outcome Measurements. Student evaluations of the clerkship. Results. Statistically significant improvements were found in the students’ evaluations of usefulness of lecturers, development of patient interviewing skills, and diagnostic and patient management skills (p≤0.05. Conclusions. This study suggests that students have a greater satisfaction with a required PM&R clerkship when lecturers utilize a variety of pedagogic methods to teach basic pain, neurology and musculoskeletal care skills in the rehabilitation setting rather than rehabilitation specific content.

  9. Family medicine in Cuba

    Directory of Open Access Journals (Sweden)

    Eduardo Alemañy Pérez

    2013-04-01

    Full Text Available Over the past 50 years, the Cuban health system has been developing a roster of programs to ensure its social mission: to achieve a health status of the population consistent with the priority established by the highest authorities of the country. In response to the call of the Commander in Chief, Fidel Castro Ruz, to create a different doctor and a new specialist that would take into account the needs of the Cuban population; the family doctor model was implemented. Thus, in the decade of the eighties, the “Family Doctor and Nurse Working Program” was established, together with the corresponding polyclinic and hospital. At the same time, comprehensive general medicine as a medical specialty was created to serve the primary health care services. Both actions constituted a vital component in the development of Cuban public health services in recent decades. This article presents an account of the unique characteristics of these processes, while highlighting their impact on health indicators, as well as the participation of this specialty in the training of human resources for the health system.

  10. Family Medicine's Waltz with Systems

    Science.gov (United States)

    Downing, Raymond

    2012-01-01

    Family Medicine first formally confronted systems thinking with the adoption of the biopsychosocial model for understanding disease in a holistic manner; this is a description of a natural system. More recently, Family Medicine has been consciously engaged in developing itself as a system for delivering health care, an artificial system. We make…

  11. Family Medicine's Waltz with Systems

    Science.gov (United States)

    Downing, Raymond

    2012-01-01

    Family Medicine first formally confronted systems thinking with the adoption of the biopsychosocial model for understanding disease in a holistic manner; this is a description of a natural system. More recently, Family Medicine has been consciously engaged in developing itself as a system for delivering health care, an artificial system. We make…

  12. Enhancing primary care clerkships with virtual patients.

    Science.gov (United States)

    Sobocan, Monika; Klemenc-Ketis, Zalika

    2016-11-01

    Virtual patients, computer-assisted patient scenarios, have been used in different medical disciplines over several years. Researchers have already gained knowledge on how it helps foster clinical thinking, fills knowledge gaps and enables patient management. Nonetheless, despite these advances in knowledge, the use of virtual patients in Family Medicine education remains limited. We point out the current knowledge, benefits and potential ways of using virtual patients in the Family Medicine setting. Virtual patients can be used as a preparation tool for clinical clerkships as well as learning about patient treatment not usually encountered in every day practice. Regardless of the means of implementation, students benefit from acquiring skills through multifaceted virtual patients. We firmly believe that, when intelligently applied, virtual patients can enhance and improve future Family Medicine education.

  13. [Teaching family medicine in Lausanne].

    Science.gov (United States)

    Bischoff, Thomas; Junod, Michel; Cornuz, Jacques; Herzig, Lilli; Bonvin, Raphael

    2010-12-01

    The Faculty of Biology and Medicine of Lausanne has integrated education of family medicine all along its new undergraduate medical curriculum. The Institute of general medicine is in charge to implement those offers among which two are presented hereafter. In the new module "Generalism" several courses cover the specificities of the discipline as for example medical decision in the practice. A mandatory one-month internship in the medical practice offers an experiential immersion into family medicine for all students. In a meeting at the end of their internship, students discuss in group with their peers their individual experiences and are asked to identify, based on their personal experience, the general concepts of the specialty of family medicine and general practice.

  14. Do we pay our community preceptors? Results from a CERA clerkship directors' survey.

    Science.gov (United States)

    Anthony, David; Jerpbak, Christine M; Margo, Katherine L; Power, David V; Slatt, Lisa M; Tarn, Derjung M

    2014-03-01

    Family medicine clerkships depend heavily on community-based family physician preceptors to teach medical students. These preceptors have traditionally been unpaid, but in recent years some clerkships have started to pay preceptors. This study determines trends in the number and geographic region of programs that pay their community preceptors, identifies reasons programs pay or do not pay, and investigates perceived advantages and disadvantages of payment. We conducted a cross-sectional, electronic survey of 134 family medicine clerkship directors at allopathic US medical schools. The response rate was 62% (83/132 clerkship directors). Nineteen of these (23%) currently pay community preceptors, 11 of whom are located in either New England or the South Atlantic region. Sixty-three percent of programs who pay report that their community preceptors are also paid for teaching other learners, compared to 32% of those programs who do not pay. Paying respondents displayed more positive attitudes toward paying community preceptors, though a majority of non-paying respondents indicated they would pay if they had the financial resources. The majority of clerkships do not pay their community preceptors to teach medical students, but competition from other learners may drive more medical schools to consider payment to help with preceptor recruitment and retention. Medical schools located in regions where there is competition for community preceptors from other medical and non-medical schools may need to consider paying preceptors as part of recruitment and retention efforts.

  15. Teaching evidence based medicine in family medicine

    Directory of Open Access Journals (Sweden)

    Davorka Vrdoljak

    2012-05-01

    Full Text Available The concept of evidence based medicine (EBM as the integrationof clinical expertise, patient values and the best evidence was introduced by David Sackett in the 1980’s. Scientific literature in medicine is often marked by expansion, acummulation and quick expiration. Reading all important articles to keep in touch with relevant information is impossible. Finding the best evidence that answers a clinical question in general practice (GP in a short time is not easy. Five useful steps are described –represented by the acronym “5A+E”: assess, ask, acquire, appraise, apply and evaluate.The habit of conducting an evidence search “on the spot’’ is proposed. Although students of medicine at University of Split School of Medicine are taught EBM from the first day of their study and in all courses, their experience of evidence-searching and critical appraisal of the evidence, in real time with real patient is inadequate. Teaching the final-year students the practical use of EBM in a GP’s office is different and can have an important role in their professional development. It can positively impact on quality of their future work in family practice (or some other medical specialty by acquiring this habit of constant evidence-checking to ensure that best practice becomes a mechanism for life-long learning. Conclusion. EBM is a foundation stone of every branch of medicine and important part of Family Medicine as scientific and professional discipline. To have an EB answer resulting from GP’s everyday work is becoming a part of everyday practice.

  16. The Family Medicine Curriculum Resource Project: implications for faculty development.

    Science.gov (United States)

    Sheets, Kent J; Quirk, Mark E; Davis, Ardis K

    2007-01-01

    Faculty development implications related to implementing the Family Medicine Curriculum Resource (FMCR) Project provide an opportunity to look at the recommendations of the Society of Teachers of Family Medicine's federally funded Faculty Futures Initiative (FFI) and the recent Future of Family Medicine (FFM) project. Implications for faculty development include the importance of the clerkship setting, originally defined in 1991, with new features added in today's practice environment as outlined by the FFM and the changing assumptions in approaching faculty development. Previously, faculty development focused on teaching learners to master current knowledge. Now, faculty must teach learners how to master new competencies throughout their lives; learners need to learn how they and others learn now. Teaching must focus on how to learn in the future as well as what to learn for the present. Competence ("what individuals know or are able to do in terms of knowledge, skills, and attitudes") has become the focus of curriculum development efforts over the last few years and most appropriately serves as the focus of curriculum development in the FMCR Project. Implications for developing teachers and preceptors focus on the skills and circumstances required to teach and evaluate all types (cognitive, metacognitive, and affective) of competence. In the new culture, novel teaching methods will serve as the focus of faculty development in teaching and of educational ("best practices") research.

  17. Rotación de residentes de medicina familiar en Unidad de Investigación Epidemiológica y en Servicios de Salud (experiencia de cinco años Clerkship of family medicine residents in a Unit of Epidemiological Research (five years experience

    Directory of Open Access Journals (Sweden)

    E. Villarreal-Ríos

    2008-06-01

    Full Text Available Introducción. Se presenta la experiencia de cinco años del Programa de Rotación del Residente de Medicina Familiar en la Unidad de Investigación. Materiales y métodos. El programa fue diseñado por los investigadores de la Unidad de Investigación Epidemiológica y en Servicios de Salud Querétaro, México, y los profesores de la Residencia de Medicina Familiar de la Unidad de Medicina Familiar n.º 16. Durante el segundo año de residencia, se estableció la rotación por la unidad de investigación con una duración de dos meses, en la que se incluyó el desarrollo de un proyecto de investigación operativa. El programa de trabajo incluyó los contenidos teóricos de metodología de investigación cursados durante el primer año de residencia. La difusión se realizó al personal directivo en forma oral y por escrito, con la elaboración de la síntesis ejecutiva y del artículo científico. Resultados. Después de cinco años y cuatro meses, han asistido 40 médicos residentes. Se han desarrollado 39 protocolos de investigación, 23 seminarios, 39 síntesis ejecutivas, dos artículos publicados, un libro con 16 capítulos y otro en prensa. Las presentaciones en congresos incluyeron 34 delegacionales, 16 regionales y 7 nacionales. Conclusión. A cinco años de implementado el Programa de Rotación de Residente de Medicina Familiar en Unidad de Investigación, se puede afirmar que es productivo. Los resultados a corto y medio plazo así lo demuestran.Introduction. The proposal is to present five years experience of Family Medicine Student in the Research Unit. Materials and methods. Program was designed by Researchers of Epidemiological and Health Services Unit of Querétaro, México and Professors of Family Medicine Residence No 16. Rotation was specified for the second year of the Residence, duration was defined in two months, included theoretical and practical aspect, an operative research project was a requirement. The program

  18. Family Medicine: Bridge to Life.

    Science.gov (United States)

    Luz, Clare

    2016-01-01

    Reflecting on the suicide of a close friend, this essay explores what comprises, and inspires a will to live, and how those in Family Medicine can address suicide risk even in the face of debilitating or terminal illness. Research indicates that the will to live is a measurable indicator of general well-being, distinct from depression, and an important predictor of a person's motivation to "hold on to life". As such, understanding what is at the heart of a desire to live should alter clinical practice. This essay offers ideas for ways in which to create bridges for patients that could help sustain life.

  19. Family medicine 360°: Global exchanges in family medicine

    Science.gov (United States)

    Barata, Ana N.; Rigon, Sara

    2015-01-01

    Objective: The global world of the 21st century has created communities and cultures that are interconnected, thanks to the development both in the field of transportation and technology. In this global intercultural community, future physicians, and even more so future general practitioners (GPs)/family physicians (FPs), need to be clinically competent and culturally sensitive and flexible in order to adapt to different social settings while delivering holistic care in multiethnic teams and environments with professionalism. As such, exchange programs are exceptional opportunities for international collaboration and the development of personal and professional competencies of these health care professionals. Materials and Methods: This article presents a review of the literature on the value of exchanges as well as the results of exchange programs with educational content that are aimed at junior GPs/FPs. Results: Exchange programs have been growing in popularity, especially among junior GPs/FPs. Since its launch in 2013, The “Family Medicine 360° (FM360°) program has been receiving up to 163 inquires till date, promoting global cooperation among the World Organization of family Doctors (WONCA)'s Young Doctors’ Movementd (YDMs). Conclusions: By participating in an exchange program, future GPs/FPs are given the chance to experience intercultural communication and peer collaboration. They also develop personal and professional skills and thus, actively contribute to the growth and development of primary care all over the world. PMID:26288763

  20. Clerkship in primary care: a cross-sectional study about expectations and experiences of undergraduates in medicine.

    Science.gov (United States)

    Fuchs, Stephan; Klement, Andreas; Lichte, Thomas; Abendroth, Jens

    2014-01-01

    With the amendment of the medical licensure act (Approbationsordnung) in 2012, a four-week clerkship in primary care (FHV) became mandatory. We investigated the expectations with which students begin the FHV, which criteria are relevant in selecting the location for the FHV, and the experiences the students had during the FHV. In a cross-sectional study, all third-year students at both medical schools in Saxony-Anhalt were surveyed in 2013 about their expectations and experiences regarding the FHV. This is the last cohort for which the FHV is optional. Questions were asked about 29 items addressing six topics (personal information, selection of FHV location, selection of FHV medical practice, expectations, experiences, and specialty selection). Out of a student body of 446, responses were received from N=424 (response rate 95.1%; of which 61.8% female). Of these students, 71 (16.7%) had completed the FHV and 70 (16.5%) were planning to; another 267 students (63%) had not (yet) planned to participate in an FHV. Where a student's parents lived, personal recommendations of a particular medical practice and the attractiveness of the region were the most important criteria for selecting the clerkship site. After completing the FHV, the learning objectives reflected themselves in the experiences of the students in a similar order and significance as in the expectations of students who planned or had not (as of yet) planned to complete the FHV. A relevant influence of the FHV confirming the choice to specialize in general practice or outpatient care was not indicated by those who had completed the FHV. After location and practice, the FHV is selected according to personal criteria and in connection with prioritized learning objectives. From the students' perspective, the most frequently named learning objectives are also identified as acquired experience after completing the FHV. However, the FHV does not have a reinforcing effect on the selection of general practice as a

  1. Assessing clinical reasoning skills in scenarios of uncertainty: convergent validity for a Script Concordance Test in an emergency medicine clerkship and residency.

    Science.gov (United States)

    Humbert, Aloysius J; Besinger, Bart; Miech, Edward J

    2011-06-01

    The Script Concordance Test (SCT) is a new method of assessing clinical reasoning in the face of uncertainty. An SCT item consists of a short clinical vignette followed by an additional piece of information and asks how this new information affects the learner's decision regarding a possible diagnosis, investigational study, or therapy. Scoring is based on the item responses of a panel of experts in the field. This study attempts to provide additional validity evidence in the realm of emergency medicine (EM). This observational study examined the performance of medical students, EM residents, and expert emergency physicians (EPs) on an SCT in the area of general EM (SCT-EM) at one of the largest medical schools in the United States. The 59-item SCT-EM was developed for a fourth-year required clerkship in EM. The results on the SCT-EM were compared between different levels of clinical experience. Results were also compared to performance on other measures to evaluate convergent validity. The SCT-EM was given to 314 fourth-year medical students (MS4), 40 EM residents, and 13 EPs during the study period. Mean differences between the three different groups of test takers was statistically significant (p reasoning skills in the face of uncertainty. Future research will compare performance on the SCT to other measures of clinical reasoning abilities. © 2011 by the Society for Academic Emergency Medicine.

  2. Open book tests: assessment of academic learning in clerkships.

    Science.gov (United States)

    Broyles, India L; Cyr, Peggy R; Korsen, Neil

    2005-08-01

    An examination of an open-book testing approach in a family medicine clerkship seeks to determine whether this method more closely mirrors the discipline of family medicine, where practitioners refer daily to written resource materials in order to make clinical decisions without compromising the learning and assessment process. Student scores on the multiple-choice test were analysed by year, by quarter and by site using ANOVA. Students in the experimental site were interviewed to determine preparation style, use of text during test, as well as attitudes toward open-book testing. Analysis of variance showed that the interaction of site and year was significant at p = 0.03. The mean score of 88.2 for Maine students in 2002 was significantly different from the other three mean scores. The desired qualitative outcomes of the intervention were confirmed: reducing the anxiety of students, wider reading of the textbook, knowing the structure of the textbook as a learning resource, and deeper understanding of concepts and principles rather than time spent on memorization. While the difference in scores did reach statistical significance, it is important to note that the difference in mean score was only four points on a 100-point scale. Given the percentage of the total grade represented by the test score, it is unlikely that this difference represents any real difference in grade for students in Maine compared with Vermont. The students appeared to approach the textbook and therefore, perhaps, the body of knowledge as a whole with the orientation of a generalist. The MMC Clerkship Director recommended the implementation of the open-book approach to the Family Practice clerkship at all sites and the University of Vermont Medical School accepted the proposal. This recommendation supports advising students on the preparation for an open-book test and on tactics for the best use of the textbook during the test.

  3. Narratives in family medicine: a global perspective

    Science.gov (United States)

    Gibson, Christine; Woollard, Robert; Kapoor, Videsh; Ponka, David

    2017-01-01

    Abstract Objective To explore the development of family medicine postgraduate training in countries with varying levels of resources at different stages of development of the discipline. Composition of the committee Since 2012, the College of Family Physicians of Canada has hosted the Besrour Conferences to reflect on its role in advancing the discipline of family medicine globally. The Besrour Narrative Working Group was conceived in 2012 at the first Besrour Conference. Their mandate was to use narrative and appreciative inquiry to gather stories of family medicine worldwide. The working group comprised members of various academic departments of family medicine in Canada and abroad who attended the conferences. Methods A consultation process with our partners from lower-middle–income countries was undertaken from 2012 to 2014. Stories were sought from each global partner institute with ties to Canadian family medicine departments. An appreciative inquiry approach was chosen to elicit narratives. Thematic analysis was used to search for common threads and important elements of success that could serve to inform other initiatives in other nations and, in turn, offer hope for greater effect. Report Sixteen narrative stories have been collected so far. These stories highlight insightful solutions, foresight, perseverance, and ultimately a steadfast belief that family medicine will improve the health system and the care provided to the citizens of each nation. Seventeen themes were elucidated by 3 independent Canadian readers. At a subsequent workshop, these themes were validated by Besrour Centre members from Canada and elsewhere. The linkage between the thematic analysis and the experiences of various schools helps to illustrate both the robustness and the usefulness of the narratives in exploring generalizable observations and the features supporting success in each institute. Conclusion If we are to understand, and contribute to, the development of family

  4. Does student performance on preclinical OSCEs relate to clerkship grades?

    Directory of Open Access Journals (Sweden)

    Margot Chima

    2016-06-01

    Full Text Available Background: Objective structured clinical examinations (OSCEs have been used to assess the clinical competence and interpersonal skills of healthcare professional students for decades. However, the relationship between preclinical (second year or M2 OSCE grades and clerkship performance had never been evaluated, until it was explored to provide information to educators at the University of Nebraska Medical Center (UNMC. In addition, the relationship between M2 OSCE communication scores (which is a portion of the total score and third-year (M3 Internal Medicine (IM clerkship OSCE scores was also explored. Lastly, conflicting evidence exists about the relationship between the amount of previous clinical experience and OSCE performance. Therefore, the relationship between M3 IM clerkship OSCE scores and the timing of the clerkship in the academic year was explored. Methods: Data from UNMC M2 OSCEs and M3 IM clerkship OSCEs were obtained for graduates of the 2013 and 2014 classes. Specifically, the following data points were collected: M2 fall OSCE total, M2 fall OSCE communication; M2 spring OSCE total, M2 spring OSCE communication; and M3 IM clerkship OSCE total percentages. Data were organized by class, M3 IM clerkship OSCE performance, and timing of the clerkship. Microsoft Excel and SPSS were used for data organization and analysis. Results: Of the 245 records, 229 (93.5% had data points for all metrics of interest. Significant differences between the classes of 2013 and 2014 existed for average M2 spring total, M2 spring communication, and M3 IM clerkship OSCEs. Retrospectively, there were no differences in M2 OSCE performances based on how students scored on the M3 IM clerkship OSCE. M3 IM clerkship OSCE performance improved for those students who completed the clerkship last in the academic year. Conclusions: There were inconsistencies in OSCE performances between the classes of 2013 and 2014, but more information is needed to determine if

  5. Generation to Generation: The Heart of Family Medicine

    Science.gov (United States)

    Winter, Robin O.

    2012-01-01

    According to the American Board of Family Medicine, "The scope of family medicine encompasses all ages, both sexes, each organ system and every disease entity." What makes the seemingly daunting task of practicing family medicine possible is that family physicians learn to utilize similar clinical reasoning for all of their patients regardless of…

  6. [Core values in family medicine revisited].

    Science.gov (United States)

    Álvarez Montero, Santiago

    2017-04-01

    Family medicine has to continually reinvent itself around a core of values that constitutes its navigation system. But accurate data on its impact on the health of people will account for how far the values are actually being implemented. Thus, we can say that family medicine is a specialty based on values and as well as evidence based. The absence of a clarification system of values or its implementation threatens its very existence. Some of the values that are reviewed have shown great recognition and survival over time. Others are presented because they seem sufficiently significant. These are: people, comprehensiveness, trust relationship, patient-centred method, accessibility, continuity, family unity and the community, teamwork, sustainability of the health system, and continuous improvement. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

  7. Clinical Nuclear Pharmacy Clerkship

    Science.gov (United States)

    Dunson, George L.; Christopherson, William J., Jr.

    1977-01-01

    The School of Pharmacy, University of the Pacific, and the Pharmacy Service, Letterman Army Medical Center, initiated a 15-week clinical nuclear pharmacy clerkship in 1975. It includes basic nuclear medical science, technical competency, professional competency, and special interest emphasis. (LBH)

  8. Shared Canadian Curriculum in Family Medicine (SHARC-FM): Creating a national consensus on relevant and practical training for medical students.

    Science.gov (United States)

    Keegan, David A; Scott, Ian; Sylvester, Michael; Tan, Amy; Horrey, Kathleen; Weston, W Wayne

    2017-04-01

    In 2006, leaders of undergraduate family medicine education programs faced a series of increasing curriculum mandates in the context of limited time and financial resources. Additionally, it became apparent that a hidden curriculum against family medicine as a career choice was active in medical schools. The Shared Canadian Curriculum in Family Medicine was developed by the Canadian Undergraduate Family Medicine Education Directors and supported by the College of Family Physicians of Canada as a national collaborative project to support medical student training in family medicine clerkship. Its key objective is to enable education leaders to meet their educational mandates, while at the same time countering the hidden curriculum and providing a route to scholarship. The Shared Canadian Curriculum in Family Medicine is an open-access, shared, national curriculum (www.sharcfm.ca). It contains 23 core clinical topics (determined through a modified Delphi process) with demonstrable objectives for each. It also includes low- and medium-fidelity virtual patient cases, point-of-care learning resources (clinical cards), and assessment tools, all aligned with the core topics. French translation of the resources is ongoing. The core topics, objectives, and educational resources have been adopted by medical schools across Canada, according to their needs. The lessons learned from mounting this multi-institutional collaborative project will help others develop their own collaborative curricula. Copyright© the College of Family Physicians of Canada.

  9. A predoctoral curriculum in family medicine.

    Science.gov (United States)

    Leaman, T L

    1975-04-01

    Development of a new discipline, such as family medicine, requires careful definition of scope and purpose. This must be followed by delineation of specific education objectives. The teaching program is often carried out by people experienced as clinicans but not as teachers and requires selection of methods most natural to this kind of faculty. This article describes the current stage of curricular development at the institution with the longest experience in predoctoral family medicine in the United States. Based on seven years' experimentation, this paper provides an overview of the philosophy behind this particular curriculum and describes, in brief, four educational methods which have proven useful. These methods will be discussed in greater detail in subsequent articles focusing on specific educational objectives, illustrative examples, and evaluative methods.

  10. Training experts in family medicine teaching.

    Science.gov (United States)

    Švab, Igor; Allen, Justin; Žebiene, Egle; Petek Šter, Marija; Windak, Adam

    2016-01-01

    Family medicine teachers require specific educational skills. A framework for their professional development is essential for future development of the discipline in Europe. EURACT developed a framework on educational expertise, and subsequently applied it in a curriculum of teaching-skills courses of various levels. The aim of this article is to describe the development of the teaching framework, and of an international three-level course programme for 'teaching-the-teachers'. Furthermore, we describe our experiences and lessons learned, in particular with regard to the level-three programme for proficient teachers, which was new. We conclude that it is possible to develop a theoretical framework of family medicine teaching expertise and to apply it in an international high-level educational programme for future experts in family medicine education. Research evidence of the usefulness of this approach is needed, and the threats for its further development into a sustainable activity are its high teacher/student ratio associated with relatively high costs and difficulties in recruiting suitable participants.

  11. Length of training debate in family medicine: idealism versus realism?

    Science.gov (United States)

    Orientale, Eugene

    2013-06-01

    How long a resident must train to achieve competency is an ongoing debate in medicine. For family medicine, there is an Accreditation Council for Graduate Medical Education (ACGME)-approved proposal to examine the benefits of lengthening family medicine training from 3 to 4 years. The rationale for adding another year of residency in family medicine has included the following: (1) overcoming the effect of the duty hour limits in further reducing educational opportunities, (2) reversing the growing number of first-time takers of the American Board of Family Medicine primary board who fail to pass the exam, (3) enhancing the family medicine training experience by "decompressing" the ever-growing number of Residency Review Committee requirements to maintain accreditation, and (4) improving the overall quality of family medicine graduates.

  12. Health is primary: Family medicine for America's health.

    Science.gov (United States)

    Phillips, Robert L; Pugno, Perry A; Saultz, John W; Tuggy, Michael L; Borkan, Jeffrey M; Hoekzema, Grant S; DeVoe, Jennifer E; Weida, Jane A; Peterson, Lars E; Hughes, Lauren S; Kruse, Jerry E; Puffer, James C

    2014-10-01

    More than a decade ago the American Academy of Family Physicians, American Academy of Family Physicians Foundation, American Board of Family Medicine, Association of Departments of Family Medicine, Association of Family Practice Residency Directors, North American Primary Care Research Group, and Society of Teachers of Family Medicine came together in the Future of Family Medicine (FFM) to launch a series of strategic efforts to "renew the specialty to meet the needs of people and society," some of which bore important fruit. Family Medicine for America's Health was launched in 2013 to revisit the role of family medicine in view of these changes and to position family medicine with new strategic and communication plans to create better health, better health care, and lower cost for patients and communities (the Triple Aim). Family Medicine for America's Health was preceded and guided by the development of a family physician role definition. A consulting group facilitated systematic strategic plan development over 9 months that included key informant interviews, formal stakeholder surveys, future scenario testing, a retreat for family medicine organizations and stakeholder representatives to review strategy options, further strategy refinement, and finally a formal strategic plan with draft tactics and design for an implementation plan. A second communications consulting group surveyed diverse stakeholders in coordination with strategic planning to develop a communication plan. The American College of Osteopathic Family Physicians joined the effort, and students, residents, and young physicians were included. The core strategies identified include working to ensure broad access to sustained, primary care relationships; accountability for increasing primary care value in terms of cost and quality; a commitment to helping reduce health care disparities; moving to comprehensive payment and away from fee-for-service; transformation of training; technology to support

  13. Personality profile and coping resources of family medicine ...

    African Journals Online (AJOL)

    Personality profile and coping resources of family medicine vocational trainees ... to various stress factors in their personal and family lives, as well as in the workplace. ... coping resources optimally and reported poor help-seeking behaviour.

  14. How medical schools can encourage students' interest in family medicine.

    Science.gov (United States)

    Rohan-Minjares, Felisha; Alfero, Charles; Kaufman, Arthur

    2015-05-01

    The discipline of family medicine is essential to improving quality and reducing the cost of care in an effective health care system. Yet the slow growth of this field has not kept pace with national demand. In their study, Rodríguez and colleagues report on the influence of the social environment and academic discourses on medical students' identification with family medicine in four countries-the United Kingdom, Canada, France, and Spain. They conclude that these factors-the social environment and discursive activity within the medical school-influence students' specialty choices. While the discourses in Canada, France, and Spain were mostly negative, in the United Kingdom, family medicine was considered a prestigious academic discipline, well paying, and with a wide range of practice opportunities. Medical students in the United Kingdom also were exposed early and often to positive family medicine role models.In the United States, academic discourses about family medicine are more akin to those in Canada, France, and Spain. The hidden curriculum includes negative messages about family medicine, and "badmouthing" primary care occurs at many medical schools. National education initiatives highlight the importance of social determinants in medical education and the integration of public health and medicine in practice. Other initiatives expose students to family medicine role models and practice during their undergraduate training and promote primary care practice through new graduate medical education funding models. Together, these initiatives can reduce the negative effects of the social environment and create a more positive discourse about family medicine.

  15. [Family medicine in Mexico: Present and future].

    Science.gov (United States)

    Varela-Rueda, Carlos E; Reyes-Morales, Hortensia; Albavera-Hernández, Cidronio; Ochoa-Díaz-López, Héctor; Gómez-Dantés, Héctor; García-Peña, Carmen

    2016-01-01

    Analyzing the challenges and the future scenario of Family Medicine is a priority to address challenges such as the reduction of benefits granted by social security; to adapt their practice to the changing health profile; and to curb demand for specialized services and contain the high costs of care in the second and third level. The program is aimed at three professional roles: medical care, research, and education. It is imperative review these in the light of changing demographic conditions, the type of health needs arising from new social determinants, the public expectations for greater participation in their care, and the evolution of the health system itself with the advancement of technology and a variety of organizational options with frequently limited resources. For primary care, as the core of a health system that covers principles of equity, solidarity, universality, participation, decentralization, and intra- and inter-sectorial coordination, it is necessary to put at the center of the primary care team the family doctor and not an administrator, who plays an important role in supporting the care team, but can not take the lead.

  16. Hospitalist involvement in family medicine residency training: A CERA study.

    Science.gov (United States)

    Baldor, Robert; Savageau, Judith A; Shokar, Navkiran; Potts, Stacy; Gravel, Joseph; Eisenstock, Kimberly; Ledwith, James

    2014-02-01

    Little is known about the impact of hospitalists on family medicine residencies. We surveyed family medicine residency directors to assess attitudes about hospitalists and their involvement in residency teaching. Questions were included in the 2012 Council of Academic Family Medicine Educational Research Alliance (CERA) survey of family medicine residency directors. Univariate statistics were used to describe programs, directors, and our questions on the use of hospitalists. Bivariate statistics were used to examine relationships between the use of hospitalists to teach and program characteristics. Forty-one percent (n=175) of residency directors completed the hospitalist section of the CERA survey. Sixty-six percent of residency programs were community based/university affiliated. The majority of directors who have, or are planning to develop, a hospitalist service currently use an internal medicine service (92.5%), followed by family medicine (39.1%), pediatrics (35.4%), OB/laborists (18.0%), and combined services (8.7%). The majority of programs with a hospitalist training track (or plans to develop one) indicated that this was for a family medicine service. Sixty percent of programs that have a hospitalist service involve hospitalists in teaching. Twenty percent of directors reported that hospitalists serve as family medicine faculty, and 63% viewed them as "good educators." However, 85% reported no reduction in inpatient teaching by family medicine faculty despite using hospitalist teaching services. Hospitalists have a significant educational role in family medicine resident training. Further research is needed to explore how hospitalists and family medicine faculty can collaborate to promote enhanced efficiency and effectiveness as residency teachers.

  17. Pre-clerkship clinical skills and clinical reasoning course performance: Explaining the variance in clerkship performance : Pre-clerkship predictors of clerkship variance.

    Science.gov (United States)

    LaRochelle, Jeffrey S; Dong, Ting; Durning, Steven J

    2016-08-01

    Evidence suggests that pre-clerkship courses in clinical skills and clinical reasoning positively impact student performance on the clerkship. Given the increasing emphasis on reducing diagnostic reasoning errors, it is very important to develop this critical area of medical education. An integrated approach between clinical skills and clinical reasoning courses may better predict struggling learners, and better allocate scarce resources to remediate these learners before the clerkship. Pre-clerkship and clerkship outcome measures from 514 medical students graduating between 2009 and 2011were analyzed in a multiple linear regression model. Learners with poor performances on integrated pre-clerkship outcome measures had a relative risk of 6.96 and 5.85 for poor performance on National Board of Medical Examiners (NBME) subject exams and clerkship performance, respectively, and explained 22 % of the variance in clerkship NBME subject exam scores and 20.2 % of the variance in clerkship grades. Pre-clerkship outcome measures from clinical skills and clinical reasoning courses explained a significant amount of clerkship performance beyond baseline academic ability. These courses provide valuable information regarding student abilities, and may serve as an early indicator for students requiring remediation. Integrating pre-clerkship outcome measures may be an important aspect of ensuring the validity of this information as the pre-clerkship curriculum becomes compressed, and may serve as the basis for identifying students in need of clinical skills remediation.

  18. Family medicine around the world: overview by region

    Science.gov (United States)

    Arya, Neil; Gibson, Christine; Ponka, David; Haq, Cynthia; Hansel, Stephanie; Dahlman, Bruce; Rouleau, Katherine

    2017-01-01

    Abstract Objective To demonstrate how family medicine has been recognized and integrated into primary health care systems in contrasting contexts around the world and to provide an overview of how family physicians are trained and certified. Composition of the committee Since 2012, the College of Family Physicians of Canada has hosted the Besrour Conferences to reflect on its role in advancing the discipline of family medicine globally. The Besrour Papers Working Group, which was struck at the 2013 conference, was tasked with developing a series of papers to highlight the key issues, lessons learned, and outcomes emerging from the various activities of the Besrour collaboration. The working group comprised members of various academic departments of family medicine in Canada and abroad who attended the conferences. Methods An initial search was conducted in PubMed using a family medicine hedge of MeSH terms, text words, and family medicine journals, combined with text words and terms representing low- and middle-income countries and the concept of family medicine training programs. A second search was completed using only family medicine terms in the CAB Direct and World Bank databases. Subsequent PubMed searches were conducted to identify articles about specific conditions or services based on suggestions from the authors of the articles selected from the second search. Additional articles were identified through reference lists of key articles and through Google searches. We then attempted to verify and augment the information through colleagues and partners. Report The scope of family medicine and the nature of family medicine training vary considerably worldwide. Challenges include limited capacity, incomplete understanding of roles, and variability of standards and recognition. Opportunities for advancement might include technology, collaboration, changes in pedagogy, flexible training methods, and system-wide support. PMID:28615392

  19. Behavioral Medicine and University Departments of Family Practice

    OpenAIRE

    Grantham, Peter

    1983-01-01

    Behavioral medicine brings knowledge and skills from the social sciences to the practice of medicine. Modifying behavior which causes a health problem, disease prevention and health promotion, improving the relationship between patients and health professionals, understanding cultural and ethical issues, and the effect of illness on behavior are all aspects of behavioral medicine. Such `whole person' medicine fits well into family practice. However, careful consideration of the risks, challen...

  20. Perception of undergraduate pediatric surgery clerkship in a developing country.

    Science.gov (United States)

    Ekenze, Sebastian O; Obi, Uchechukwu M

    2014-01-01

    Medical students' perception of their clerkship may influence their choice of ultimate career. In most medical schools, pediatric surgery clerkship (PSC) is not compulsory. This study evaluates the perception of PSC by students and determines the importance of this on the choice of pediatric surgery as a career. We surveyed 2009 and 2010 graduating medical classes of University of Nigeria, Nsukka, using self-administered questionnaires. The clerkship evaluation was assessed using a 3-point scale (1 = poor and 3 = excellent). Students who had PSC were analyzed to compare their rating of pediatric surgery vis-à-vis other clinical clerkships and determine the effect of the clerkship on their ultimate choice of a career. Overall response rate was 70.3% (275/391), and 119 (43.3%) had PSC. For overall quality, PSC rated (2.16) compared with general surgery (2.04), internal medicine (2.11), obstetrics and gynecology (2.13), and pediatrics (2.37). Aspects of PSC that rated poorly include opportunity to participate in direct patient care, feedback on performance during clerkship, ability to manage problem in a general medical setting, and experience in learning history-taking skills and interpretation of laboratory data. Among the students who had PSC, 14 (11.8%) selected pediatric surgery as a specialty choice compared with 13 (8.3%) who did not have PSC (p = 0.457). Of those that had PSC, pediatric surgery was selected as a career by 2 of 19 (10.5%), 6 of 63 (9.5%), and 6 of 37 (16.2%) who rated PSC as poor, just right, and excellent, respectively. The decision to select pediatric surgery was influenced mostly by clerkship experience in 37% (10/27) and personal satisfaction in 40.7% (11/27). Improvement in the quality of PSC may involve more participation of the students in direct patient care (n = 54; 45.4%) and enhancement in student-faculty interaction (n = 31; 26.1%). PSC may have a good rating in our setting. Nonetheless, improving the quality and experience of the

  1. What Is the Relationship Between a Preclerkship Portfolio Review and Later Performance in Clerkships?

    Science.gov (United States)

    O'Brien, Celia Laird; Thomas, John X; Green, Marianne M

    2017-06-20

    Medical educators struggle to find effective ways to assess essential competencies such as communication, professionalism, and teamwork. Portfolio-based assessment provides one method of addressing this problem by allowing faculty reviewers to judge performance, as based on a longitudinal record of student behavior. At the Feinberg School of Medicine, the portfolio system measures behavioral competence using multiple assessments collected over time. This study examines whether a preclerkship portfolio review is a valid method of identifying problematic student behavior affecting later performance in clerkships. The authors divided students into two groups based on a summative preclerkship portfolio review in 2014: students who had concerning behavior in one or more competencies and students progressing satisfactorily. They compared how students in these groups later performed on two clerkship outcomes as of October 2015: final grades in required clerkships, and performance on a clerkship clinical composite score. They used Mann-Whitney tests and multiple linear regression to examine the relationship between portfolio review results and clerkship outcomes. They used USMLE Step 1 to control for knowledge acquisition. Students with concerning behavior preclerkship received significantly lower clerkship grades than students progressing satisfactorily (P = .002). They also scored significantly lower on the clinical composite score (P portfolio review can identify behaviors that impact clerkship performance. A comprehensive portfolio system is a valid way to measure behavioral competencies.

  2. Undergraduate Courses in Family Medicine in the UK, Ireland, the Netherlands and the Nordic Countries

    DEFF Research Database (Denmark)

    Larsen, Jan-Helge

    1993-01-01

    Almen medicin, Family Medicine, undergraduate Courses, the UK, Ireland, the Netherlands, the Nordic Countries......Almen medicin, Family Medicine, undergraduate Courses, the UK, Ireland, the Netherlands, the Nordic Countries...

  3. AAAS joins the Translational Medicine family.

    Science.gov (United States)

    Brander, Christian; Marincola, Francesco M

    2009-05-07

    The AAAS has announced the launch of Science Translational Medicine. This is further and critical recognition of this discipline and we are deeply gratified that translational medicine has risen to the level of recognition by one of the world's most prestigious scientific organizations. We believe that Science Translational Medicine will provide another valuable venue for the rapid and broad dissemination of important articles in the field and contribute to enhancing the effectiveness of translational medicine overall. It has been almost six years since we launched the Journal of Translational Medicine as an open-access journal with Biomed Central. At the beginning, we faced the inevitable skepticism and received several inquires among others also from Science reporters questioning both the significance of translational medicine in today's biomedical world and the need for a new journal dedicated to it.

  4. AAAS joins the Translational Medicine family

    Directory of Open Access Journals (Sweden)

    Marincola Francesco M

    2009-05-01

    Full Text Available Abstract The AAAS has announced the launch of Science Translational Medicine. This is further and critical recognition of this discipline and we are deeply gratified that translational medicine has risen to the level of recognition by one of the world's most prestigious scientific organizations. We believe that Science Translational Medicine will provide another valuable venue for the rapid and broad dissemination of important articles in the field and contribute to enhancing the effectiveness of translational medicine overall. It has been almost six years since we launched the Journal of Translational Medicine as an open-access journal with Biomed Central 1. At the beginning, we faced the inevitable skepticism and received several inquires among others also from Science reporters questioning both the significance of translational medicine in today's biomedical world and the need for a new journal dedicated to it.

  5. Gender-based education during clerkships: a focus group study

    Directory of Open Access Journals (Sweden)

    van Leerdam L

    2014-02-01

    Full Text Available Lotte van Leerdam, Lianne Rietveld, Doreth Teunissen, Antoine Lagro-JanssenDepartment of Primary and Community Care, Gender and Women's Health, Radboud University Medical Center, Nijmegen, The NetherlandsObjectives: One of the goals of the medical master's degree is for a student to become a gender-sensitive doctor by applying knowledge of gender differences in practice. This study aims to investigate, from the students’ perspective, whether gender medicine has been taught in daily practice during clerkship.Methods: A focus group study was conducted among 29 medical students from Radboud University, Nijmegen, The Netherlands, who had just finished either their internal medicine or surgical clerkships. Data were analyzed in line with the principles of constant comparative analysis.Results: Four focus groups were conducted with 29 participating students. Clinical teachers barely discuss gender differences during students’ clerkships. The students mentioned three main explanatory themes: insufficient knowledge; unawareness; and minor impact. As a result, students feel that they have insufficient competencies to become gender-sensitive doctors.Conclusion: Medical students at our institution perceive that they have received limited exposure to gender-based education after completing two key clinical clerkships. All students feel that they have insufficient knowledge to become gender-sensitive doctors. They suppose that their clinical teachers have insufficient knowledge regarding gender sensitivity, are unaware of gender differences, and the students had the impression that gender is not regarded as an important issue. We suggest that the medical faculty should encourage clinical teachers to improve their knowledge and awareness of gender issues.Keywords: medical education, clerkship, gender, hidden curriculum, clinical teachers

  6. Three generations of family medicine: a comparison of social identities.

    Science.gov (United States)

    Fox, T G; Cole, D R; Lieberman, J A

    1984-01-01

    Recent studies have shown that students and residents choosing Family Medicine career orientations have attained an academic parity with their counterparts in other specialties which was not demonstrated by their general practitioner predecessors. Similarly, the advent of Family Practice residencies and undergraduate course work has significantly altered the educational experience of today's medical students. This study adds to the literature by comparing a third element, the social character of Family Medicine oriented students, residents and practicing physicians. Three subgroups of Family Medicine oriented individuals; students, residents, and physicians, were surveyed through a mailed questionnaire. A study population of 768 individuals yielded a 73% response rate. The findings show that students and residents share a common pattern of identities and that this pattern is not shared with the physician subgroup. This results in rejection of the cohort replication theory. It also suggests a need for Family Practice training to provide role models from the new and emerging generation of family physicians.

  7. Complementary and alternative medicine use among military family medicine patients in Hawaii.

    Science.gov (United States)

    Kent, Jeremy B; Oh, Robert C

    2010-07-01

    Complementary and alternative medicine (CAM) is a growing component of medicine within the U.S. civilian and military populations. Tripler Army Medical Center (TAMC) Family Medicine Clinic represents an overseas medical facility stationed among a diverse ethnic population. The impact that local cultures have on CAM utilization in the military population in overseas medical facilities is unknown. Cross-sectional survey. The authors surveyed all volunteer soldiers, family members, and retirees 18 years old or greater enrolled at TAMC Family Medicine Clinic with appointments between September 1 and September 25, 2008. 503 volunteers were surveyed with a response rate of 73% (n = 369). A total of 50.7% reported using at least one CAM therapy within the last year. CAM use was significantly higher among women, Caucasians, and a college level education or greater. Prevalence of CAM use is higher within a military family medicine clinic in Hawaii than the prevalence among mainland civilian or other military populations.

  8. Erasmus exchange in the field of family medicine in Slovenia.

    Science.gov (United States)

    Rotar-Pavlič, Danica

    2012-01-01

    The purpose of this paper is to analyze the Erasmus exchange of students at the University of Ljubljana, Department of family medicine in the period from 2005 to 2010. The beginnings of an Erasmus exchange in the field of family medicine in Europe are described. Ljubljana Medical School has currently 60 bilateral agreements with universities or medical faculties in the EU and EFTA countries. We collected data of all students who come from the foreign faculties to the Department of family medicine and those from Slovenia who went to study abroad. In addition to basic descriptive statistics, we used the elements of qualitative analysis, where we reviewed the reports of the Slovenian Erasmus students, who went on exchange in the field of family medicine. Department of family medicine cooperated with 14 foreign medical schools since 2005. 42 Slovenian students went on academic exchange in the field of family medicine. 21 foreign students came to Department of family medicine in Ljubljana. Female students were more frequent in exchange compared with male students. The largest proportion of students went abroad in 2009. Most foreign students visited Department of Family medicine in Ljubljana in 2011. Reports of students show that they learned a lot. Students were able to compare the organization of health care in a foreign country and Slovenian health care system. Erasmus exchange has proven to be an important addition to the existing educational system. Students are acquainted with the progress of health care in Europe in this way. They are able to compare the benefits and disadvantages of foreign health care systems with home health care organization. Copyright 2012 by Academy of Sciences and Arts of Bosnia and Herzegovina.

  9. Erasmus exchange in the field of family medicine in Slovenia

    Directory of Open Access Journals (Sweden)

    Danica Rotar-Pavlič

    2012-05-01

    Full Text Available Objective. The purpose of this paper is to analyze the Erasmus exchange of students at the University of Ljubljana, Department of family medicine in the period from 2005 to 2010. The beginnings of an Erasmus exchange in the field of family medicine in Europe are described. Ljubljana Medical School has currently 60 bilateral agreements with universities or medical faculties in the EU and EFTA countries. Materials and methods. We collected data of all students who come from the foreign faculties to the Department of family medicine and those from Slovenia who went to study abroad. In addition to basic descriptive statistics, we used the elements of qualitative analysis, where we reviewed the reports of the Slovenian Erasmus students, who went on exchange in the field of family medicine. Results. Department of family medicine cooperated with 14 foreign medical schools since 2005. 42 Slovenian students went on academic exchange in the field of family medicine. 21 foreign students came to Department of family medicine in Ljubljana. Female students were more frequent in exchange compared with male students. The largest proportion of students went abroad in 2009. Most foreign students visited Department of Family medicine in Ljubljana in 2011. Reports of students show that they learned a lot. Students were able to compare the organization of health care in a foreign country and Slovenian health care system. Conclusion. Erasmus exchange has proven to be an important addition to the existing educational system. Students are acquainted with the progress of health care in Europe in this way. They are able to compare the benefits and disadvantages of foreign health care systems with home health care organization.

  10. Student perceptions of clerkship handbooks.

    Science.gov (United States)

    Atherley, Anique; Taylor, Charles

    2017-08-01

    When students transition into new clerkships, it can be useful to provide them with information to assist them in their adjustment to the new social environment. Handbooks could support students by providing information, particularly during clerkship orientation. The authors explored aspects of existing handbooks that students found useful, and sought additional desirable content. During seven semi-structured focus group discussions, 48 final-year medical students discussed their perceptions of six handbooks at the end of their training. Focus group discussions continued until data saturation. Transcripts were thematically analysed. Students appreciated handbooks that were concise, and valued reviewing handbooks with faculty members who could highlight important content. Most students valued and desired content related to assessment, and specifically used handbooks when preparing for examinations. Most students appreciated handbooks that provided study guidance such as a syllabus. Students also appreciated logistical aspects such as a timetable and information on clerkship cultural norms. Students disliked handbooks with vague descriptions of faculty member expectations and students' roles. Students liked, disliked and desired many aspects of clerkship handbooks. The findings of our study could be used when designing handbooks to enhance their perceived value to students. Further research is needed on the impact of handbooks on learning and increasing students' engagement with handbook content. There are many aspects of handbook content and delivery that could be used to improve students' perceptions regarding handbooks. Handbooks could support students by providing information. © 2016 John Wiley & Sons Ltd and The Association for the Study of Medical Education.

  11. Experiences of family medicine residents in primary care obstetrics training.

    Science.gov (United States)

    Koppula, Sudha; Brown, Judith Belle; Jordan, John M

    2012-03-01

    Obstetrical practice by family physicians has been declining rapidly for many reasons over the past number of decades. One reason for this trend is family medicine residents not considering intrapartum care as part of their future careers. Decisions such as this may be related to experiences during obstetrical training. This study explored the experiences of family medicine residents in core primary care obstetrics training. Using qualitative approaches, focus groups of family medicine residents were conducted. The resulting data were audiotaped and transcribed verbatim. Independent and team analysis was both iterative and interpretive. Data obtained from the focus groups revealed findings relating to the following categories: (1) perceived facilitators to practicing primary care obstetrics, (2) perceived barriers to practicing primary care obstetrics, and (3) learner experiences at the fulcrum of career decision making. Family medicine residents were encouraged by favorable learning experiences and group shared-call arrangements by their primary care obstetrics preceptors. Some concerns about a career including obstetrics persisted; however, positive experiences, including influential fulcrum points, may inspire family medicine residents to pursue a career involving primary care obstetrics.

  12. Opinions of Primary Care Family Physicians About Family Medicine Speciality Training Program

    Directory of Open Access Journals (Sweden)

    Hamit Sirri Keten

    2014-04-01

    Material and Method: A total of 170 family physicians working in Kahramanmaras were included in the study. After obtaining informed consent a questionnaire comprising questions regarding socio-demographic properties, conveying contracted family physicians as family medicine specialists and organization of the training program was applied to participants. Results: Among physicians participating in the study 130 (76.5% were male and 40 (23.5% were female, with a mean age of 40.7±7.1 (min = 26 years, max = 64 years. The mean duration of professional experience of physicians was 15.3±7.0 (min = 2 years, max = 40 years years. Of all, 91 (53.5% participants had already read the decree on family medicine specialist training program for contracted family physicians. A hundred and fifteen (67.6% family physicians supported that Family Medicine Specialty program should be taken part-time without interrupting routine medical tasks. Only 51 (30.0% participants stated the requirement of an entrance examination (TUS for family medicine specialty training. Conclusion: Family medicine specialty training program towards family physicians should be considered in the light of scientific criteria. In family medicine, an area exhibited a holistic approach to the patient; specialty training should be through residency training instead of an education program. For this purpose, family medicine departments in medical faculties should play an active role in this process. Additionally further rotations in needed branches should be implemented with a revision of area should be performed. In medicine practical training is of high importance and distant or part-time education is not appropriate, and specialist training shall be planned in accordance with the medical specialty training regulations. [Cukurova Med J 2014; 39(2.000: 298-304

  13. Defining competency-based evaluation objectives in family medicine

    Science.gov (United States)

    Allen, Tim; Brailovsky, Carlos; Rainsberry, Paul; Lawrence, Katherine; Crichton, Tom; Carpentier, Marie-Pierre; Visser, Shaun

    2011-01-01

    Abstract Objective To develop a definition of competence in family medicine sufficient to guide a review of Certification examinations by the Board of Examiners of the College of Family Physicians of Canada. Design Delphi analysis of responses to a 4-question postal survey. Setting Canadian family practice. Participants A total of 302 family physicians who have served as examiners for the College of Family Physicians of Canada’s Certification examination. Methods A survey comprising 4 short-answer questions was mailed to the 302 participating family physicians asking them to list elements that define competence in family medicine among newly certified family physicians beginning independent practice. Two expert groups used a modified Delphi consensus process to analyze responses and generate 2 basic components of this definition of competence: first, the problems that a newly practising family physician should be competent to handle; second, the qualities, behaviour, and skills that characterize competence at the start of independent practice. Main findings Response rate was 54%; total number of elements among all responses was 5077, for an average 31 per respondent. Of the elements, 2676 were topics or clinical situations to be dealt with; the other 2401 were skills, behaviour patterns, or qualities, without reference to a specific clinical problem. The expert groups identified 6 essential skills, the phases of the clinical encounter, and 99 priority topics as the descriptors used by the respondents. More than 20% of respondents cited 30 of the topics. Conclusion Family physicians define the domain of competence in family medicine in terms of 6 essential skills, the phases of the clinical encounter, and priority topics. This survey represents the first level of definition of evaluation objectives in family medicine. Definition of the interactions among these elements will permit these objectives to become detailed enough to effectively guide assessment. PMID

  14. On becoming a teacher of family medicine.

    Science.gov (United States)

    Stephens, G

    1977-02-01

    The emergence of family practice education in the past decade has created an unprecedented demand for faculty. Since no reservoir of trained teachers existed, it has become necessary for practicing family physicians to enter the academic world and assume the role of teacher. This paper examines the internal processes by which this transformation occurs. It begins with the fantasies common to physicians who are considering the decision to teach;, and progresses through self-assessment of qualifications to a consideration of the content of family practice teaching. It concludes with guidelines for negotiation with an academic institution and the early stages of professionalization in the new role.

  15. Evaluation of problem-based learning curriculum implementation in a clerkship rotation of a newly established African medical training institution: lessons from the University of Botswana

    Science.gov (United States)

    Tshitenge, Stephane Tshitenge; Ndhlovu, Chiratidzo Ellen; Ogundipe, Radiance

    2017-01-01

    Introduction Problem-based Learning (PBL) curricula, like all curricula, require systematic evaluation as there is a risk of implementing a dysfunctional PBL curriculum. The study intended to evaluate the PBL curriculum delivery from the perspective of the clerkship students at the University of Botswana-Faculty of Medicine. Methods A cross-sectional study was conducted among clerkship students in Family Medicine, Paediatrics, Internal Medicine and Surgery. During a 4-week period, each respondent completed weekly a questionnaire based survey tool. The three part questionnaire consisted of demographic data, 'seven-jumps' adapted from a 'typical' PBL tool to evaluate PBL process and 11 items 'adopted 'from the Short-Questionnaire-to-Evaluate-the-Effectiveness-of-Tutors in the PBL tool to evaluate the PBL facilitation with open ended questions at the end. Results Of the 81 eligible participants, 89% (n=72) responded. We collected back 141 (49%) forms out of the 288 expected (72 X 4 weeks). PBL first sessions took place all the time only in Family Medicine and in about 75% of the time in Pediatrics but none were conducted in the other disciplines. Overall, they evaluated the PBL process as 'good' (median= 8 /10) and the PBL facilitation as 'very good' (median=9 /10). Students appeared to have differing opinions on the preferred approach to the nature of patient problems that the PBL sessions should be structured around. Conclusion Despite students rating PBL process as 'good' and facilitation as 'very good', PBL first sessions were not consistently undertaken. PMID:28748015

  16. Translating the family medicine vision into educational programmes in Singapore.

    Science.gov (United States)

    Wong, Teck Yee; Cheong, Seng Kwing; Koh, Gerald Ch; Goh, Lee Gan

    2008-05-01

    The core of the Family Medicine (FM) vision is patient-centred care, requiring specific education and vocational training. We traced how FM education started and what have been achieved. FM training began in 1971 with the formation of the College of General Practitioners Singapore. Previously, training consisted of self-directed learning, lunchtime talks and examination preparation courses run by hospital specialists. Formal FM vocational training programmes in the United Kingdom and Australia provided the model for a 3-year programme in 1988. The tripartite relationship between the local university, College of Family Physicians and Ministry of Health, together with a structured training programme, contributed to its success. To date, more than 240 Family Physicians in Singapore have been awarded the Masters in Medicine (FM) degree. The Graduate Diploma in Family Medicine programme (GDFM) was introduced in 2000 for Family Physicians who wished to practice at an enhanced level. This programme has trained 194 doctors since then. Behind the scenes, the following were important developments: counterculture with a difference, tripartite stake-holding, training the trainers and learning from others. For the FM undergraduate programme, our aim is to develop the knowledge base, core values and roles of the Family Physician. Sustaining the value of Family Medicine as a career choice is the enduring vision.

  17. Benefits of comprehensive reproductive health education in family medicine residency.

    Science.gov (United States)

    Nothnagle, Melissa; Prine, Linda; Goodman, Susan

    2008-03-01

    Given the high prevalence of unintended pregnancy and early pregnancy failure, family physicians frequently encounter these clinical problems. Early abortion care and miscarriage management are within the scope of family medicine, yet few family medicine residency programs' curricula routinely include training in these skills. Comprehensive reproductive health education for family physicians could benefit patients by improving access to safe care for unintended pregnancy and early pregnancy loss and by improving continuity of care, especially for rural and low-income women. By promoting reflection on conflicts between personal beliefs and responsibility to patients, training in options counseling and abortion care fosters patient-centered care and informed decision making. Managing pregnancy loss and termination also improves skills in patient-centered counseling and primary care gynecology. Multiple studies document the feasibility and success of several training models for abortion and miscarriage management in family medicine. Incorporating comprehensive reproductive health care into family medicine residency training enables family physicians to provide a full range of reproductive health services.

  18. Teaching Humanities in Medicine: The University of Massachusetts Family Medicine Residency Program Experience

    Science.gov (United States)

    Silk, Hugh; Shields, Sara

    2012-01-01

    Humanities in medicine (HIM) is an important aspect of medical education intended to help preserve humanism and a focus on patients. At the University of Massachusetts Family Medicine Residency Program, we have been expanding our HIM curriculum for our residents including orientation, home visit reflective writing, didactics and a department-wide…

  19. [Education in family medicine--a new approach].

    Science.gov (United States)

    Zildzić, M; Masić, I; Hasanović, M; Beganlić, A; Tulumović, A; Herenda, S; Salihefendić, N

    2001-01-01

    The subject of the family medicine on the medical faculties in Bosnia and Herzegovina existed from recently as a separate curiculum of the medical study. Until recently the contents of this discipline interpreted within the subject of the social medicine or the object of the primary healthcare protection, and programs of teaching were based mainly on Anglosaxon experiences. The fact is that some teachers of the medical faculty in Sarajevo had their own visions and programs of the family medicine which by years were tested in the units of the family healthcare protection in Sarajevo, Mostar, and Banja Luka, about what was published in our and foreign literature. New approach from the family medicine should be based on as follows: greater use of the standardized procedures for the improvement of the communication skills; revised educational procedure of all the participants 6 interdisciplinaryilly in the education of the family medicine; improvement of knowledge about methodlogy and the principles of the research; improvement of the techniques and knowledge about the maipulatin of the medical informations; development of the skills of the continued studying through the total working aga; to the development of the capability of the critical estimation of the own work important; by the defining of the important educational goals in the curriculum of the urgent medicine; to the development and use of the methods feed-back informations from the students; to the modernizing of the methods of the evaluation of the educational process-adopted knowledge and the attitudes and the carrying out of the practice of the patients, and the ethic values in that process. In this work the authors consider the stated experiences in the education from the subject family medicine at our faculties realting to the foreign, and suggest that new concept of the education on the basis of these experiences in the practice.

  20. Importance of international networking in academic family medicine

    Directory of Open Access Journals (Sweden)

    Zalika Klemenc-Ketiš

    2014-05-01

    Full Text Available European family medicine/general practice (FM/GP has travelled the long and successful journey of profiling the discipline and has produced valuable position papers on education and research. Nowadays, academic medicine is one of the pillars in the future development of FM/GP in Europe. A common European curriculum on undergraduate and postgraduate family medicine is needed. Also, a sound international platform of teaching institutions and/or teachers of family medicine would foster the further development of family medicine as an academic discipline. This would stimulate students and teachers to engage in international exchange to gain new knowledge and experiences, present their work and ideas abroad and prepare the conditions for further exchange of students and teachers. Conclusion. Established departments of FM/GP, led by a teacher who is a family physician/general practitioner, at each Medical School in Europe should provide students with knowledge and skills related to the core attributes of FM/GP. International exchanges of teachers and students should foster the development of a common curriculum on FM in Europe and foster improvement in the quality of FM education.

  1. Determinants of choosing a career in family medicine.

    Science.gov (United States)

    Scott, Ian; Gowans, Margot; Wright, Bruce; Brenneis, Fraser; Banner, Sandra; Boone, Jim

    2011-01-11

    Student choice is an important determinant of the distribution of specialties of practising physicians in many countries. Understanding characteristics at entry into medical school that are associated with the choice of residency in family medicine can assist medical schools in admitting an appropriate mix of students to serve the health care needs of their regions. From 2002 to 2004, we collected data from students in 15 classes at 8 of 16 Canadian medical schools at entry. Surveys included questions on career choice, attitudes to practice and socio-demographic characteristics. We followed students prospectively with these data linked to their residency choice. We used multiple logistic regression analysis to identify entry characteristics that predicted a student's ultimate career choice in family medicine. Of 1941 eligible students in the participating classes, 1542 (79.4%) contributed data to the final analyses. The following 11 entry variables predicted whether a student named family medicine as his or her top residency choice: being older, being engaged or in a long-term relationship, not having parents with postgraduate university education nor having family or close friends practicing medicine, having undertaken voluntary work in a developing nation, not volunteering with elderly people, desire for varied scope of practice, a societal orientation, a lower interest in research, desire for short postgraduate training, and lower preference for medical versus social problems. Demographic and attitudinal characteristics at entry into medical school predicted whether students chose a career in family medicine.

  2. Training Experiences of Family Medicine Residents on Behavioral Health Rotations.

    Science.gov (United States)

    Zubatsky, Max; Brieler, Jay; Jacobs, Christine

    2017-09-01

    Although accreditation guidelines for residency in family medicine include behavioral health curriculum, little is known about resident learning activities in real world training. Our study explored residents' perceptions about and exposure to specific activities during their behavioral health rotations. Family medicine residents (N=84) recruited via faculty list serves completed a survey about their experiences during behavioral health rotations. The survey included quantitative Likert scale questions, along with open-ended questions on which a qualitative content analysis was performed. Open-ended responses indicated that many residents receive constructive observation and collaboration opportunities during their training month. However, residents wanted more time to practice behavioral health skills beyond the rotation, more practice in psychotherapy skills, and additional education on medication management. Most residents (62%) received either limited or no training in couples or family therapy during their behavioral health rotation. Residents who reported more behavioral health knowledge gain during the rotation also reported higher self-perceived competency using Motivational Interviewing (M=3.82, P<.01). While family medicine as a discipline is based on the biopsychosocial model of care, residents reported deficits in education about family systems. Residents desire additional opportunities to learn psychotherapy techniques and practice counseling skills. Family medicine residency programs and faculty may consider supplementing their core behavioral curriculum to include these content areas.

  3. Defining competency-based evaluation objectives in family medicine

    Science.gov (United States)

    Lawrence, Kathrine; Allen, Tim; Brailovsky, Carlos; Crichton, Tom; Bethune, Cheri; Donoff, Michel; Laughlin, Tom; Wetmore, Stephen; Carpentier, Marie-Pierre; Visser, Shaun

    2011-01-01

    Abstract Objective To develop key features for priority topics previously identified by the College of Family Physicians of Canada that, together with skill dimensions and phases of the clinical encounter, broadly describe competence in family medicine. Design Modified nominal group methodology, which was used to develop key features for each priority topic through an iterative process. Setting The College of Family Physicians of Canada. Participants An expert group of 7 family physicians and 1 educational consultant, all of whom had experience in assessing competence in family medicine. Group members represented the Canadian family medicine context with respect to region, sex, language, community type, and experience. Methods The group used a modified Delphi process to derive a detailed operational definition of competence, using multiple iterations until consensus was achieved for the items under discussion. The group met 3 to 4 times a year from 2000 to 2007. Main findings The group analyzed 99 topics and generated 773 key features. There were 2 to 20 (average 7.8) key features per topic; 63% of the key features focused on the diagnostic phase of the clinical encounter. Conclusion This project expands previous descriptions of the process of generating key features for assessment, and removes this process from the context of written examinations. A key-features analysis of topics focuses on higher-order cognitive processes of clinical competence. The project did not define all the skill dimensions of competence to the same degree, but it clearly identified those requiring further definition. This work generates part of a discipline-specific, competency-based definition of family medicine for assessment purposes. It limits the domain for assessment purposes, which is an advantage for the teaching and assessment of learners. A validation study on the content of this work would ensure that it truly reflects competence in family medicine. PMID:21998245

  4. Influence of folk medicine on the family practitioner.

    Science.gov (United States)

    Gums, J G; Carson, D S

    1987-02-01

    The practice of folk medicine in the United States is increasing. Awareness by the family practitioner is essential in order to effectively communicate and successfully recommend medical treatment to those patients who hold belief in these traditional practices. Root medicine is particularly thriving in the southeastern United States. The influx of refugees into the southern coastal states has introduced new concepts into traditional medical practices. Interaction with patients who are involved with traditional health care providers and the modern medical community occurs more frequently than may be appreciated by the physicians. This article is intended to increase physicians' knowledge of some of the basic philosophies and practices of folk medicine, particularly root medicine, and to provide some insight into the reasons why the practitioners of folk medicine can be strongly influential in the medical and psychologic concerns of patients who believe in the power of the supernatural.

  5. Violence against health workers in Family Medicine Centers

    OpenAIRE

    Al-Turki N; Afify AAM; AlAteeq M

    2016-01-01

    Nouf Al-Turki,1 Ayman AM Afify,1 Mohammed AlAteeq2 1Family Medicine Department, Prince Sultan Military Medical City, 2Department of Family Medicine and PHC, King Abdul-Aziz Medical City, National Guard Health Affairs, Riyadh, Kingdom of Saudi Arabia Background: Health care violence is a significant worldwide problem with negative consequences on both the safety and well-being of health care workers as well as workplace activities. Reports examining health care violence in Saudi Arabia are lim...

  6. Teaching-skills training programs for family medicine residents

    Science.gov (United States)

    Lacasse, Miriam; Ratnapalan, Savithiri

    2009-01-01

    ABSTRACT OBJECTIVE To review the literature on teaching-skills training programs for family medicine residents and to identify formats and content of these programs and their effects. DATA SOURCES Ovid MEDLINE (1950 to mid-July 2008) and the Education Resources Information Center database (pre-1966 to mid-July 2008) were searched using and combining the MeSH terms teaching, internship and residency, and family practice; and teaching, graduate medical education, and family practice. STUDY SELECTION The initial MEDLINE and Education Resources Information Center database searches identified 362 and 33 references, respectively. Titles and abstracts were reviewed and studies were included if they described the format or content of a teaching-skills program or if they were primary studies of the effects of a teaching-skills program for family medicine residents or family medicine and other specialty trainees. The bibliographies of those articles were reviewed for unidentified studies. A total of 8 articles were identified for systematic review. Selection was limited to articles published in English. SYNTHESIS Teaching-skills training programs for family medicine residents vary from half-day curricula to a few months of training. Their content includes leadership skills, effective clinical teaching skills, technical teaching skills, as well as feedback and evaluation skills. Evaluations mainly assessed the programs’ effects on teaching behaviour, which was generally found to improve following participation in the programs. Evaluations of learner reactions and learning outcomes also suggested that the programs have positive effects. CONCLUSION Family medicine residency training programs differ from all other residency training programs in their shorter duration, usually 2 years, and the broader scope of learning within those 2 years. Few studies on teaching-skills training, however, were designed specifically for family medicine residents. Further studies assessing the

  7. Predoctoral education in family medicine: a ten-year perspective.

    Science.gov (United States)

    Leaman, T L

    1979-11-01

    The educational goals chosen by teachers of family medicine for predoctoral students a decade ago differ substantially from the present goals. The original goals were to increase the number of family physicians, provide them with the basic knowledge and skills to practice, integrate the concepts of family medicine into the total medical school curriculum, and develop the "attitudes and ideals" of the good family physician. A series of basic learning principles were evolved to attain these goals. These included: teach in a practice setting, focus on persons rather than disease processes, use a team approach to teaching, involve students in the planning and evaluation process, and recognize curriculum development as a dynamic process. The present curriculum has an increased emphasis on clinical skills in family practice and on integration of behavioral science; there is a new emphasis on the role of the physician in the community and a better understanding of health care systems. Future directions for family medicine include increasing the emphasis on interpersonal communications, clinical synthesis, and clinical assessment.

  8. Frequently asked questions about family medicine in India.

    Science.gov (United States)

    Kumar, Raman

    2016-01-01

    Family medicine (FM) is an independent and distinct medical specialty in the developed countries such as USA, UK, Australia, and Canada since 1960s. FM teaching is imparted at undergraduate and postgraduate levels in countries such as Nepal, Pakistan, and Sri Lanka. Family practice is the practicing vocation of the majority doctors in India. The practitioners of FM include general practitioners, family physicians, FM specialists, and medical officers in the public sector. Medical students are largely unaware about FM career as this concept is not introduced at MBBS level. Faculty and senior doctors from other disciplines are also not able to answer the queries related to FM as they themselves also have gone through the same education system for last three decades, largely unexposed to the concept of academic family medicine. This article is a compilation of frequently asked questions, and their appropriate responses, presented here to dispel myths and misinformation about FM specialty. The answers are deliberated upon by Dr. Raman Kumar the founder president of the Academy of Family Physicians of India and the chief editor of the Journal of Family Medicine and Primary Care. This article was originally published as an interview in Docplexus, a popular online network and website for medical doctors in November 2015.

  9. Teaching prenatal ultrasound to family medicine residents.

    Science.gov (United States)

    Dresang, Lee T; Rodney, William MacMillan; Dees, Jason

    2004-02-01

    Prenatal ultrasound is a powerful diagnostic tool, but there has been little research on how to teach ultrasound to family physicians. The available evidence supports teaching through didactics followed by supervised scanning. Didactic topics include physics and machine usage, indications, fetal biometry, anatomic survey, practice management, ethical issues, and resources. Supervised scanning reinforces the didactic components of training. A "hand-on-hand" supervised scanning technique is recommended for the transmission of psychomotor skills in these sessions. Curricula for teaching ultrasound should include information on which residents will be taught prenatal ultrasound, who will teach them, how to create time for learning ultrasound skills, and how to test for competency. The literature suggests that competency can be achieved within 25-50 supervised scans. Measures of competency include examination and qualitative analysis of scanning. Competency-based testing needs further development because no uniform standards have been established.

  10. Genetic Programming for Medicinal Plant Family Identification System

    Directory of Open Access Journals (Sweden)

    Indra Laksmana

    2014-11-01

    Full Text Available Information about medicinal plants that is available in text documents is generally quite easy to access, however, one needs some efforts to use it. This research was aimed at utilizing crucial information taken from a text document to identify the family of several species of medicinal plants using a heuristic approach, i.e. genetic programming. Each of the species has its unique features. The genetic program puts the characteristics or special features of each family into a tree form. There are a number of processes involved in the investigated method, i.e. data acquisition, booleanization, grouping of training and test data, evaluation, and analysis. The genetic program uses a training process to select the best individual, initializes a generate-rule process to create several individuals and then executes a fitness evaluation. The next procedure is a genetic operation process, which consists of tournament selection to choose the best individual based on a fitness value, the crossover operation and the mutation operation. These operations have the purpose of complementing the individual. The best individual acquired is the expected solution, which is a rule for classifying medicinal plants. This process produced three rules, one for each plant family, displaying a feature structure that distinguishes each of the families from each other. The genetic program then used these rules to identify the medicinal plants, achieving an average accuracy of 86.47%.

  11. Pharmacist educators in family medicine residency programs: A qualitative analysis

    Directory of Open Access Journals (Sweden)

    Jorgenson Derek

    2012-08-01

    Full Text Available Abstract Background 25-29% of North American family medicine residency programs utilize a pharmacist to teach residents. Little is known about the impact that these pharmacist educators have on residency training. The purpose of this study was to examine the experiences of residents, residency directors and pharmacists within Canadian family medicine residency programs that employ a pharmacist educator to better understand the impact of the role. Methods Recruitment from three cohorts (residents, residency directors, pharmacists within family medicine residency programs across Canada for one-on-one semi-structured interviews followed by thematic analysis of anonymized transcript data. Results 11 residents, 6 residency directors and 17 pharmacist educators participated in interviews. Data themes were: (1 strong value of the teaching with respect to improved resident knowledge, confidence and patient care delivery; (2 lack of a formal pharmacotherapy curriculum; (3 desire for expansion of pharmacist teaching; (4 impact of teaching on collaboration; (5 impact of teaching on residency program faculty; and (6 lack of criticism of the role. Conclusions The pharmacist educator role is valued within residency programs across Canada and the role has a positive impact on several important aspects of family medicine resident training. Suggestions for improvement focused on expanding the teaching role and on implementing a formal curriculum for pharmacist educators to follow.

  12. Family Medicine and Primary Care: Trends and Student Characteristics

    Science.gov (United States)

    Herman, Mary W.; Veloski, Jon

    1977-01-01

    Using data from a longitudinal study of medical students at Jefferson Medical College, the authors analyzed trends in senior student interest in primary care specialties between 1971 and 1975 and selected background characteristics and performance levels of students choosing family medicine compared with those in other specialties. (Author/LBH)

  13. NON-MUSCULOSKELETAL SPORTS MEDICINE LEARNING IN FAMILY MEDICINE RESIDENCY PROGRAMS

    Directory of Open Access Journals (Sweden)

    Pasqualino Caputo

    2008-06-01

    Full Text Available Despite the increasing popularity of primary care sports medicine fellowships, as evidenced by the more than two-fold increase in family medicine sports medicine fellowships from a total of 31 accredited programs during the 1998/1999 academic year (ACGME, 1998 to 63 during the 2003/2004 academic year (ACGME, 2006, there are few empirical studies to support the efficacy of such programs. To the best of our knowledge, no studies have been conducted to assess the impact of primary care sports medicine fellowships on family medicine residents' learning of non-musculoskeletal sports medicine topics. Rigorous evaluations of the outcomes of such programs are helpful to document the value of such programs to both the lay public and interested medical residents. In order to evaluate such programs, it is helpful to apply the same objective standards to residents trained across multiple programs. Hence, we would like to know if there is a learning effect with respect to non-musculoskeletal sports medicine topics identified on yearly administered American Board of Family Medicine (ABFM in-training exams (ITE to family medicine residents in family medicine residency programs in the United States with and without primary care sports medicine fellowship programs. Review and approval for the research proposal was granted by the ABFM, who also allowed access to the required data. Permission to study and report only non-musculoskeletal sports medicine topics excluding musculoskeletal topics was granted at the time due to other ongoing projects at the ABFM involving musculoskeletal topics. ABFM allowed us access to examinations from 1998 to 2003. We were given copies of each exam and records of responses to each item (correct or incorrect by each examinee (examinees were anonymous for each year.For each year, each examinee was classified by the ABFM as either (a belonging to a program that contained a sports medicine fellowship, or (b not belonging to a program

  14. An Evaluation of a Clerkship In Cardiology

    Science.gov (United States)

    Edson, John N.; and others

    1969-01-01

    Evaluation of the clinical clerkship in Cardiology for general practitioners proves there is an urgent need for continuing post graduate medical education for general practitioners. Clerkship was offered jointly by the Long Island College Hospital and the State University of New York Downstate Medical Center, Brooklyn, New York. (IR)

  15. An Evaluation of a Clerkship In Cardiology

    Science.gov (United States)

    Edson, John N.; and others

    1969-01-01

    Evaluation of the clinical clerkship in Cardiology for general practitioners proves there is an urgent need for continuing post graduate medical education for general practitioners. Clerkship was offered jointly by the Long Island College Hospital and the State University of New York Downstate Medical Center, Brooklyn, New York. (IR)

  16. Differences between family and emergency medicine training before sports medicine fellowship.

    Science.gov (United States)

    Christensen, Mark; Christensen, Heidi K

    2015-01-01

    Residency training clearly impacts physicians' approach toward fellowship in Primary Care Sports Medicine. Although the Accreditation Council for Graduate Medical Education sets strict standards for all programs, family medicine and emergency medicine training differ a great deal in general and provide physicians from both backgrounds varied perspectives and skill sets. The family physician acquires a substantial amount of experience in continuity of care and integration of health care into a patient's everyday life. On the other hand, the emergency physician receives exceptional training in the management of acutely ill and injured patients and leadership of a large health care team. Furthermore, while the emergency physician may be skilled in procedures such as fracture reduction and diagnostic ultrasound, the family physician is proficient in developing patient rapport and compliance with a treatment plan. Although physicians from different backgrounds may start with many differences, fellowship training is essential in bridging those gaps.

  17. Transitional clerkship: an experiential course based on workplace learning theory.

    Science.gov (United States)

    Chittenden, Eva H; Henry, Duncan; Saxena, Varun; Loeser, Helen; O'Sullivan, Patricia S

    2009-07-01

    Starting clerkships is anxiety provoking for medical students. To ease the transition from preclerkship to clerkship curricula, schools offer classroom-based courses which may not be the best model for preparing learners. Drawing from workplace learning theory, the authors developed a seven-day transitional clerkship (TC) in 2007 at the University of California, San Francisco School of Medicine in which students spent half of the course in the hospital, learning routines and logistics of the wards along with their roles and responsibilities as members of ward teams. Twice, they admitted and followed a patient into the next day as part of a shadow team that had no patient-care responsibilities. Dedicated preceptors gave feedback on oral presentations and patient write-ups. Satisfaction with the TC was higher than with the previous year's classroom-based course. TC students felt clearer about their roles and more confident in their abilities as third-year students compared with previous students. TC students continued to rate the transitional course highly after their first clinical rotation. Preceptors were enthusiastic about the course and expressed willingness to commit to future TC preceptorships. The transitional course models an approach to translating workplace learning theory into practice and demonstrates improved satisfaction, better understanding of roles, and increased confidence among new third-year students.

  18. Predictors of job satisfaction among academic family medicine faculty

    Science.gov (United States)

    Krueger, Paul; White, David; Meaney, Christopher; Kwong, Jeffrey; Antao, Viola; Kim, Florence

    2017-01-01

    Abstract Objective To identify predictors of job satisfaction among academic family medicine faculty members. Design A comprehensive Web-based survey of all faculty members in an academic department of family medicine. Bivariate and multivariable analyses (logistic regression) were used to identify variables associated with job satisfaction. Setting The Department of Family and Community Medicine at the University of Toronto in Ontario and its 15 affiliated community teaching hospitals and community-based teaching practices. Participants All 1029 faculty members in the Department of Family and Community Medicine were invited to complete the survey. Main outcome measures Faculty members’ demographic and practice information; teaching, clinical, administration, and research activities; leadership roles; training needs and preferences; mentorship experiences; health status; stress levels; burnout levels; and job satisfaction. Faculty members’ perceptions about supports provided, recognition, communication, retention, workload, teamwork, respect, resource distribution, remuneration, and infrastructure support. Faculty members’ job satisfaction, which was the main outcome variable, was obtained from the question, “Overall, how satisfied are you with your job?” Results Of the 1029 faculty members, 687 (66.8%) responded to the survey. Bivariate analyses revealed 26 predictors as being statistically significantly associated with job satisfaction, including faculty members’ ratings of their local department and main practice setting, their ratings of leadership and mentorship experiences, health status variables, and demographic variables. The multivariable analyses identified the following 5 predictors of job satisfaction: the Maslach Burnout Inventory subscales of emotional exhaustion and personal accomplishment; being born in Canada; the overall quality of mentorship that was received being rated as very good or excellent; and teamwork being rated as very

  19. The longitudinal primary care clerkship at Harvard Medical School.

    Science.gov (United States)

    Peters, A S; Feins, A; Rubin, R; Seward, S; Schnaidt, K; Fletcher, R H

    2001-05-01

    The primary care clerkship (PCC) at Harvard Medical School was established in 1997. The goals are to provide students with longitudinal experiences with patients and to include modern themes in the curriculum: managing illness and clinical relationships over time; finding the best available answers to clinical questions; preventing illness and promoting health; dealing with clinical uncertainty; getting the best outcomes with available resources; working in a health care team; and sharing decision making with patients. The PCC, a required course in the clinical years, meets one afternoon a week for nine months. Students spend three afternoons per month in primary care practices, where they see three to five patients per session and follow at least one patient ("longitudinal patient") over time. Classroom sessions, in both large- and small-group formats, promote a common educational philosophy and experience, and reinforce habits of problem-based learning established in the preclinical years. The students rated 74% of their preceptors excellent, especially praising their ability to facilitate and support good interpersonal relationships with patients, their ability to encourage students' independent evaluation of patients (as opposed to shadowing), and their enthusiasm for teaching. Students saw their longitudinal patients a mean of 4.8 times; 83% saw their patients at least three times. The PCC complements the curriculum of block clerkships in hospitals, and because the two are offered concurrently, students are required to come to terms with two substantially different cultures within medicine. Other medical schools are beginning to develop longitudinal clerkships to ensure that students have essential educational experiences that are difficult to achieve in block, hospital-based clerkships.

  20. Health care of homeless families. A growing challenge for family medicine.

    Science.gov (United States)

    Weinreb, L F; Bassuk, E L

    1990-07-01

    The number of homeless families in the United States is growing at an alarming rate. Homeless families are at an increased risk for numerous medical conditions and have complex health and psychosocial needs. In response to the growing crisis, policymakers have generally focused on families' immediate needs rather than developing a comprehensive long-term response. Health programs have been challenged to develop effective methods of providing outreach and comprehensive, continuous, coordinated services. Family medicine is uniquely qualified to meet the health care needs of homeless families and can play an important role in providing clinical service, designing medical education, developing research, and defining a national advocacy agenda.

  1. Folk medicinal uses of Verbenaceae family plants in Bangladesh.

    Science.gov (United States)

    Rahmatullah, Mohammed; Jahan, Rownak; Azam, F M Safiul; Hossan, S; Mollik, M A H; Rahman, Taufiq

    2011-01-01

    Folk medicinal practitioners form the first tier of primary health-care providers to most of the rural population of Bangladesh. They are known locally as Kavirajes and rely almost solely on oral or topical administration of whole plants or plant parts for treatment of various ailments. Also about 2% of the total population of Bangladesh are scattered among more than twenty tribes residing within the country's borders. The various tribes have their own tribal practitioners, who use medicinal plants for treatment of diseases. The objective of the present survey was to conduct an ethnomedicinal survey among the Kavirajes and tribal practitioners to determine which species of plants belonging to the Verbenaceae family are used by the practitioners. The Verbenaceae family plants are well known for constituents having important bio-active properties. The present survey indicated that 13 species belonging to 8 genera are used by the folk and tribal medicinal practitioners of Bangladesh. A comparison of their folk medicinal uses along with published reports in the scientific literature suggests that the Verbenaceae family plants used in Bangladesh can potentially be important sources of lead compounds or novel drugs for treatment of difficult to cure debilitating diseases like malaria and rheumatoid arthritis.

  2. Competency-based evaluation tools for integrative medicine training in family medicine residency: a pilot study

    Directory of Open Access Journals (Sweden)

    Schneider Craig

    2007-04-01

    Full Text Available Abstract Background As more integrative medicine educational content is integrated into conventional family medicine teaching, the need for effective evaluation strategies grows. Through the Integrative Family Medicine program, a six site pilot program of a four year residency training model combining integrative medicine and family medicine training, we have developed and tested a set of competency-based evaluation tools to assess residents' skills in integrative medicine history-taking and treatment planning. This paper presents the results from the implementation of direct observation and treatment plan evaluation tools, as well as the results of two Objective Structured Clinical Examinations (OSCEs developed for the program. Methods The direct observation (DO and treatment plan (TP evaluation tools developed for the IFM program were implemented by faculty at each of the six sites during the PGY-4 year (n = 11 on DO and n = 8 on TP. The OSCE I was implemented first in 2005 (n = 6, revised and then implemented with a second class of IFM participants in 2006 (n = 7. OSCE II was implemented in fall 2005 with only one class of IFM participants (n = 6. Data from the initial implementation of these tools are described using descriptive statistics. Results Results from the implementation of these tools at the IFM sites suggest that we need more emphasis in our curriculum on incorporating spirituality into history-taking and treatment planning, and more training for IFM residents on effective assessment of readiness for change and strategies for delivering integrative medicine treatment recommendations. Focusing our OSCE assessment more narrowly on integrative medicine history-taking skills was much more effective in delineating strengths and weaknesses in our residents' performance than using the OSCE for both integrative and more basic communication competencies. Conclusion As these tools are refined further they will be of value both in improving

  3. Leadership training in a family medicine residency program

    Science.gov (United States)

    Gallagher, Erin; Moore, Ainsley; Schabort, Inge

    2017-01-01

    Abstract Objective To assess the current status of leadership training as perceived by family medicine residents to inform the development of a formal leadership curriculum. Design Cross-sectional quantitative survey. Setting Department of Family Medicine at McMaster University in Hamilton, Ont, in December 2013. Participants A total of 152 first- and second-year family medicine residents. Main outcome measures Family medicine residents’ attitudes toward leadership, perceived level of training in various leadership domains, and identified opportunities for leadership training. Results Overall, 80% (152 of 190) of residents completed the survey. On a Likert scale (1 = strongly disagree, 4 = neutral, 7 = strongly agree), residents rated the importance of physician leadership in the clinical setting as high (6.23 of 7), whereas agreement with the statement “I am a leader” received the lowest rating (5.28 of 7). At least 50% of residents desired more training in the leadership domains of personal mastery, mentorship and coaching, conflict resolution, teaching, effective teamwork, administration, ideals of a healthy workplace, coalitions, and system transformation. At least 50% of residents identified behavioural sciences seminars, a lecture and workshop series, and a retreat as opportunities to expand leadership training. Conclusion The concept of family physicians as leaders resonated highly with residents. Residents desired more personal and system-level leadership training. They also identified ways that leadership training could be expanded in the current curriculum and developed in other areas. The information gained from this survey might facilitate leadership development among residents through application of its results in a formal leadership curriculum. PMID:28292816

  4. E-Learning Readiness in Medicine: Turkish Family Medicine (FM) Physicians Case

    Science.gov (United States)

    Parlakkiliç, Alaattin

    2015-01-01

    This research investigates e-learning readiness level of family medicine physicians (FM) in Turkey. The study measures the level of e-learning readiness of Turkish FM physicians by an online e-learning readiness survey. According to results five areas are ready at Turkish FM physicians but need a few improvements:…

  5. Residents' views about family medicine specialty education in Turkey

    Directory of Open Access Journals (Sweden)

    Uzuner Arzu

    2010-04-01

    Full Text Available Abstract Background Residents are one of the key stakeholders of specialty training. The Turkish Board of Family Medicine wanted to pursue a realistic and structured approach in the design of the specialty training programme. This approach required the development of a needs-based core curriculum built on evidence obtained from residents about their needs for specialty training and their needs in the current infrastructure. The aim of this study was to obtain evidence on residents' opinions and views about Family Medicine specialty training. Methods This is a descriptive, cross-sectional study. The board prepared a questionnaire to investigate residents' views about some aspects of the education programme such as duration and content, to assess the residents' learning needs as well as their need for a training infrastructure. The questionnaire was distributed to the Family Medicine Departments (n = 27 and to the coordinators of Family Medicine residency programmes in state hospitals (n = 11 by e-mail and by personal contact. Results A total of 191 questionnaires were returned. The female/male ratio was 58.6%/41.4%. Nine state hospitals and 10 university departments participated in the study. The response rate was 29%. Forty-five percent of the participants proposed over three years for the residency duration with either extensions of the standard rotation periods in pediatrics and internal medicine or reductions in general surgery. Residents expressed the need for extra rotations (dermatology 61.8%; otolaryngology 58.6%; radiology 52.4%. Fifty-nine percent of the residents deemed a rotation in a private primary care centre necessary, 62.8% in a state primary care centre with a proposed median duration of three months. Forty-seven percent of the participants advocated subspecialties for Family Medicine, especially geriatrics. The residents were open to new educational methods such as debates, training with models, workshops and e

  6. Patterns of Benzodiazepine Usage in a Family Medicine Centre

    OpenAIRE

    1980-01-01

    In a one year survey of the use of diazepam, chlordiazepoxide and flurazepam at a university family medicine centre, the per capita prescribing of the three drugs rose with the age of the patients. Diazepam was used approximately four times as frequently as chlordiazepoxide and for four times as many problems, even though it has similar pharmacological properties and a half-life nearly three times that of chlordiazepoxide. The over 65 age group received 36% of prescriptions for diazepam for m...

  7. Validity and reliability of a novel written examination to assess knowledge and clinical decision making skills of medical students on the surgery clerkship.

    Science.gov (United States)

    Reinert, Anna; Berlin, Ana; Swan-Sein, Aubrie; Nowygrod, Roman; Fingeret, Abbey

    2014-02-01

    The Surgery Clerkship Clinical Skills Examination (CSE) is a novel written examination developed to assess the surgical knowledge, clinical decision making, communication skills, and professionalism of medical students on the surgery clerkship. This study was undertaken to determine its validity. Data were prospectively collected from July 2011 through February 2013. Multivariate linear and logistic regression analyses were used to assess score trend; convergent validity with National Board of Medical Examiners surgery and medicine subject scores, United States Medical Licensing Examination Step 1 and Step 2 Clinical Knowledge scores, and evaluation of clinical reasoning and fund of knowledge; and the effect of clerkship order. Exam reliability was assessed using a modified Cronbach's α statistic. During the study period, 262 students completed the CSE, with a normal distribution of performance. United States Medical Licensing Examination Step 2 Clinical Knowledge score and end-of-clerkship evaluations of fund of knowledge and clinical reasoning predicted CSE score. Performance on the CSE was independent of clerkship order or prior clerkships. The modified Cronbach's α value for the exam was .67. The CSE is an objective, valid, reliable instrument for assessing students on the surgery clerkship, independent of clerkship order. Copyright © 2014 Elsevier Inc. All rights reserved.

  8. Fellowship or Further Training for Family Medicine Residents?

    Science.gov (United States)

    Sairenji, Tomoko; Dai, Mingliang; Eden, Aimee R; Peterson, Lars E; Mainous, Arch G

    2017-09-01

    The breadth of family medicine (FM) generates debate about the length of residency training. One argument used by proponents for lengthening training is that residents feel unprepared for practice. The objectives of our study were to (1) identify the proportion of FM residency graduates intending to pursue fellowship training and those who would have done an additional year of core residency training had it been available, and (2) determine whether an association exists between these two variables. We used data collected by the American Board of Family Medicine (ABFM) as part of resident certification examination application in 2014 and 2015. Data included fellowship intention, and interest in pursuing another year of residency training if it were available. We used descriptive and bivariate statistics. The questionnaire was completed by 6,235 residents, of which 17.0% (n=1,063) intended to enroll in a fellowship. Overall 54.2% of residents were "not at all likely" to extend residency training, with 19.9% "extremely/moderately likely". Forty-six percent of those intending a fellowship were "not at all likely" to extend training and only 29% of those "extremely/moderately likely" to extend residency training intended to enroll in a fellowship. We found a disconnect between fellowship intention and desire for another year of residency training. Desire for fellowship may be more about obtaining specific skills and expertise or additional certifications, and less about being prepared for general practice in family medicine.

  9. The new curriculum for family medicine at the University of Split, School of Medicine

    Directory of Open Access Journals (Sweden)

    Ivančica Pavličević

    2012-05-01

    Full Text Available According to the new curriculum at the University of Split School ofMedicine for the 2010/2011 academic year, the Department of FamilyMedicine based its teaching on its own expert and research work. Theadequacy of the communication with the patient, his or her familyand the social environment, as well as the concept of evidence-basedmedicine (EBM have been defined as the foundation of expert andresearch work in family medicine. In accordance with this strategy,the members of the Department are involved in conducting journalclubs, Cochrane systematic reviews, research into the health of families where the father is absent working abroad (there are many such families with emigrant fathers in the region, and some are working on developing student letters to patients as an instrument for encouraging communication and empathy. The proportion of theoreticalclasses was reduced to provide more time for practice-based classes for students. The Work Diary was also introduced, as well as the student letter to the patient, practice of clinical skills and objective, structured, clinical examination (OSCE. The assessment of students is performed in four parts: the grade given by the student’s practice supervisor, the grade for student letters to patients, the OSCE exam grade and the written exam grade. Students achieved, on average, very high grades. The Department is also involved in the course on clinical and social skills to first and second year students, taking on the task of introducing students to patients and their surroundings.

  10. Examining Critical Thinking Skills in Family Medicine Residents.

    Science.gov (United States)

    Ross, David; Schipper, Shirley; Westbury, Chris; Linh Banh, Hoan; Loeffler, Kim; Allan, G Michael; Ross, Shelley

    2016-02-01

    Our objective was to determine the relationship between critical thinking skills and objective measures of academic success in a family medicine residency program. This prospective observational cohort study was set in a large Canadian family medicine residency program. Intervention was the California Critical Thinking Skills Test (CCTST), administered at three points in residency: upon entry, at mid-point, and at graduation. Results from the CCTST, Canadian Residency Matching Service file, and interview scores were compared to other measures of academic performance (Medical Colleges Admission Test [MCAT] and College of Family Physicians of Canada [CCFP] certification examination results). For participants (n=60), significant positive correlations were found between critical thinking skills and performance on tests of knowledge. For the MCAT, CCTST scores correlated positively with full scores (n=24, r=0.57) as well as with each section score (verbal reasoning: r=0.59; physical sciences: r=0.64; biological sciences: r=0.54). For CCFP examination, CCTST correlated reliably with both sections (n=49, orals: r=0.34; short answer: r=0.47). Additionally, CCTST was a better predictor of performance on the CCFP exam than was the interview score at selection into the residency program (Fisher's r-to-z test, z=2.25). Success on a critical thinking skills exam was found to predict success on family medicine certification examinations. Given that critical thinking skills appear to be stable throughout residency training, including an assessment of critical thinking in the selection process may help identify applicants more likely to be successful on final certification exam.

  11. [Family medicine as a medical specialty and an academic discipline in the medical students' assessment].

    Science.gov (United States)

    Krztoń-Królewiecka, Anna; Jarczewska, Dorota Łucja; Windak, Adam

    2015-01-01

    Family medicine has been recognized as the key element of a good health care system. Despite the significance of the family physician's role the number of medical students choosing to train in family medicine has been declining in recent years. The aim of this study was to describe opinions about family medicine and family medicine teaching among medical students. A cross sectional study with an anonymous questionnaire was carried out. The study population was all sixth-year students in Faculty Medicine of Jagiellonian University Medical College, who completed family medicine course in winter semester of academic year 2012/2013. 111 students filled in the questionnaire. The response rate was 84.1%. Less than one third of respondents (30.6%) considered family medicine as a future career choice. Almost all students recognized responsibility of the family doctor for the health of community. 52% of respondents agreed that the family doctor is competent to provide most of the health care an individual may require. Experience from family medicine course was according to the students the most important factor influencing their opinions. Medical students appreciate the social role of family doctors. Family medicine teachers should not only pass on knowledge, but they also should encourage medical students to family medicine as a future career choice.

  12. Interdisciplinary, interinstitutional and international collaboration of family medicine researchers in Taiwan.

    Science.gov (United States)

    Lin, Yi-Hsuan; Tseng, Yen-Han; Chang, Hsiao-Ting; Lin, Ming-Hwai; Tseng, Yen-Chiang; Chen, Tzeng-Ji; Hwang, Shinn-Jang

    2015-01-01

    The family medicine researches flourished worldwide in the past decade. However, the collaborative patterns of family medicine publications had not been reported. Our study analyzed the collaborative activity of family medicine researchers in Taiwan. We focused on the types of collaboration among disciplines, institutions and countries. We searched "family medicine" AND "Taiwan" in address field from Web of Science and documented the disciplines, institutions and countries of all authors. We analyzed the collaborative patterns of family medicine researchers in Taiwan from 2010 to 2014. The journal's impact factor of each article in the same publication year was also retrieved. Among 1,217 articles from 2010 to 2014, interdisciplinary collaboration existed in 1,185 (97.3%) articles, interinstitutional in 1,012 (83.2%) and international in 142 (11.7%). Public health was the most common collaborative discipline. All international researches were also interdisciplinary and interinstitutional. The United States (75 articles), the United Kingdom (21) and the People's Republic of China (20) were the top three countries with which family medicine researchers in Taiwan had collaborated. We found a high degree of interdisciplinary and interinstitutional collaboration of family medicine researches in Taiwan. However, the collaboration of family medicine researchers in Taiwan with family medicine colleagues of other domestic or foreign institutions was insufficient. The future direction of family medicine studies could focus on the promotion of communication among family medicine researchers.

  13. Context and trade-offs in family medicine.

    Science.gov (United States)

    Seehusen, Dean A; Bowman, Marjorie A; Neale, Anne Victoria

    2014-01-01

    This issue contains several articles that highlight the effect of context and tradeoffs encountered in the practice of family medicine. Some articles demonstrate how context affects the implementation of the patient-centered medical home model, the community risk of a measles outbreak, the rate of complementary and alternative medicine among different generations, and the number of family physicians primarily providing urgent and emergent care in a region. Tradeoffs are explored in articles that look at how electronic medical record use has changed the composition of workload in primary care and how the burgeoning number of clinical guidelines affects the choices made by family physicians. A look at diabetic patients' perceptions of their risk of negative outcomes reveals an interesting pattern of underestimation of the risk of death. Patients with chronic mental disorders are at risk of having significant difficulties in the workplace, which may place a heavy cost on the individual and society. An interesting retrospective study found that it takes a surprising amount of replacement therapy to correct vitamin D deficiency.

  14. Family medicine residents' practice intentions: Theory of planned behaviour evaluation.

    Science.gov (United States)

    Grierson, Lawrence E M; Fowler, Nancy; Kwan, Matthew Y W

    2015-11-01

    To assess residents' practice intentions since the introduction of the College of Family Physicians of Canada's Triple C curriculum, which focuses on graduating family physicians who will provide comprehensive care within traditional and newer models of family practice. A survey based on Ajzen's theory of planned behaviour was administered on 2 occasions. McMaster University in Hamilton, Ont. Residents (n = 135) who were enrolled in the Department of Family Medicine Postgraduate Residency Program at McMaster University in July 2012 and July 2013; 54 of the 60 first-year residents who completed the survey in 2012 completed it again in 2013. The survey was modeled so as to measure the respondents' intentions to practise with a comprehensive scope; determine the degree to which their attitudes, subjective norms, and perceptions of control about comprehensive practice influence those intentions; and investigate how these relationships change as residents progress through the curriculum. The survey also queried the respondents about their intentions with respect to particular medical services that underpin comprehensive practice. The responses indicate that the factors modeled by the theory of planned behaviour survey account for 60% of the variance in the residents' intentions to adopt a comprehensive scope of practice upon graduation, that there is room for curricular improvement with respect to encouraging residents to practise comprehensive care, and that targeting subjective norms about comprehensive practice might have the greatest influence on improving resident intentions. The theory of planned behaviour presents an effective approach to assessing curricular effects on resident practice intentions while also providing meaningful information for guiding further program evaluation efforts in the Department of Family Medicine at McMaster University.

  15. Distributed radiology clerkship for the core clinical year of medical school.

    Science.gov (United States)

    Chew, Felix S

    2002-11-01

    The central role that diagnostic radiology has in the modern practice of medicine has not always been reflected in radiology's place in the curriculum. We developed a new radiology clerkship for undergraduate medical students during their core clinical year that was supported by Web technology. The assumptions underlying the design of the clerkship were that radiology is best learned from radiologists and that students are most receptive to learning radiology when it is related to concurrent patient care experiences. Beginning in May 2000, a required radiology clerkship experience was incorporated into the core clinical year at Wake Forest University School of Medicine. The core clinical year was organized into three 16-week blocks of clerkships. Two or four independent half-day radiology tutorial sessions were included with each clerkship block, and attended by all students in the block (approximately 35 students), regardless of their specific clerkship assignments. There were ten different radiology tutorials, each given three times during the year as students rotated through the clerkship blocks. Thus, each student attended a radiology tutorial session every four to eight weeks during the year. The topics covered during the tutorials were correlated with the content of the clerkship blocks and included adult and pediatric chest radiology, adult and pediatric abdominal radiology, body CT, neuroradiology, obstetric ultrasound, gynecologic ultrasound, osteoporosis, adult and pediatric fractures, mammography, and cervical spine trauma. The tutorials included pre- and post-test, lectures, case presentations, and sometimes tours of the radiology department. The educational emphasis was on pragmatic case-based learning exercises, development of verbal and visual vocabulary, and learning when and where to seek more information. To provide continuity and organization, Web-based curriculum materials were designed and implemented as a component of the clerkship. The home

  16. Twitter use at a family medicine conference: analyzing #STFM13.

    Science.gov (United States)

    Mishori, Ranit; Levy, Brendan; Donvan, Benjamin

    2014-09-01

    The use of social media is expanding in medicine. A few articles sought to describe participant behavior using Twitter at scientific conferences. Family physicians are known as active participants in social media, but their behavior and practices at conferences have not been methodically described. We recorded all public tweets at the 2013 Society of Teachers of Family Medicine (STFM) Annual Spring Conference bearing the hashtag #STFM13, using commercially available services. We created a transcript of all tweets for the 5 days of the conference and 3 days before and after. We looked at the total number of tweets, number of original tweets and re-tweets, active users, most prolific users, and impressions. We categorized the content based on (1) Session related, (2) Social, (3) Logistics, (4) Ads, and (5) Other. We compared major metrics (but not content) to the 2012 STFM Annual Spring Conference. There were a total of 1,818 tweets from 181 user accounts: 13% of the conference registrants. The top tweeter accounted for over 15% of the total tweets, and the top 10 accounted for over 50% of the total volume. Most original tweets (69.7%) were related to session content. Social content came in second (14.2%), followed by other, logistics, and advertisement (7.6%, 6.9%, 1.6%). This preliminary analysis provides an initial snapshot of twitter activity at a family medicine conference. It may suggest avenues for further inquiry: trend identification, "influencer" identification, and qualitative analysis. Interdisciplinary research should focus on evaluation methods that can assess the quality, value, and impact of tweeting.

  17. Teaching and assessing family medicine clerks' use of medical interpreters.

    Science.gov (United States)

    Shriner, Constance J; Hickey, Daniel P

    2008-05-01

    Academic health centers must develop strategies to prepare health care providers to meet the needs of an increasingly diverse population. We designed a curriculum module, including didactic presentation and a standardized patient experience, to teach and evaluate the knowledge and skills necessary for third-year family medicine clerks to effectively communicate with non-English-speaking patients when using interpreters in clinical settings. Analyses indicated improvement both in students' knowledge and skills following participation in the curriculum module. The instructional intervention was successful in improving students' effective use of interpreters in a simulated clinical setting.

  18. Interdisciplinary, interinstitutional and international collaboration of family medicine researchers in Taiwan

    Directory of Open Access Journals (Sweden)

    Yi-Hsuan Lin

    2015-10-01

    Full Text Available The family medicine researches flourished worldwide in the past decade. However, the collaborative patterns of family medicine publications had not been reported. Our study analyzed the collaborative activity of family medicine researchers in Taiwan. We focused on the types of collaboration among disciplines, institutions and countries. We searched “family medicine” AND “Taiwan” in address field from Web of Science and documented the disciplines, institutions and countries of all authors. We analyzed the collaborative patterns of family medicine researchers in Taiwan from 2010 to 2014. The journal’s impact factor of each article in the same publication year was also retrieved. Among 1,217 articles from 2010 to 2014, interdisciplinary collaboration existed in 1,185 (97.3% articles, interinstitutional in 1,012 (83.2% and international in 142 (11.7%. Public health was the most common collaborative discipline. All international researches were also interdisciplinary and interinstitutional. The United States (75 articles, the United Kingdom (21 and the People’s Republic of China (20 were the top three countries with which family medicine researchers in Taiwan had collaborated. We found a high degree of interdisciplinary and interinstitutional collaboration of family medicine researches in Taiwan. However, the collaboration of family medicine researchers in Taiwan with family medicine colleagues of other domestic or foreign institutions was insufficient. The future direction of family medicine studies could focus on the promotion of communication among family medicine researchers.

  19. Grade Inflation in Medical Student Radiation Oncology Clerkships: Missed Opportunities for Feedback?

    Energy Technology Data Exchange (ETDEWEB)

    Grover, Surbhi, E-mail: surbhi.grover@uphs.upenn.edu [Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania (United States); Swisher-McClure, Samuel [Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania (United States); Sosnowicz, Stasha [University of Pennsylvania, Philadelphia, Pennsylvania (United States); Li, Jiaqi; Mitra, Nandita [Department of Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, Pennsylvania (United States); Berman, Abigail T.; Baffic, Cordelia; Vapiwala, Neha; Freedman, Gary M. [Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania (United States)

    2015-07-15

    Purpose: To test the hypothesis that medical student radiation oncology elective rotation grades are inflated and cannot be used to distinguish residency applicants. Methods and Materials: The records of 196 applicants to a single radiation oncology residency program in 2011 and 2012 were retrospectively reviewed. The grades for each rotation in radiation oncology were collected and converted to a standardized 4-point grading scale (honors, high pass, pass, fail). Pass/fail grades were scored as not applicable. The primary study endpoint was to compare the distribution of applicants' grades in radiation oncology with their grades in medicine, surgery, pediatrics, and obstetrics/gynecology core clerkships. Results: The mean United States Medical Licensing Examination Step 1 score of the applicants was 237 (range, 188-269), 43% had additional Masters or PhD degrees, and 74% had at least 1 publication. Twenty-nine applicants were graded for radiation oncology rotations on a pass/fail basis and were excluded from the final analysis. Of the remaining applicants (n=167), 80% received the highest possible grade for their radiation oncology rotations. Grades in radiation oncology were significantly higher than each of the other 4 clerkships studied (P<.001). Of all applicants, 195 of 196 matched into a radiation oncology residency. Higher grades in radiation oncology were associated with significantly higher grades in the pediatrics core clerkship (P=.002). However, other medical school performance metrics were not significantly associated with higher grades in radiation oncology. Conclusions: Although our study group consists of a selected group of radiation oncology applicants, their grades in radiation oncology clerkships were highly skewed toward the highest grades when compared with grades in other core clerkships. Student grading in radiation oncology clerkships should be re-evaluated to incorporate more objective and detailed performance metrics to allow for

  20. Student evaluation of a primary care clerkship: quality assurance and identification of potential for improvement

    Directory of Open Access Journals (Sweden)

    Himmel Wolfgang

    2009-04-01

    Full Text Available Abstract Background In Germany, like many other countries, general practice clerkships have only recently become mandatory during medical education. The biggest challenges for the organisation of such clerkships are achieving a minimum level of standardisation, and developing and maintaining a system of quality assurance. The aim of this study is to assess the instructional quality in teaching practices using a benchmark system. Methods Before commencing, students anonymously assessed the importance of core aspects of the mandatory primary care clerkship. After the clerkship, they evaluated learning opportunities and teaching performance. Based on this data, a benchmark system was developed to identify areas of strength and weakness for all practices as well as individual teaching practices. Results A total of 695 students evaluated 97 general practices belonging to a teaching network. Prior to the clerkship, most students considered recognition of frequent diseases (85% and communication skills (65% the most important learning goals. After the clerkship, nearly 90% of students confirmed that the general practitioner (GP was good or excellent at teaching these two goals but only two-thirds thought the GP's teaching performance good or excellent in preventive medicine and screening. In an exemplary analysis, we identified the 2 best and the 2 worst practices that consistently received scores far above or below average, respectively. Conclusion We were able to identify areas of weakness in teaching and identified specific GPs who did not meet the students' needs and expectations. This evaluation seems to be a useful quality assurance tool to identify the potential for improvement and faculty development.

  1. Social media beliefs and usage among family medicine residents and practicing family physicians.

    Science.gov (United States)

    Klee, David; Covey, Carlton; Zhong, Laura

    2015-03-01

    Incorporation of social media (SM) use in medicine is gaining support. The Internet is now a popular medium for people to solicit medical information. Usage of social networks, such as Facebook and Twitter, is growing daily and provides physicians with nearly instantaneous access to large populations for both marketing and patient education. The benefits are myriad, but so are the inherent risks. We investigated the role providers' age and medical experience played in their beliefs and use of SM in medicine. Using multiple state-wide and national databases, we assessed social media use by family medicine residents, faculty, and practicing family physicians with a 24-question online survey. Descriptive data is compared by age and level of medical experience. A total of 61 family medicine residents and 192 practicing family physicians responded. There is a trend toward higher SM utilization in the younger cohort, with 90% of resident respondents reporting using SM, half of them daily. A total of 64% of family physician respondents over the age of 45 have a SM account. An equal percentage of senior physicians use SM daily or not at all. Practicing physicians, more than residents, agree that SM can be beneficial in patient care. The vast majority of residents and physicians polled believe that SM should be taught early in medical education. The high utilization of SM by younger providers, high prevalence of patient use of the Internet, and the countless beneficial opportunities SM offers should be catalysts to drive curriculum development and early implementation in medical education. This curriculum should focus around four pillars: professional standards for SM use, SM clinical practice integration, professional networking, and research.

  2. Family medicine residents' and community physicians' concerns about patient truthfulness.

    Science.gov (United States)

    Woolley, D; Clements, T

    1997-02-01

    To assess how often family physicians question patient truthfulness, what factors influence them to do so, and how often resident physicians experience such doubts as compared with senior physicians. In 1994-95, after half-day patient care sessions, 44 residents from the University of Kansas School of Medicine's three Wichita family practice residency programs and nine community family physicians associated with the programs recorded their impressions of each patient's truthfulness, what issues prompted concern about patient truthfulness, and their feelings about each encounter. The residents doubted patients in 54 of 277 encounters (19.5%); the senior physicians doubted patients in 16 of 183 encounters (8.7%) (p = .003). Both groups had more negative than positive emotions toward such encounters, with no significant difference in feelings. The demographics of the resident and senior physician populations differed greatly. Although preliminary, the present study suggests that family physicians question patient truthfulness fairly often, resident physicians more than senior physicians, and that these physicians have some negative feelings toward such situations. Because such feelings may contribute to inadequate patient care, the authors recommend that further research is warranted to understand contributing factors and to guide the development of resident and student education programs in this neglected area of the doctor-patient relationship.

  3. [Family medicine and practice in the Mexican Social Security Institute].

    Science.gov (United States)

    Casas Patiño, Donovan; Jarillo Soto, Edgar; Rodríguez Torres, Alejandra

    2014-06-26

    The central ideas of this research paper are related to the practice of family medicine as a specialty. It focuses in its origins, problems, unique characteristics, limitations, scope, management, and processes within the context of primary care of the Mexican Social Security System. This approach was based on a qualitative, hermeneutical study closely related to the Structural Functionalism Theory. Within this framework, medical practice is seen as an equation: Meaning = action + function/structure. This offers an approach to the understanding of reality through surveys and observations in five categories: identity, activity, purpose, values/norms, and power/relationship. The practice of family medicine is defined as a medical act in the Mexican Social Security Institute. This act is limited to a brief encounter and a prescription, which makes it a short, fleeting, medicalized interaction. The result is a negative social imaginary of the physician, the patient and the whole of society. Thus, individuals and society host a negative social imaginary bestowed on doctors and users of the health system.

  4. Family medicine and practice in the Mexican Social Security Institute

    Directory of Open Access Journals (Sweden)

    Donovan Casas Patiño

    2014-06-01

    Full Text Available The central ideas of this research paper are related to the practice of family medicine as a specialty. It focuses in its origins, problems, unique characteristics, limitations, scope, management, and processes within the context of primary care of the Mexican Social Security System. This approach was based on a qualitative, hermeneutical study closely related to the Structural Functionalism Theory. Within this framework, medical practice is seen as an equation: Meaning = action + function/structure. This offers an approach to the understanding of reality through surveys and observations in five categories: identity, activity, purpose, values/norms, and power/relationship. The practice of family medicine is defined as a medical act in the Mexican Social Security Institute. This act is limited to a brief encounter and a prescription, which makes it a short, fleeting, medicalized interaction. The result is a negative social imaginary of the physician, the patient and the whole of society. Thus, individuals and society host a negative social imaginary bestowed on doctors and users of the health system.

  5. Improving integration of clinical clerkship didactic curriculum

    Directory of Open Access Journals (Sweden)

    Lindsay A. Mazotti

    2010-12-01

    Full Text Available Curricular integration is a primary focus of many efforts to improve clinical education, but the practical realities of connecting content across discipline-based learning experience is a formidable challenge. This paper describes the construction of a third-year clinical clerkship curriculum featuring integrated didactics, purposeful sequencing, linkage to clinical context and introduction of competency-based learning activities. We describe the organization of our curriculum, the methods by which we integrated our didactic curriculum, and the results of curricular evaluations. Over two years, we improved integration and reduced fragmented learning experiences in a longitudinal integrated clerkship. Individual lectures were highly rated with a mean overall score of 4.29 (SD=0.78 (1=poor, 5= excellent(N=23. Integrated didactic sessions and competency-based learning activities, including a quality improvement curriculum and reflection sessions, were also highly rated. Purposeful integration of clinical content, sequencing of didactics across the academic year, linking didactic content to a clinical context and creating new competency-based learning activities were highly rated and feasible ways to combine didactics across disciplines in the core clerkship year. Similar integrated curricula may be used with students in longitudinal integrated clerkships or in a traditional third-year clerkship model.

  6. ¿Medicina general integral o medicina familiar? ¿Integral general medicine or family medicine?

    Directory of Open Access Journals (Sweden)

    Leonardo A. Cuesta Mejías

    2007-09-01

    Full Text Available En el presente trabajo, además de ofrecer la opinión basada en la experiencia personal del autor, se aplica encuesta confeccionada al efecto en la que se indaga fundamentalmente cuál es la preferencia de los profesionales vinculados a la práctica de la Medicina General Integral o de la Medicina Familiar a la hora de denominar la especialidad que desempeñan. Es decir, responder la pregunta que da título al trabajo es la intención u objetivo general del mismo.At present paper, beside to offer author's personal experience-based opinion, it is applied survey to know which is the preference of professionals related to practice of Integral General Medicine o Family Medicine, at moment of to denominates its real specialty. That is, to answer the question that is the title of this paper, is its general aim.

  7. Ethical dilemmas in clerkship rotations.

    Science.gov (United States)

    Myers, Michael F; Herb, Alice

    2013-11-01

    A sound clinical education should include the opportunity for medical students to engage in a spirited and informed discussion with faculty about the ethical challenges they will undoubtedly face. Unfortunately, in many medical schools today this goal is thwarted by many factors, including denial that a problem exists, relentless system overload, unprofessional behavior, breakdown in communication, and inertia. What is worse is that this problem is not new, and the fallout is not insignificant. Another potential contributing factor is burnout, which is well documented in a high percentage of medical students, residents, and faculty, and two of its most serious consequences are patient dissatisfaction and medical error.The authors draw on hundreds of student reflections on ethical dilemmas submitted during classroom exercises to examine persistent themes. They posit that classroom and didactic teaching is not enough to enable students to face ethical dilemmas. The authors call for a major culture change in medical education: "buy in" from top administration, especially the dean (and associate/assistant deans), chairs of all departments, and clerkship and residency training directors; the appointing of an ombudsperson and/or ethicist to oversee and resolve issues as they arise; instructional workshops and materials to enhance and impart skills for all teachers; remediation or retiring of errant faculty; and ongoing research and dialogue between and among medical centers about novel solutions.

  8. Violence against health workers in Family Medicine Centers

    Directory of Open Access Journals (Sweden)

    Al-Turki N

    2016-05-01

    Full Text Available Nouf Al-Turki,1 Ayman AM Afify,1 Mohammed AlAteeq2 1Family Medicine Department, Prince Sultan Military Medical City, 2Department of Family Medicine and PHC, King Abdul-Aziz Medical City, National Guard Health Affairs, Riyadh, Kingdom of Saudi Arabia Background: Health care violence is a significant worldwide problem with negative consequences on both the safety and well-being of health care workers as well as workplace activities. Reports examining health care violence in Saudi Arabia are limited and the results are conflicting.Objective: To estimate the prevalence and determine the demographic and occupational characteristics associated with workplace violence in primary care centers in Riyadh, Saudi Arabia.Methods: A cross-sectional study included 270 health care workers in 12 family medicine centers in Riyadh during November and December 2014. A structured self-administered questionnaire was used to estimate the frequency, timing, causes, reactions, and consequences of workplace violence plus participants’ demographic and occupational data.Results: A total 123 health care workers (45.6% experienced some kind of violence over 12 months prior to the study. These included physical (6.5% and nonphysical violence (99.2%, including verbal violence (94.3% and intimidation (22.0%. Offenders were patients (71.5% in the majority of cases, companions (20.3%, or both (3.3%. Almost half (48.0% of health care workers who experienced violence did nothing, 38.2% actively reported the event, and 13.8% consulted a colleague. A significant association of workplace violence was found with working multiple shifts, evening or night shift, and lack of an encouraging environment to report violence.Conclusion: Workplace violence is still a significant problem in primary care centers. The high frequency of violence together with underreporting may indicate the inefficiency of the current safety program. More safety programs and training activities for health care

  9. Instruction to the authors of the Journal of Family and Community Medicine

    OpenAIRE

    Editor RBMFC

    2010-01-01

    The Journal of Family Medicine and Community RBMFC) is a quarterly publication of the Brazilian Society of Family Medicine and Community, which aims to: raise awareness among professionals and health authorities in the area of interest of Family Medicine and Community; stimulate and disseminate research on issues and Primary Health Care (PHC), enabling the exchange between academia, service and social movement organizations, to promote the dissemination of abordageminterdisciplinar and serve ...

  10. FAMNET: The Use of an Electronic Mail System in Canadian Academic Family Medicine

    Science.gov (United States)

    Ostbye, Truls; Needler, M.C.; Shires, David B.

    1988-01-01

    The major Canadian universities are connected via a computer communications network called `Netnorth'. We have used Netnorth's accessible, low-cost, electronic mail system to develop a network of academic Family Medicine users (Famnet). We then tested Famnet's utility for conducting rapid surveys. Famnet shows promise of being a useful means of undertaking regular inter-departmental communication. This system may also increase collegiality among Canadian Departments of Family Medicine and facilitate international communication in family medicine. PMID:21264023

  11. Transforming a clinical clerkship with team learning.

    Science.gov (United States)

    Levine, Ruth E; O'Boyle, Michael; Haidet, Paul; Lynn, David J; Stone, Michael M; Wolf, Dwight V; Paniagua, Freddy A

    2004-01-01

    Team learning, an innovative educational method combining interactive small group learning with expert-based content delivery, was introduced into our psychiatry clerkship in 2002. The main goal was to increase classroom engagement and improve educational outcomes. Eight of 16 lectures were replaced with team learning activities, including prerequisite readings, readiness assurance tests, and application exercises. Data on students' performance and educational experiences were compared before and after curricular change. Following implementation of team learning, students performed significantly better on the National Board of Medical Examiners (NBME) psychiatry subject test and scored higher on attitudes about working in teams. Students perceived team learning activities to be more engaging, effective, and enjoyable than conventional didactics. Incorporating team learning into the psychiatry clerkship was associated with improved student performance and increased student engagement and satisfaction. Team learning is a promising educational strategy that may prove useful in other clerkships.

  12. An innovative clerkship module focused on patients with disabilities.

    Science.gov (United States)

    Woodard, Laurie J; Havercamp, Susan M; Zwygart, Kira K; Perkins, Elizabeth A

    2012-04-01

    Lack of medical training results in physicians being unprepared to provide care to people with disabilities, which, in turn, contributes to the substantial health disparities that are evident in this population. Few medical schools or primary care residencies address the care of adults with disabilities. Competencies and guidelines to assist American physicians in caring for patients with physical or intellectual disabilities have yet to be established, thus making educational goals unclear. This article describes one novel training module regarding people with disabilities that was developed at the University of South Florida Health, Morsani College of Medicine (USF) and inserted into the primary care clerkship during a major curriculum redesign in 2005. Since then, all USF third-year medical students have been required to participate in this disability-related course component. The authors describe the module's development and integration into the primary care clerkship, as well as the specific elements of their curriculum. By using a variety of teaching modalities in the classroom and community, and especially by involving people with disabilities themselves, the medical students have a very comprehensive learning experience regarding people who have physical, sensory, or intellectual disabilities. The authors have been able to show that USF medical students, on completion of this module, demonstrate improved knowledge, attitudes, and comfort in caring for people with disabilities, which the authors believe will lead to improved health and health care access for this underserved population. Suggestions for program replication, including common challenges, are also discussed.

  13. The American Board of Family Medicine: New Tools to Assist Program Directors and Graduates Achieve Success.

    Science.gov (United States)

    Kozakowski, Stanley M; Pugno, Perry A

    2017-01-01

    In this commentary we review the improvements in the pass rates for first-time American Board of Family Medicine (ABFM) Certification Examination test takers in the context of new tools and resources for program directors against the backdrop of a changing accreditation system and increased competition for a relatively fixed number of graduate medical education positions in family medicine. While causality cannot be established between the strategic initiatives of the ABFM and higher pass rates, we can all celebrate the new tools and resources provided to residents and program directors, and the improved performance of family medicine graduates on the certification examination. © Copyright 2017 by the American Board of Family Medicine.

  14. Medical advertising: the Family Encyclopaedia of Medicine scandal of 1914.

    Science.gov (United States)

    Jellinek, E H

    2008-12-01

    The past 100 years have seen a transition from a total ban in Britain on all advertising by doctors to the laity to almost total freedom of medical information, with probable benefit to public health but also a risk of loss of privacy. The Family Encyclopaedia of Medicine, written by Dr Hugh Howard Riddle and published by Lord Northcliffe's Daily Mail in 1914, started a flood of medical journalism in the press and the newer media. The lavishly advertised misattribution of its authorship to 'thirty eminent specialists', including Clifford Allbutt and William Osler, caused a major rumpus in the London Royal College of Physicians, but the fortnightly publication continued and became a four-volume book, popular with a public avid for more and more medical information.

  15. Neuro-Linguistic Programming and Its Use in Family Medicine

    Directory of Open Access Journals (Sweden)

    Kenan Taştan1

    2014-09-01

    Full Text Available Neuro-Linguistic Programming (NLP is reprogramming the brain nerve language (or NLP means that you can program the language of your mind. NLP helps to the effective use of language in order to achieve a success behavior and provides us programs and techniques to organize the nervous system for achieving our goals which were determined before. NLP is particularly assertive in this field because of the fact that NLP takes its roots from psychotherapy (or because of the roots of NLP are based on the psychotherapy. On the other hand, due to the effect of human psychology on a person’s body and that the healing process can be modeled NLP is also used as a powerful tool in other branches of therapy. In this article it is intended to give information about the nature of NLP as it is practiced today and it’s usage in family medicine practice.

  16. Satisfaction of trainees of Saudi Diploma Family Medicine, Saudi Arabia.

    Science.gov (United States)

    Al-Khaldi, Yahia M; AlDawood, Kassim M; AlKhudeer, Basima K; AlSaqqaf, Abdullah A

    2016-09-01

    This paper aims to assess trainees' satisfaction with the process and assessment aspects of the Saudi Diploma of Family Medicine (SDFM). This cross-sectional study was conducted in February 2015 among trainees undertaking the SDFM. A questionnaire was distributed to all trainees in four examination centres in Saudi Arabia, under the supervision and guidance of the investigators (four members of the scientific committee of SDFM). There was a total of 97 participants in this study, the majority of whom were Saudis. More than 85% were satisfied with most elements of training including; an adequate number and variety of patients and cases, allocating time for training, giving regular written evaluation. Satisfaction with mentoring and giving constructive feedback scored less well and trainees were less satisfied with some hospital clinical rotations, which requires further exploration.

  17. Human capital identification process: linkage for family medicine and community medicine to mobilize the community.

    Science.gov (United States)

    Tanasugarn, Chanuantong; Thongbunjob, Krid

    2012-06-01

    Community diagnosis and approach has shifted from a professional focus to a community focus. The information system has also been developed to reflect socio-cultural information. This new system has been established throughout the country and is being recorded in the computer system. However these data still lack human capital information to promote community mobilization. The present study aims to develop a process which reflects human capital from the insider and outsider points of view and which builds on the existing work system of primary care service, family medicine, and community medicine. The present study applies the participatory action research design with mixed methods including community grand-tour, household survey socio-metric questionnaire and focus group discussion in order to gather insider view of human capital. A key instrument developed in the present study is the socio-metric questionnaire which was designed according to the community grand tour and household survey results. The findings indicate that the process is feasible and the insider point of view given a longer evidence based list of the human capital. The model enhanced a closer relationship between professional and community people and suggested the realistic community mobilizer name list. Human capital identification process is feasible and should be recommended to integrate in the existing work process of the health staff in family and community practice.

  18. Improving consistency in student evaluation at affiliated family practice centers.

    Science.gov (United States)

    Rabinowitz, H K

    1986-01-01

    The Department of Family Medicine at Jefferson Medical College has since 1974 been successful in administering a required third-year family medicine clerkship, providing students with a structured, didactic, and experiential curriculum in six affiliated family practice centers. Prior analysis (1976-1981) had indicated, however, that variation existed in evaluating similar students, depending on the clerkship training site, i.e., three sites graded students in a significantly different fashion than the three other sites. Utilizing these data to focus on the evaluation process, a comprehensive and specific six-point plan was developed to improve consistency in evaluations at the different training sites. This plan consisted of a yearly meeting of affiliate faculty, assigning predoctoral training administrative responsibility to one faculty member at each training site, increased telephone communication, affiliate-faculty attendance at the university site evaluation session, faculty rotation to spend time at other training sites, and financial reimbursement to the affiliate training sites. After intervention, analysis (1981-1983) indicated that five of the six clerkship sites now grade students in a consistent fashion, with only one affiliate using different grading standards. The intervention was therefore judged to be successful for five of the six training sites, allowing for better communication and more critical and consistent evaluation of medical students.

  19. Narratives in family medicine: a global perspective: The Besrour Papers: a series on the state of family medicine in the world.

    Science.gov (United States)

    Gibson, Christine; Woollard, Robert; Kapoor, Videsh; Ponka, David

    2017-02-01

    To explore the development of family medicine postgraduate training in countries with varying levels of resources at different stages of development of the discipline. Since 2012, the College of Family Physicians of Canada has hosted the Besrour Conferences to reflect on its role in advancing the discipline of family medicine globally. The Besrour Narrative Working Group was conceived in 2012 at the first Besrour Conference. Their mandate was to use narrative and appreciative inquiry to gather stories of family medicine worldwide. The working group comprised members of various academic departments of family medicine in Canada and abroad who attended the conferences. A consultation process with our partners from lower-middle-income countries was undertaken from 2012 to 2014. Stories were sought from each global partner institute with ties to Canadian family medicine departments. An appreciative inquiry approach was chosen to elicit narratives. Thematic analysis was used to search for common threads and important elements of success that could serve to inform other initiatives in other nations and, in turn, offer hope for greater effect. Sixteen narrative stories have been collected so far. These stories highlight insightful solutions, foresight, perseverance, and ultimately a steadfast belief that family medicine will improve the health system and the care provided to the citizens of each nation. Seventeen themes were elucidated by 3 independent Canadian readers. At a subsequent workshop, these themes were validated by Besrour Centre members from Canada and elsewhere. The linkage between the thematic analysis and the experiences of various schools helps to illustrate both the robustness and the usefulness of the narratives in exploring generalizable observations and the features supporting success in each institute. If we are to understand, and contribute to, the development of family medicine throughout the world (a key objective of the Besrour Centre), we must

  20. Report on financing the new model of family medicine.

    Science.gov (United States)

    Spann, Stephen J

    2004-12-02

    To foster redesigning the work and workplaces of family physicians, this Future of Family Medicine task force was created to formulate and recommend a financial model that sustains and promotes a thriving New Model of care by focusing on practice reimbursement and health care finances. The goals of the task force were to develop a financial model that assesses the impact of the New Model on practice finances, and to recommend health care financial policies that, if implemented, would be expected to promote the New Model and the primary medical care function in the United States for the next few decades. The members of the task force reflected a wide range of professional backgrounds and expertise. The group met in person on 2 occasions and communicated by e-mail and conference calls to achieve consensus. A marketing study was carried out using focus groups to test the concept of the New Model with consumers. External consultants with expertise in health economics, health care finance, health policy, and practice management were engaged to assist the task force with developing the microeconomic (practice level) and macroeconomic (societal level) financial models necessary to achieve its goals. Model assumptions were derived from the published medical literature, existing practice management databases, and discussions with experienced physicians and other content experts. The results of the financial modeling exercise are included in this report. The initial draft report of the findings and recommendations was shared with a reactor panel representing a broad spectrum of constituencies. Feedback from these individuals was reviewed and incorporated, as appropriate, into the final report. The practice-level financial model suggests that full implementation of the New Model of care within the current fee-for-service system of reimbursement would result in a 26% increase in compensation (from 167,457 dollars to 210,288 dollars total annual compensation) for prototypical

  1. Trialing a new clinical clerkship record in Japanese clinical training

    Directory of Open Access Journals (Sweden)

    Nomura S

    2015-09-01

    Full Text Available Shosaku Nomura, Noboru Tanigawa, Yo Kinoshita, Koichi TomodaFirst Department of Internal Medicine, Kansai Medical University, Shinmachi, Hirakata, Osaka, JapanUndergraduate medical education has several problems.1,2 In particular, clinical training, which is the unique feature of medical education, tends to be performed less extensively. In Japan, the current clinical training method is clinical clerkship (CC. CC differs from conventional clinical training, which is study by observation. In CC, the student is a member of the medical team and participates in actual medical care. The student is allowed to practice medical actions in the definite range under the guidance and monitoring of a teaching doctor. Therefore, students can acquire practical clinical abilities. In their study of medical care, students are required to have their own sense of identity and personal responsibility. Clinical training is performed by CC following the original curriculum for diagnoses and treatments in various medical departments.

  2. Compensation and Production in Family Medicine by Practice Ownership

    Directory of Open Access Journals (Sweden)

    Alison C. Essary

    2016-02-01

    Full Text Available The increasing focus on high performance, patient-centered, team-based care calls for a strategy to evaluate cost-effective primary care. The trend toward physician practice consolidation further challenges the primary care health care system. Productivity measures establish provider value and help inform decision making regarding resource allocation in this evolving health care system. In this national survey of family medicine practices, physician assistant (PA productivity, as defined by mean annual patient encounters, exceeds that of both nurse practitioners (NPs and physicians in physician-owned practices and of NPs in hospital or integrated delivery system-owned practices. Total compensation, defined as salary, bonus, incentives, and honoraria for physicians, is significantly more compared to both PAs and NPs, regardless of practice ownership or productivity. Physician assistants and NPs earn equivalent compensation, regardless of practice ownership or productivity. Not only do these data support the value and role of PAs and NPs on the primary care team but also highlight differences in patient encounters between practice settings. Rural and underserved community practices, where physician-owned practices persist, also merit further consideration. Further research is needed to inform both organizational and policy decisions for the provision of high-quality, cost-effective, and accessible primary health care.

  3. Compensation and Production in Family Medicine by Practice Ownership

    Directory of Open Access Journals (Sweden)

    Alison C. Essary

    2016-02-01

    Full Text Available The increasing focus on high performance, patient-centered, team-based care calls for a strategy to evaluate cost-effective primary care. The trend toward physician practice consolidation further challenges the primary care health care system. Productivity measures establish provider value and help inform decision making regarding resource allocation in this evolving health care system. In this national survey of family medicine practices, physician assistant (PA productivity, as defined by mean annual patient encounters, exceeds that of both nurse practitioners (NPs and physicians in physician-owned practices and of NPs in hospital or integrated delivery system-owned practices. Total compensation, defined as salary, bonus, incentives, and honoraria for physicians, is significantly more compared to both PAs and NPs, regardless of practice ownership or productivity. Physician assistants and NPs earn equivalent compensation, regardless of practice ownership or productivity. Not only do these data support the value and role of PAs and NPs on the primary care team but also highlight differences in patient encounters between practice settings. Rural and underserved community practices, where physician-owned practices persist, also merit further consideration. Further research is needed to inform both organizational and policy decisions for the provision of high-quality, cost-effective, and accessible primary health care.

  4. The influence of academic discourses on medical students' identification with the discipline of family medicine.

    Science.gov (United States)

    Rodríguez, Charo; López-Roig, Sofía; Pawlikowska, Teresa; Schweyer, François-Xavier; Bélanger, Emmanuelle; Pastor-Mira, Maria Angeles; Hugé, Sandrine; Spencer, Sarah; Lévasseur, Gwenola; Whitehead, Ian; Tellier, Pierre-Paul

    2015-05-01

    To understand the influence of academic discourses about family medicine on medical students' professional identity construction during undergraduate training. The authors used a multiple case study research design involving international medical schools, one each from Canada, France, Spain, and the United Kingdom (UK). The authors completed the fieldwork between 2007 and 2009 by conducting 18 focus groups (with 132 students) and 67 semistructured interviews with educators and by gathering pertinent institutional documents. They carried out discursive thematic analyses of the verbatim transcripts and then performed within- and cross-case analyses. The most striking finding was the diverging responses between those at the UK school and those at the other schools. In the UK case, family medicine was recognized as a prestigious academic discipline; students and faculty praised the knowledge and skills of family physicians, and students more often indicated their intent to pursue family medicine. In the other cases, family medicine was not well regarded by students or faculty. This was expressed overtly or through a paradoxical academic discourse that stressed the importance of family medicine to the health care system while decrying its lack of innovative technology and the large workload-to-income ratio. Students at these schools were less likely to consider family medicine. These results stress the influence of academic discourses on medical students' ability to identify with the practice of family medicine. Educators must consider processes of professional identity formation during undergraduate medical training as they develop and reform medical education.

  5. Impact of clerkship in the attitudes toward psychiatry among Portuguese medical students

    Directory of Open Access Journals (Sweden)

    Almeida José C

    2010-08-01

    Full Text Available Abstract Background Given the shortage of human resources and the launching of a new Mental Health Plan, recruitment of psychiatrists is currently a major concern in Portugal, as well as in several other countries. Medical students' attitude toward psychiatry has been pointed as a predictor of recruitment. This study aims to evaluate the medical students' perception of psychiatry before and after a clerkship, and the impact on their intention to pursue psychiatry as a future specialty option. Methods Two self-report questionnaires were administered to all 6th year students in a medical school in Lisbon, before and after a 4-weeks full-time psychiatric clerkship, in order to evaluate attitudes toward psychiatry and intention to follow psychiatry in the future. Statistical analysis included Wilcoxon and Chi-square tests. Results 153 students (60.8% female filled in both questionnaires (no dropouts. After the clerkship, there was a significant improvement regarding the overall merits of psychiatry, efficacy, role definition and functioning of psychiatrists, use of legal powers to hospitalize patients and specific medical school factors. There was also a significant increase of students decided or considering the possibility to take a residency in psychiatry. However, perceptions of low prestige and negative pressure from family and peers regarding a future choice of psychiatry remained unchanged in about one-third of the students. Conclusions The results indicate clearly that the clerkship had a favorable overall impact on the student attitude towards psychiatry, as well as in the number of students considering a future career in psychiatry. Attitudes toward psychiatry seems a promising outcome indicator of the clerkship's quality, but further research is needed in order to assess its reliability as a sound predictor of recruitment.

  6. Impact of clerkship in the attitudes toward psychiatry among Portuguese medical students.

    Science.gov (United States)

    Xavier, Miguel; Almeida, José C

    2010-08-02

    Given the shortage of human resources and the launching of a new Mental Health Plan, recruitment of psychiatrists is currently a major concern in Portugal, as well as in several other countries. Medical students' attitude toward psychiatry has been pointed as a predictor of recruitment. This study aims to evaluate the medical students' perception of psychiatry before and after a clerkship, and the impact on their intention to pursue psychiatry as a future specialty option. Two self-report questionnaires were administered to all 6th year students in a medical school in Lisbon, before and after a 4-weeks full-time psychiatric clerkship, in order to evaluate attitudes toward psychiatry and intention to follow psychiatry in the future. Statistical analysis included Wilcoxon and Chi-square tests. 153 students (60.8% female) filled in both questionnaires (no dropouts). After the clerkship, there was a significant improvement regarding the overall merits of psychiatry, efficacy, role definition and functioning of psychiatrists, use of legal powers to hospitalize patients and specific medical school factors. There was also a significant increase of students decided or considering the possibility to take a residency in psychiatry.However, perceptions of low prestige and negative pressure from family and peers regarding a future choice of psychiatry remained unchanged in about one-third of the students. The results indicate clearly that the clerkship had a favorable overall impact on the student attitude towards psychiatry, as well as in the number of students considering a future career in psychiatry. Attitudes toward psychiatry seems a promising outcome indicator of the clerkship's quality, but further research is needed in order to assess its reliability as a sound predictor of recruitment.

  7. Management of early pregnancy failure and induced abortion by family medicine educators.

    Science.gov (United States)

    Herbitter, Cara; Bennett, Ariana; Schubert, Finn D; Bennett, Ian M; Gold, Marji

    2013-01-01

    Reproductive health care, including treatment of early pregnancy failure (EPF) and induced abortion, is an integral part of patient-centered care provided by family physicians, but data suggest that comprehensive training is not widely available to family medicine residents. The purpose of this study was to assess EPF and induced abortion management practices and attitudes of family medicine physician educators throughout the United States and Canada. These data were collected as part of a cross-sectional survey conducted by the Council of Academic Family Medicine Educational Research Alliance that was distributed via E-mail to 3152 practicing physician members of Council of Academic Family Medicine organizations. The vast majority of respondents (88.2%) had treated EPF, whereas few respondents (15.3%) had provided induced medication or aspiration abortions. Of those who had treated EPF, most had offered medication management (72.7%), whereas a minority had provided aspiration management (16.4%). Almost all respondents (95%) agreed that EPF management is within the scope of family medicine, and nearly three-quarters (73.2%) agreed that early induced abortion is within the scope of family medicine. Our findings suggest that family physician educators are more experienced with EPF management than elective abortion. Given the overlap of skills needed for provision of these services, there is the potential to increase the number of family physician faculty members providing induced abortions.

  8. Skills training in laboratory and clerkship: connections, similarities, and differences

    Directory of Open Access Journals (Sweden)

    Berit Eika, MD, PhD

    2003-03-01

    Full Text Available Context: During the third semester of a 6 year long curriculum medical students train clinical skills in the skills laboratory (2 hours per week for 9 weeks as well as in an early, 8 week clinical clerkship at county hospitals. Objectives: to study students’ expectations and attitudes towards skills training in the skills laboratory and clerkship. Subjects: 126 medical students in their 3rd semester. Methods: During the fall of 2001 three consecutive, constructed questionnaires were distributed prior to laboratory training, following laboratory training but prior to clerkships, and following clerkships respectively. Results: Almost all (98% respondents found that training in skills laboratory improved the outcome of the early clerkship and 70% believed in transferability of skills from the laboratory setting to clerkship. Still, a majority (93% of students thought that the clerkship provided students with a better opportunity to learn clinical skills when compared to the skills laboratory. Skills training in laboratory as well as in clerkship motivated students for becoming doctors. Teachers in both settings were perceived as being committed to their teaching jobs, to demonstrate skills prior to practice, and to give students feed back with a small but significant more positive rating of the laboratory. Of the 22 skills that students had trained in the laboratory, a majority of students tried out skills associated with physical examination in the clerkship, whereas only a minority of students tried out more intimate skills. Female medical students tried significantly fewer skills during their clerkship compared to male students. Conclusions: Students believe that skills laboratory training prepare them for their subsequent early clerkship but favour the clerkship over the laboratory

  9. A National CERA Study of the Use of Laborists in Family Medicine Residency Training.

    Science.gov (United States)

    Baldor, Robert A; Pecci, Christine Chang; Moreno, Gerardo; Van Duyne, Virginia; Potts, Stacy E

    2017-02-01

    Little is known about the impact of laborists (which we defined as "clinicians dedicated to providing L&D care services in the hospital environment for pregnant patients, regardless of who provided the prenatal care" for this survey) on family medicine residency training. We surveyed family medicine residency directors to assess characteristics about laborist services and their involvement in family medicine residency teaching. Questions were included in the 2015 Council of Academic Family Medicine Educational Research Alliance (CERA) survey of family medicine residency directors. Univariate statistics were used to describe programs, directors, and our questions on the use of laborists. Chi-square tests and Student's t tests were used to evaluate bivariate relationships using a P30% of their graduates included L&D care in their first practice.. Laborists have an important role in family medicine resident obstetrics training and education. More research is needed to explore how laborists and family medicine faculty can collaborate to promote enhanced efficiency and effectiveness as residency teachers.

  10. Family medicine in undergraduate medical curriculum: a cost-effective approach to health care in Pakistan.

    Science.gov (United States)

    Iqbal, Saima P

    2010-01-01

    Shifa College of Medicine introduced a two-week rotation in Family Medicine for their third-year medical students in 2008. The purpose of this study was to determine what impact it made on students and how many would consider becoming Family Physicians in future. A questionnaire-based prospective study conducted at Shifa College of Medicine, Islamabad during academic year 2008. A total of 46 students rotated in Family Medicine throughout the academic year-2008. Fifteen students were aware of Family Medicine as a specialty prior to starting their rotation, and only 3 expressed an interest to pursue Family Medicine as a future career. At the start of the rotation only 15 students were able to give correct definition of Family Medicine and on questioning whether it should be a part of the undergraduate curriculum, only 24 answered yes while the rest were unsure. After the rotation, a significant number of students (37%; p definition of Family Medicine as a humanistic approach of medicine with aim to prevent, treat and rehabilitate. About its utility in the undergraduate curriculum, 44 (96%) students believed it should be a regular feature in their curriculum, while 30 (65%) students agreed that their outlook towards patient care had changed. When asked what they learnt most during the rotation, students quoted empathy and development of communication skills. Family medicine rotation as part of undergraduate medical curriculum may help in fostering an interest among medical students in this newly emerging subspecialty which could have a profound effect on delivery of quality health care in this country.

  11. The loss of student idealism in the 3rd-year clinical clerkships.

    Science.gov (United States)

    Griffith, C H; Wilson, J F

    2001-03-01

    The purpose of this study was to specify how student attitudes toward different types of patients and the profession change during clinical rotations. A questionnaire was given to all medical students prior to 3rd-year rotations regarding their attitudes toward the medical profession and patient types. It was given again after students completed their 16-week medicine-surgery clerkship. Eighty-eight of 96 students responded to pre- and posttests. Students became less idealistic toward two patient groups: the elderly and people with chronic pain. After clerkship, students believed a greater percentage of the elderly were demented (26% increasing to 35%, p = .09 and that a greater percentage of patients with chronic pain are drug seekers (15% increasing to 24%, p = .004). The authors conclude that in the 3rd year of medical school students become less idealistic toward elderly patients, those with chronic pain, and the profession.

  12. Differences in prescribing patterns for anxiety and depression between General Internal Medicine and Family Medicine.

    Science.gov (United States)

    Brieler, Jay A; Scherrer, Jeffrey F; Salas, Joanne

    2015-02-01

    Depression and anxiety are routinely managed by physicians in Family Medicine (FM) or General Internal Medicine (GIM). Because FM requires more behavioral health training than GIM, we sought to determine if prescribing patterns for patients with anxiety, depression, or both differed between FM vs. GIM providers. In a cross-sectional design, patient data and provider type were obtained from 2008 to 2013 electronic medical record patient data registry (n=27,225 (FM=10,994, GIM=16,231)) Prescription orders were modeled for specific benzodiazepines and antidepressants and by drug class. Covariates included gender, age, race, marital status and comorbidity index. Separate logistic regression models were computed, before and after adjusting for covariates, to estimate the odds of FM vs. GIM providers prescribing benzodiazepine or antidepressant medication to patients with anxiety, depression, and both disorders. After adjusting for covariates, patients with anxiety alone, depression alone, and both had significantly greater odds of receiving an antidepressant (OR=2.08;95%CI:1.46-2.96, OR=2.13;95%CI:1.48-3.06, and OR=2.26;95%CI:1.09-4.66, respectively) if treated by FM vs. GIM. Benzodiazepine prescription did not differ by physician type. It is not known if results will generalize to other regions of the United States. Patients with anxiety, depression, and both seen by FM providers, as compared to GIM providers, are more likely to receive antidepressant medications. Further investigation into the determinants of these differences is warranted. Under-treatment in GIM may result in less advantageous outcomes. Copyright © 2014 Elsevier B.V. All rights reserved.

  13. Comparison of Patient Health History Questionnaires Used in General Internal and Family Medicine, Integrative Medicine, and Complementary and Alternative Medicine Clinics.

    Science.gov (United States)

    Laube, Justin G R; Shapiro, Martin F

    2017-05-01

    Health history questionnaires (HHQs) are a set of self-administered questions completed by patients prior to a clinical encounter. Despite widespread use, minimal research has evaluated the content of HHQs used in general internal medicine and family medicine (GIM/FM), integrative medicine, and complementary and alternative medicine (CAM; chiropractic, naturopathic, and Traditional Chinese Medicine [TCM]) clinics. Integrative medicine and CAM claim greater emphasis on well-being than does GIM/FM. This study investigated whether integrative medicine and CAM clinics' HHQs include more well-being content and otherwise differ from GIM/FM HHQs. HHQs were obtained from GIM/FM (n = 9), integrative medicine (n = 11), naturopathic medicine (n = 5), chiropractic (n = 4), and TCM (n = 7) clinics in California. HHQs were coded for presence of medical history (chief complaint, past medical history, social history, family history, surgeries, hospitalizations, medications, allergies, review of systems), health maintenance procedures (immunization, screenings), and well-being components (nutrition, exercise, stress, sleep, spirituality). In HHQs of GIM/FM clinics, the average number of well-being components was 1.4 (standard deviation [SD], 1.4) compared with 4.0 (SD, 1.1) for integrative medicine (p medicine (p = 0.04), 2.0 (SD, 1.4) for chiropractic (p = 0.54), and 2.0 (SD, 1.5) for TCM (p = 0.47). In HHQs of GIM/FM clinics, the average number of medical history components was 6.4 (SD, 1.9) compared with 8.3 (SD, 1.2) for integrative medicine (p = 0.01), 9.0 (SD, 0) for naturopathic medicine (p = 0.01), 7.1 (SD, 2.8) for chiropractic (p = 0.58), and 7.1 (SD, 1.7) for TCM (p = 0.41). Integrative and naturopathic medicine HHQs included significantly more well-being and medical history components than did GIM/FM HHQs. Further investigation is warranted to determine the optimal HHQ content to support the clinical and preventive

  14. Development and Validation of Search Filters to Identify Articles on Family Medicine in Online Medical Databases.

    Science.gov (United States)

    Pols, David H J; Bramer, Wichor M; Bindels, Patrick J E; van de Laar, Floris A; Bohnen, Arthur M

    2015-01-01

    Physicians and researchers in the field of family medicine often need to find relevant articles in online medical databases for a variety of reasons. Because a search filter may help improve the efficiency and quality of such searches, we aimed to develop and validate search filters to identify research studies of relevance to family medicine. Using a new and objective method for search filter development, we developed and validated 2 search filters for family medicine. The sensitive filter had a sensitivity of 96.8% and a specificity of 74.9%. The specific filter had a specificity of 97.4% and a sensitivity of 90.3%. Our new filters should aid literature searches in the family medicine field. The sensitive filter may help researchers conducting systematic reviews, whereas the specific filter may help family physicians find answers to clinical questions at the point of care when time is limited.

  15. Lessons learned in developing family medicine residency training programs in Japan

    Directory of Open Access Journals (Sweden)

    Kitamura Kazuya

    2005-09-01

    Full Text Available Abstract Background While family medicine is not well established as a discipline in Japan, a growing number of Japanese medical schools and training hospitals have recently started sougoushinryoubu (general medicine departments. Some of these departments are incorporating a family medicine approach to residency training. We sought to learn from family medicine pioneers of these programs lessons for developing residency training. Methods This qualitative project utilized a long interview research design. Questions focused on four topics: 1 circumstances when becoming chair/faculty member; 2 approach to starting the program; 3 how Western ideas of family medicine were incorporated; and 4 future directions. We analyzed the data using immersion/crystallization to identify recurring themes. From the transcribed data, we selected representative quotations to illustrate them. We verified the findings by emailing the participants and obtaining feedback. Results Participants included: five chairpersons, two program directors, and three faculty members. We identified five lessons: 1 few people understand the basic concepts of family medicine; 2 developing a core curriculum is difficult; 3 start with undergraduates; 4 emphasize clinical skills; and 5 train in the community. Conclusion While organizational change is difficult, the identified lessons suggest issues that merit consideration when developing a family medicine training program. Lessons from complexity science could inform application of these insights in other countries and settings newly developing residency training.

  16. The Effects of Abortion Training on Family Medicine Residents' Clinical Experience.

    Science.gov (United States)

    Summit, Aleza K; Gold, Marji

    2017-01-01

    RHEDI, Reproductive Health Education in Family Medicine, offers technical assistance and funding to family medicine residency programs to support integrated opt-out abortion and reproductive health training for residents. This study assessed the impact of this enhanced training on residents' reproductive health experience. Investigator-developed pre- and post-surveys were administered online to 214 residents at 12 family medicine residency programs before and after their RHEDI training experience. Surveys addressed experience in contraception and abortion, attitudes around abortion provision, and post-residency intentions. Descriptive statistics were generated, and statistical tests were performed to assess changes after training. Surveys had a 90% response rate. After the RHEDI enhanced reproductive health rotation, residents reported increased experience in contraception provision, early pregnancy ultrasound, aspiration and medication abortion, and miscarriage management. After training, residents with experience in IUD insertion increased from 85% to 99%, and contraceptive implant insertion experience rose from 60% to 85%. Residents who had performed any abortions increased from 15% to 79%, and self-rated competency in abortion increased. Finally, almost all residents agreed that early abortion was within the scope of family medicine, and training confirmed residents' intentions to provide reproductive health services after residency. Integrated training in reproductive health, with an emphasis on abortion, increases residents' experience and underscores their understanding of the role of these services in family medicine. Increasing the number of family medicine residency programs that offer this training could help prepare family physicians to meet their patients' needs for reproductive health services.

  17. Geriatric core competencies for family medicine curriculum and enhanced skills: care of elderly.

    Science.gov (United States)

    Charles, Lesley; Triscott, Jean A C; Dobbs, Bonnie M; McKay, Rhianne

    2014-06-01

    There is a growing mandate for Family Medicine residency programs to directly assess residents' clinical competence in Care of the Elderly (COE). The objectives of this paper are to describe the development and implementation of incremental core competencies for Postgraduate Year (PGY)-I Integrated Geriatrics Family Medicine, PGY-II Geriatrics Rotation Family Medicine, and PGY-III Enhanced Skills COE for COE Diploma residents at a Canadian University. Iterative expert panel process for the development of the core competencies, with a pre-defined process for implementation of the core competencies. Eighty-five core competencies were selected overall by the Working Group, with 57 core competencies selected for the PGY-I/II Family Medicine residents and an additional 28 selected for the PGY-III COE residents. The core competencies follow the CanMEDS Family Medicine roles. Both sets of core competencies are based on consensus. Due to demographic changes, it is essential that Family Physicians have the required skills and knowledge to care for the frail elderly. The core competencies described were developed for PGY-I/II Family Medicine residents and PGY-III Enhanced Skills COE, with a focus on the development of geriatric expertise for those patients that would most benefit.

  18. Impact of clerkship attachments on students’ attitude toward pharmaceutical care in Ethiopia

    Directory of Open Access Journals (Sweden)

    Tsega B

    2015-05-01

    Full Text Available Bayew Tsega,1 Akshaya Srikanth Bhagavathula,1 Barun Ranjan Sarkar,1 Tadesse Melaku,1 Zewdneh Shewamene2 1Department of Clinical Pharmacy, 2Department of Pharmacology, School of Pharmacy, University of Gondar-College of Medicine and Health Sciences, Gondar, Ethiopia Objective: The study objective is to investigate the impact of mandatory clinical clerkship courses on 5th-year pharmacy students' attitudes and perceived barriers toward providing pharmaceutical care (PC. Methods: A cross-sectional survey was conducted among 5th-year pharmacy students undertaking mandatory clinical clerkship in the University of Gondar, Ethiopia. A pharmaceutical care attitudes survey (PCAS questionnaire was used to assess the attitude (14 items, commonly identified drug-related problem/s (1 item during clerkships, and perceived barriers (12 items toward the provision of PC. Statistical analysis was conducted on the retrieved data. Results: Out of the total of 69 clerkship students, 65 participated and completed the survey (94.2% response rate. Overall, 74.45% of participants opinioned a positive attitude toward PC provision. Almost all respondents agreed that the primary responsibility of pharmacists in the healthcare setting was to prevent and solve medication-related problems (98.5%, practice of PC was valuable (89.3%, and the PC movement will improve patient health (95.4%, respectively. Unnecessary drug therapy (43%, drug–drug interactions (33%, and non-adherence to medications (33% were the most common drug-related problems identified in wards. Highly perceived barriers for PC provision included lack of a workplace for counseling in the pharmacy (75.4%, a poor image of pharmacist’s role in wards (67.7%, and inadequate technology in the pharmacy (64.6%. Lack of access to a patient’s medical record in the pharmacy had significant association (P<0.05 with PC practice, performance of PC during clerkship, provision of PC as clinical pharmacists, and Ethiopian

  19. Feasibility of self-directed learning in clerkships

    DEFF Research Database (Denmark)

    Tolsgaard, M G; Arendrup, H; Pedersen, P

    2013-01-01

    Self-directed learning has been well described in preclinical settings. However, studies report conflicting results when self-directed initiatives are implemented in clinical clerkships.......Self-directed learning has been well described in preclinical settings. However, studies report conflicting results when self-directed initiatives are implemented in clinical clerkships....

  20. Training Family Medicine Residents to Perform Home Visits: A CERA Survey.

    Science.gov (United States)

    Sairenji, Tomoko; Wilson, Stephen A; D'Amico, Frank; Peterson, Lars E

    2017-02-01

    Home visits have been shown to improve quality of care, save money, and improve outcomes. Primary care physicians are in an ideal position to provide these visits; of note, the Accreditation Council for Graduate Medical Education no longer requires home visits as a component of family medicine residency training. To investigate changes in home visit numbers and expectations, attitudes, and approaches to training among family medicine residency program directors. This research used the Council of Academic Family Medicine Educational Research Alliance (CERA) national survey of family medicine program directors in 2015. Questions addressed home visit practices, teaching and evaluation methods, common types of patient and visit categories, and barriers. There were 252 responses from 455 possible respondents, representing a response rate of 55%. At most programs, residents performed 2 to 5 home visits by graduation in both 2014 (69% of programs, 174 of 252) and 2015 (68%, 172 of 252). The vast majority (68%, 172 of 252) of program directors expect less than one-third of their graduates to provide home visits after graduation. Scheduling difficulties, lack of faculty time, and lack of resident time were the top 3 barriers to residents performing home visits. There appeared to be no decline in resident-performed home visits in family medicine residencies 1 year after they were no longer required. Family medicine program directors may recognize the value of home visits despite a lack of few formal curricula.

  1. Long-term evaluation of undergraduate family medicine curriculum in Slovenia

    Directory of Open Access Journals (Sweden)

    Švab Igor

    2008-01-01

    Full Text Available Introduction In 1994, as a result of curriculum reform, the Ljubljana medical school established its first department of family medicine and introduced its first curriculum of family medicine. The new subject was well accepted by the students and the medical school. Nevertheless, there was no comprehensive analysis of the curriculum during this period. Objective Our aims were to assess the quality of teaching based on fulfilled expectations, pre-defined learning objectives and satisfaction in a 10-year period, and to measure changes in career preference towards family medicine. Method An analysis of two sets of questionnaires, routinely given to medical students in academic years 1997/1998 and 2006/2007, was made. Results Most of the students' expectations were met, and the level increased over ten years. The level of achievement of learning objectives has been high and increased over the ten-year period. Family medicine still receives high scores in students' satisfaction. Although there is evidence that the family medicine curriculum is well accepted and that it improves some of the attitudes towards family medicine, it does not influence the career choice of students. Conclusion The level of achievement of learning objectives increased with the experiences of the teachers. We improved the attitude of medical students toward general practice and general practitioners. We have not been successful in influencing career choice of students, which is an objective that is probably outside our reach.

  2. A Family Medicine Health Technology Strategy for Achieving the Triple Aim for US Health Care.

    Science.gov (United States)

    Phillips, Robert L; Bazemore, Andrew W; DeVoe, Jennifer E; Weida, Thomas J; Krist, Alex H; Dulin, Michael F; Biagioli, Frances E

    2015-09-01

    Health information technology (health IT) and health technology, more broadly, offer tremendous promise for connecting, synthesizing, and sharing information critical to improving health care delivery, reducing health system costs, and achieving personal and community health. While efforts to spur adoption of electronic health records (EHRs) among US practices and hospitals have been highly successful, aspirations for effective data exchanges and translation of data into measureable improvements in health outcomes remain largely unrealized. There are shining examples of health enhancement through new technologies, and the discipline of family medicine is well poised to take advantage of these innovations to improve patient and population health. The Future of Family Medicine led to important family medicine health IT initiatives over the past decade. For example, the American Academy of Family Physicians (AAFP) Center for Health Information Technology and the Robert Graham Center provided important leadership for informing health IT policy and standard-setting, such as the Centers for Medicare and Medicaid Services EHR incentives programs (often referred to as "meaningful use."). As we move forward, there is a need for a new and more comprehensive family medicine strategy for technology. To inform the Family Medicine for America's Health (FMAHealth) initiative, this paper explores strategies and tactics that family medicine could pursue to improve the utility of technology for primary care and to help primary care become a leader in rapid development, testing, and implementation of new technologies. These strategies were also designed with a broader stakeholder audience in mind, intending to reach beyond the work being done by FMAHealth. Specific suggestions include: a shared primary care health IT center, meaningful primary care quality measures and capacity to assess/report them, increased primary care technology research, a national family medicine registry

  3. Assessment of a pattern-recognition examination in a clinical clerkship.

    Science.gov (United States)

    Dunn, M M; Woolliscroft, J O

    1994-08-01

    To develop a pattern-recognition examination (called PAT) for use in assessing surgical clerkship students. The PAT was developed in 1992-93 by the surgery faculty at the Wright State University School of Medicine. The top 30 diagnoses of patients seen by clerkship students in 1991-92 were identified, and possible presenting complaints were selected for each diagnosis. Then for each complaint faculty selected 18 common or catastrophic diagnoses, and a distinctive patient description was written for each diagnosis. An examination of 200 items was compiled covering 20 presenting complaints, each with a set of ten patient descriptions and 18 diagnoses from which to choose the most likely diagnosis. Scoring was by the percentage of correct responses. The PAT was given to 77 students during the 1992-93 clerkship along with other forms of evaluation. The PAT was also administered to 18 surgical residents. The students' mean score on the PAT was 65%, SD, 12.7. Split-half reliability was high (Spearman-Brown r = .91). The students' PAT performances correlated strongly with other cued-response testing formats, e.g., rs = .79, PAT versus the surgery subject examination of the National Board of Medical Examiners. Moderate correlations with essay scores (r = .49) and preceptors' ratings (r = .49) were found. The residents' PAT performances were significantly higher for senior than junior residents (82% versus 63%, p = .004). Utilizing this examination format, it is possible to locally develop a reliable examination that is grounded in the actual clinical problems seen by clerkship students and that assesses more than factual recall.

  4. Using a web-based, iterative education model to enhance clinical clerkships.

    Science.gov (United States)

    Alexander, Erik K; Bloom, Nurit; Falchuk, Kenneth H; Parker, Michael

    2006-10-01

    Although most clinical clerkship curricula are designed to provide all students consistent exposure to defined course objectives, it is clear that individual students are diverse in their backgrounds and baseline knowledge. Ideally, the learning process should be individualized towards the strengths and weakness of each student, but, until recently, this has proved prohibitively time-consuming. The authors describe a program to develop and evaluate an iterative, Web-based educational model assessing medical students' knowledge deficits and allowing targeted teaching shortly after their identification. Beginning in 2002, a new educational model was created, validated, and applied in a prospective fashion to medical students during an internal medicine clerkship at Harvard Medical School. Using a Web-based platform, five validated questions were delivered weekly and a specific knowledge deficiency identified. Teaching targeted to the deficiency was provided to an intervention cohort of five to seven students in each clerkship, though not to controls (the remaining 7-10 students). Effectiveness of this model was assessed by performance on the following week's posttest question. Specific deficiencies were readily identified weekly using this model. Throughout the year, however, deficiencies varied unpredictably. Teaching targeted to deficiencies resulted in significantly better performance on follow-up questioning compared to the performance of those who did not receive this intervention. This model was easily applied in an additive fashion to the current curriculum, and student acceptance was high. The authors conclude that a Web-based, iterative assessment model can effectively target specific curricular needs unique to each group; focus teaching in a rapid, formative, and highly efficient manner; and may improve the efficiency of traditional clerkship teaching.

  5. Engaging rural preceptors in new longitudinal community clerkships during workforce shortage: a qualitative study

    Directory of Open Access Journals (Sweden)

    Weston Kathryn M

    2011-09-01

    Full Text Available Abstract Background In keeping with its mission to produce doctors for rural and regional Australia, the University of Wollongong, Graduate School of Medicine has established an innovative model of clinical education. This includes a 12-month integrated community-based clerkship in a regional or rural setting, offering senior students longitudinal participation in a 'community of practice' with access to continuity of patient care experiences, continuity of supervision and curriculum, and individualised personal and professional development. This required developing new teaching sites, based on attracting preceptors and providing them with educational and physical infrastructure. A major challenge was severe health workforce shortages. Methods Before the new clerkship started, we interviewed 28 general practitioners to determine why they engaged as clerkship preceptors. Independent researchers conducted semi-structured interviews. Responses were transcribed for inductive qualitative content analysis. Results The new model motivated preceptors to engage because it enhanced their opportunities to contribute to authentic learning when compared with the perceived limitations of short-term attachments. Preceptors appreciated the significant recognition of the value of general practice teaching and the honour of major involvement in the university. They predicted that the initiative would have positive effects on general practitioner morale and improve the quality of their practice. Other themes included the doctors' commitment to their profession, 'handing on' to the next generation and helping their community to attract doctors in the future. Conclusions Supervisors perceive that new models of clinical education offer alternative solutions to health care education, delivery and workforce. The longitudinal relationship between preceptor, student and community was seen as offering reciprocal benefits. General practitioners are committed to refining

  6. Physician and medical student perceptions and expectations of the pediatric clerkship: a Qatar experience

    Directory of Open Access Journals (Sweden)

    Hendaus MA

    2016-05-01

    Full Text Available Mohamed A Hendaus,1,2 Shabina Khan,1 Samar Osman,1 Yasser Alsamman,2 Tushar Khanna,2 Ahmed H Alhammadi1,2 1Department of Pediatrics, General Academic Pediatrics Division, Hamad Medical Corporation, Doha, 2Weill Cornell Medical College-Qatar, Al Rayyan, Qatar Background: The average number of clerkship weeks required for the pediatric core rotation by the US medical schools is significantly lower than those required for internal medicine or general surgery. Objective: The objective behind conducting this survey study was to explore the perceptions and expectations of medical students and pediatric physicians about the third-year pediatric clerkship. Methods: An anonymous survey questionnaire was distributed to all general pediatric physicians at Hamad Medical Corporation and to students from Weill Cornell Medical College-Qatar. Results: Feedback was obtained from seven attending pediatricians (100% response rate, eight academic pediatric fellow physicians (100% response rate, 36 pediatric resident physicians (60% response rate, and 36 medical students (60% response rate. Qualitative and quantitative data values were expressed as frequencies along with percentages and mean ± standard deviation and median and range. A P-value <0.05 from a 2-tailed t-test was considered to be statistically significant. Participants from both sides agreed that medical students receive <4 hours per week of teaching, clinical rounds is the best environment for teaching, adequate bedside is provided, and that there is no adequate time for both groups to get acquainted to each other. On the other hand, respondents disagreed on the following topics: almost two-thirds of medical students perceive postgraduate year 1 and 2 pediatric residents as the best teachers, compared to 29.4% of physicians; 3 weeks of inpatient pediatric clerkship is enough for learning; the inpatient pediatric environment is safe and friendly; adequate feedback is provided by physicians to

  7. Nursing students’ valuation on their clinical clerkship

    Directory of Open Access Journals (Sweden)

    Ana R. Rodríguez Gonzalo

    2011-05-01

    Full Text Available Objectives: To know how the nursing students evaluate the clinical-practical knowledge appraised at their clinical clerkship, measured through the satisfaction with the nursing staff Teaching Skills, the Perceived Support and their Global Satisfaction. Methodology: Cross-section, descriptive study carried out at the Ramon y Cajal Hospital. The target population were the 2008/09 nursing students at their clinical clerkship in the hospital, with a total number of 459 shifts. Questionnaire was self-designed and self-administered. Analyzed variables were the student academic year, the hospital ward and their relation with: 1. Teaching Skills, 2. Perceived Support, 3. General Satisfaction.Results: 314 questionnaires were filled out and returned, which is 69,41% of the total number of questionnaires. Students at the Operating Rooms and at the Paediatric Wards gave statistically significant lower qualifications (p=0,005 and p=0,003 than the Emergencies students to the nursing staff Teaching Skills. Regarding the Perceived Support, statistically significant higher scores were given to the Paediatrics (p=0,002 and the Surgical Wards (0,001 compared to the Operating Rooms staff. Finally, in General Satisfaction the lowest, but non statistically significant, scores were given also to the Operating Rooms (p>0,05.Conclusions: Nursing staff from the Operating Rooms and the Paediatric Wards should ameliorate their teaching skills, and those at the Operating Rooms, also the support given during the students clinical clerkship. The proposed improvement actions suggest that meetings between supervisors, nursing staff and professors in order to discuss the teaching objectives are necessary, as well as informational sessions between students and nursing staff at the wards.

  8. Solidarity in family medicine in Brazil and in Italy: reflecting on ethical issues and contemporary challenges

    Directory of Open Access Journals (Sweden)

    Rita de Cássia Gabrielli Souza Lima

    2010-01-01

    Full Text Available This study reflects on solidarity in the practice of family medicine in two realities. The objective is to search for solidarity as an ethical principle in the relationship between family doctor and subject. It is a descriptive exploratory research carried out in Florianópolis, state of Santa Catarina, Brazil, and in the Province of Rome, Lazio Region, Italy. It included fourteen Brazilian family doctors and fifteen Italian family doctors. The theoretical framework consisted of Pierre Bourdieu's theory of Symbolic Power. The results show the importance of the role of the family doctor in the materialization of this ethical principle, as a spokesman for scientific knowledge and as an agent of a State policy. Solidarity was understood within distinct domains and the discursive productions also demonstrated the negation of solidarity in such practice. Globalization proved to be a contemporary challenge for an ethical practice of family medicine that is marked by solidarity.

  9. Family medicine in Denmark: Are there lessons for Botswana and Africa?

    Directory of Open Access Journals (Sweden)

    Vincent Setlhare

    2016-03-01

    Full Text Available Family medicine is a new specialty in Botswana and many African countries and its definitionand scope are still evolving. In this region, healthcare is constrained by resource limitation andinefficiencies in resource utilisation. Experiences in countries with good health indicators canhelp inform discussions on the future of family medicine in Africa. Observations made duringa visit to family physicians (FPs in Denmark showed that the training of FPs, the practice offamily medicine and the role of support staff in a family practice were often different andsometimes unimaginable by African standards. Danish family practices were friendly andenmeshed in an egalitarian and efficient health system, which is supported by an effectiveinformation technology network. There was a lot of task shifting and nurses and clerical staffattended to simple or uncomplicated aspects of patient care whilst FPs attended to morecomplicated patient problems. Higher taxation and higher health expenditure seemed toundergird the effective health system. An egalitarian relationship amongst patients andhealthcare workers (HCW may help improve patient care in Botswana. Task shifting shouldbe formalised, and all sectors of primary healthcare should have fast and effective informationtechnology systems. HCW training and roles should be revised. Higher health expenditure isnecessary to achieve good health indicators.Keywords: task shifting, Family Medicine, Family Physician, Denmark, health expenditure, egalitarian

  10. [USE OF COMPLEMENTARY AND ALTERNATIVE MEDICINE AMONG FAMILY MEDICINE PATIENTS--EXAMPLE OF THE TOWN OF ČAKOVEC].

    Science.gov (United States)

    Vitale, Ksenija; Munđar, Roko; Sović, Slavica; Bergman-Marković, Biserka; Janev Holcer, Nataša

    2014-12-01

    The use of complementary and alternative medicine (CAM) is widespread around the world including Croatia. The number of studies that investigate both quantitative and qualitative use of CAM in Croatia is limited. The aim of this study was to investigate the use of CAM among family medicine patients in the town of Čakovec and the rate they report it to their family doctor. This was a cross-sectional study in a sample of 300 patients that visited primary health center for any reason. We used anonymous questionnaire already employed in a previous investigation (Čižmešija et al. 2008), which describes socioeconomic characteristics, modalities of CAM use, and reasons for use. We also added questions on the type of herbs used and use of over-the-counter vitamin and mineral supplements. On data analysis we used descriptive statistics, χ2-test and Fisher's exact test, while the level of statistical significance was set at p ≤ 0.05. The response rate was 76%. Out of the total number of patients, 82% used some modality of CAM. Women, patients with secondary school education, employed and retired persons used CAM more often. Students and pupils reported least use of CAM. The most commonly used were herbs (87%), bioenergy (29%), diet therapy (28%), chiropractics (22%), and homeopathy and acupuncture (11% each). Vitamin and mineral supplements were used by 77% of study subjects. CAM was most frequently used for respiratory, urinary and musculoskeletal problems, as well as to improve overall health condition. Of the respondents that reported CAM use, 55% believed it would help them, 43% used it because they wanted to try something new, while only 2% indicated dissatisfaction with their physician as the reason for using CAM. Statistically, there were more subjects that used CAM and did not notify their family doctor about it, which could indicate poor communication between family doctors and health care users. Our results are consistent with a previous quantitative study

  11. Cancer Risk Assessment by Rural and Appalachian Family Medicine Physicians

    Science.gov (United States)

    Kelly, Kimberly M.; Love, Margaret M.; Pearce, Kevin A.; Porter, Kyle; Barron, Mary A.; Andrykowski, Michael

    2009-01-01

    Context: Challenges to the identification of hereditary cancer in primary care may be more pronounced in rural Appalachia, a medically underserved region. Purpose: To examine primary care physicians' identification of hereditary cancers. Methods: A cross-sectional survey was mailed to family physicians in the midwestern and southeastern United…

  12. A Problem-Solving Oral Examination for Family Medicine

    Science.gov (United States)

    Van Wart, Arthur D.

    1974-01-01

    The College of Family Physicians of Canada has used in its certification examination a new type of structured problem-solving examination called the Formal Oral. A series of preselected problem areas such as the complaint, relevant data base, investigation, and treatment are scored by two examiners. (Editor/PG)

  13. Cancer Risk Assessment by Rural and Appalachian Family Medicine Physicians

    Science.gov (United States)

    Kelly, Kimberly M.; Love, Margaret M.; Pearce, Kevin A.; Porter, Kyle; Barron, Mary A.; Andrykowski, Michael

    2009-01-01

    Context: Challenges to the identification of hereditary cancer in primary care may be more pronounced in rural Appalachia, a medically underserved region. Purpose: To examine primary care physicians' identification of hereditary cancers. Methods: A cross-sectional survey was mailed to family physicians in the midwestern and southeastern United…

  14. The challenge of training for family medicine across different contexts: Insights from providing training in China

    Directory of Open Access Journals (Sweden)

    John Sandars

    2016-05-01

    Full Text Available Physicians with expertise in providing training for family medicine, at both undergraduate level and postgraduate level, are frequently invited to run training workshops in countries with developing systems of family medicine but this approach is often a challenge for the incoming external trainers. There are general challenges in working across different contexts, especially cultural factors, the different approaches to training, including the aims, methods, and assessment, and additional organizational factors, influenced by the wider sociopolitical environment of the host country. Practical responses to these challenges are discussed, with relevance to both external trainers and those responsible for requesting training. This commentary contains insights from the experiences of the authors in providing training for family medicine in China.

  15. Closing the door on pharma? A national survey of family medicine residencies regarding industry interactions.

    Science.gov (United States)

    Fugh-Berman, Adriane; Brown, Steven R; Trippett, Rachel; Bell, Alicia M; Clark, Paige; Fleg, Anthony; Siwek, Jay

    2011-05-01

    To assess the extent and type of interactions U.S. family medicine residencies permit industry to have with medical students and residents. In 2008, the authors e-mailed a four-question survey to residency directors or coordinators at all 460 accredited U.S. family medicine residencies concerning the types of industry support and interaction permitted. The authors conducted quantitative and qualitative analyses of survey responses and written comments. Residencies that did not permit any industry food, gifts, samples, or support of residency activities were designated "pharma-free." The survey response rate was 62.2% (286/460). Among responding family medicine residencies, 52.1% refused drug samples, 48.6% disallowed industry gifts or food, 68.5% forbade industry-sponsored residency activities, and 44.1% denied industry access to students and residents at the family medicine center. Seventy-five residencies (26.2%) were designated as "pharma-free." Medical-school-based and medical-school-administered residencies were no more likely than community-based residencies to be pharma-free. Among the 211 programs that permitted interaction, 68.7% allowed gifts or food, 61.1% accepted drug samples, 71.1% allowed industry representatives access to trainees in the family medicine center, and 37.9% allowed industry-sponsored residency activities. Respondents commented on challenges inherent to limiting industry interactions. Many programs noted recent changes in plans or practices. Most family medicine residencies limit industry interaction with trainees. Because industry interactions can have adverse effects on rational prescribing, residency programs should assess the benefits and harms of these relationships. Copyright © by the Association of American medical Colleges.

  16. Argentine folk medicine: genotoxic effects of Chenopodiaceae family.

    Science.gov (United States)

    Gadano, A B; Gurni, A A; Carballo, M A

    2006-01-16

    Chenopodium ambrosioides L. and Chenopodium multifidum L. (Chenopodiaceae), common name: Paico, are medicinal plants. They are aromatic shrubs growing in South America. For centuries, they have been used due to its medicinal properties. However, there are few reports in literature about the genotoxic effects of these plants. There for, the aim of these work is the evaluation of genetic damage induced by decoction and infusion of this plants which were assayed in different concentrations (1, 10, 100, 1,000 microL extract/mL culture), by addition of the extract to human lymphocyte cell cultures, negative controls were included. The endpoints evaluated were chromosomal aberrations (CA), sister chromatid exchanges (SCE), cell proliferation kinetics (CPK) and mitotic index (MI). The repeated measure analysis of variance was used for statistic evaluation of the results. The results showed: (a) statistical increase in the percentage of cells with CA and in the frequency of SCE when cultures were exposed to both aromatic plants, (b) a decrease in MI of both Paicos assayed, although no modification in the CPK values was observed, (c) no effect was noticed in the analysis of Chenopodium album L., which was used as negative control of the essential oil. These results suggest a cyto and genotoxic effect of Chenopodium ambrosioides and Chenopodium multifidum aqueous extracts related to the essential oil of the plant (as Chenopodium album did not perform).

  17. Library support of mobile resources during clinical clerkships.

    Science.gov (United States)

    Stokes, Alice; Light, Jeanene; Haines, Laura L

    2014-01-01

    In response to frequent use of mobile devices among medical students, Dana Medical Library at the University of Vermont provided mobile resource support to medical students preparing for clerkships. The librarians offered group instruction, individual assistance, and an online subject guide. These activities were assessed through evaluations, web statistics, and a survey. Survey questions gathered data on access to mobile devices, use of library-licensed mobile resources, and benefits and barriers to use in the clinical setting. The majority of survey respondents believed access to mobile resources improved their clerkship experience and contributed to comparable educational experiences across clerkship sites. Researchers found that library support affected student perception of the value of mobile resources in the clerkship experience.

  18. Learning strategies during clerkships and their effects on clinical performance

    NARCIS (Netherlands)

    van Lohuizen, M. T.; Kuks, J. B. M.; van Hell, E. A.; Raat, A. N.; Cohen-Schotanus, J.

    2009-01-01

    Background: Previous research revealed relationships between learning strategies and knowledge acquisition. During clerkships, however, students' focus widens beyond mere knowledge acquisition as they further develop overall competence. This shift in focus can influence learning strategy use. Aim: W

  19. Multiple Strategies for Studying Medical Clerkship Experiences: A Case Study.

    Science.gov (United States)

    LaPalio, Lawrence R.; And Others

    1983-01-01

    A method of evaluating clerkship experiences was developed that combined several elements: close observation of students for six consecutive days of the first and last weeks of each rotation, student diaries, and interviews. (Author/MSE)

  20. Positioning Medical Students for the Geriatric Imperative: Using Geriatrics to Effectively Teach Medicine

    Science.gov (United States)

    Nguyen, Annie L.; Duthie, Elizabeth A.; Denson, Kathryn M.; Franco, Jose; Duthie, Edmund H.

    2013-01-01

    Medical schools must consider innovative ways to ensure that graduates are prepared to care for the aging population. One way is to offer a geriatrics clerkship as an option for the fulfillment of a medical school's internal medicine rotation requirement. The authors' purpose was to evaluate the geriatrics clerkship's impact on internal medicine…

  1. Positioning Medical Students for the Geriatric Imperative: Using Geriatrics to Effectively Teach Medicine

    Science.gov (United States)

    Nguyen, Annie L.; Duthie, Elizabeth A.; Denson, Kathryn M.; Franco, Jose; Duthie, Edmund H.

    2013-01-01

    Medical schools must consider innovative ways to ensure that graduates are prepared to care for the aging population. One way is to offer a geriatrics clerkship as an option for the fulfillment of a medical school's internal medicine rotation requirement. The authors' purpose was to evaluate the geriatrics clerkship's impact on internal medicine…

  2. A Significant Number of Charter Diplomates Participate in American Board of Family Medicine (ABFM) Maintenance of Certification.

    Science.gov (United States)

    Puffer, James C

    2015-01-01

    Considerable controversy about the value of participating in Maintenance of Certification has recently arisen within the medical community. Despite this controversy, large numbers of family physicians certified by the American Board of Family Medicine participate in Maintenance of Certification for Family Physicians. Surprisingly, a small but significant number of charter diplomats--those initially certified by the American Board of Family Medicine at its founding--are engaged in the process.

  3. An ethnomedicinal survey of cucurbitaceae family plants used in the folk medicinal practices of Bangladesh 1

    Directory of Open Access Journals (Sweden)

    Mohammed Rahmatullah

    2012-01-01

    Full Text Available Background: The Cucurbitaceae family comprising about 125 genera and 960 species is a family that is further characterized by commonly having five-angled stems and coiled tendrils and is also known as gourd family of flowering plants. Plant species belonging to this family have a worldwide distribution, but most species can be found in tropical and subtropical countries. A number of the plants belonging to this family have reported important pharmacological activities. Cucurbitaceae family plants are also in use in the folk medicinal system of Bangladesh-a traditional medicinal system, which mainly relies on medicinal plants for treatment of diverse ailments. Aims: Since folk medicinal practitioners form the first tier of primary health care in Bangladesh, the objective of this study was to conduct ethnomedicinal surveys among 75 folk medicinal practitioners (Kavirajes practicing among the mainstream Bengali-speaking population of randomly selected 75 villages in 64 districts of Bangladesh and 8 tribal practitioners (1 each from 8 major indigenous communities or tribes, namely, Bede, Chakma, Garo, Khasia, Marma, Murong, Santal, and Tripura of the country. Materials and Methods: Surveys were carried out with the help of a semi-structured questionnaire and the guided field-walk method. Results: It was observed that the folk and tribal medicinal practitioners use a total of 19 Cucurbitaceae family species for treatment of ailments such as dysentery, diabetes, edema, skin disorders, leukoderma, hypertension, jaundice, typhoid, spleen disorders, respiratory problems, leprosy, rheumatoid arthritis, chicken pox, and cancer. The 19 species of Cucurbitaceae family plants in use were Benincasa hispida, Bryonopsis laciniosa, Citrullus colocynthis, Citrullus lanatu, Coccinia grandis, Cucumis melo, Cucumis sativus, Cucurbita maxima, Cucurbita pepo, Hodgsonia macrocarpa, Lagenaria vulgaris, Luffa acutangula, Luffa cylindrica, Momordica charantia, Momordica

  4. Family medicine training in sub-Saharan Africa: South-South cooperation in the Primafamed project as strategy for development.

    Science.gov (United States)

    Flinkenflögel, Maaike; Essuman, Akye; Chege, Patrick; Ayankogbe, Olayinka; De Maeseneer, Jan

    2014-08-01

    Health-care systems based on primary health care (PHC) are more equitable and cost effective. Family medicine trains medical doctors in comprehensive PHC with knowledge and skills that are needed to increase quality of care. Family medicine is a relatively new specialty in sub-Saharan Africa. To explore the extent to which the Primafamed South-South cooperative project contributed to the development of family medicine in sub-Saharan Africa. The Primafamed (Primary Health Care and Family Medicine Education) project worked together with 10 partner universities in sub-Saharan Africa to develop family medicine training programmes over a period of 2.5 years. A SWOT (strengths, weaknesses, opportunities and threats) analysis was done and the training development from 2008 to 2010 in the different partner universities was analysed. During the 2.5 years of the Primafamed project, all partner universities made progress in the development of their family medicine training programmes. The SWOT analysis showed that at both national and international levels, the time is ripe to train medical doctors in family medicine and to integrate the specialty into health-care systems, although many barriers, including little awareness, lack of funding, low support from other specialists and reserved support from policymakers, are still present. Family medicine can play an important role in health-care systems in sub-Saharan Africa; however, developing a new discipline is challenging. Advocacy, local ownership, action research and support from governments are necessary to develop family medicine and increase its impact. The Primafamed project showed that development of sustainable family medicine training programmes is a feasible but slow process. The South-South cooperation between the ten partners and the South African departments of family medicine strengthened confidence at both national and international levels. © The Author 2014. Published by Oxford University Press.

  5. Family medicine training in sub-Saharan Africa: South–South cooperation in the Primafamed project as strategy for development

    Science.gov (United States)

    Flinkenflögel, Maaike; Essuman, Akye; Chege, Patrick; Ayankogbe, Olayinka; De Maeseneer, Jan

    2014-01-01

    Background. Health-care systems based on primary health care (PHC) are more equitable and cost effective. Family medicine trains medical doctors in comprehensive PHC with knowledge and skills that are needed to increase quality of care. Family medicine is a relatively new specialty in sub-Saharan Africa. Objective. To explore the extent to which the Primafamed South–South cooperative project contributed to the development of family medicine in sub-Saharan Africa. Methods. The Primafamed (Primary Health Care and Family Medicine Education) project worked together with 10 partner universities in sub-Saharan Africa to develop family medicine training programmes over a period of 2.5 years. A SWOT (strengths, weaknesses, opportunities and threats) analysis was done and the training development from 2008 to 2010 in the different partner universities was analysed. Results. During the 2.5 years of the Primafamed project, all partner universities made progress in the development of their family medicine training programmes. The SWOT analysis showed that at both national and international levels, the time is ripe to train medical doctors in family medicine and to integrate the specialty into health-care systems, although many barriers, including little awareness, lack of funding, low support from other specialists and reserved support from policymakers, are still present. Conclusions. Family medicine can play an important role in health-care systems in sub-Saharan Africa; however, developing a new discipline is challenging. Advocacy, local ownership, action research and support from governments are necessary to develop family medicine and increase its impact. The Primafamed project showed that development of sustainable family medicine training programmes is a feasible but slow process. The South–South cooperation between the ten partners and the South African departments of family medicine strengthened confidence at both national and international levels. PMID:24857843

  6. Breaking bad news: structured training for family medicine residents.

    Science.gov (United States)

    Ungar, Lea; Alperin, Mordechai; Amiel, Gilad E; Beharier, Zvi; Reis, Shmuel

    2002-09-01

    Previous research has shown that physicians experience incompetence and difficulty in dealing with patients' feelings after they have broken bad news to them. During the past 10 years, we have implemented a longitudinal training program targeting these issues. The present article describes this training and discusses its contribution to doctors' skills at approaching distressed patients. In order to cope with breaking bad news to patients and their families, physicians should be skilled at crisis intervention and communication techniques. They should also be aware of their personal attitudes and emotional reactions when breaking bad news. Each session encompassed these areas, as well as the most prominent issues arising when breaking bad news. In a 1-5 Likert scale, the course received an overall score of 4.47 (S.D. 0.51). Participants noted that they had gained relevant communication skills for future patient encounters.

  7. The aquaporin family of water channel proteins in clinical medicine.

    Science.gov (United States)

    Lee, M D; King, L S; Agre, P

    1997-05-01

    The aquaporins are a family of membrane channel proteins that serve as selective pores through which water crosses the plasma membranes of many human tissues and cell types. The sites where aquaporins are expressed implicate these proteins in renal water reabsorption, cerebrospinal fluid secretion and reabsorption, generation of pulmonary secretions, aqueous humor secretion and reabsorption, lacrimation, and multiple other physiologic processes. Determination of the aquaporin gene sequences and their chromosomal locations has provided insight into the structure and pathophysiologic roles of these proteins, and primary and secondary involvement of aquaporins is becoming apparent in diverse clinical disorders. Aquaporin-1 (AQP1) is expressed in multiple tissues including red blood cells, and the Colton blood group antigens represent a polymorphism on the AQP1 protein. AQP2 is restricted to renal collecting ducts and has been linked to congenital nephrogenic diabetes insipidus in humans and to lithium-induced nephrogenic diabetes insipidus and fluid retention from congestive heart failure in rat models. Congenital cataracts result from mutations in the mouse gene encoding the lens homolog Aqp0 (Mip). The present understanding of aquaporin physiology is still incomplete; identification of additional members of the aquaporin family will affect future studies of multiple disorders of water distribution throughout the body. In some tissues, the aquaporins may participate in the transepithelial movement of fluid without being rate limiting, so aquaporins may be involved in clinical disorders without being causative. As outlined in this review, our challenge is to identify disease states in which aquaporins are involved, to define the aquaporins' roles mechanistically, and to search for ways to exploit this information therapeutically.

  8. Patterns of relating between physicians and medical assistants in small family medicine offices.

    Science.gov (United States)

    Elder, Nancy C; Jacobson, C Jeffrey; Bolon, Shannon K; Fixler, Joseph; Pallerla, Harini; Busick, Christina; Gerrety, Erica; Kinney, Dee; Regan, Saundra; Pugnale, Michael

    2014-01-01

    The clinician-colleague relationship is a cornerstone of relationship-centered care (RCC); in small family medicine offices, the clinician-medical assistant (MA) relationship is especially important. We sought to better understand the relationship between MA roles and the clinician-MA relationship within the RCC framework. We conducted an ethnographic study of 5 small family medicine offices (having career motivations and clinician-MA relationships. MA career motivations comprised interest in health care, easy training/workload, and customer service orientation. Clinician-MA relationships were influenced by how MAs and clinicians respond to their perceptions of MA clinical competence (illustrated predominantly by comparing MAs with nurses) and organizational structure. We propose a model, trust and verify, to describe the structure of the clinician-MA relationship. This model is informed by clinicians' roles in hiring and managing MAs and the social familiarity of MAs and clinicians. Within the RCC framework, these findings can be seen as previously undefined constraints and freedoms in what is known as the Complex Responsive Process of Relating between clinicians and MAs. Improved understanding of clinician-MA relationships will allow a better appreciation of how clinicians and MAs function in family medicine teams. Our findings may assist small offices undergoing practice transformation and guide future research to improve the education, training, and use of MAs in the family medicine setting.

  9. Acting as Standardized Patients Enhances Family Medicine Residents' Self-Reported Skills in Palliative Care

    Science.gov (United States)

    Sittikariyakul, Pat; Jaturapatporn, Darin; Kirshen, A. J.

    2015-01-01

    Recent publications have confirmed the use of standardized patients (SPs) in improving clinical skills and enhancing competency. Little research has studied the benefits residents may themselves gain in palliative care playing the role of SPs. Nineteen Family Medicine residents were recruited as standardized patients (FMR-SPs) for a mandatory…

  10. Development and Validation of Search Filters to Identify Articles on Family Medicine in Online Medical Databases

    NARCIS (Netherlands)

    Pols, D.H.; Bramer, W.M.; Bindels, P.J.; Laar, F.A. van de; Bohnen, A.M.

    2015-01-01

    Physicians and researchers in the field of family medicine often need to find relevant articles in online medical databases for a variety of reasons. Because a search filter may help improve the efficiency and quality of such searches, we aimed to develop and validate search filters to identify

  11. Development and validation of search filters to identify articles on family medicine in online medical databases

    NARCIS (Netherlands)

    D.H.J. Pols (David); W.M. Bramer (Wichor); P.J.E. Bindels (Patrick J.E.); F.A. van de Laar (Floris A.); A.M. Bohnen

    2015-01-01

    textabstractPhysicians and researchers in the field of family medicine often need to find relevant articles in online medical databases for a variety of reasons. Because a search filter may help improve the efficiency and quality of such searches, we aimed to develop and validate search filters to

  12. Palliative medicine fellows attend to compassion fatigue using John Stone's 'Talking to the Family'.

    Science.gov (United States)

    Groninger, Hunter

    2015-04-01

    For graduate medical education trainees, as well as contemporary practitioners, developing skills in recognizing compassion fatigue and practising self-care is vital to professional sustainability. The field of palliative medicine is no exception. In our fellowship programme, we use John Stone's poem, 'Talking to the Family,' to engage trainees in a professional development workshop on personal experiences and strategies for self-care.

  13. Multi-Source Evaluation of Interpersonal and Communication Skills of Family Medicine Residents

    Science.gov (United States)

    Leung, Kai-Kuen; Wang, Wei-Dan; Chen, Yen-Yuan

    2012-01-01

    There is a lack of information on the use of multi-source evaluation to assess trainees' interpersonal and communication skills in Oriental settings. This study is conducted to assess the reliability and applicability of assessing the interpersonal and communication skills of family medicine residents by patients, peer residents, nurses, and…

  14. Development and Validation of Search Filters to Identify Articles on Family Medicine in Online Medical Databases

    NARCIS (Netherlands)

    Pols, D.H.; Bramer, W.M.; Bindels, P.J.; Laar, F.A. van de; Bohnen, A.M.

    2015-01-01

    Physicians and researchers in the field of family medicine often need to find relevant articles in online medical databases for a variety of reasons. Because a search filter may help improve the efficiency and quality of such searches, we aimed to develop and validate search filters to identify rese

  15. Development and validation of search filters to identify articles on family medicine in online medical databases

    NARCIS (Netherlands)

    D.H.J. Pols (David); W.M. Bramer (Wichor M); P.J.E. Bindels (Patrick J.E.); F.A. van de Laar (Floris A.); A.M. Bohnen

    2015-01-01

    textabstractPhysicians and researchers in the field of family medicine often need to find relevant articles in online medical databases for a variety of reasons. Because a search filter may help improve the efficiency and quality of such searches, we aimed to develop and validate search filters to i

  16. Views and Experiences of Malaysian Family Medicine Trainees of Female Sexual Dysfunction.

    Science.gov (United States)

    Lai, Pauline Siew Mei; Tan, Sing Yee; Liew, Su May

    2016-11-01

    Sociocultural factors have been shown to be important influencers of sexual health and sexuality. Hence, the aim of our study was to explore the views and experiences of family medicine trainees regarding female sexual dysfunction (FSD) with a focus on the barriers and facilitators towards the initiation of conversation on this topic. A qualitative study design involving semi-structured focus group discussions (FGDs) was conducted with 19 family medicine trainees in Malaysia. The conceptual framework used was based on the Theory of Planned Behavior. Thematic approach was used to analyze the data. Participants perceived FSD as being uncommon and unimportant. According to our participants, patients often presented with indirect complaints, and doctors were not proactive in asking about FSD. Three main barriers were identified: doctor factors, perceived patient factors, and system factors. Lack of confidence, knowledge, experience, time, and embarrassment were the key barriers identified at the doctors' level. Lack of awareness, among patients regarding FSD, and local cultural and religious norms were the perceived patient barriers. System barriers were lack of time and privacy. Various facilitators, such as continuous medical education and public forums, were suggested as means to encourage family medicine trainees to initiate discussion on sexual matters during consultations. In conclusion, family medicine trainees found it difficult to initiate conversation on FSD with patients. Interventions to encourage conversation on FSD should target this and other identified barriers.

  17. Monetary Value of a Prescription Assistance Program Service in a Rural Family Medicine Clinic

    Science.gov (United States)

    Whitley, Heather P.

    2011-01-01

    Purpose: To quantify the monetary value of medications provided to rural Alabamians through provision of pharmaceutical manufacturer-sponsored prescription assistance programs (PAPs) provided by a clinical pharmacist in a private Black Belt family medicine clinic during 2007 and 2008. Methods: Patients struggling to afford prescription medications…

  18. Clinical Poems and Clinical Conversations: Some Thoughts on Working with Family Medicine Residents

    Science.gov (United States)

    Stein, Howard F.

    2006-01-01

    This paper describes an experiment in which Family Medicine residents composed, read, and discussed their poems as a way of bringing to life their often complex relationships with patients. It argues that this approach mobilizes the physicians' own creativity in the service of reflective practice and improved doctor-patient relationships. This…

  19. Evolution of family medicine in Kenya (1990s to date): a case study

    African Journals Online (AJOL)

    PM Chege

    1999-08-26

    Aug 26, 1999 ... PM Chegea*, J Pennerb, P Godoy-Ruizc, V Kapoorb, J Rodasc and K Rouleauc ... bDepartment of Family Medicine, University of British Columbia, Vancouver, Canada ..... Ssenyonga gives a Ugandan history of FM development that .... 2.5. Under-five mortality rate (per 1 000 live births). 73. 48. Maternal ...

  20. Teaching wound care to family medicine residents on a wound care service

    Directory of Open Access Journals (Sweden)

    Little SH

    2013-08-01

    Full Text Available Sahoko H Little,1,2 Sunil S Menawat,1,3 Michael Worzniak,1 Michael D Fetters2 1Oakwood Annapolis Family Medicine Residency, Wayne, Michigan, USA; 2University of Michigan, Department of Family Medicine, Ann Arbor, Michigan, USA; 3Ghent Family Medicine Residency, Eastern Virginia Medical School, Norfolk, Virginia, USA Abstract: Primary care physicians often care for patients with chronic wounds, and they can best serve patients if they have knowledge and proficient skills in chronic wound care, including sharp debridement. The Oakwood Annapolis Family Medicine Residency in Michigan, USA developed a Wound Care Service, incorporating wound care training during the surgical rotation. Effectiveness of the wound care training was evaluated through pre- and posttesting of residents, to assess changes in knowledge and comfort in treating chronic wounds. The results demonstrate significant improvement in residents’ knowledge and comfort in wound care. This innovation demonstrates the feasibility of educating residents in chronic wound care through hands-on experience. Keywords: wound care education, primary care, residency education, surgery rotation, curriculum development

  1. Family Medicine Maternity Care Call to Action: Moving Toward National Standards for Training and Competency Assessment.

    Science.gov (United States)

    Magee, Susanna R; Eidson-Ton, W Suzanne; Leeman, Larry; Tuggy, Michael; Kim, Thomas O; Nothnagle, Melissa; Breuner, Joseph; Loafman, Mark

    2017-03-01

    Maternity care is an integral part of family medicine, and the quality and cost-effectiveness of maternity care provided by family physicians is well documented. Considering the population health perspective, increasing the number of family physicians competent to provide maternity care is imperative, as is working to overcome the barriers discouraging maternity care practice. A standard that clearly defines maternity care competency and a systematic set of tools to assess competency levels could help overcome these barriers. National discussions between 2012 and 2014 revealed that tools for competency assessment varied widely. These discussions resulted in the formation of a workgroup, culminating in a Family Medicine Maternity Care Summit in October 2014. This summit allowed for expert consensus to describe three scopes of maternity practice, draft procedural and competency assessment tools for each scope, and then revise the tools, guided by the Family Medicine and OB/GYN Milestones documents from the respective residency review committees. The summit group proposed that achievement of a specified number of procedures completed should not determine competency; instead, a standardized competency assessment should take place after a minimum number is performed. The traditionally held required numbers for core procedures were reassessed at the summit, and the resulting consensus opinion is proposed here. Several ways in which these evaluation tools can be disseminated and refined through the creation of a learning collaborative across residency programs is described. The summit group believed that standardization in training will more clearly define the competencies of family medicine maternity care providers and begin to reduce one of the barriers that may discourage family physicians from providing maternity care.

  2. The role of family therapists in veterinary medicine: opportunities for clinical services, education, and research.

    Science.gov (United States)

    Hafen, McArthur; Rush, Bonnie R; Reisbig, Allison M J; McDaniel, Kara Z; White, Mark B

    2007-04-01

    Marriage and family therapists (MFTs) are applying their specific skill set in a variety of arenas. A new area for collaboration is veterinary medicine. The veterinary medical profession is emphasizing the importance of non-biomedical skills such as communication skills, acknowledging that human clientele are likely to view their pets as family members, and discussing veterinarian personal well-being. Each of these trends has clear application for intervention by MFTs. A discussion of how MFTs may be uniquely positioned to assist veterinary medicine is presented. An example of collaboration between MFT and veterinary medicine at Kansas State University is highlighted. Recommendations are made for development of effective educational relationships and possible private sector collaborations.

  3. Aromatic Medicinal Plants of the Lamiaceae Family from Uzbekistan: Ethnopharmacology, Essential Oils Composition, and Biological Activities

    Directory of Open Access Journals (Sweden)

    Nilufar Z. Mamadalieva

    2017-02-01

    Full Text Available Plants of the Lamiaceae family are important ornamental, medicinal, and aromatic plants, many of which produce essential oils that are used in traditional and modern medicine, and in the food, cosmetics, and pharmaceutical industry. Various species of the genera Hyssopus, Leonurus, Mentha, Nepeta, Origanum, Perovskia, Phlomis, Salvia, Scutellaria, and Ziziphora are widespread throughout the world, are the most popular plants in Uzbek traditional remedies, and are often used for the treatment of wounds, gastritis, infections, dermatitis, bronchitis, and inflammation. Extensive studies of the chemical components of these plants have led to the identification of many compounds, as well as essentials oils, with medicinal and other commercial values. The purpose of this review is to provide a critical overview of the literature surrounding the traditional uses, ethnopharmacology, biological activities, and essential oils composition of aromatic plants of the family Lamiaceae, from the Uzbek flora.

  4. Developing a curriculum framework for global health in family medicine: emerging principles, competencies, and educational approaches

    Directory of Open Access Journals (Sweden)

    Wilson Briana

    2011-07-01

    Full Text Available Abstract Background Recognizing the growing demand from medical students and residents for more comprehensive global health training, and the paucity of explicit curricula on such issues, global health and curriculum experts from the six Ontario Family Medicine Residency Programs worked together to design a framework for global health curricula in family medicine training programs. Methods A working group comprised of global health educators from Ontario's six medical schools conducted a scoping review of global health curricula, competencies, and pedagogical approaches. The working group then hosted a full day meeting, inviting experts in education, clinical care, family medicine and public health, and developed a consensus process and draft framework to design global health curricula. Through a series of weekly teleconferences over the next six months, the framework was revised and used to guide the identification of enabling global health competencies (behaviours, skills and attitudes for Canadian Family Medicine training. Results The main outcome was an evidence-informed interactive framework http://globalhealth.ennovativesolution.com/ to provide a shared foundation to guide the design, delivery and evaluation of global health education programs for Ontario's family medicine residency programs. The curriculum framework blended a definition and mission for global health training, core values and principles, global health competencies aligning with the Canadian Medical Education Directives for Specialists (CanMEDS competencies, and key learning approaches. The framework guided the development of subsequent enabling competencies. Conclusions The shared curriculum framework can support the design, delivery and evaluation of global health curriculum in Canada and around the world, lay the foundation for research and development, provide consistency across programmes, and support the creation of learning and evaluation tools to align with the

  5. Developing a curriculum framework for global health in family medicine: emerging principles, competencies, and educational approaches

    Science.gov (United States)

    2011-01-01

    Background Recognizing the growing demand from medical students and residents for more comprehensive global health training, and the paucity of explicit curricula on such issues, global health and curriculum experts from the six Ontario Family Medicine Residency Programs worked together to design a framework for global health curricula in family medicine training programs. Methods A working group comprised of global health educators from Ontario's six medical schools conducted a scoping review of global health curricula, competencies, and pedagogical approaches. The working group then hosted a full day meeting, inviting experts in education, clinical care, family medicine and public health, and developed a consensus process and draft framework to design global health curricula. Through a series of weekly teleconferences over the next six months, the framework was revised and used to guide the identification of enabling global health competencies (behaviours, skills and attitudes) for Canadian Family Medicine training. Results The main outcome was an evidence-informed interactive framework http://globalhealth.ennovativesolution.com/ to provide a shared foundation to guide the design, delivery and evaluation of global health education programs for Ontario's family medicine residency programs. The curriculum framework blended a definition and mission for global health training, core values and principles, global health competencies aligning with the Canadian Medical Education Directives for Specialists (CanMEDS) competencies, and key learning approaches. The framework guided the development of subsequent enabling competencies. Conclusions The shared curriculum framework can support the design, delivery and evaluation of global health curriculum in Canada and around the world, lay the foundation for research and development, provide consistency across programmes, and support the creation of learning and evaluation tools to align with the framework. The process used to

  6. Developing a curriculum framework for global health in family medicine: emerging principles, competencies, and educational approaches.

    Science.gov (United States)

    Redwood-Campbell, Lynda; Pakes, Barry; Rouleau, Katherine; MacDonald, Colla J; Arya, Neil; Purkey, Eva; Schultz, Karen; Dhatt, Reena; Wilson, Briana; Hadi, Abdullahel; Pottie, Kevin

    2011-07-22

    Recognizing the growing demand from medical students and residents for more comprehensive global health training, and the paucity of explicit curricula on such issues, global health and curriculum experts from the six Ontario Family Medicine Residency Programs worked together to design a framework for global health curricula in family medicine training programs. A working group comprised of global health educators from Ontario's six medical schools conducted a scoping review of global health curricula, competencies, and pedagogical approaches. The working group then hosted a full day meeting, inviting experts in education, clinical care, family medicine and public health, and developed a consensus process and draft framework to design global health curricula. Through a series of weekly teleconferences over the next six months, the framework was revised and used to guide the identification of enabling global health competencies (behaviours, skills and attitudes) for Canadian Family Medicine training. The main outcome was an evidence-informed interactive framework http://globalhealth.ennovativesolution.com/ to provide a shared foundation to guide the design, delivery and evaluation of global health education programs for Ontario's family medicine residency programs. The curriculum framework blended a definition and mission for global health training, core values and principles, global health competencies aligning with the Canadian Medical Education Directives for Specialists (CanMEDS) competencies, and key learning approaches. The framework guided the development of subsequent enabling competencies. The shared curriculum framework can support the design, delivery and evaluation of global health curriculum in Canada and around the world, lay the foundation for research and development, provide consistency across programmes, and support the creation of learning and evaluation tools to align with the framework. The process used to develop this framework can be applied

  7. Family medicine in Denmark: Are there lessons for Botswana and Africa?

    Science.gov (United States)

    Setlhare, Vincent

    2016-03-30

    Family medicine is a new specialty in Botswana and many African countries and its definitionand scope are still evolving. In this region, healthcare is constrained by resource limitation andinefficiencies in resource utilisation. Experiences in countries with good health indicators canhelp inform discussions on the future of family medicine in Africa. Observations made duringa visit to family physicians (FPs) in Denmark showed that the training of FPs, the practice offamily medicine and the role of support staff in a family practice were often different andsometimes unimaginable by African standards. Danish family practices were friendly andenmeshed in an egalitarian and efficient health system, which is supported by an effectiveinformation technology network. There was a lot of task shifting and nurses and clerical staffattended to simple or uncomplicated aspects of patient care whilst FPs attended to morecomplicated patient problems. Higher taxation and higher health expenditure seemed toundergird the effective health system. An egalitarian relationship amongst patients andhealthcare workers (HCW) may help improve patient care in Botswana. Task shifting shouldbe formalised, and all sectors of primary healthcare should have fast and effective informationtechnology systems. HCW training and roles should be revised. Higher health expenditure isnecessary to achieve good health indicators.

  8. How Many Graduating Family Medicine Residents Have Chosen Financial Support for Service Commitments?

    Science.gov (United States)

    Phillips, Julie; Peterson, Lars E; Fang, Bo; Kovar-Gough, Iris; Phillips, Robert L

    2017-09-01

    New family physicians have opportunities to avoid accruing educational debt or have loans repaid by making a commitment to public service. Little information is available about the numbers of early career family physicians who have made service commitments to fund their education. The purpose of this study is to describe the proportion of graduating family medicine residents who have enrolled in US military and National Health Service Corps (NHSC) scholarship and loan repayment programs, thus obligating them to future public service. The study was a secondary analysis of de-identified data from the 2014 and 2015 American Board of Family Medicine examination registration questionnaire, which is required of all residents applying for board certification. Descriptive statistics were used to indicate the numbers and proportions of respondents who indicated military or NHSC financial support. Chi square analyses were used to analyze differences between groups. Of the 6,231 residents studied, 271 (4.4%) had either obtained military support (n=191, 3.1%) or enrolled in the NHSC (n=80, 1.3%). More men had enrolled in the military than women (4.2% vs 2.2%, P<0.01), but there was no significant NHSC gender difference. Underrepresented minorities (URM) were twice as likely to have enrolled in NHSC as non-URM residents (2.5% vs 1.0%, P<0.01). Only a small fraction of graduating family medicine residents have used either military enrollment or NHSC scholarships to fund their education. Family medicine should advocate strongly for expansion of the NHSC scholarship program, which receives many more applications than it can support.

  9. Complementary and alternative medicine use by visitors to rural Japanese family medicine clinics: results from the international complementary and alternative medicine survey.

    Science.gov (United States)

    Shumer, Gregory; Warber, Sara; Motohara, Satoko; Yajima, Ayaka; Plegue, Melissa; Bialko, Matthew; Iida, Tomoko; Sano, Kiyoshi; Amenomori, Masaki; Tsuda, Tsukasa; Fetters, Michael D

    2014-09-25

    There is growing interest in the use of complementary and alternative medicine (CAM) throughout the world, however previous research done in Japan has focused primarily on CAM use in major cities. The purpose of this study was to develop and distribute a Japanese version of the International Complementary and Alternative Medicine Questionnaire (I-CAM-Q) to assess the use of CAM among people who visit rural Japanese family medicine clinics. Using a Japanese version of the International Complementary and Alternative Medicine Questionnaire (I-CAM-Q), a cross-sectional survey was conducted in three rural family medicine clinics. All patients and those accompanying patients who met inclusion criteria were eligible to participate. Data were entered into SPSS Statistics and analyzed for use by age, gender, and location. Of the 519 respondents who participated in the project, 415 participants reported CAM use in the past 12 months (80.0%). When prayer is excluded, the prevalence of CAM use drops to 77.3% in the past year, or 403 respondents. The most common forms of CAM used by respondents were pain relief pads (n = 170, 32.8%), herbal medicines/supplements (n = 167, 32.2%), and massage by self or family (n = 166, 32.0%). Female respondents, individuals with higher levels of education, and those with poorer overall health status were more likely to use CAM than respondents without these characteristics. Only 22.8% of CAM therapies used were reported to physicians by survey participants. These data indicate that CAM use in rural Japan is common. The results are consistent with previous studies that show that Japanese individuals are more interested in forms of CAM such as pain relief pads and massage, than in mind-body forms of CAM like relaxation and meditation. Due to the high utilization of certain CAM practices, and given that most CAM users do not disclose their CAM use to their doctors, we conclude that physicians in rural Japan would benefit by asking about CAM use

  10. Ready or not? Expectations of faculty and medical students for clinical skills preparation for clerkships

    Directory of Open Access Journals (Sweden)

    Marjorie Wenrich

    2010-08-01

    Full Text Available Background: Preclerkship clinical-skills training has received increasing attention as a foundational preparation for clerkships. Expectations among medical students and faculty regarding the clinical skills and level of skill mastery needed for starting clerkships are unknown. Medical students, faculty teaching in the preclinical setting, and clinical clerkship faculty may have differing expectations of students entering clerkships. If students' expectations differ from faculty expectations, students may experience anxiety. Alternately, congruent expectations among students and faculty may facilitate integrated and seamless student transitions to clerkships. Aims: To assess the congruence of expectations among preclerkship faculty, clerkship faculty, and medical students for the clinical skills and appropriate level of clinical-skills preparation needed to begin clerkships. Methods: Investigators surveyed preclinical faculty, clerkship faculty, and medical students early in their basic clerkships at a North American medical school that focuses on preclerkship clinical-skills development. Survey questions assessed expectations for the appropriate level of preparation in basic and advanced clinical skills for students entering clerkships. Results: Preclinical faculty and students had higher expectations than clerkship faculty for degree of preparation in most basic skills. Students had higher expectations than both faculty groups for advanced skills preparation. Conclusions: Preclinical faculty, clerkship faculty, and medical students appear to have different expectations of clinical-skills training needed for clerkships. As American medical schools increasingly introduce clinical-skills training prior to clerkships, more attention to alignment, communication, and integration between preclinical and clerkship faculty will be important to establish common curricular agendas and increase integration of student learning. Clarification of skills

  11. The Future of Family Medicine version 2.0: reflections from Pisacano scholars.

    Science.gov (United States)

    Doohan, Noemi C; Duane, Marguerite; Harrison, Bridget; Lesko, Sarah; DeVoe, Jennifer E

    2014-01-01

    The Future of Family Medicine (FFM) project has helped shape and direct the evolution of primary care medicine over the past decade. Pisacano Scholars, a group of leaders in family medicine supported by the American Board of Family Medicine, gathered for a 2-day symposium in April 2013 to explore the history of the FFM project and outline a vision for the next phase of this work-FFM version 2.0 (v2.0). After learning about the original FFM project (FFM v1.0), the group held interactive discussions using the World Café approach to conversational leadership. This commentary summarizes the discussions and highlights major themes relevant to FFM v2.0 identified by the group. The group endorsed the FFM v1.0 recommendations as still relevant and marvelled at the progress made toward achieving many of those goals. Most elements of FFM v1.0 have moved forward, and some have been incorporated into policy blueprints for reform. Now is the time to refocus attention on facets of FFM v1.0 not yet realized and to identify key aspects missing from FFM v1.0. The Pisacano Scholars are committed to moving the FFM goals forward and hope that this expression of the group's vision will help to do so.

  12. ocial representation of family support for diabetic patients in users of a family medicine unit in Chalco, State of Mexico

    Directory of Open Access Journals (Sweden)

    Alejandra Rodríguez Torres

    2014-08-01

    Full Text Available OBJECTIVE The goal of this study is to compare and interpret the meaning of family support for diabetic patients and their families using social representations according to a structural approach of Abric’s theory. METHODS The study was carried out in a Family Medicine Center of the Chalco Municipality in Mexico State. The population studied comprised ten diabetic patient-family pairs. The first part of the study was a simple word association test that aimed to find terms or statements related to the concept of “family support”, as well as its frequency of appearance and range of association. Once the terms or statements were obtained, they were categorized according to their “support” capabilities. A semi-structured interview for each category was conducted as well as a graphic analysis of Friedman’s meanings. The discourse of diabetic patients was compared to that of the families in order to find similarities and differences. RESULTS Evocation of terms was done in the first part of the study, and it was found that the emotional domain was central to the discourse. However, in the second part of the study, when categorization and analysis of discourse is performed, there are differences in the centrality of terms and statements. The family tends to center in the active domain, whereas the patient centers in the emotional domain. CONCLUSIONS This study brings up the emotional needs of the patient as essential components of support efforts. This promotes reflection about changing strategies in the design of public healthcare programs in that they may include family support from the viewpoint of otherness.

  13. [Social representation of family support for diabetic patients in users of a family medicine unit in Chalco, State of Mexico].

    Science.gov (United States)

    Rodríguez, Alejandra; Camacho, Esteban Jaime; Escoto, María Del Consuelo; Contreras, Georgina; Casas, Donovan

    2014-08-27

    The goal of this study is to compare and interpret the meaning of family support for diabetic patients and their families using social representations according to a structural approach of Abric's theory. The study was carried out in a Family Medicine Center of the Chalco Municipality in Mexico State. The population studied comprised ten diabetic patient-family pairs. The first part of the study was a simple word association test that aimed to find terms or statements related to the concept of "family support", as well as its frequency of appearance and range of association. Once the terms or statements were obtained, they were categorized according to their "support" capabilities. A semi-structured interview for each category was conducted as well as a graphic analysis of Friedman's meanings. The discourse of diabetic patients was compared to that of the families in order to find similarities and differences. Evocation of terms was done in the first part of the study, and it was found that the emotional domain was central to the discourse. However, in the second part of the study, when categorization and analysis of discourse is performed, there are differences in the centrality of terms and statements. The family tends to center in the active domain, whereas the patient centers in the emotional domain. This study brings up the emotional needs of the patient as essential components of support efforts. This promotes reflection about changing strategies in the design of public healthcare programs in that they may include family support from the viewpoint of otherness.

  14. The extent of familial hypercholesterolemia instruction in US schools and colleges of medicine, pharmacy, and osteopathic medicine.

    Science.gov (United States)

    Withycombe, Bethany; Winden, Janae C; Hassanyn, Reem; Duell, P Barton; Ito, Matthew K

    2015-01-01

    Familial hypercholesterolemia (FH) is a common autosomal codominant disease characterized by extreme plasma cholesterol concentrations and high risk of early heart disease. FH is underdiagnosed and severely undertreated. This may be due in part to gaps in FH education within medical and pharmacy training programs. To assess the extent to which FH is covered in professional curriculums in accredited schools and colleges of medicine, pharmacy, and osteopathic medicine in the United States. An 18-question survey was distributed via e-mail to 288 US schools and colleges of medicine, pharmacy, and osteopathic medicine. Fifty-six of 288 (19.4%) programs responded to the survey. Three were excluded from analysis because of lack of program accreditation and FH instruction. Overall, 43% indicated that FH instruction at their respective institution was perceived to be adequate. More than 90% of the programs indicated that the following topics were covered within the curriculum: FH pathophysiology; associated morbidity and mortality; guideline-recommended low-density lipoprotein cholesterol goals and risk factor management; consequences of poor lipid management; and the screening, diagnosis, and treatment of adult patients. However, instruction was lacking for FH screening methods as one-third of the programs covered cascade screening and only half of the programs reported distinguishing between heterozygous and homozygous FH including differences in treatment approach. The results suggested important gaps in the coverage of FH in the curriculum, and strategies need to be developed to ensure that FH instruction is sufficient within these professional programs. Copyright © 2015 National Lipid Association. Published by Elsevier Inc. All rights reserved.

  15. Dimensions and singularities of Family and Community Medicine

    Directory of Open Access Journals (Sweden)

    Armando Henrique Norman

    2012-11-01

    Full Text Available A edição nº 24 da Revista Brasileira de Medicina de Família e Comunidade (RBMFC traz importantes temas a nossa reflexão, tanto para a Estratégia Saúde da Família (ESF - quanto à sua efetividade e abrangência - como para a especialidade em Medicina de Família e Comunidade (MFC, visto que apresenta temas que nos distinguem de outras áreas da biomedicina. A primeira temática poderia ser definida enquanto o potencial da ESF para a produção de saúde no Brasil. Um exemplo é o artigo Desempenho de indicadores nos municípios com alta cobertura da Estratégia Saúde da Família no Estado de São Paulo que destaca como alguns municípios desse Estado apresentam melhores resultados com relação aos indicadores pactuados, quando comparados com municípios que não expandiram a cobertura da ESF. A segunda temática resgata aspectos centrais da especialidade em MFC. Apesar da morte e sofrimento serem comuns a todas as especialidades médicas, na MFC, em particular, ela é problematizada na relação médico-paciente e nos programas de formação, como, por exemplo, na ferramenta Ciclo de vida1. Nesta ferramenta, a morte se destaca como uma das crises normativas que marcam a existência, visto que nela se encerra o drama do sofrimento e da condição humana2. Assim, o artigo Crying Patients in General/Family Practice: incidence, reasons for encounter and health problems resgata o potencial do MFC para ressignificar o sofrimento humano através do cuidado personalizado e longitudinal dos pacientes. Quais os significados das lágrimas? Estamos preparados para um aprofundamento nesta dimensão do cuidado? Esses matizes da profissão do MFC também se descortinam no caso clínico intitulado Ser Médico de (sua Família. Nele, o autor explora os limites da ética e da relação profissional-familiar ao contextualizar a tomada de decisão frente ao processo de cuidado, adoecimento e morte de um membro da família. Entretanto, a morte ainda segue

  16. Medical students' preparedness for professional activities in early clerkships.

    Science.gov (United States)

    Bosch, Josefin; Maaz, Asja; Hitzblech, Tanja; Holzhausen, Ylva; Peters, Harm

    2017-08-22

    Sufficient preparedness is important for transitions to workplace participation and learning in clinical settings. This study aims to analyse medical students' preparedness for early clerkships using a three-dimensional, socio-cognitive, theory-based model of preparedness anchored in specific professional activities and their supervision level. Medical students from a competency-based undergraduate curriculum were surveyed about preparedness for 21 professional activities and level of perceived supervision during their early clerkships via an online questionnaire. Preparedness was operationalized by the three dimensions of confidence to carry out clerkship activities, being prepared through university teaching and coping with failure by seeking support. Factors influencing preparedness and perceived stress as outcomes were analysed through step-wise regression. Professional activities carried out by the students (n = 147; 19.0%) and their supervision levels varied. While most students reported high confidence to perform the tasks, the activity-specific analysis revealed important gaps in preparation through university teaching. Students regularly searched for support in case of difficulty. One quarter of the variance of each preparedness dimension was explained by self-efficacy, supervision quality, amount of prior clerkship experience and nature of professional activities. Preparedness contributed to predicting perceived stress. The applied three-dimensional concept of preparedness and the task-specific approach provided a detailed and meaningful view on medical students' workplace participation and experiences in early clerkships.

  17. Making the 2007-2010 Action Plan work for women in family medicine in the Asia Pacific

    Directory of Open Access Journals (Sweden)

    Coles Jan

    2010-01-01

    Full Text Available Abstract The Wonca Working Party for Women and Family Medicine (WWPWFM was organized in 2001 with the following objectives: to identify the key issues for women doctors; to review Wonca policies and procedures for equity and transparency; to provide opportunities to network at meetings and through the group's listserve and website; and to promote women doctors' participation in Wonca initiatives. In October 2008, at the Asia Pacific Regional conference, the Wonca Working Party on Women in Family Medicine (WWPWFM held a preconference day and conference workshops, building on the success and commitment to initiatives which enhance women's participation in Wonca developed in Ontario, Canada (2006 and at the Singapore World Congress (2007. At this meeting fifty women workshopped issues for women in Family Medicine in the Asia Pacific. Using the Action Plan formulated in Singapore (2007 the participants identified key regional issues and worked towards a solution. Key issues identified were professional issues, training in family medicine and women's health. Solutions were to extend the understanding of women's contributions to family medicine, improved career pathways for women in family medicine and improving women's participation in practices, family medicine organizations and academic meetings.

  18. Teaching maternity care in family medicine residencies: what factors predict graduate continuation of obstetrics? A 2013 CERA program directors study.

    Science.gov (United States)

    Sutter, Mary Beth; Prasad, Ramakrishna; Roberts, Mary B; Magee, Susanna R

    2015-06-01

    Maternity care is an essential component of family medicine, yet the number of residency graduates providing this care continues to decline. Residency programs have struggled to identify strategies to increase continuation of obstetric practice among graduates. Leaders in family medicine obstetrics previously proposed a tiered model of training to ensure adequate volume for those desiring to continue maternity care upon graduation. However, whether this approach will be successful is unknown. This study aimed to identify program characteristics and teaching methods that may influence residents to continue obstetrics practice upon graduation. A nationwide survey of family medicine residency program directors (PDs) was conducted as part of the 2013 CERA survey to characterize teaching in maternity care and identify program-level predictors of graduate continuation of obstetrics (OB). Family medicine programs, which were community-based, university-affiliated programs in the Midwest and West, contributed more trainees who continued to provide OB care upon graduation. Trainees at these programs received greater supervision by family medicine faculty preceptors on labor and delivery, reported at least 80 deliveries by graduates during residency, and experienced greater autonomy in decision-making during OB rotations. This study supports a targeted approach to teaching maternity care in family medicine residency programs. Prioritizing continuity delivery experiences and fostering resident independence are strategies toward promoting increased provision of obstetric care by family medicine graduates. Further research is needed to evaluate the impact of tiered or track systems in practice.

  19. The relationship between marriage and family therapists and complementary and alternative medicine approaches: a national survey.

    Science.gov (United States)

    Caldwell, Karen L; Winek, Jon L; Becvar, Dorothy S

    2006-01-01

    Respondents to a mail survey of a random sample (N = 424) of Clinical Members of the American Association for Marriage and Family Therapy provided information about their contexts of practice, use of complementary and alternative medicine (CAM), and relationships with CAM providers. Consistent with both national trends and the experience of psychologists as reported in a similar survey, the results of this survey suggest that marriage and family therapists have been affected significantly by and have a growing awareness of CAM practices. Limitations of the study and implications for the field are discussed.

  20. The Declaration of Alma Ata on its 30th anniversary: relevance for family medicine today.

    Science.gov (United States)

    Hixon, Allen L; Maskarinec, Gregory G

    2008-09-01

    The Declaration of Alma Ata, issued on September 12, 1978, provides a moral vision for primary care that remains valuable today at a time of transformation of the specialty of family medicine. The Declaration asserts a comprehensive definition of health that recognizes health as a fundamental human right, argues persuasively that gross inequalities in health status are politically, socially, and economically unacceptable, and identifies primary health care as the key to improving health and reducing health status inequalities. The values of Alma Ata can guide the specialty of family medicine to lead positive health system change through renewed collaboration, addressing inequalities, efficient use of resources and appropriate technology, and advocacy in the spirit of social justice.

  1. Sherbrooke - Montevideo: a socially responsible international collaboration to foster family medicine.

    Science.gov (United States)

    Morin, Martine; Grand'Maison, Paul; Henderson, Eduardo; Vignolo, Julio

    2014-01-01

    The World Health Organization advocates for faculties of medicine to orient health professional education toward the needs of the populations graduates are to serve and to include a greater emphasis on primary health care. It was in this framework that in 2007, the Faculty of Medicine and Health Sciences at the Université de Sherbrooke (FMHS-UdeS) in Canada and the Facultad de Medicina de la Universidad de la Republica (FMUdelaR) in Montevideo, Uruguay developed a comprehensive collaboration to sustain the development of family medicine in both universities through education, practice and research. ACTIVITIES AND OUTCOMES: In addition to information sharing through email and teleconferencing, this five year collaboration has included 28 bilateral visits by the two institutions' teachers and leaders. During these visits, Uruguayan members participated in workshops and benefited from exchanges during educational and clinical activities. Interactions led to the improvement of their skills as teachers of family medicine with an emphasis on clinical teaching, supervision, feedback to learners in clinical evaluations, use of various educational methods, use of standardized patients for teaching and evaluation, and research. FMHS-UdeS members learned about the community aspects of family medicine in Uruguay and reflected on how these could be implemented to the benefit of Canadians. The international collaboration forged between the FMHS-UdeS and the FMUdelaR represents a socially responsible endeavor that has been highly rewarding for all involved. It represents a significant learning opportunity for each group aiming to better prepare physicians to serve as primary health care providers in their communities.

  2. Personal values of exemplary family physicians: implications for professional satisfaction in family medicine.

    Science.gov (United States)

    Eliason, B C; Schubot, D B

    1995-09-01

    Personal social values have been identified as important determinants of generalists' specialty choice. However, the personal values or "guiding principles" of generalist physicians have not been identified scientifically. To establish a benchmark, we measured the personal values of exemplary family physicians because they serve as role models for current and future physicians. We also explored the relationship between personal values and practice satisfaction. We obtained a list of 330 family physicians nominated for the American Academy of Family Physicians' (AAFP) Family Doctor of the Year award for the years 1988 through 1993. We asked them to complete the Schwartz Values Questionnaire, a 56-item instrument for measuring personal values. They also answered three questions concerning practice satisfaction. The return rate was 83%. The physicians' mean age was 63 years. They had been in practice an average of 34 years, 93% were male, and 52% practiced in rural areas. Honesty was rated as the most important of the 56 values, and social power as the least important. Of the 10 value types (groups of common values), the responding physicians rated "Benevolence" as most important and "Power" as least important. Practice satisfaction correlated positively with the Benevolence value type (r = .21, P = .001) and negatively with the Power value type (r = -.15, P = .023). Of the 10 value types, Benevolence was rated the most important and Power the least important by exemplary family physicians, and both value types also correlated, positively and negatively, respectively, with their practice satisfaction. These results have implications for the selection, training, and career satisfaction of generalist physicians.

  3. Federal Research Funding for Family Medicine: Highly Concentrated, with Decreasing New Investigator Awards.

    Science.gov (United States)

    Cameron, Brianna J; Bazemore, Andrew W; Morley, Christopher P

    2016-01-01

    A small proportion of National Institutes of Health and other federal research funding is received by university departments of family medicine, the largest primary care specialty. That limited funding is also concentrated, with roughly a quarter of all National Institutes of Health, Centers for Disease Control and Prevention, and Agency for Healthcare Research and Quality funding awarded to 3 departments, almost half of that funding coming from 3 agencies, and a recent trend away from funding for new investigators.

  4. The effect of simulation training on PALS skills among family medicine residents.

    Science.gov (United States)

    Gerard, James M; Thomas, Scott M; Germino, Kevin W; Street, Megan H; Burch, Wesley; Scalzo, Anthony J

    2011-06-01

    The Accreditation Council for Graduate Medical Education requires that family medicine residents receive structured skills training on pediatric advanced life support (PALS) and should learn procedures for medical emergencies in patients of all ages. Traditional methods of training family medicine residents in PALS is challenging given their limited clinical exposure to critically ill patients. The primary objective of this study was to assess the effect of a 2-hour PALS training session utilizing high-fidelity mannequins on residents' psychomotor skills performances. Between February and June 2009, residents from two urban family medicine residency programs received training on four PALS procedures (bag-mask ventilation, tracheal intubation, intraosseous line placement, and cardiac rhythm assessment/defibrillation) at a university simulation center. Residents completed questionnaires to provide data on previous resuscitation training and experience. We collected self-confidence data and video recordings of residents performing the procedures before and after training. To assess retention at 6 months, we collected self-confidence data and video recordings of PGY-1 and PGY-2 residents performing the procedures. A blinded reviewer scored the video recordings. Forty-seven residents completed the study. The majority of residents (53.2%) had never performed any of the procedures on a real patient. Immediately following skills training, mean overall performance improved from 39.5% (± 11.5%) to 76.5% (± 10.4%), difference 37.0% (95% CI, 33.5%--40.6%). Bag-mask ventilation and intraosseous insertion skills remained above baseline at 6-month follow-up. Simulation training is beneficial for teaching PALS procedures to family medicine residents.

  5. Clinical Clerkship Education Improves With Implementing a System of Internal Program Evaluation Using Medical Students' Feedbacks.

    Science.gov (United States)

    Sadeghi, Anahita; Aghaei Meybodi, Hamidreza; Navabakhsh, Behrouz; Soroush, Ahmadreza; Malekzadeh, Masoud Mohammad; Khorgami, Zhamak

    2016-08-01

    Quality of clinical education for medical students has always been a concern in academic medicine. This concern has increased in today's time-squeeze while faculty members have to fulfill their complementary roles as a teacher, researcher, and practitioner. One of the strategies for program evaluation is obtaining trainees' feedbacks since they are the main customers of educational programs; however, there are debates about the efficacy of student feedback as a reliable source for reforms. We gathered Likert scores on a 16-item questionnaire from 2,771 medical students participating in all clerkship programs in a multidisciplinary teaching hospital. An expert panel consisting of 8 attending physicians established content validity of the questionnaire while a high Cronbach's Alpha (0.93) proved its reliability. Summary reports of these feedbacks were presented to heads of departments, clerkship program directors, and hospital administrators, at the end of each semester. Analysis of variance was used for comparing hospital scores across different time periods and different departments. Significant changes (Pprogram directors can lead to an improved educational performance in teaching hospitals.

  6. New family medicine residency training programme: Residents’ perspectives from the University of Botswana

    Science.gov (United States)

    Tshitenge, Stephane; Setlhare, Vincent; Tsima, Billy; Adewale, Ganiyu; Parsons, Luise

    2016-01-01

    Background Family Medicine (FM) training is new in Botswana. No previous evaluation of the experiences and opinions of residents of the University of Botswana (UB) Family Medicine training programme has been reported. Aims This study explored and assessed residents’ experiences and satisfaction with the FM training programme at the UB and solicited potential strategies for improvement from the residents. Methods A descriptive survey using a self-administered questionnaire based on a Likert-type scale and open-ended questions was used to collect data from FM residents at the UB. Results Eight out the 14 eligible residents participated to this study. Generally, residents were not satisfied with the FM training programme. Staff shortage, inadequate supervision and poor programme organisation by the faculty were the main reasons for this. However, the residents were satisfied with weekly training schedules and the diversity of patients in the current training sites. Residents’ potential solutions included an increase in staff, the acquisition of equipment at teaching sites and emphasis on FM core topics teachings. They had different views regarding how certain future career paths will be. Conclusions Despite the general dissatisfaction among residents because of challenges faced by the training programme, we have learnt that residents are capable of valuable inputs for improvement of their programme when engaged. There is need for the Department of Family Medicine to work with the Ministry of Health to set a clear career pathway for future graduates and to reflect on residents’ input for possible implementation.

  7. Neurology clerkship goals and their effect on learning and satisfaction.

    Science.gov (United States)

    Strowd, Roy E; Salas, Rachel Marie E; Cruz, Tiana E; Gamaldo, Charlene E

    2016-02-16

    To define medical student goals in the neurology clerkship and explore the association between goal setting and student performance, clerkship satisfaction, self-directed learning (SDL), and interest in neurology. A 4-year prospective study of consecutive second- to fourth-year medical students rotating through a required 4-week neurology clerkship was conducted. A goal-generating cohort (first 2 years) was enrolled to describe the breadth of student-derived goals. A goal-evaluating cohort (second 2 years) was used to evaluate the frequency of goal achievement and assess associations with performance (e.g., National Board of Medical Examiners [NBME], examination), satisfaction, and SDL behaviors (both based on 5-point Likert scale). Of 440 evaluable students, 201 were goal-generating and 239 goal-evaluating. The top 3 goals were (1) improvement in neurologic examination, (2) understanding neurologic disease, and (3) deriving a differential diagnosis. More than 90% (n = 216/239) of students reported achieving goals. Achievers reported significantly higher clerkship satisfaction (4.2 ± 0.8 vs. 2.8 ± 1.0, p neurology (71% vs. 35%, p = 0.001), and higher observed tendency toward SDL (4.5 ± 0.5 vs. 4.1 ± 0.8, p neurology clerkship. Goal achievers had better adjusted standardized test scores, higher satisfaction, and greater tendency toward SDL. This student-generated, goal-setting program may be particularly appealing to clinicians, educators, and researchers seeking resource-lean mechanisms to improve student experience and performance in the clinical clerkships. © 2015 American Academy of Neurology.

  8. Qualitative Evaluation of Theses Written in area of Family Medicine in Turkey

    Directory of Open Access Journals (Sweden)

    Yaman H et al.

    2011-10-01

    Full Text Available Aim: to evaluate qualitatively thesis written in Family medicine and to investigate their status of citation and publication as article.Material and Method: the descriptive and cross-sectional included 140 thesis, indexed by ULAKBIM, in area of Family Medicine written between 1981 and 2008 according to status of their citation and publication as article were analyzed as regards of their subjects, date of presentation and publication, study type and place in which to be written were registered in the study. To access data of thesis, ULAKBIM, SCI, CINAHL, Google and PUBMED was screened. Keywords such as “family medicine”, “primary care”, “family practitioner” have been used during the search.Results: Average page of thesis was 82.9±37.0 (19-258. Majority of manager for thesis was academic degree of professor. It was found that several theses were associated with other areas of specialization. Theses were usually designed as descriptive, cross-sectional and observational. Of 140 theses, 15 ones were indexed by international publication. Three different articles in SCI were cited four times until date of present study. When evaluating date of thesis according to years, it peaked in 1999 (27; 19.3% and 2007 (25; 17.9%. Conclusion: Although discipline of Family Medicine was not achieved to come at targets, it was considered that thesis preparation and writing was able with association and cooperation with other medical department disciples. However, it was considered that majority of thesis was not published as article.

  9. How to rationally use information diagnostic technologies in family and general medicine practice.

    Science.gov (United States)

    Sivić, Suad; Masic, Izet; Petkovic, Darko; Huseinagic, Senad; Tandir, Salih; Zunic, Lejla

    2009-01-01

    NONE DECLARED New discoveries in technology indeed enabled significant improvement of health care in the last three decades. Only during the last few years a significant breakthrough is achieved in the field of antiviral drugs, biotechnology, digital diagnostic technology, molecular diagnosis, tissues and organs transplantation as well as surgical and information technologies, which all contributed to the improvement of health care. Rapid growth of medical technology has led to the increase in costs of health care, increased access to these technologies and improvement of health care that is permanently encouraging the further development of technology. Technology encompasses the skills, knowledge and ability to understand, use and create useful things. It is the practical application of knowledge. Evaluation of health technology is the systematic evaluation of characteristics, results or impact of health technologies. The primary purpose of evaluation is to provide information to responsible parties for the technology in the health care system, which will be used in decision-making and introduction of these technologies. Information technology in medicine and health care represents all medical and health technology in the process of work, monitoring and evaluation done using computer technology. Progress of medical science in recent years especially needs to thank to the development of information technologies. The health care system of Bosnia and Herzegovina is currently operating in the two sub-systems of primary health care. One is inherited from the past system, in which the primary health care is provided by general practitioners, specialists in general practice, as well as gynecologists, pediatricians and pulmologists, and the second subsystem occurs when in PHC is introduced the system of family medicine doctors and family medicine specialists. Family medicine, based on the concept of orientation towards the methods which are more effective, rational and

  10. Satisfaction with Family Physicians and Specialists and the use of Complementary and Alternative Medicine in Israel

    Directory of Open Access Journals (Sweden)

    Amir Shmueli

    2006-01-01

    Full Text Available Higher utilization of complementary and alternative medicine (CAM is commonly explained by dissatisfaction or disappointment with conventional medical treatment. To explore, at two points in time in Israel, the associations between six domains of satisfaction (attitude, length of visits, availability, information sharing, perceived quality of care and overall with conventional family physicians' and specialists' services and the likelihood of consulting CAM providers. This is a secondary analysis of interviews, which were conducted with 2000 persons in 1993 and 2500 persons in 2000, representing the Israeli Jewish urban population aged 45–75 in those years. Bivariate and multivariate analyses were used in the investigation. In 1993, users of CAM were less satisfied than non-users with both family physicians' and specialists' care. Lower satisfaction with the attitude of, the amount of information sharing by and in general with family physicians, and with the length of visits and perceived quality of care of specialists were significantly associated with CAM use. In 2000, lower satisfaction with specialists' attitude, length of visits, availability and in general was significantly related to the use of CAM. Lower satisfaction with family physicians and specialists is significantly associated with consulting CAM providers. However, with CAM becoming a mainstream medical care specialty in its own, lower satisfaction with conventional medicine specialists becomes the most important factor.

  11. Striving for excellence: developing a framework for the Triple C curriculum in family medicine education.

    Science.gov (United States)

    MacDonald, Colla J; McKeen, Martha; Wooltorton, Eric; Boucher, Francois; Lemelin, Jacques; Leith-Gudbranson, Donna; Viner, Gary; Pullen, Judi

    2012-10-01

    Postgraduate medical education programs will need to be restructured in order to respond to curriculum initiatives promoted by the College of Family Physicians of Canada. To develop a framework for the Triple C Competency-based Curriculum that will help provide residents with quality family medicine (FM) education programs. The Family Medicine Curriculum Framework (FMCF) incorporates the 4 principles of FM, the CanMEDs-FM roles, the Triple C curriculum principles, the curriculum content domains, and the pedagogic strategies, all of which support the development of attitudes, knowledge, and skills in postgraduate FM training programs. The FMCF was an effective approach to the development of an FM curriculum because it incorporated not only core competencies of FM health education but also contextual educational values, principles, and dynamic learning approaches. In addition, the FMCF provided a foundation and quality standard to designing, delivering, and evaluating the FM curriculum to ensure it met the needs of FM education stakeholders, including preceptors, residents, and patients and their families.

  12. Development and professional qualification of general practice and family medicine in Germany

    Directory of Open Access Journals (Sweden)

    Markus Herrmann

    2013-04-01

    Full Text Available Objective: This article aims to analyze the professional and faculty development of general practice and family medicine (GP/FM in Germany and discuss its facing challenges. Methods: It is a case study identifying characteristics and potential intervention tools, describing training and qualification requirements in family medicine in Germany. Results: The traditional caring role of GP in Germany has a long history, but GP has no gatekeeper function, which weakens its position in the system. In the past decades, GP has undergone several transformations; it is no longer a practice based on the traditional “Hausarzt” style. It has become a medical specialty of primary care with more modern foundations; it requires five years of practical training in internal medicine, paediatrics, surgery and general medicine, and it is governed by the Physician Chambers. In undergraduate education, courses in General Practice are mandatory. In recent years, the new curriculum requirements have led to an intense process of academic development with the creation of General Practice departments in 20 of the 36 public medical schools in the country. Conclusions: The process of professionalization and faculty development in GP/FM as well as the expansion of undergraduate training in the specialty aim to enhance the appeal of GP/FM to young doctors. This development strengthens academic research on GP/FM, which contributes to enhancing the institutional basis of GP/FM as a science, allowing bolder interaction and collaboration with other branches of medicine and real appreciation of this subject (GP/FM.

  13. [Mental Health in General Family Medicine - obstacles and expectations perceived by Family Physicians].

    Science.gov (United States)

    Fernandes, Liliana; Basílio, Nuno; Figueira, Sofia; Nunes, José Mendes

    2017-03-01

    This study seeks to understand the difficulties experienced by family physicians (FP) in the management of mental disorders (MD) and their proposals to improve the quality of care. It is qualitative study with semi-structured interviews with ten family physicians. These were recorded, transcribed and their content analyzed. Eight thematic categories were identified: perceived working conditions and available resources; perceived level of training in mental health; therapies used for treatment of MD; mental health instruments used in consultation; MD addressed in Primary Health Care (PHC) and referral to hospitals; patient's reaction to referral; articulation of PHC with hospitals; proposals to improve mental health care in PHC. Articulation with the Mental Health Services suffers from lack of accessibility, one-way communication and delayed response. The FP propose creation of consultancies; multidisciplinary teams in the community; creating a two-way communication platform; continuous learning through discussion of cases. The FP have responsibilities in providing MHC. This requires working in a multidisciplinary team. Services should be organized to function as a learning system that allows the progressive improvement of the professionals and the improvement of the interfaces between them.

  14. Public Health Aspects of the Family Medicine Concepts in South Eastern Europe

    Science.gov (United States)

    Masic, Izet; Hadziahmetovic, Miran; Donev, Doncho; Pollhozani, Azis; Ramadani, Naser; Skopljak, Amira; Pasagic, Almir; Roshi, Enver; Zunic, Lejla; Zildzic, Muharem

    2014-01-01

    Introduction: Family medicine as a part of the primary health care is devoted to provide continuous and comprehensive health care to the individuals and families regardless of age, gender, types of diseases and affected system or part of the body. Special emphasis in such holistic approach is given to the prevention of diseases and health promotion. Family Medicine is the first step/link between doctors and patients within patients care as well as regular inspections/examinations and follow-up of the health status of healthy people. Most countries aspire to join the European Union and therefore adopting new regulations that are applied in the European Union. Aim: The aim of this study is to present the role and importance of family medicine, or where family medicine is today in 21 Century from the beginning of development in these countries. The study is designed as a descriptive epidemiological study with data from 10 countries of the former Communist bloc, Slovenia, Croatia, Bosnia and Herzegovina, Serbia, Montenegro, Macedonia, Kosovo, Albania, Bulgaria, Romania, Czech Republic, Slovakia and Hungary, just about half of them are members of the EU. We examined the following variables: socio-organizational indicators, health and educational indicators and health indicators. The data used refer to 2002 and as a source of data are used official data from reference WebPages of family medicine doctors associations, WONCA website (EURACT, EQuiP, EGPRN), WebPages of Bureau of Statistics of the countries where the research was conducted as well as the Ministries of Health. Results: Results indicates that the failures and shortcomings of health care organizations in Southeast Europe. Lack of money hinders the implementation of health care reform in all mentioned countries, the most of them that is more oriented to Bismarck financing system. Problems in the political, legal and economic levels are obstacles for efficient a problem reconstructing health care system toward

  15. Clarifying students' feedback-seeking behaviour in clinical clerkships

    NARCIS (Netherlands)

    Bok, H.G.; Teunissen, P.W.; Spruijt, A.; Fokkema, J.P.; Beukelen, P. van; Jaarsma, D.A.; Vleuten, C.P.M. van der

    2013-01-01

    CONTEXT: Why and how do students seek feedback on their performance in the clinical workplace and which factors influence this? These questions have remained largely unanswered in research into workplace learning during clinical clerkships. Research on feedback has focused mainly on feedback provide

  16. The Development and Implementation of a Community Pharmacy Practice Clerkship.

    Science.gov (United States)

    Weissman, Fred G.; And Others

    1984-01-01

    A clerkship at the University of Southern California School of Pharmacy was developed to provide students with (1) experience in the identification, development,, implementation, and evaluation of patient care services in community pharmacies and (2) the skills required to successfully operate a community pharmacy on a day-to-day basis.…

  17. Challenges in communication during clerkships: A case report

    NARCIS (Netherlands)

    Pol, M.H. van de; Weel-Baumgarten, E.M. van

    2012-01-01

    Patient-centered communication skills training is an integral part of the medical training of students of the Radboud Univeristy Nijmegen Medical Centre. During their clerkships, however, students are confronted with a variety of physicians, demonstrating communication skills which differ from what

  18. Feasibility of self-directed learning in clerkships.

    Science.gov (United States)

    Tolsgaard, M G; Arendrup, H; Pedersen, P; Ringsted, C

    2013-08-01

    Self-directed learning has been well described in preclinical settings. However, studies report conflicting results when self-directed initiatives are implemented in clinical clerkships. To explore the feasibility of self-directed learning stimulated by clinical encounter-cards (CECs) in clinical clerkships. Two focus groups of year-four and year-five students were interviewed about the usefulness of CECs to their learning in clerkships. The CECs were then introduced in two cohorts of 248 year-four and 250 year-five medical students and evaluated on a nine-point scale with regard to usefulness and feasibility. The pilot groups reported that the CECs had positive effects in terms of engaging in diagnostic reasoning, reflection on management plans, and professional identity formation. However, the two large cohorts of students rated the usefulness of the CECs on learning in clerkship low (year-four: mean 2.92, SD 1.54; year-five: mean 2.28, SD 1.06) along with preceptor support (year-four: mean 2.68, SD 1.62; year-five: mean 2.59, SD 1.78, p = 0.34). Self-directed CECs can have a positive effect on participation and clinical reasoning but are highly dependent on the context of use. Self-directed learning initiatives that aim to increase participation in communities of practice may not be feasible without major faculty development initiatives.

  19. Support for and aspects of use of educational games in family medicine and internal medicine residency programs in the US: a survey

    Directory of Open Access Journals (Sweden)

    Wilson Mark C

    2010-03-01

    Full Text Available Abstract Background The evidence supporting the effectiveness of educational games in graduate medical education is limited. Anecdotal reports suggest their popularity in that setting. The objective of this study was to explore the support for and the different aspects of use of educational games in family medicine and internal medicine residency programs in the United States. Methods We conducted a survey of family medicine and internal medicine residency program directors in the United States. The questionnaire asked the program directors whether they supported the use of educational games, their actual use of games, and the type of games being used and the purpose of that use. Results Of 434 responding program directors (52% response rate, 92% were in support of the use of games as an educational strategy, and 80% reported already using them in their programs. Jeopardy like games were the most frequently used games (78%. The use of games was equally popular in family medicine and internal medicine residency programs and popularity was inversely associated with more than 75% of residents in the program being International Medical Graduates. The percentage of program directors who reported using educational games as teaching tools, review tools, and evaluation tools were 62%, 47%, and 4% respectively. Conclusions Given a widespread use of educational games in the training of medical residents, in spite of limited evidence for efficacy, further evaluation of the best approaches to education games should be explored.

  20. Support for and aspects of use of educational games in family medicine and internal medicine residency programs in the US: a survey.

    Science.gov (United States)

    Akl, Elie A; Gunukula, Sameer; Mustafa, Reem; Wilson, Mark C; Symons, Andrew; Moheet, Amir; Schünemann, Holger J

    2010-03-25

    The evidence supporting the effectiveness of educational games in graduate medical education is limited. Anecdotal reports suggest their popularity in that setting. The objective of this study was to explore the support for and the different aspects of use of educational games in family medicine and internal medicine residency programs in the United States. We conducted a survey of family medicine and internal medicine residency program directors in the United States. The questionnaire asked the program directors whether they supported the use of educational games, their actual use of games, and the type of games being used and the purpose of that use. Of 434 responding program directors (52% response rate), 92% were in support of the use of games as an educational strategy, and 80% reported already using them in their programs. Jeopardy like games were the most frequently used games (78%). The use of games was equally popular in family medicine and internal medicine residency programs and popularity was inversely associated with more than 75% of residents in the program being International Medical Graduates. The percentage of program directors who reported using educational games as teaching tools, review tools, and evaluation tools were 62%, 47%, and 4% respectively. Given a widespread use of educational games in the training of medical residents, in spite of limited evidence for efficacy, further evaluation of the best approaches to education games should be explored.

  1. Practical training in family medicine in the Dalmatian hinterland: first-hand experience of four physicians

    Directory of Open Access Journals (Sweden)

    Minka Jerčić

    2012-05-01

    Full Text Available Four physicians working in private family medicine offices in Dalmatian Hinterland described their first hand experience of teaching sixthyear medical students. They supervised students during the 2010/2011 academic year, in an area that is economically undeveloped, rural, and where a number of people live in extended families. Although hesitant at first, the patients came to like the interaction with students, and later even yearned to provide students with as much information as possible. They also liked the letters that students had to write to them about their illness, because they could take them home and look for information without needing to see the doctor. The students showed diverse attitudes to different types of work in family medicine offices, mostly depending on their plans for future career. In general, they either complained or hesitated to perform duties that they did not fully master during earlier education, especially working with children. They needed several days to adapt to direct contact with the patients, and were more relaxed and cooperative when working in pairs than alone. The physicians themselves felt that they profited both from the novelty in the everyday routine and from the exchange of their experiences with the students. They liked their young colleagues and admitted they could not objectively review their own work, knowledge and skills.

  2. A Methodological Strategy for the Family Health Course in General Internal Medicine Residency

    Directory of Open Access Journals (Sweden)

    Mabel Rocha Vázquez

    2011-04-01

    Full Text Available Background: the continuous improvement of the educational process is one of the permanent challenges of medical education in Cuba. When dealing particularly with family medicine it must be ensured that physicians are always getting a better clinical approach to the management of families, since this is one of the key areas that have been identified as problematic in professional practices. Objective: to design a methodological strategy for the improvement of educational activities in the Family Health Course of the General Internal Medicine Residency. Method: a development research, conducted at the University of Medical Sciences of Cienfuegos, from November 2005 to January 2007 is presented. Document analysis and validation by expert criteria were also implemented. Results: for each of the four themes that make up this course, the following aspects are stated: teaching organization, length, contents, activity objectives, methodological guidelines to implement these activities, assessment proposals for some of them and some literature. Conclusions: the design of educational activities, with emphasis on actual or simulated medical practice, could help improving the quality of the teaching process. In addition, following the logical structure of activities, teachers can develop similar proposals to address other health problems according to the different learning needs.

  3. Postgraduate family medicine training in Singapore--a new way forward.

    Science.gov (United States)

    Wong, Teck Yee; Chong, Phui Nah; Chng, Shih Kiat; Tay, Ee Guan

    2012-05-01

    Postgraduate Family Medicine (FM) training is important to train future primary care doctors to provide accessible and cost effective healthcare. In Singapore, a structured postgraduate FM training programme has been available for 20 years. This programme is characterised by involvement of both FM and non-FM doctors, well written modules and a rigorous assessment process. However, challenges faced by both the current healthcare system and training structure underlie the need to review the training structure to ensure its relevancy for future Family Physicians (FPs) to manage the needs of their patients. A workgroup was formed to review the current FM postgraduate programme and to explore the possibility of using the Accreditation Council for Graduate Medical Education (ACGME) framework to enhance our current system. The workgroup felt that broad-based training and comprehensive coverage of topics are areas that are important to retain in any new FM residency programme. Weaknesses identified included a lack of early FM exposure and the need to strengthen formative assessments. New organisational structures such as Family Medicine Centres (FMC) need to be established and the involvement of the private sector in any FM residency progammes could be enhanced. The implementation of the FM Residency Programme in 2011 presented a unique opportunity to realign FM postgraduate education in line with the national objectives and to equip FPs with the necessary knowledge and skills for managing the future healthcare needs of Singaporeans.

  4. Exploring the experience of residents during the first six months of family medicine residency training

    Science.gov (United States)

    Martin, Dawn; Nasmith, Louise; Takahashi, Susan Glover; Harvey, Bart J.

    2017-01-01

    Background The shift from undergraduate to postgraduate education signals a new phase in a doctor’s training. This study explored the resident’s perspective of how the transition from undergraduate to postgraduate (PGME) training is experienced in a Family Medicine program as they first meet the reality of feeling and having the responsibility as a doctor. Methods Qualitative methods explored resident experiences using interpretative inquiry through monthly, individual in-depth interviews with five incoming residents during the first six months of training. Focus groups were also held with residents at various stages of training to gather their reflection about their experience of the first six months. Residents were asked to describe their initial concerns, changes that occurred and the influences they attributed to those changes. Results Residents do not begin a Family Medicine PGME program knowing what it means to be a Family Physician, but learn what it means to fulfill this role. This process involves adjusting to significant shifts in responsibility in the areas of Knowledge, Practice Management, and Relationships as they become more responsible for care outcomes. Conclusion This study illuminated the resident perspective of how the transition is experienced. This will assist medical educators to better understand the early training experiences of residents, how these experiences contribute to consolidating their new professional identity, and how to better align teaching strategies with resident learning needs. PMID:28344713

  5. Findings from the Harvard Medical School Cambridge Integrated Clerkship, a Year-Long Longitudinal Psychiatry Experience.

    Science.gov (United States)

    Cheng, Elisa; Hirsh, David; Gaufberg, Elizabeth; Griswold, Todd; Wesley Boyd, J

    2017-06-23

    The Harvard Medical School Cambridge Integrated Clerkship is a longitudinal integrated clerkship that has provided an alternative clinical model for medical education in psychiatry since its inception in 2004. This study was undertaken in an effort to better understand the student experience of the Cambridge Integrated Clerkship and how it may have impacted students' perceptions of and interest in psychiatry, as well as performance. Qualitative surveys were sent via e-mail to the first 11 student cohorts who had completed the Cambridge Integrated Clerkship (from 2004 to 2014) and for whom we had e-mail addresses (N = 100), and the free-text responses were coded thematically. All available standardized scoring data and residency match data for Cambridge Integrated Clerkship graduates were obtained. From 2006 to 2014, 12 out of 73 Cambridge Integrated Clerkship students who entered the match chose a psychiatry residency (16.4%), four times more than students in traditional clerkships at Harvard Medical School (3.8% of 1355 students) or the national average (4.1% of 146,066 US applicants). Thirty of the 100 surveyed Cambridge Integrated Clerkship graduates (30%) responded to the qualitative survey with free-text remarks on a number of themes. Cambridge Integrated Clerkship students compared positively to their classmates in terms of standardized test performance. Their fourfold higher match rate into psychiatry compared to other students raises intriguing questions as to what role a longitudinal clerkship might have played in developing interest in psychiatry as a career.

  6. Vaginal delivery simulation in the Obstetrics and Gynaecology clerkship.

    Science.gov (United States)

    Nitsche, Joshua; Morris, Dana; Shumard, Kristina; Akoma, Ugochi

    2016-10-01

    Although simulation is now used in other areas of obstetrics and gynaecology, its utility in the training of an uncomplicated vaginal delivery is surprisingly under-explored. Here we describe our experience integrating simulation into the third-year Obstetrics and Gynaecology (OB/GYN) clerkship. In 2013/14, at the start of each 4-week OB/GYN clerkship, each third-year student participated in a 90-minute vaginal delivery simulation session using the Noelle(®) simulator. Upon completion of the clerkship, they were surveyed using a five-point Likert scale questionnaire (1, inferior; 5, superior) to assess self-perceived training adequacy, clinical preparedness and number of deliveries performed during the clerkship. Students who completed the clerkship in 2012/13, before the introduction of the simulation, were also surveyed to serve as a comparison group. Survey scores and number of deliveries performed were compared between the two cohorts of students. The 2013/14 cohort (n = 98) who received simulation training gave their training in vaginal deliveries an average rating of 4.1, versus 2.7 for the 2012/13 cohort that did not receive the simulation (n = 80; p < 0.001). Self-perceived preparedness to perform a vaginal delivery was 4.0 in the 2013/14 cohort, versus 3.0 in the 2012/13 cohort (p < 0.001). There was no difference in the number of deliveries performed between the cohorts. Students that received simulation rated their training adequacy and readiness to perform a vaginal delivery higher than students that did not receive training. Simulation did not increase participation in real-life deliveries. The utility of simulation in the training of an uncomplicated vaginal delivery is under-explored. © 2015 John Wiley & Sons Ltd.

  7. Learning behaviour and preferences of family medicine residents under a flexible academic curriculum

    Science.gov (United States)

    Sy, Alice; Wong, Eric; Boisvert, Leslie

    2014-01-01

    Abstract Objective To determine family medicine residents’ learning behaviour and preferences outside of clinical settings in order to help guide the development of an effective academic program that can maximize their learning. Design Retrospective descriptive analysis of academic learning logs submitted by residents as part of their academic training requirements between 2008 and 2011. Setting London, Ont. Participants All family medicine residents at Western University who had completed their academic program requirements (N = 72) by submitting 300 or more credits (1 credit = 1 hour). Main outcome measures Amount of time spent on various learning modalities, location where the learning took place, resources used for self-study, and the objective of the learning activity. Results A total of 72 residents completed their academic requirements during the study period and logged a total of 25 068 hours of academic learning. Residents chose to spend most of their academic time engaging in self-study (44%), attending staff physicians’ teaching sessions (20%), and participating in conferences, courses, or workshops (12%) and in postgraduate medical education sessions (12%). Textbooks (26%), medical journals (20%), and point-of-care resources (12%) were the 3 most common resources used for self-study. The hospital (32%), residents’ homes (32%), and family medicine clinics (14%) were the most frequently cited locations where academic learning occurred. While all physicians used a variety of educational activities, most residents (67%) chose self-study as their primary method of learning. The topic for academic learning appeared to have some influence on the learning modalities used by residents. Conclusion Residents used a variety of learning modalities and chose self-study over other more traditional modalities (eg, lectures) for most of their academic learning. A successful academic program must take into account residents’ various learning preferences and

  8. Use and teaching of pneumatic otoscopy in a family medicine residency program.

    Science.gov (United States)

    Ouedraogo, Eva; Labrecque, Michel; Côté, Luc; Charbonneau, Katerine; Légaré, France

    2013-09-01

    To determine to what extent FPs teach and use pneumatic otoscopy and to identify the chief influences on this behaviour. Mixed-methods descriptive study conducted between March and May 2011. The family medicine residency program at Laval University in Quebec city, Que. Directors of the family medicine teaching units (FMTUs), teachers, and residents. We used questionnaires to assess the availability of pneumatic otoscopy equipment in 12 FMTUs, current behaviour and behavioural intention among physicians (residents and teachers) to use or teach pneumatic otoscopy, and facilitators and barriers to these practices. We also conducted 2 focus groups to further explore the facilitators of and barriers to using pneumatic otoscopy. We used descriptive statistics for quantitative data, transcribed the qualitative material, and performed content analysis. Eight of the 12 FMTUs reported having pneumatic otoscopy equipment. Four had it in all of their consulting rooms, and 2 formally taught it. Nine (4%) of 211 physicians reported regular use of pneumatic otoscopy. Mean (SD) intention to teach or use pneumatic otoscopy during the next year was low (2.4 [1.0] out of 5). Teachers identified improved diagnostic accuracy as the main facilitator both for use and for teaching, while residents identified recommendation by practice guidelines as the main facilitator for use. All physicians reported lack of availability of equipment as the main barrier to use. The main barrier to teaching pneumatic otoscopy reported by teachers was that they did not use it themselves. In focus groups, themes of consequences, capabilities, and socioprofessional influences were most dominant. Residents clearly identified role modeling by teachers as facilitating the use of pneumatic otoscopy. Pneumatic otoscopy is minimally used and taught in the family medicine residency program studied. Interventions to increase its use should target identified underlying beliefs and facilitators of and barriers to its

  9. Development of a global health curriculum for family medicine based on ACGME competencies.

    Science.gov (United States)

    Zink, Therese; Solberg, Erik

    2014-01-01

    With the popularity of global health among medical students and residents, family medicine (FM) residencies are developing pathways in global health. Curriculum based on Accreditation Council for Graduate Medical Education (ACGME) competencies adds rigor to the efforts. We describe the adaptation of a comprehensive pediatric global health curriculum based on ACGME competencies for family medicine. The curriculum maps out goals, objectives, curricular elements, and evaluation modalities for each of the six competencies (medical knowledge, patient care, practice-based learning, professionalism, communication, and systems-based practice). A literature review, followed by an iterative process, guided the expansion of the pediatric curriculum and the prioritization of domains for FM. Input was sought from FM global health faculty at our 8 residencies, affiliated community faculty, and international health experts from across the United States who attended our workshop at a national FM global health meeting. The final product includes comprehensive competency-based curriculum, open-source resources, and evaluation modalities. The goals and objectives pertinent to all FM residents, and those specific to global health pathway residents and fellows, are outlined. The limiting and enabling factors of the curriculum implementation are presented. This global family medicine curriculum has added structure and rigor to our international electives in the department at the University of Minnesota. The competency-based curriculum is in the early stages of implementation and evaluation. It has already strengthened components of the residency learning experience for all residents. A robust evaluation is needed and requires monitoring pathway graduates and their career choices into the future. The curriculum is available for adoption by other FM residencies.

  10. Increasing Interest in Child and Adolescent Psychiatry in the Third-Year Clerkship: Results from a Post-Clerkship Survey

    Science.gov (United States)

    Malloy, Erin; Hollar, David; Lindsey, Anthony

    2008-01-01

    Objective: The authors aimed to determine whether a structured clinical experience in child and adolescent psychiatry (CAP) during the third-year psychiatry clerkship would impact interest in pursuing careers in psychiatry and CAP. Methods: The authors constructed and administered a post-rotation survey, the Child and Adolescent Psychiatry…

  11. The learning environment in the obstetrics and gynecology clerkship: an exploratory study of students' perceptions before and after the clerkship.

    Science.gov (United States)

    Baecher-Lind, Laura E; Chang, Katherine; Blanco, Maria A

    2015-01-01

    For reasons that remain not entirely clear, Obstetrics and Gynecology (Ob/Gyn) clerkships often exhibit comparatively higher rates of medical student mistreatment. To explore perceptions of our local learning environment, focus groups were held with students yet to start (pre-students) and students having completed (post-students) their Ob/Gyn clerkship. Topics of discussion included learning expectations and experiences, perceptions of mistreatment, and suggestions for improving the learning environment and student treatment. Using a naturalistic approach, we conducted a conventional content analysis to identify emergent themes. Nine pre-students and nine post-students participated. While pre-students anticipated being actively engaged, they also expected - based on peer accounts - to be subject to an unwelcoming learning environment on the Ob/Gyn clerkship, despite working hard to become team members. Due to patient advocacy and protection concerns, post-students reported low levels of student involvement and, subsequently, an overall passive learning experience. Students from both groups offered valuable suggestions for improving the learning environment and student treatment. The sensitive nature of Ob/Gyn clinical encounters may lead to overprotective behaviors that contribute to students feeling mistreated and excluded from patient care and team membership. Students' experiences during Ob/Gyn clerkships could be improved by better balancing patient advocacy and student involvement. Practical implications to address these issues are offered.

  12. Factors associated to the career choice of family medicine among Japanese physicians: the dawn of a new era.

    Science.gov (United States)

    Ie, Kenya; Tahara, Masao; Murata, Akiko; Komiyama, Manabu; Onishi, Hirotaka

    2014-01-01

    Despite recent developments in post-graduate family medicine training in Japan, the numbers of junior doctors entering family medicine residencies are still limited. The objective of this qualitative study was to investigate the possible factors associated to the career choice of family medicine, especially in the context of the newly established family medicine programs in Japan. From December 2010 to January 2011, we distributed a semi-structured questionnaire about career choice to 58 physician members of the Japan Primary Care Association, and 41 of them responded. Four researchers used the Modified Grounded Theory Approach (Kinoshita, 2003) for three-stage conceptualization. We extracted a conceptual model of the choice of newly established family medicine as a career in Japan, consisting of six categories and 77 subordinate concepts from 330 variations. The subcategories of personal background affecting the family-medicine career choice were characteristics ("self-reliance," "pioneering spirit"), career direction ("community/rural-orientedness," "multifaceted orientation") and experience (e.g., "discomfort with fragmented care"). We divided the influencing factors that were identified for career choice into supporters (e.g., "role model"), conflict of career choice (e.g., "anxiety about diverse/broad practice"), and the dawn of a new era in family medicine in Japan (e.g., "lack of social recognition," "concern about livelihood," and "too few role models"). Although the dawn of a new era seemed a rather negative influencer, it was unique to our study that the dawn itself could attract those with a "pioneering spirit" and an "attitude of self-training." Unlike previous studies, the positive factors such as lifestyle and the short residency program were not shown to be part of family medicine's attractiveness. In contrast, "concern about livelihood" was specific among our respondents and was related to career choice in the dawn period. "Community

  13. Exploration of Medicinal Species of Lamiaceae family in Ilkhji and Sharafaldin Regions of Esat Azarbaijan in Iran

    Directory of Open Access Journals (Sweden)

    Leila Joudi

    2011-07-01

    Full Text Available In this research medicinal species of Lamiaceae family were detected. As medicinal plants are suitable alternatives for synthetic and chemical drugs (Idu and Osemwegie also because of medical and nutritional importance and valuable protein contents of Lamiaceae sp., all plants of Lamiaceae family are collected in Ilkhji and sharafaldin regions during growth seasons of 2007-2009. Plants were collected in 2 regions according to the classical method of regional floristical studies. Collected plants were recognized by valid references (Parsa 1943-1950; Reshinger, 1963-1990. Then medical species are chosen by using pharmacopeias. The results of the current study demonstrated that at Ilkhji region 16 species belong to 8 genuses and at Sharafaldin region 4 species belong to 4 genuses that all of them belong to Lamiaceae family. Among these species, 18 species at Ilkhji and sharafaldin region had medicinal properties. Medicinal species of these 2 regions consist of: Marrubium vulgare, Mentha longifolia, Nepeta meyeri, Nepeta persica, Nepeta racemosa, Phlomis olivieri, Salvia nemorasa, Salvia sahendica, Salvia spinosa, Stachys virgata, Stachys inflate, Stachys lavandifolia, Stachys turcomanica, Stachys persica, Thymus cotschyanus, Thymus pubescens, Ziziphora tenuior Lamium amplexicaule. The results of this study showed that the region has a great potential for producing respective medicinal plants species belong to those families. Medicinal plants recently become more important because of their medicinal uses and in addition they are valuable source of protein.

  14. Improving health care globally : a critical review of the necessity of family medicine research and recommendations to build research capacity

    NARCIS (Netherlands)

    Weel, C. van; Rosser, W.W.

    2004-01-01

    An invitational conference led by the World Organization of Family Doctors (Wonca) involving selected delegates from 34 countries was held in Kingston, Ontario, Canada, March 8 to12, 2003. The conference theme was "Improving Health Globally: The Necessity of Family Medicine Research." Guiding confer

  15. Are familial factors underlying the association between socioeconomic position and prescription medicine?

    DEFF Research Database (Denmark)

    Madsen, Mia; Andersen, Per Kragh; Gerster, Mette;

    2013-01-01

    OBJECTIVES: Although well established, the association between socioeconomic position and health and health behaviour is not clearly understood, and it has been speculated that familial factors, for example, dispositional factors or exposures in the rearing environment, may be underlying...... analyses were compared. RESULTS: An inverse social gradient in filling of prescriptions for all-purpose and system-specific drugs was observed in the unpaired analyses. In the intrapair analyses, associations were attenuated some in DZSS and more in MZ twins. Filling of drugs targeting the nervous system...... was still strongly associated with income in the intrapair analyses. CONCLUSIONS: Familial factors seem to account for part of the observed social inequality in filling of prescription medicine....

  16. Behavioral interventions for office-based care: interventions in the family medicine setting.

    Science.gov (United States)

    Larzelere, Michele McCarthy

    2014-03-01

    The practice of family medicine includes the care of many patients with mental health or behavior change needs. Patients in mild to moderate distress may benefit from brief interventions performed in the family physician's office. Patients in more extreme distress may be helped by referral to behavioral health clinicians for short-term or open-ended therapies. Electronic therapy programs and bibliotherapy are also useful resources. The transition to the patient-centered medical home model may allow for more widespread integration of behavioral health care clinicians into primary care, in person and through telemental health care. Integrated care holds the promise of improved access, greater effectiveness of behavioral health service provision, and enhanced efficiency of primary care for patients with behavioral health care needs.

  17. 1 st National conference on family medicine and primary care: A journey toward stronger primary care in India

    Directory of Open Access Journals (Sweden)

    Raman Kumar

    2013-01-01

    Full Text Available Academy of Family Physicians of India organized the first National Conference on Family Medicine and Primary Care (FMPC on 20-21 April 2013 at India International Centre New Delhi. The conference was a major success towards positioning of requirement for a distinct academic discipline (family medicine within the medical and nursing education system as a means for strengthening of primary care in India. The event gained its prominence in the times when universal health coverage is being debated. A generalist approach in development of human resource prominently figured in the discussions. The deliberations and talks of the Indian as well as international experts were recorded and released as the report of national consultation on family medicine programme.

  18. Family medicine: its core principles and impact on patient care and medical education in the United States.

    Science.gov (United States)

    Jimbo, Masahito

    2004-06-01

    The specialty of family medicine arose out of a combination of American public and professional concerns regarding fragmentation of health care and was intended to foster a type of physician with a scope of clinical competence that would allow the patient, not the disease, to be the focus. Family physicians serve as the patient's personal physician and provide entry to the health care system, provide comprehensive care, maintain continuing responsibility for the patient including necessary coordination of care and referral, and provide care appropriate to the patient's physical, emotional, and social needs in the context of family and community. The specialty is currently second only to internal medicine in size, and makes a significant contribution to patient care and medical education. As family medicine looks to the future, some of its challenges include continuing to attract medical students to the specialty, refine research themes, and gain further acceptance in academic medical centers.

  19. Where should family medicine papers be published - following the impact factor?

    Science.gov (United States)

    Peleg, Roni; Shvartzman, Pesach

    2006-01-01

    Academic institutions weigh the research contribution of family physicians and take this factor into account when determining eligibility for the candidates' promotion. Among other parameters, these institutions consider the journals in which family physicians publish. In this respect, the impact factor (IF) has gained a foothold as one of the most accepted means to measure this contribution. The IF may be a measure of the main importance of a scientific journal. IF has a huge, but controversial, influence on the perception and evaluation of published scientific research. It is important for family physicians to understand and be aware of the importance of the IF and the way it is calculated. The IF is one consideration in the decision-making process of a researcher as to where to publish because the IF of most family medicine journals is less than 2.0. Thus publication in these journals might not yield the proper "score" for academic promotion in many institutions. On the other hand, publication in journals with higher IF that are not necessarily widely read by primary care physicians could result in a small impact of their findings on direct patient care.

  20. [Patient safety culture in family and community medicine residents in Aragon].

    Science.gov (United States)

    Rodríguez-Cogollo, R; Paredes-Alvarado, I R; Galicia-Flores, T; Barrasa-Villar, J I; Castán-Ruiz, S

    2014-01-01

    having an appropriate patient safety culture is the first recommendation to improve it. The aim of this article is to determine the safety culture in family medicine residents and then to identify improvement strategies. an online cross-sectional survey of residents in family medicine teaching units of Aragon using the translated, validated and adapted to Spanish, Medical Office Survey on Patient Safety Culture (MOSPS) questionnaire. The results were grouped in 12-dimensional responses for analysis, and the mean value of each dimension was calculated. Perceptions were described by Percentages of Positive (PRP) and Negative Responses (PRN) to each dimension. positive results were seen in «the Patient Care Tracking/Follow-up». There were significant differences in the «Information Exchange With Other Settings», «Staff Training» and «Overall Perceptions of Patient Safety and Quality». Study participants viewed «Work Pressure and Pace» negatively. the institutions providing health services, as well as their staff, are increasingly aware of the importance of improving Patient Safety, and the results of this study allowed us to present information that helps identify weaknesses, and to design initiatives and strategies to improve care practices. Copyright © 2013 SECA. Published by Elsevier Espana. All rights reserved.

  1. Educational Competitions of the Family Doctor in their Acting as Tutor in the Career of Medicine

    Directory of Open Access Journals (Sweden)

    José de la Caridad Lorenzo López

    2012-06-01

    Full Text Available Background: for the identification of a group of competitions characteristic of the educational work of the Family doctors that you/they act as tutors in the formative scenarios of the Primary Attention of Health in University Policlínico Cecilio Ruíz of Zárate. Objective: to identify the educational main competitions of the doctors of the family like tutors in the career of Medicine, in the Area II of the municipality of Cienfuegos. Method: pedagogic investigation of descriptive type in the mark of the medical education that looked for to define the group of educational basic competitions, what can favor a pedagogic management of more quality in the medical clinics as formative scenario of University Policlínico Cecilio Ruíz of Zárate during the year 2010. Results: 61,5% of our tutors has more than 10 years of medical formation; more than the half, their 73.1% is not categorized, 84.6% is specialist of general integral medicine, but of the half they received the preparation shop for tutors and 96.2% they consider the basic competitions as very important. Conclusion: deficiencies exist in the way of the tutor's performance for categorized personnel's lack, pedagogic scarce preparation and the assistance load of the professors in the primary attention of health.

  2. [Diabetic foot risk in patients with type II diabetes mellitus in a family medicine unit].

    Science.gov (United States)

    Márquez-Godínez, S A; Zonana-Nacach, A; Anzaldo-Campos, M C; Muñoz-Martínez, J A

    2014-01-01

    To determine the risk of diabetic foot in patients with type II diabetes mellitus (DM) seen in a Family Medicine Unit. The study included type II DM patients with a disease duration ≥ 5 years seen in a Family Medicine Unit, Tijuana, Mexico, during September-December 2011. Neuropathy was assessed with the Diabetic Neuropathy Symptom questionnaire, and pressure sensation using a 10-g Semmes-Weinstein monofilament. A patient had a high risk of diabetic foot if there was sensitivity loss, foot deformities, and non-palpable pedal pulses. We studied 205 patients with an average (± SD) age and DM duration of 59 ± 10 years and 10.7 ± 6.7 years, respectively. Ninety one patients (44%) had a high risk of developing diabetic foot, and it was associated with; an education of less than 6 years (OR 2.3; 95%CI: 1-1-4.1), DM disease duration ≥ 10 years (OR 5.1; 95%CI: 2.8-9.4), female gender (OR 2.0; 95%CI: 1.1-3.6), monthly familiar income diabetic neuropathy, since they have a high risk of diabetic foot. Copyright © 2013 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España. All rights reserved.

  3. Impact of a family medicine resident wellness curriculum: a feasibility study

    Directory of Open Access Journals (Sweden)

    Christine Runyan

    2016-06-01

    Full Text Available Background: Up to 60% of practicing physicians report symptoms of burnout, which often peak during residency. Residency is also a relevant time for habits of self-care and resiliency to be emphasized. A growing literature underscores the importance of this; however, evidence about effective burnout prevention curriculum during residency remains limited. Objectives: The purpose of this project is to evaluate the impact of a new, 1-month wellness curriculum for 12 second-year family medicine residents on burnout, empathy, stress, and self-compassion. Methods: The pilot program, introduced during a new rotation emphasizing competencies around leadership, focused on teaching skills to cultivate mindfulness and self-compassion in order to enhance empathy and reduce stress. Pre-assessments and 3-month follow-up assessments on measures of burnout, empathy, self-compassion, and perceived stress were collected to evaluate the impact of the curriculum. It was hypothesized that this curriculum would enhance empathy and self-compassion as well as reduce stress and burnout among family medicine residents. Results: Descriptive statistics revealed positive trends on the mean scores of all the measures, particularly the Mindfulness Scale of the Self-Compassion Inventory and the Jefferson Empathy Scale. However, the small sample size and lack of sufficient power to detect meaningful differences limited the use of inferential statistics. Conclusions: This feasibility study demonstrates how a residency wellness curriculum can be developed, implemented, and evaluated with promising results, including high participant satisfaction.

  4. Learning to See Beneath the Surface: A Qualitative Analysis of Family Medicine Residents' Reflections About Communication.

    Science.gov (United States)

    Duggan, Ashley P; Vicini, Andrea; Allen, Lucas; Shaughnessy, Allen F

    2015-01-01

    Patients share straightforward statements with physicians such as describing their fears about their diagnosis. Physicians need to also understanding implicit, indirect, subtle communication cues that give broader context to patients' illness experiences. This project examines physicians' written reflections that offer insight into their interpretation of both the stated and the tacit aspects of their observations about communication, their resulting responses, and their intended actions. Tufts University Family Medicine residents (N = 33) of the Tufts Family Medicine Cambridge Health Alliance completed three reflective exercises each week over the course of 1 year (756 reflective entries). An interdisciplinary research team identified communication-related concepts within the reflections. Identified themes include (a) physicians recognizing and discovering mutual interplay of their communication with and patient disclosure, (b) physicians paying attention to subtleties of patient behavior as indicative of a fuller picture of patients' lives and their coping with illness, and (c) physician images of growth and awareness about communication indicative of their potential for growth and improvement. The project extends the literature in communication and medical education by examining explicit and tacit points of reflection about communication. The project (a) allows for unpacking the multifaceted aspects of reflection and (b) bridges reflective theory and medical education with communication foundations.

  5. Patient empowerment, an additional characteristic of the European definitions of general practice/family medicine.

    Science.gov (United States)

    Mola, Ernesto

    2013-06-01

    Growing evidence supports the inclusion of patient empowerment as a key ingredient of care for patients with chronic conditions. In recent years, several studies based on patient empowerment, have been carried out in different European countries in the context of general practice and primary care to improve management of chronic diseases. These studies have shown good results of the care model, increasing patient and health professionals' satisfaction, adherence to guidelines and to treatment, and improving clinical outcomes. In 2011, the Wonca European Council included as the twelfth characteristic of the European definitions of general practice/family medicine: 'promote patient empowerment'. The aim of this paper is to clarify the meaning of 'patient empowerment' and to explain why family medicine should be considered the most suitable setting to promote it. The inclusion of patient empowerment as one of the essential characteristics of general practice fills a conceptual gap and clearly suggests to the European health care systems a tested model to face chronic diseases: involving and empowering patients in managing their own conditions to improve health and well-being.

  6. Teaching family medicine residents how to answer clinical questions using QUIPs

    Directory of Open Access Journals (Sweden)

    Lisa Bishop

    2013-09-01

    Full Text Available Background: “Questions in Practice” (QUIP rounds are used to encourage residents to quickly find, evaluate, and incorporate information into clinical practice. It is an opportunity for residents to identify a clinical question, research the answer, present the evidence, and discuss how to apply it to practice. The value of using this method to teach residents has not been evaluated. Methods: A sampling of all first and second-year family medicine residents enrolled in the Memorial University Family Medicine program were invited to participate in the survey. The survey gathered information about the residents’ current experiences with answering clinical questions, their experience during QUIP rounds, and the value of an interdisciplinary approach. Results: The response rate was 91% (42/46. Medical websites (45% and journal article indexes (34% were most often used. Through QUIPs, 50% of the students identified new methods to retrieve answers, 80% considered it a useful learning experience, 75% had improved confidence, and clinical knowledge improved in 97%. Conclusions: Residents are familiar with many general sources of medical information, and QUIPs helped improve confidence in their knowledge and ability to answer questions. QUIPs appear to be a useful tool for teaching information resources and how to interpret and apply evidence to clinical situations.

  7. Impact of a family medicine resident wellness curriculum: a feasibility study

    Science.gov (United States)

    Runyan, Christine; Savageau, Judith A.; Potts, Stacy; Weinreb, Linda

    2016-01-01

    Background Up to 60% of practicing physicians report symptoms of burnout, which often peak during residency. Residency is also a relevant time for habits of self-care and resiliency to be emphasized. A growing literature underscores the importance of this; however, evidence about effective burnout prevention curriculum during residency remains limited. Objectives The purpose of this project is to evaluate the impact of a new, 1-month wellness curriculum for 12 second-year family medicine residents on burnout, empathy, stress, and self-compassion. Methods The pilot program, introduced during a new rotation emphasizing competencies around leadership, focused on teaching skills to cultivate mindfulness and self-compassion in order to enhance empathy and reduce stress. Pre-assessments and 3-month follow-up assessments on measures of burnout, empathy, self-compassion, and perceived stress were collected to evaluate the impact of the curriculum. It was hypothesized that this curriculum would enhance empathy and self-compassion as well as reduce stress and burnout among family medicine residents. Results Descriptive statistics revealed positive trends on the mean scores of all the measures, particularly the Mindfulness Scale of the Self-Compassion Inventory and the Jefferson Empathy Scale. However, the small sample size and lack of sufficient power to detect meaningful differences limited the use of inferential statistics. Conclusions This feasibility study demonstrates how a residency wellness curriculum can be developed, implemented, and evaluated with promising results, including high participant satisfaction. PMID:27282276

  8. Training Future Clinician-Educators: A Track for Family Medicine Residents.

    Science.gov (United States)

    Lin, Steven; Sattler, Amelia; Chen Yu, Grace; Basaviah, Preetha; Schillinger, Erika

    2016-03-01

    Despite a growing demand for skilled clinician-educators, residents today rarely receive formal training in clinical teaching, curriculum development, administration, leadership, or educational scholarship. The authors describe the development, implementation, and preliminary evaluation of the O'Connor Stanford Leaders in Education Residency (OSLER) track, a novel clinician-educator track within the family medicine residency program affiliated with Stanford University School of Medicine. In 2010, the OSLER track was introduced at O'Connor Hospital, a community hospital that houses an 8-8-8 family medicine residency program. Residents who are in good standing can apply to the track at the midpoint of their first postgraduate year. Residents are immersed in a flexible, experience-based, 2.5-year-long curriculum with hands-on teaching activities at its core. To foster skills in educational scholarship, track residents are required to design and complete a scholarly project. A comprehensive evaluation plan is currently in progress. Preliminary data indicates high levels of satisfaction with the track's overall value, impact on core teaching skills, and effect on career trajectory. Residents gained more confidence in core teaching skills as they progressed through the track. Scholarly work output by residents has increased significantly since the track was implemented. The residency program has seen an increased interest from applicants since the track was started, with data suggesting that applicant quality has increased from the pre-track to post-track years. More research is needed to assess the effectiveness and reproducibility of this clinician-educator track. If proven, this model may be replicated at other academic medical centers.

  9. Evaluation of four commonly used DNA barcoding Loci for chinese medicinal plants of the family schisandraceae.

    Science.gov (United States)

    Zhang, Jian; Chen, Min; Dong, Xiaoyu; Lin, Ruozhu; Fan, Jianhua; Chen, Zhiduan

    2015-01-01

    Many species of Schisandraceae are used in traditional Chinese medicine and are faced with contamination and substitution risks due to inaccurate identification. Here, we investigated the discriminatory power of four commonly used DNA barcoding loci (ITS, trnH-psbA, matK, and rbcL) and corresponding multi-locus combinations for 135 individuals from 33 species of Schisandraceae, using distance-, tree-, similarity-, and character-based methods, at both the family level and the genus level. Our results showed that the two spacer regions (ITS and trnH-psbA) possess higher species-resolving power than the two coding regions (matK and rbcL). The degree of species resolution increased with most of the multi-locus combinations. Furthermore, our results implied that the best DNA barcode for the species discrimination at the family level might not always be the most suitable one at the genus level. Here we propose the combination of ITS+trnH-psbA+matK+rbcL as the most ideal DNA barcode for discriminating the medicinal plants of Schisandra and Kadsura, and the combination of ITS+trnH-psbA as the most suitable barcode for Illicium species. In addition, the closely related species Schisandra rubriflora Rehder & E. H. Wilson and Schisandra grandiflora Hook.f. & Thomson, were paraphyletic with each other on phylogenetic trees, suggesting that they should not be distinct species. Furthermore, the samples of these two species from the southern Hengduan Mountains region formed a distinct cluster that was separated from the samples of other regions, implying the presence of cryptic diversity. The feasibility of DNA barcodes for identification of geographical authenticity was also verified here. The database and paradigm that we provide in this study could be used as reference for the authentication of traditional Chinese medicinal plants utilizing DNA barcoding.

  10. Evaluation of four commonly used DNA barcoding Loci for chinese medicinal plants of the family schisandraceae.

    Directory of Open Access Journals (Sweden)

    Jian Zhang

    Full Text Available Many species of Schisandraceae are used in traditional Chinese medicine and are faced with contamination and substitution risks due to inaccurate identification. Here, we investigated the discriminatory power of four commonly used DNA barcoding loci (ITS, trnH-psbA, matK, and rbcL and corresponding multi-locus combinations for 135 individuals from 33 species of Schisandraceae, using distance-, tree-, similarity-, and character-based methods, at both the family level and the genus level. Our results showed that the two spacer regions (ITS and trnH-psbA possess higher species-resolving power than the two coding regions (matK and rbcL. The degree of species resolution increased with most of the multi-locus combinations. Furthermore, our results implied that the best DNA barcode for the species discrimination at the family level might not always be the most suitable one at the genus level. Here we propose the combination of ITS+trnH-psbA+matK+rbcL as the most ideal DNA barcode for discriminating the medicinal plants of Schisandra and Kadsura, and the combination of ITS+trnH-psbA as the most suitable barcode for Illicium species. In addition, the closely related species Schisandra rubriflora Rehder & E. H. Wilson and Schisandra grandiflora Hook.f. & Thomson, were paraphyletic with each other on phylogenetic trees, suggesting that they should not be distinct species. Furthermore, the samples of these two species from the southern Hengduan Mountains region formed a distinct cluster that was separated from the samples of other regions, implying the presence of cryptic diversity. The feasibility of DNA barcodes for identification of geographical authenticity was also verified here. The database and paradigm that we provide in this study could be used as reference for the authentication of traditional Chinese medicinal plants utilizing DNA barcoding.

  11. Objective Evaluation of Otoscopy Skills Among Family and Community Medicine, Pediatric, and Otolaryngology Residents.

    Science.gov (United States)

    Oyewumi, Modupe; Brandt, Michael G; Carrillo, Brian; Atkinson, Adelle; Iglar, Karl; Forte, Vito; Campisi, Paolo

    2016-01-01

    The objective of this study is to evaluate and compare the perceived need for otolaryngology training and otoscopy diagnostic skills in primary care (Family and Community Medicine, Pediatric Medicine), and Otolaryngology Head and Neck Surgery (OTO-HNS) postgraduate trainees. Participant otoscopy skills were evaluated using the OtoSim simulator. Family and Community Medicine, Pediatric, and OTO-HNS residents were recruited. Each resident participated in 3 separate otoscopy training and assessment sessions. The ability to correctly identify middle ear pathology was objectively evaluated using OtoSim™. Pretest, posttest, and 3-month retention test results were compared among residents in a paired comparison paradigm. Survey data assessing exposure to OTO-HNS during undergraduate and postgraduate training were also collected. A total of 57 residents participated in the study. All residents reported limited exposure to OTO-HNS during undergraduate medical training. Primary care trainees performed poorly on pretest assessments (30% ± 7.8%; 95% CI). Significant improvement in diagnostic accuracy was demonstrated following a single 1-hour teaching session (30%-62%; p < 0.001). Primary care residents demonstrated a significant decrease in diagnostic accuracy at a 3-month follow-up assessment (62%-52%, p < 0.001). Self-perceived comfort with otology was poorly correlated to pretest performance among primary care trainees (r = 0.26) and showed a stronger positive correlation among OTO-HNS trainees (r = 0.56). A single teaching session with an otoscopy simulator significantly improved diagnostic accuracy in primary care and OTO-HNS trainees. Improved performance is susceptible to deterioration at 3 months if acquired skills are not frequently used. Self-perceived comfort with otology may not be an accurate predictor of otoscopic diagnostic skill. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  12. Evaluation of teaching and learning in family medicine by students: A Sri Lankan experience

    Directory of Open Access Journals (Sweden)

    R. P. J. C. Ramanayake

    2015-01-01

    Full Text Available Background: Family Medicine occupies a prominent place in the undergraduate curriculum of the Faculty of Medicine, University of Kelaniya, Sri Lanka. The one month clinical attachment during the fourth year utilizes a variety of teaching methods. This study evaluates teaching learning methods and learning environment of this attachment. Methodology: A descriptive cross sectional study was carried out among consenting students over a period of six months on completion of the clinical attachment using a pretested self administered questionnaire. Results: Completed questionnaires were returned by 114(99% students. 90.2% were satisfied with the teaching methods in general while direct observation and feed back from teachers was the most popular(95.1% followed by learning from patients(91.2%, debate(87.6%, seminar(87.5% and small group discussions(71.9%. They were highly satisfied with the opportunity they had to develop communication skills (95.5% and presentation skills (92.9%. Lesser learning opportunity was experienced for history taking (89.9%, problem solving (78.8% and clinical examination (59.8% skills. Student satisfaction regarding space within consultation rooms was 80% while space for history taking and examination (62% and availability of clinical equipment (53% were less. 90% thought the programme was well organized and adequate understanding on family medicine concepts and practice organization gained by 94% and 95% of the students respectively. Conclusions: Overall student satisfaction was high. Students prefer learning methods which actively involve them. It is important to provide adequate infra structure facilities for student activities to make it a positive learning experience for them.

  13. A national radiation oncology medical student clerkship survey: Didactic curricular components increase confidence in clinical competency

    Science.gov (United States)

    Jagadeesan, Vikrant S.; Raleigh, David R.; Koshy, Matthew; Howard, Andrew R.; Chmura, Steven J.; Golden, Daniel W.

    2014-01-01

    Purpose/Objectives Students applying to radiation oncology residency programs complete one or more radiation oncology clerkships. This study assesses student experiences and perspectives during radiation oncology clerkships. The impact of didactic components and number of clerkship experiences in relation to confidence in clinical competency and preparation to function as a first year radiation oncology resident are evaluated. Methods and Materials An anonymous, internet-based survey was sent via direct e-mail to all applicants to a single radiation oncology residency program during the 2012–2013 academic year. The survey was composed of three main sections including questions regarding baseline demographic information and prior radiation oncology experience, rotation experiences, and ideal clerkship curriculum content. Results The survey response rate was 37% (70/188). Respondents reported 191 unique clerkship experiences. 27% of respondents (19/70) completed at least one clerkship with a didactic component geared towards their level of training. Completing a clerkship with a didactic component was significantly associated with a respondent’s confidence to function as a first- year radiation oncology resident (Wilcoxon rank-sum p = 0.03). However, the total number of clerkships completed did not correlate with confidence to pursue radiation oncology as a specialty (Spearman’s rho p = 0.48) or confidence to function as a first year resident (Spearman’s rho p = 0.43). Conclusions Based on responses to this survey, rotating students perceive that the majority of radiation oncology clerkships do not have formal didactic curricula. Survey respondents who completed a clerkship with a didactic curriculum reported feeling more prepared to function as a radiation oncology resident. However, completing an increasing number of clerkships does not appear to improve confidence in the decision to pursue radiation oncology as a career or to function as a radiation

  14. A National Radiation Oncology Medical Student Clerkship Survey: Didactic Curricular Components Increase Confidence in Clinical Competency

    Energy Technology Data Exchange (ETDEWEB)

    Jagadeesan, Vikrant S. [Department of Radiation and Cellular Oncology, Pritzker School of Medicine, University of Chicago, Chicago, Illinois (United States); Raleigh, David R. [Department of Radiation Oncology, School of Medicine, University of California–San Francisco, San Francisco, California (United States); Koshy, Matthew; Howard, Andrew R.; Chmura, Steven J. [Department of Radiation and Cellular Oncology, Pritzker School of Medicine, University of Chicago, Chicago, Illinois (United States); Golden, Daniel W., E-mail: dgolden@radonc.uchicago.edu [Department of Radiation and Cellular Oncology, Pritzker School of Medicine, University of Chicago, Chicago, Illinois (United States)

    2014-01-01

    Purpose: Students applying to radiation oncology residency programs complete 1 or more radiation oncology clerkships. This study assesses student experiences and perspectives during radiation oncology clerkships. The impact of didactic components and number of clerkship experiences in relation to confidence in clinical competency and preparation to function as a first-year radiation oncology resident are evaluated. Methods and Materials: An anonymous, Internet-based survey was sent via direct e-mail to all applicants to a single radiation oncology residency program during the 2012-2013 academic year. The survey was composed of 3 main sections including questions regarding baseline demographic information and prior radiation oncology experience, rotation experiences, and ideal clerkship curriculum content. Results: The survey response rate was 37% (70 of 188). Respondents reported 191 unique clerkship experiences. Of the respondents, 27% (19 of 70) completed at least 1 clerkship with a didactic component geared towards their level of training. Completing a clerkship with a didactic component was significantly associated with a respondent's confidence to function as a first-year radiation oncology resident (Wilcoxon rank–sum P=.03). However, the total number of clerkships completed did not correlate with confidence to pursue radiation oncology as a specialty (Spearman ρ P=.48) or confidence to function as a first year resident (Spearman ρ P=.43). Conclusions: Based on responses to this survey, rotating students perceive that the majority of radiation oncology clerkships do not have formal didactic curricula. Survey respondents who completed a clerkship with a didactic curriculum reported feeling more prepared to function as a radiation oncology resident. However, completing an increasing number of clerkships does not appear to improve confidence in the decision to pursue radiation oncology as a career or to function as a radiation oncology resident. These

  15. An assessment of implementation of CommunityOriented Primary Care in Kenyan family medicine postgraduate medical education programmes

    Directory of Open Access Journals (Sweden)

    Ian J. Nelligan

    2016-03-01

    Full Text Available Background and objectives: Family medicine postgraduate programmes in Kenya are examining the benefits of Community-Oriented Primary Care (COPC curriculum, as a method to train residents in population-based approaches to health care delivery. Whilst COPC is an established part of family medicine training in the United States, little is known about its application in Kenya. We sought to conduct a qualitative study to explore the development and implementation of COPC curriculum in the first two family medicine postgraduate programmes in Kenya. Method: Semi-structured interviews of COPC educators, practitioners, and academic stakeholders and focus groups of postgraduate students were conducted with COPC educators, practitioners and academic stakeholders in two family medicine postgraduate programmes in Kenya. Discussions were transcribed, inductively coded and thematically analysed. Results: Two focus groups with eight family medicine postgraduate students and interviews with five faculty members at two universities were conducted. Two broad themes emerged from the analysis: expected learning outcomes and important community-based enablers. Three learning outcomes were (1 making a community diagnosis, (2 understanding social determinants of health and (3 training in participatory research. Three community-based enablers for sustainability of COPC were (1 partnerships with community health workers, (2 community empowerment and engagement and (3 institutional financial support. Conclusions: Our findings illustrate the expected learning outcomes and important communitybased enablers associated with the successful implementation of COPC projects in Kenya and will help to inform future curriculum development in Kenya.

  16. Use of WONCA global standards to evaluate family medicine postgraduate education for curriculum development and review in Nepal and Myanmar.

    Science.gov (United States)

    Gibson, Christine; Ladak, Farah; Shrestha, Ashis; Yadav, Bharat; Thu, Kyaw; Aye, Tin

    2016-09-01

    Family medicine is an integral part of primary care within health systems. Globally, training programmes exhibit a great degree of variability in content and skill acquisition. While this may in part reflect the needs of a given setting, there exists standard criteria that all family medicine programmes should consider core activities. WONCA has provided an open-access list of standards that their expert community considers essential for family medicine (GP) post-graduate training. Evaluation of developing or existing training programmes using these standards can provide insight into the degree of variability, gaps within programmes and equally as important, gaps within recommendations. In collaboration with the host institution, two family medicine programmes in Nepal and Myanmar were evaluated based on WONCA global standards. The results of the evaluation demonstrated that such a process can allow for critical review of curriculum in various stages of development and evaluation. The implications of reviewing training programmes according to WONCA standards can lead to enhanced training world-wide and standardisation of training for post-graduate family medicine.

  17. Reliability testing of a portfolio assessment tool for postgraduate family medicine training in South Africa

    Directory of Open Access Journals (Sweden)

    Louis Jenkins

    2013-01-01

    Full Text Available Background: Competency-based education and the validity and reliability of workplace-based assessment of postgraduate trainees have received increasing attention worldwide.Family medicine was recognised as a speciality in South Africa six years ago and a satisfactory portfolio of learning is a prerequisite to sit the national exit exam. A massive scaling up of the number of family physicians is needed in order to meet the health needs of the country.Aim: The aim of this study was to develop a reliable, robust and feasible portfolio assessment tool (PAT for South Africa.Methods: Six raters each rated nine portfolios from the Stellenbosch University programme, using the PAT, to test for inter-rater reliability. This rating was repeated three months later to determine test–retest reliability. Following initial analysis and feedback the PAT was modified and the inter-rater reliability again assessed on nine new portfolios. An acceptable intra-classcorrelation was considered to be > 0.80.Results: The total score was found to be reliable, with a coefficient of 0.92. For test–retest reliability, the difference in mean total score was 1.7%, which was not statistically significant. Amongst the subsections, only assessment of the educational meetings and the logbook showed reliability coefficients > 0.80.Conclusion: This was the first attempt to develop a reliable, robust and feasible national portfolio assessment tool to assess postgraduate family medicine training in the South African context. The tool was reliable for the total score, but the low reliability of several sections in the PAT helped us to develop 12 recommendations regarding the use of the portfolio, the design of the PAT and the training of raters.

  18. Evidence-based medicine in primary care: qualitative study of family physicians

    Directory of Open Access Journals (Sweden)

    Dantas Guilherme

    2003-05-01

    Full Text Available Abstract Background The objectives of this study were: a to examine physician attitudes to and experience of the practice of evidence-based medicine (EBM in primary care; b to investigate the influence of patient preferences on clinical decision-making; and c to explore the role of intuition in family practice. Method Qualitative analysis of semi-structured interviews of 15 family physicians purposively selected from respondents to a national survey on EBM mailed to a random sample of Canadian family physicians. Results Participants mainly welcomed the promotion of EBM in the primary care setting. A significant number of barriers and limitations to the implementation of EBM were identified. EBM is perceived by some physicians as a devaluation of the 'art of medicine' and a threat to their professional/clinical autonomy. Issues regarding the trustworthiness and credibility of evidence were of great concern, especially with respect to the influence of the pharmaceutical industry. Attempts to become more evidence-based often result in the experience of conflicts. Patient factors exert a powerful influence on clinical decision-making and can serve as trumps to research evidence. A widespread belief that intuition plays a vital role in primary care reinforced views that research evidence must be considered alongside other factors such as patient preferences and the clinical judgement and experience of the physician. Discussion Primary care physicians are increasingly keen to consider research evidence in clinical decision-making, but there are significant concerns about the current model of EBM. Our findings support the proposed revisions to EBM wherein greater emphasis is placed on clinical expertise and patient preferences, both of which remain powerful influences on physician behaviour.

  19. Reliability testing of a portfolio assessment tool for postgraduate family medicine training in South Africa

    Science.gov (United States)

    Mash, Bob; Derese, Anselme

    2013-01-01

    Abstract Background Competency-based education and the validity and reliability of workplace-based assessment of postgraduate trainees have received increasing attention worldwide. Family medicine was recognised as a speciality in South Africa six years ago and a satisfactory portfolio of learning is a prerequisite to sit the national exit exam. A massive scaling up of the number of family physicians is needed in order to meet the health needs of the country. Aim The aim of this study was to develop a reliable, robust and feasible portfolio assessment tool (PAT) for South Africa. Methods Six raters each rated nine portfolios from the Stellenbosch University programme, using the PAT, to test for inter-rater reliability. This rating was repeated three months later to determine test–retest reliability. Following initial analysis and feedback the PAT was modified and the inter-rater reliability again assessed on nine new portfolios. An acceptable intra-class correlation was considered to be > 0.80. Results The total score was found to be reliable, with a coefficient of 0.92. For test–retest reliability, the difference in mean total score was 1.7%, which was not statistically significant. Amongst the subsections, only assessment of the educational meetings and the logbook showed reliability coefficients > 0.80. Conclusion This was the first attempt to develop a reliable, robust and feasible national portfolio assessment tool to assess postgraduate family medicine training in the South African context. The tool was reliable for the total score, but the low reliability of several sections in the PAT helped us to develop 12 recommendations regarding the use of the portfolio, the design of the PAT and the training of raters.

  20. Providing competency-based family medicine residency training in substance abuse in the new millennium: a model curriculum

    Directory of Open Access Journals (Sweden)

    Shellenberger Sylvia

    2010-05-01

    Full Text Available Abstract Background This article, developed for the Betty Ford Institute Consensus Conference on Graduate Medical Education (December, 2008, presents a model curriculum for Family Medicine residency training in substance abuse. Methods The authors reviewed reports of past Family Medicine curriculum development efforts, previously-identified barriers to education in high risk substance use, approaches to overcoming these barriers, and current training guidelines of the Accreditation Council for Graduate Medical Education (ACGME and their Family Medicine Residency Review Committee. A proposed eight-module curriculum was developed, based on substance abuse competencies defined by Project MAINSTREAM and linked to core competencies defined by the ACGME. The curriculum provides basic training in high risk substance use to all residents, while also addressing current training challenges presented by U.S. work hour regulations, increasing international diversity of Family Medicine resident trainees, and emerging new primary care practice models. Results This paper offers a core curriculum, focused on screening, brief intervention and referral to treatment, which can be adapted by residency programs to meet their individual needs. The curriculum encourages direct observation of residents to ensure that core skills are learned and trains residents with several "new skills" that will expand the basket of substance abuse services they will be equipped to provide as they enter practice. Conclusions Broad-based implementation of a comprehensive Family Medicine residency curriculum should increase the ability of family physicians to provide basic substance abuse services in a primary care context. Such efforts should be coupled with faculty development initiatives which ensure that sufficient trained faculty are available to teach these concepts and with efforts by major Family Medicine organizations to implement and enforce residency requirements for

  1. Family medicine residents’ perceived level of comfort in treating common sports injuries across residency programs in the United States

    Directory of Open Access Journals (Sweden)

    Amoako AO

    2015-03-01

    Full Text Available Adae O Amoako,1 Agyenim B Amoako,2 George GA Pujalte3 1Department of Family and Community Medicine, Penn State Hershey Medical Center, Hershey, PA, USA; 2Department of Family Medicine, University of Arkansas for Medical Sciences Northwest, Fayetteville, AR, USA; 3Sports Medicine, Divisions of Primary Care, and Orthopedics, Mayo Clinic Health System, Waycross, GA, USA Background and objective: Family physicians are expected to be comfortable in treating common sports injuries. Evidence shows a limited level of comfort in treating these injuries in pediatric and internal medicine residents. Studies are lacking, however, in family medicine residents. The purpose of this study is to assess the comfort level of family medicine residents in treating common sports injuries in adults and children based on their perceived level of knowledge and attitudes. Methods: This is a cross-sectional study of family medicine residents in the United Sates. A written survey of 25 questions related to sports injury knowledge and factors affecting comfort level were collected. A chi-square test was implemented in calculating P-values. Results: Five hundred and fifty-seven residents responded to the survey. A higher percentage of doctors of osteopathy (86.6%, 82.5%, 69.6%, and 68.7% compared to doctors of medicine (78.5%, 71.6%, 53.4%, and 52.8% respectively identified ankle sprain, concussion, plantar fasciitis, and lateral epicondylitis as common injuries, and felt comfortable in treating them (P-values =0.015, 0.004, 0.0001, and 0.0002, respectively. Residents with high interest in sports medicine correctly identified the injuries as common and felt comfortable treating them as well (knowledge, P=0.027, 0.0029, <0.0001, and 0.0001, respectively; comfort level, P=0.0016, <0.0001, 0.0897, and 0.0010, respectively. Conclusion: Medical education background, factors that affect training, and an interest in sports medicine contribute to residents' knowledge and comfort

  2. Student assessment by objective structured examination in a neurology clerkship

    Science.gov (United States)

    Adesoye, Taiwo; Smith, Sandy; Blood, Angela; Brorson, James R.

    2012-01-01

    Objectives: We evaluated the reliability and predictive ability of an objective structured clinical examination (OSCE) in the assessment of medical students at the completion of a neurology clerkship. Methods: We analyzed data from 195 third-year medical students who took the OSCE. For each student, the OSCE consisted of 2 standardized patient encounters. The scores obtained from each encounter were compared. Faculty clinical evaluations of each student for 2 clinical inpatient rotations were also compared. Hierarchical regression analysis was applied to test the ability of the averaged OSCE scores to predict standardized written examination scores and composite clinical scores. Results: Students' OSCE scores from the 2 standardized patient encounters were significantly correlated with each other (r = 0.347, p neurology clerkship. PMID:22855865

  3. Conference report: Undergraduate family medicine and primary care training in Sub-Saharan Africa: Reflections of the PRIMAFAMED network

    Science.gov (United States)

    Mash, Robert; Essuman, Akye; Flinkenflögel, Maaike

    2017-01-01

    Internationally, there is a move towards strengthening primary healthcare systems and encouraging community-based and socially responsible education. The development of doctors with an interest in primary healthcare and family medicine in the African region should begin during undergraduate training. Over the last few years, attention has been given to the development of postgraduate training in family medicine in the African region, but little attention has been given to undergraduate training. This article reports on the 8th PRIMAFAMED (Primary Care and Family Medicine Education) network meeting held in Nairobi from 21 to 24 May 2016. At this meeting the delegates spent time presenting and discussing the current state of undergraduate training at 18 universities in the region and shared lessons on how to successfully implement undergraduate training. This article reports on the rationale for, information presented, process followed and conclusions reached at the conference. PMID:28155289

  4. Conference report: Undergraduate family medicine and primary care training in Sub-Saharan Africa: Reflections of the PRIMAFAMED network

    Directory of Open Access Journals (Sweden)

    Innocent Besigye

    2017-01-01

    Full Text Available Internationally, there is a move towards strengthening primary healthcare systems and encouraging community-based and socially responsible education. The development of doctors with an interest in primary healthcare and family medicine in the African region should begin during undergraduate training. Over the last few years, attention has been given to the development of postgraduate training in family medicine in the African region, but little attention has been given to undergraduate training. This article reports on the 8th PRIMAFAMED (Primary Care and Family Medicine Education network meeting held in Nairobi from 21 to 24 May 2016. At this meeting the delegates spent time presenting and discussing the current state of undergraduate training at 18 universities in the region and shared lessons on how to successfully implement undergraduate training. This article reports on the rationale for, information presented, process followed and conclusions reached at the conference.

  5. Career advising in family medicine: a theoretical framework for structuring the medical student/faculty advisor interview

    Directory of Open Access Journals (Sweden)

    Melissa Bradner

    2013-08-01

    Full Text Available Background: There are unique challenges to recruiting students into the specialty of family medicine within academic medical centers. Methods: At Virginia Commonwealth University, we developed an advising framework to help students address institutional and personal obstacles to choosing family medicine as a career. Results: The role of a faculty advisor is not to direct the student to a career choice but rather to foster a mentor relationship and help the student come to his or her own realizations regarding career choice. The faculty advisor/medical student interview is conceptualized as five discussion topics: self-knowledge, perception, organizational voice, cognitive dissonance, and anticipatory counseling. Conclusion: This framework is intended to assist faculty in their efforts to encourage students to consider a career in family medicine.

  6. Do personality differences between teachers and learners impact students' evaluations of a surgery clerkship?

    Science.gov (United States)

    Bell, Mary Alice; Wales, Paula S; Torbeck, Laura J; Kunzer, John M; Thurston, Virginia C; Brokaw, James J

    2011-01-01

    Historically, the surgery clerkship at the Indiana University School of Medicine (IUSM) has received poor evaluations from medical students, and the authors of this article hypothesized that this negative feedback may reflect, at least in part, inherent differences in the personality styles of the learners compared with those of the surgery teachers (faculty and residents). Differences between teachers and learners could impede effective communication and impact adversely students' perception of, and satisfaction with, the learning environment. The objective of this study was to compare the inherent personality styles of surgery teachers and medical students. Using the Myers-Briggs Type Indicator (MBTI) to assess personality styles, we administered the instrument to 154 teachers in the surgery department and to 1395 medical students. Aggregate MBTI data for teachers and learners were analyzed based on four dichotomous scales. Chi square tests of independence were performed to examine the relationship between teachers and learners on the MBTI scales. The study was undertaken at IUSM, which has been engaged in a process of cultural change for over 10 years, in part to ensure that both the formal curriculum and the learning environment support the development of self-awareness and professionalism among our graduates. We found that teachers were similar to learners on the Introversion/Extraversion scale and dissimilar from learners on the three remaining scales: Sensing/Intuition scale (p personality styles may affect the teacher-learner interaction during the surgery clerkship and may influence negatively students' perception of the learning environment. Copyright © 2011 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  7. Reflective Writing for Medical Students on the Surgical Clerkship: Oxymoron or Antidote?

    Science.gov (United States)

    Liu, Geoffrey Z; Jawitz, Oliver K; Zheng, Daniel; Gusberg, Richard J; Kim, Anthony W

    2017-01-01

    Objectives Reflective writing has emerged as a solution to declining empathy during clinical training. However, the role for reflective writing has not been studied in a surgical setting. The aim of this proof-of-concept study was to assess receptivity to a reflective writing intervention among third-year medical students on their surgical clerkship. Study Design The reflective writing intervention was a one hour, peer-facilitated writing workshop. This study employed a pre-post-intervention design. Subjects were surveyed on their experience four weeks prior to participation in the intervention and immediately afterwards. Surveys assessed student receptivity to reflective writing as well as self-perceived empathy, writing habits and communication behaviors using a Likert response scale. Quantitative responses were analyzed using paired t-tests and linear regression. Qualitative responses were analyzed using an iterative consensus model. Setting Yale-New Haven hospital, a tertiary care academic center. Participants All Yale School of Medicine medical students rotating on their surgical clerkship during a 9 month period (74 in total) were eligible. In all, 25 students completed this study. Results The proportion of students desiring more opportunities for reflective writing increased from 32% to 64%. The proportion of students receptive to a mandatory writing workshop increased from 16% to 40%. These differences were both significant (p=0.003 and p = 0.001). 88% of students also reported new insight as a result of the workshop. 39% of students reported a more positive impression of the surgical profession after participation. Conclusion Overall, the workshop was well-received by students and improved student attitudes towards reflective writing and the surgical profession. Larger studies are required to validate the effect of this workshop on objective empathy measures. This study demonstrates how reflective writing can be incorporated into a pre-surgical curriculum

  8. Reflective Writing for Medical Students on the Surgical Clerkship: Oxymoron or Antidote?

    Science.gov (United States)

    Liu, Geoffrey Z; Jawitz, Oliver K; Zheng, Daniel; Gusberg, Richard J; Kim, Anthony W

    2016-01-01

    Reflective writing has emerged as a solution to declining empathy during clinical training. However, the role for reflective writing has not been studied in a surgical setting. The aim of this proof-of-concept study was to assess receptivity to a reflective-writing intervention among third-year medical students on their surgical clerkship. The reflective-writing intervention was a 1-hour, peer-facilitated writing workshop. This study employed a pre-post-intervention design. Subjects were surveyed on their experience 4 weeks before participation in the intervention and immediately afterwards. Surveys assessed student receptivity to reflective writing as well as self-perceived empathy, writing habits, and communication behaviors using a Likert-response scale. Quantitative responses were analyzed using paired t tests and linear regression. Qualitative responses were analyzed using an iterative consensus model. Yale-New Haven hospital, a tertiary care academic center. All medical students of Yale School of Medicine, rotating on their surgical clerkship during a 9-month period (74 in total) were eligible. In all, 25 students completed this study. The proportion of students desiring more opportunities for reflective writing increased from 32%-64%. The proportion of students receptive to a mandatory writing workshop increased from 16%-40%. These differences were both significant (p = 0.003 and p = 0.001). In all, 88% of students also reported new insight as a result of the workshop. In total, 39% of students reported a more positive impression of the surgical profession after participation. Overall, the workshop was well-received by students and improved student attitudes toward reflective writing and the surgical profession. Larger studies are required to validate the effect of this workshop on objective empathy measures. This study demonstrates how reflective writing can be incorporated into a presurgical curriculum. Copyright © 2015 Association of Program Directors in

  9. The Columbia-Bronx VA amalgamative clerkship: an effective, 12-week, integrated, longitudinal clinical experience.

    Science.gov (United States)

    Diuguid-Gerber, Jillian; Porter, Samuel; Quiah, Samuel C; Nickerson, Katherine; Jones, Deborah; Audi, Zeena; Richards, Boyd F

    2017-01-01

    Many medical schools have adopted the longitudinal integrated clerkship (LIC) model in response to calls for increased continuity in clinical learning environments. However, because of implementation challenges, such programs are not feasible at some institutions or are limited to a small number of students. In January 2014, Columbia University College of Physicians and Surgeons (P&S) recognized the need to explore different LIC formats and began offering four, 12-week amalgamative clerkships (AC). Students within this curricular track experienced primary care, internal medicine 'away', orthopedic surgery, urology, and an elective in an integrated format. P&S developed the AC in partnership with the James J. Peters VA Medical Center in Bronx, NY (BVA). All patient care and educational conferences took place at the BVA during the 12-week experience. The learning objectives of the AC were aligned to the learning objectives of a 52-week20 LIC also offered at Columbia. An evaluation process was developed to determine studentlearning experiences and preliminary outcomes, including how well the LIC-related objectivescould be achieved in a shorter period of time. In 2015, P&S collected AC evaluation data through three student feedback sessions. Students reported that the AC provided opportunity for patient continuity, patient-centered care approaches, meaningful roles for students, career development opportunities, and health systems awareness. Early outcomes indicate that the BVA AC provides a degree of longitudinality that can influence student perceptions of patient care, career development, and health systems, consistent with the larger LIC. The team continues to gather additional data on students' experiences and investigate additional sites that have potential to serve as future AC learning environments.

  10. Knowledge and perceptions of family leave policies among female faculty in academic medicine.

    Science.gov (United States)

    Gunn, Christine M; Freund, Karen M; Kaplan, Samantha A; Raj, Anita; Carr, Phyllis L

    2014-01-01

    The purpose of this research was to examine the knowledge and perceptions of family leave policies and practices among senior leaders including American Association of Medical College members of the Group on Women in Medicine and Science (GWIMS) to identify perceived barriers to career success and satisfaction among female faculty. In 2011 and 2012, GWIMS representatives and senior leaders at 24 medical schools were invited to participate in an interview about faculty perceptions of gender equity and overall institutional climate. An inductive, thematic analysis of the qualitative data was conducted to identify themes represented in participant responses. The research team read and reviewed institutional family leave policies for concordance with key informant descriptions. There were 22 GWIMS representatives and senior leaders in the final sample. Participants were all female; 18 (82%) were full professors with the remainder being associate professors. Compared with publicly available policies at each institution, the knowledge of nine participants was consistent with policies, was discrepant for six, with the remaining seven acknowledging a lack of knowledge of policies. Four major themes were identified from the interview data: 1) Framing family leave as a personal issue undermines its effect on female faculty success; 2) poor communication of policies impairs access and affects organizational climate; 3) discrepancies in leave implementation disadvantage certain faculty in terms of time and pay; and 4) leave policies are valued and directly related to academic productivity. Family leave policies are an important aspect of faculty satisfaction and academic success, yet policy awareness among senior leaders is lacking. Further organizational support is needed to promote equitable policy creation and implementation to support women in medical academia. Copyright © 2014 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

  11. The relationship between marriage and family therapists and complementary and alternative medicine approaches: a qualitative study.

    Science.gov (United States)

    Becvar, Dorothy S; Caldwell, Karen L; Winek, Jon L

    2006-01-01

    In this article, we delineate the qualitative phase of a mixed-method research study focused on understanding the relationship between Clinical Members of the American Association for Marriage and Family Therapy (MFT) and complementary alternative medicine (CAM). Based on an analysis of the data derived from telephone interviews with 54 respondents, we describe four themes: definitional issues, depth of awareness of CAM, fit with MFT, and ethical considerations. Our discussion focuses on the findings of this phase, considerations from the quantitative phase, and reflections on the research study as a whole. While acknowledging the limitations of the study, we conclude that the growing awareness of and involvement with CAM approaches and practitioners among MFTs suggest a need for further education for both professionals and clients. We also note the importance of additional research support for the use of CAM practices.

  12. Early Career Outcomes of Family Medicine Residency Graduates Exposed to Innovative Flexible Longitudinal Tracks.

    Science.gov (United States)

    Young, Richard A; Casey, Dan; Singer, Diana; Waller, Elaine; Carney, Patricia A

    2017-05-01

    The Preparing the Personal Physician for Practice (P4) project used a case series design to study innovations in the content, length, structure, and location of residency training in 14 geographically diverse family medicine programs between 2007 and 2012. We aimed to explore how offering flexible longitudinal tracks (FLT) affected graduates' scope of practice, particularly in maternal child health (MCH), which included at least 17 months of focused training that increased each year over 4 years. We administered a cross-sectional survey to graduates of P4 residencies approximately 18 months after they completed training (2011-2014) and compared graduates of the John Peter Smith (JPS) Family Medicine Residency MCH FLT to all other P4 graduates. The overall response rate was 81.8% (365/446). JPS graduates who completed the flexible MCH track (n=15) compared to all other P4 graduates (n=332) were more likely to deliver babies (13/15, 86.7% versus 48/324, 14.6%) and perform C-sections as the primary surgeon (12/15, 80.0% versus 15/322, 4.7%). Additional areas of expanded scope associated with the MCH track included endoscopy (4/15, 26.7% versus 10/323, 3.1%), the care of hospitalized adults and associated procedures (central lines, eg: 8/15, 53.3% versus 47/322, 14.6%), and the care of hospitalized children (13/15, 86.7% versus 111/323, 34.4%). Graduating from the JPS MCH FLT was associated with a higher provision of maternal, child, and ill adult patient care services, including associated procedures.

  13. Geriatrics Curricula for Internal and Family Medicine Residents: Assessing Study Quality and Learning Outcomes.

    Science.gov (United States)

    Cheng, Huai Yong; Davis, Molly

    2017-02-01

    Prior reviews of geriatrics curricula for internal medicine (IM) and family medicine (FM) residents have not evaluated study quality or assessed learning objectives or specific IM or FM competencies. This review of geriatrics curricula for IM and FM residents seeks to answer 3 questions: (1) What types of learning outcomes were measured? (2) How were learning outcomes measured? and (3) What was the quality of the studies? We evaluated geriatrics curricula that reported learning objectives or competencies, teaching methods, and learning outcomes, and those that used a comparative design. We searched PubMed and 4 other data sets from 2003-2015, and assessed learning outcomes, outcome measures, and the quality of studies using the Medical Education Research Study Quality Instrument (MERSQI) and Best Evidence Medical Education (BEME) methods. Fourteen studies met inclusion criteria. Most curricula were intended for IM residents in the inpatient setting; only 1 was solely dedicated to FM residents. Median duration was 1 month, and minimum geriatrics competencies covered were 4. Learning outcomes ranged from Kirkpatrick levels 1 to 3. Studies that reported effect size showed a considerable impact on attitudes and knowledge, mainly via pretests and posttests. The mean MERSQI score was 10.5 (range, 8.5-13) on a scale of 5 (lowest quality) to 18 (highest quality). Few geriatrics curricula for IM and FM residents that included learning outcome assessments were published recently. Overall, changes in attitudes and knowledge were sizeable, but reporting was limited to low to moderate Kirkpatrick levels. Study quality was moderate.

  14. Comparative Analysis of Family Medicine Education and Exams at Cathedras of Family Medicine of Universities in Southeastern Europe - "Splitska inicijativa", Sarajevo, 2017.

    Science.gov (United States)

    Masic, Izet; Mujanovic, Olivera Batic; Racic, Maja; Gavran, Larisa; Stanetic, Kosana; Hodzic, Merzika; Cojic, Milena; Cvejanov-Kezunovic, Ljiljana; Stepanovic, Aleksandar; Stavrikj, Katarina; Jatic, Zaim; Obrdalj, Edita Cerny; Zalihic, Amra; Tusek-Bunc, Ksenija

    2017-03-01

    the ability of students and physicians to follow its growth on the other. Furthermore, in our environment, the term technology is generally reserved for its technical component. This terminology essentially means not only the purchase of the computer and related equipment, but also the technological foresight and technological progress, which are defined as specific combination of fundamental scientific, research and development work that gives a concrete result. The quality of the teaching-learning process at the universities in former Yugoslav countries and abroad, depends mainly of infrastructure that includes an optimal teaching space, personnel and equipment, in accordance with existing standards and norms at the cantonal or entity level, which are required to implement adequately the educational curriculum for students from first to sixth year by Bologna studying concept. For all of this it is necessary to ensure adequate funding. Technologies (medical and information, including communications) have a special role and value in ensuring the quality of medical education at universities and their organizational units (faculties). "Splitska inicijativa" project, which started 6 years ago as simple intention to exchange experiences of application new model of education, based on: Bologna studying concept, and other types of under and postgraduate education, was good idea to improve also theory and practice of it within Family medicine as academic and scientific discipline. This year scope of our scientific meeting held in Sarajevo on 24th and 25th March 2017, was quality assessment of theoretical and practical education and, also, evaluation of knowledge by students exams (a-y).

  15. Intended Career Choice in Family Medicine in Slovenia: An Issue of Gender, Family Background or Empathic Attitudes in Final Year Medical Students?

    Science.gov (United States)

    Ster, Marija Petek; Selic, Polona

    2017-01-01

    Background: Among a variety of complex factors affecting a decision to take family medicine as a future specialisation, this study focused on demographic characteristics and assessed empathic attitudes in final year medical students. Methods: A convenience sampling method was employed in two consecutive academic years of final year medical students at the Faculty of Medicine in Ljubljana, Slovenia, in May 2014 and May 2015. A modified version of the 16-item Jefferson Scale of Empathy – Student Version (JSE-S) was administered to examine self-reported empathic attitudes. An intended career in family medicine was reported using a five-point Likert scale. Results: Of the 175 medical school seniors in study year 2013/14, there were 64 (36.6%) men and 111 (63.4%) women, while in the second group (study year 2014/5), there were 68 (40.5%) men and 100 (59.5%) women; 168 students in total. They were 24.9±1.6 (generation 2013/4) and 24.9±1.7 (generation 2014/15) years old. Thirty-six percent of the students in the academic year 2013/14 intended to choose family medicine as a future career, and a similar proportion in academic year 2014/15 (31.7%). Gender (χ2=6.763, p=0.034) and empathic attitudes (c2=14.914; p=0.001) had a bivariate association with an intended career choice of family medicine in the 2014/15 generation. When logistic regression was applied to this group of students, an intended career choice in family medicine was associated with empathic attitudes (OR 1.102, 95% CI 1.040-1.167, p=0.001), being single (OR 3.659, 95% CI 1.150-11.628, p=0.028) and the father having only primary school education (OR 142.857 95% CI 1.868, p=0.025), but not with gender (OR 1.117, 95% CI 0.854-1.621, p=0.320). Conclusion: The level of students’ father’s education, and not living in an intimate partnership, increased the odds on senior medical students to choose family medicine, yet we expected higher JSE-S scores to be associated with interest in this speciality. To

  16. 'These reforms killed me': doctors' perceptions of family medicine during the transition from communism to capitalism.

    Science.gov (United States)

    Czachowski, Slawomir; Pawlikowska, Teresa

    2011-08-01

    The establishment of family medicine (FM) in Poland following political reform. To describe family doctors' (FD) experiences during the introduction of FM. A qualitative study of 25 FDs in Poland, using thematic analysis of semi-structured interviews. Open-structured narrative-based interviews with five FDs were then used to deepen understanding of the major emergent themes. Fifteen of 25 had a different initial specialization to FM; 10 of 25 overseas work experience. Many doctors were driven by personal circumstances to engage with this new discipline, which provided a better fit with their life circumstances and a chance to escape from hierarchical structures characterizing the old regime. Personal experience of role models helped embrace FM, whereas adherence to ingrained biomedical approaches led to difficulty with exposure to common problems and could facilitate burnout. Shifting relationships in the reformed system caused tensions between primary and secondary care. While relationships with patients and specialists were being renegotiated, the concept of an independent FD practice surfaced. We observed that the most serious problems that the doctors encountered were circumstances related to the former health care system, in contrast to any lack of professional skills. This is a rare qualitative study exploring Polish doctors' perspectives of the health care reform after the collapse of communism in Central and Eastern Europe. This analysis of newly qualified FDs has provided an insight into the authentic experiences, and motivation of grass roots FM pioneers in Poland.

  17. Evaluation of the educational environment of the Saudi family medicine residency training program

    Directory of Open Access Journals (Sweden)

    Abdullah T Khoja

    2015-01-01

    Full Text Available Objectives: The study was conducted to evaluate the educational environment (EE in Family Medicine Training Programs. Materials and Methods: A cross-sectional survey, The Postgraduate Hospital Educational Environment Measure (PHEEM, was distributed to all residents at the four training centers in the central region. Cronbach′s alpha was used to test the reliability. The mean and standard deviation (SD for each item, the overall score and the three domains were calculated. A multiple linear regression model was developed with PHEEM scores as an outcome. The Mann-Whitney-Wilcoxon test was used to compare each item based on the selected factors. Results: The overall score was 67.1/160 (SD: 20.1. The PHEEM′s domains scores: 24.2/56 (SD: 7.13 for perception of role autonomy; 25.3/60 (SD: 8.88, for perception of teaching; and 17/44 (SD: 5.6, for perception of social support. Training center and Level of training were the significant outcome predictors. Centre 1 (Joint Program significantly had better scores than Centre 2. The instrument showed great reliability with a Cronbach′s alpha of 0.92. Conclusions: There are many problems in the training program. Urgent actions are needed to improve the residents′ learning experience particularly during rotations. Also, the curriculum should be restructured, and effective training methods introduced using the Best Evidence in Medical Education to meet the expectations and learning needs of family physicians.

  18. Pharmaceutical Care in Rural Community Pharmacy Clerkships: Emphasis on Developing Computer Skills To Enhance Patient Education.

    Science.gov (United States)

    Miller, Lucinda G.; And Others

    1996-01-01

    Two pharmacy computer training laboratories were developed in Nebraska to facilitate student acquisition of computer skills for patient education prior to their clerkships at Nebraska Drug Information Network rural sites. Students' previous computer experience and computer use in delivering education during clerkships were assessed. Patterns in…

  19. Integrated Clinical Geriatric Pharmacy Clerkship in Long Term, Acute and Ambulatory Care.

    Science.gov (United States)

    Polo, Isabel; And Others

    1994-01-01

    A clinical geriatric pharmacy clerkship containing three separate practice areas (long-term, acute, and ambulatory care) is described. The program follows the medical education clerkship protocol, with a clinical pharmacy specialist, pharmacy practice resident, and student. Participation in medical rounds, interdisciplinary conferences, and…

  20. Shorter Psychiatry Clerkship Length Is Associated with Lower NBME Psychiatry Shelf Exam Performance

    Science.gov (United States)

    Bostwick, J. Michael; Alexander, Cara

    2012-01-01

    Objective: The goal of this study was to evaluate a recent medical school curriculum change at our institution 3 years ago; specifically: shortening the Psychiatry core clerkship from 4 to 3 weeks and adding an optional 6-week core/elective combination rotation in lieu of the 3-week core. The authors aimed to determine whether clerkship length was…

  1. Psychiatric OSCE Performance of Students with and without a Previous Core Psychiatry Clerkship

    Science.gov (United States)

    Goisman, Robert M.; Levin, Robert M.; Krupat, Edward; Pelletier, Stephen R.; Alpert, Jonathan E.

    2010-01-01

    Objective: The OSCE has been demonstrated to be a reliable and valid method by which to assess students' clinical skills. An OSCE station was used to determine whether or not students who had completed a core psychiatry clerkship demonstrated skills that were superior to those who had not taken the clerkship and which areas discriminated between…

  2. Shorter Psychiatry Clerkship Length Is Associated with Lower NBME Psychiatry Shelf Exam Performance

    Science.gov (United States)

    Bostwick, J. Michael; Alexander, Cara

    2012-01-01

    Objective: The goal of this study was to evaluate a recent medical school curriculum change at our institution 3 years ago; specifically: shortening the Psychiatry core clerkship from 4 to 3 weeks and adding an optional 6-week core/elective combination rotation in lieu of the 3-week core. The authors aimed to determine whether clerkship length was…

  3. Effect of Curriculum Change on Exam Performance in a 4-Week Psychiatry Clerkship

    Science.gov (United States)

    Niedermier, Julie; Way, David; Kasick, David; Kuperschmidt, Rada

    2010-01-01

    Objective: The authors investigated whether curriculum change could produce improved performance, despite a reduction in clerkship length from 8 to 4 weeks. Methods: The exam performance of medical students completing a 4-week clerkship in psychiatry was compared to national data from the National Board of Medical Examiners' Psychiatry Subject…

  4. Pharmaceutical Care in Rural Community Pharmacy Clerkships: Emphasis on Developing Computer Skills To Enhance Patient Education.

    Science.gov (United States)

    Miller, Lucinda G.; And Others

    1996-01-01

    Two pharmacy computer training laboratories were developed in Nebraska to facilitate student acquisition of computer skills for patient education prior to their clerkships at Nebraska Drug Information Network rural sites. Students' previous computer experience and computer use in delivering education during clerkships were assessed. Patterns in…

  5. Curricula for teaching the content of clinical practice guidelines to family medicine and internal medicine residents in the US: a survey study

    Directory of Open Access Journals (Sweden)

    Moheet Amir

    2009-09-01

    Full Text Available Abstract Background Teaching the content of clinical practice guidelines (CPGs is important to both clinical care and graduate medical education. The objective of this study was to determine the characteristics of curricula for teaching the content of CPGs in family medicine and internal medicine residency programs in the United States. Methods We surveyed the directors of family medicine and internal medicine residency programs in the United States. The questionnaire included questions about the characteristics of the teaching of CPGs: goals and objectives, educational activities, evaluation, aspects of CPGs that the program teaches, the methods of making texts of CPGs available to residents, and the major barriers to teaching CPGs. Results Of 434 programs responding (out of 839, 52%, 14% percent reported having written goals and objectives related to teaching CPGs. The most frequently taught aspect was the content of specific CPGs (76%. The top two educational strategies used were didactic sessions (76% and journal clubs (64%. Auditing for adherence by residents was the primary evaluation strategy (44%, although 36% of program directors conducted no evaluation. Programs made texts of CPGs available to residents most commonly in the form of paper copies (54% while the most important barrier was time constraints on faculty (56%. Conclusion Residency programs teach different aspects of CPGs to varying degrees, and the majority uses educational strategies not supported by research evidence.

  6. Predictors of job satisfaction among academic family medicine faculty: Findings from a faculty work-life and leadership survey.

    Science.gov (United States)

    Krueger, Paul; White, David; Meaney, Christopher; Kwong, Jeffrey; Antao, Viola; Kim, Florence

    2017-03-01

    To identify predictors of job satisfaction among academic family medicine faculty members. A comprehensive Web-based survey of all faculty members in an academic department of family medicine. Bivariate and multivariable analyses (logistic regression) were used to identify variables associated with job satisfaction. The Department of Family and Community Medicine at the University of Toronto in Ontario and its 15 affiliated community teaching hospitals and community-based teaching practices. All 1029 faculty members in the Department of Family and Community Medicine were invited to complete the survey. Faculty members' demographic and practice information; teaching, clinical, administration, and research activities; leadership roles; training needs and preferences; mentorship experiences; health status; stress levels; burnout levels; and job satisfaction. Faculty members' perceptions about supports provided, recognition, communication, retention, workload, teamwork, respect, resource distribution, remuneration, and infrastructure support. Faculty members' job satisfaction, which was the main outcome variable, was obtained from the question, "Overall, how satisfied are you with your job?" Of the 1029 faculty members, 687 (66.8%) responded to the survey. Bivariate analyses revealed 26 predictors as being statistically significantly associated with job satisfaction, including faculty members' ratings of their local department and main practice setting, their ratings of leadership and mentorship experiences, health status variables, and demographic variables. The multivariable analyses identified the following 5 predictors of job satisfaction: the Maslach Burnout Inventory subscales of emotional exhaustion and personal accomplishment; being born in Canada; the overall quality of mentorship that was received being rated as very good or excellent; and teamwork being rated as very good or excellent. The findings from this study show that job satisfaction among academic

  7. Barriers to Screening and Possibilities for Active Detection of Family Medicine Attendees Exposed to Intimate Partner Violence

    Directory of Open Access Journals (Sweden)

    Kopčavar Guček Nena

    2016-03-01

    Full Text Available In 1996 the World Health Organization declared intimate partner violence (IPV the most important public health problem. Meta-analyses in 2013 showed every third female globally had been a victim of violence. Experts find screening controversial; family medicine is the preferred environment for identifying victims of violence, but barriers on both sides prevent patients from discussing it with doctors.

  8. Family medicine publications in Taiwan: An analysis of the Web of Science database from 1993 to 2012

    Directory of Open Access Journals (Sweden)

    Ming-Hwai Lin

    2014-11-01

    Conclusion: Publications from departments/institutes of family medicine in Taiwan increased rapidly from 1993 to 2012. However, the trends of decreased citation number of articles and journal impact factor, as well as the small amount of articles published in the Primary Health Care Category, deserve further attention and effort.

  9. Toward competency-based curricula in patient-centered spiritual care: recommended competencies for family medicine resident education.

    Science.gov (United States)

    Anandarajah, Gowri; Craigie, Frederic; Hatch, Robert; Kliewer, Stephen; Marchand, Lucille; King, Dana; Hobbs, Richard; Daaleman, Timothy P

    2010-12-01

    Spiritual care is increasingly recognized as an important component of medical care. Although many primary care residency programs incorporate spiritual care into their curricula, there are currently no consensus guidelines regarding core competencies necessary for primary care training. In 2006, the Society of Teachers of Family Medicine's Interest Group on Spirituality undertook a three-year initiative to address this need. The project leader assembled a diverse panel of eight educators with dual expertise in (1) spirituality and health and (2) family medicine. The multidisciplinary panel members represented different geographic regions and diverse faith traditions and were nationally recognized senior faculty. They underwent three rounds of a modified Delphi technique to achieve initial consensus regarding spiritual care competencies (SCCs) tailored for family medicine residency training, followed by an iterative process of external validation, feedback, and consensus modifications of the SCCs. Panel members identified six knowledge, nine skills, and four attitude core SCCs for use in training and linked these to competencies of the Accreditation Council for Graduate Medical Education. They identified three global competencies for use in promotion and graduation criteria. Defining core competencies in spiritual care clarifies training goals and provides the basis for robust curricula evaluation. Given the breadth of family medicine, these competencies may be adaptable to other primary care fields, to medical and surgical specialties, and to medical student education. Effective training in this area may enhance physicians' ability to attend to the physical, mental, and spiritual needs of patients and better maintain sustainable healing relationships.

  10. Obstetrics and gynecology clerkship for males and females: similar curriculum, different outcomes?

    Science.gov (United States)

    Craig, LaTasha B.; Smith, Chad; Crow, Sheila M.; Driver, Whitney; Wallace, Michelle; Thompson, Britta M.

    2013-01-01

    Objective To determine if performance differences exist between male and female students on a 6-week obstetrics and gynecology (Ob/Gyn) clerkship and to evaluate potential variables that might underlie any observed variations. Study Design Final clerkship grades and component scores (clinical evaluations, objective structured clinical examination [OSCE], oral examination, and National Board of Medical Examiners [NBME] subject examination) from July 2007 to June 2010 were matched by student and analyzed by gender. Basic science grade point average (GPA) and initial United States Medical Licensing Exam (USMLE) Step 1 scores were used to establish students’ baseline medical knowledge. On a post-clerkship questionnaire, a subset of students reported the numbers of procedures they performed during the clerkship; students also completed online pre- and post-clerkship questionnaires reflecting their self-assessed confidence in women's health clinical skills. Results Scores were analyzed for 136 women and 220 men. Final clerkship grades were significantly higher for females than for males (89.05 vs. 87.34, p=0.0004, η 2=0.08). Specifically, females outscored males on the OSCE, oral, and NBME subject examination portions of the clerkship but not clinical evaluations. Males reported completing fewer breast examinations (p=0.001, η 2=0.14). Pre-clerkship, males were significantly less confident than females in women's health clinical skills (p<0.01) but reached similar levels upon completion of the clerkship. No gender differences were detected for basic science GPA and USMLE Step 1 scores. Conclusion Student gender is associated with final grades on an Ob/Gyn clerkship. Further research regarding these differences should be explored. PMID:24300748

  11. Obstetrics and gynecology clerkship for males and females: similar curriculum, different outcomes?

    Directory of Open Access Journals (Sweden)

    LaTasha B. Craig

    2013-12-01

    Full Text Available Objective : To determine if performance differences exist between male and female students on a 6-week obstetrics and gynecology (Ob/Gyn clerkship and to evaluate potential variables that might underlie any observed variations. Study Design : Final clerkship grades and component scores (clinical evaluations, objective structured clinical examination [OSCE], oral examination, and National Board of Medical Examiners [NBME] subject examination from July 2007 to June 2010 were matched by student and analyzed by gender. Basic science grade point average (GPA and initial United States Medical Licensing Exam (USMLE Step 1 scores were used to establish students’ baseline medical knowledge. On a post-clerkship questionnaire, a subset of students reported the numbers of procedures they performed during the clerkship; students also completed online pre- and post-clerkship questionnaires reflecting their self-assessed confidence in women's health clinical skills. Results : Scores were analyzed for 136 women and 220 men. Final clerkship grades were significantly higher for females than for males (89.05 vs. 87.34, p=0.0004, η 2=0.08. Specifically, females outscored males on the OSCE, oral, and NBME subject examination portions of the clerkship but not clinical evaluations. Males reported completing fewer breast examinations (p=0.001, η 2=0.14. Pre-clerkship, males were significantly less confident than females in women's health clinical skills (p<0.01 but reached similar levels upon completion of the clerkship. No gender differences were detected for basic science GPA and USMLE Step 1 scores. Conclusion : Student gender is associated with final grades on an Ob/Gyn clerkship. Further research regarding these differences should be explored.

  12. Development of a portfolio of learning for postgraduate family medicine training in South Africa: a Delphi study

    Directory of Open Access Journals (Sweden)

    Jenkins Louis

    2012-03-01

    Full Text Available Abstract Background Within the 52 health districts in South Africa, the family physician is seen as the clinical leader within a multi-professional district health team. Family physicians must be competent to meet 90% of the health needs of the communities in their districts. The eight university departments of Family Medicine have identified five unit standards, broken down into 85 training outcomes, for postgraduate training. The family medicine registrar must prove at the end of training that all the required training outcomes have been attained. District health managers must be assured that the family physician is competent to deliver the expected service. The Colleges of Medicine of South Africa (CMSA require a portfolio to be submitted as part of the uniform assessment of all registrars applying to write the national fellowship examinations. This study aimed to achieve a consensus on the contents and principles of the first national portfolio for use in family medicine training in South Africa. Methods A workshop held at the WONCA Africa Regional Conference in 2009 explored the purpose and broad contents of the portfolio. The 85 training outcomes, ideas from the WONCA workshop, the literature, and existing portfolios in the various universities were used to develop a questionnaire that was tested for content validity by a panel of 31 experts in family medicine in South Africa, via the Delphi technique in four rounds. Eighty five content items (national learning outcomes and 27 principles were tested. Consensus was defined as 70% agreement. For those items that the panel thought should be included, they were also asked how to provide evidence for the specific item in the portfolio, and how to assess that evidence. Results Consensus was reached on 61 of the 85 national learning outcomes. The panel recommended that 50 be assessed by the portfolio and 11 should not be. No consensus could be reached on the remaining 24 outcomes and these were

  13. Seeing the other through the screen: movies, humanization of medical education and Family and Community Medicine

    Directory of Open Access Journals (Sweden)

    Gustavo de Araújo Porto Landsberg

    2010-11-01

    Full Text Available The unprecedented technological development observed in the last century and beginning of this one has expanded the horizons of the medical science exponentially, making the content to be envisaged by the colleges practically unfeasible. The incorporation of this knowledge in the curricula took place in detriment to human sciences, formerly included as a routine in the schools of medicine all over the world. Negligence of the humanization of medical education may keep from endowing future physicians with the affective resources necessary to the establishment of a satisfactory physical-patient relationship. This study proposes evaluating the use of motion pictures in the humanization of the way graduates see patients, providing them with capability and empathy toward their patients. Three documentaries that correlate indirectly with themes relative to Family and Community Medicine were selected: worker’s mental and community health. After screening to small groups of students, there was a multidisciplinary discussion covering all the several themes relevant to the medical practice. Finally, questionnaires were applied where the students evaluated the importance of the experience in their education, as well as replied to questions about their contact with arts and personal interests. All the students considered the level of correlation of the motion pictures chosen as a good or excellent medical practice. Questioned on the relevance of the themes covered in their education, 94,1% of them answered good or fine. The same percentage considered the curricular inclusion of methodology also good or fine. It was observed that the students evaluated read less than the national average, and a considerable amount of them is not interested in or has never been to a theater, an art exposition or a dance show. The movies, however, proved to be very popular - confirming its potential as a humanizing teaching resource.

  14. A new paradigm for teaching behavior change: Implications for residency training in family medicine and psychiatry

    Directory of Open Access Journals (Sweden)

    Triana A

    2012-08-01

    Full Text Available Abstract Background Primary care physicians (PCPs provide ~50 % of all mental health services in the U.S. Given the widening gap between patient mental health needs and resources available to meet those needs, there is an increasing demand for family medicine and psychiatry trainees to master competencies in both behavioral medicine and primary care counseling during residency-if for no other reason than to accommodate the realities of medical practice given the oft present gap between the need for psychiatric services and the availability, quality, and/or affordability of specialized psychiatric care. To begin to address this gap, a skills-based, interactive curriculum based on motivational interviewing (MI as a teaching method is presented. Methods The curriculum described in this paper is a four-week block rotation taught in the second year of residency. Motivational interviewing (MI is used as a teaching approach toward the goal of clinical behavior change. Residents’ strengths, personal choice and autonomy are emphasized. Each week of the rotation, there is a clinical topic and a set of specific skills for mastery. Residents are offered a “menu” of skills, role modeling, role/real play, practice with standardized patients (SP, and direct supervision in clinic. Results Thirty-nine residents have completed the curriculum. Based on residents’ subjective reporting using pre-post scales (i.e., importance and confidence, all participants to date have reported substantial increases in confidence/self-efficacy using primary care counseling skills in their continuity clinic. Conclusions This paper presents an innovative, empirically based model for teaching the essential skills necessary for physicians providing care for patients with mental/emotional health needs as well as health-behavior change concerns. Implications for training in the broader context, particularly as it relates to multi-disciplinary and collaborative models of

  15. Leadership training in a family medicine residency program: Cross-sectional quantitative survey to inform curriculum development.

    Science.gov (United States)

    Gallagher, Erin; Moore, Ainsley; Schabort, Inge

    2017-03-01

    To assess the current status of leadership training as perceived by family medicine residents to inform the development of a formal leadership curriculum. Cross-sectional quantitative survey. Department of Family Medicine at McMaster University in Hamilton, Ont, in December 2013. A total of 152 first- and second-year family medicine residents. Family medicine residents' attitudes toward leadership, perceived level of training in various leadership domains, and identified opportunities for leadership training. Overall, 80% (152 of 190) of residents completed the survey. On a Likert scale (1 = strongly disagree, 4 = neutral, 7 = strongly agree), residents rated the importance of physician leadership in the clinical setting as high (6.23 of 7), whereas agreement with the statement "I am a leader" received the lowest rating (5.28 of 7). At least 50% of residents desired more training in the leadership domains of personal mastery, mentorship and coaching, conflict resolution, teaching, effective teamwork, administration, ideals of a healthy workplace, coalitions, and system transformation. At least 50% of residents identified behavioural sciences seminars, a lecture and workshop series, and a retreat as opportunities to expand leadership training. The concept of family physicians as leaders resonated highly with residents. Residents desired more personal and system-level leadership training. They also identified ways that leadership training could be expanded in the current curriculum and developed in other areas. The information gained from this survey might facilitate leadership development among residents through application of its results in a formal leadership curriculum. Copyright© the College of Family Physicians of Canada.

  16. Quality of osteoarthritis care in family medicine - a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Račić Maja

    2016-01-01

    Full Text Available Introduction. Effective treatments for osteoarthritis are available, yet little is known about the quality of primary care in the Republic of Srpska for this disabling condition. Objective. The main objective of this study was to analyze the overall quality of osteoarthritis treatment in a family medicine setting, as well as to explore whether the achievement of quality indicators was associated with particular patient characteristics and severity of osteoarthritis. Methods. The cross-sectional study included 120 patients with confirmed hand, knee, and hip osteoarthritis, recruited at seven family practices in the town of Ugljevik, Republic of Srpska, Bosnia and Herzegovina. Data were extracted from a patient questionnaire on quality indicators, as well as from their electronic and paper records, to assess care against 14 indicators. The included quality indicators were based on the Arthritis Foundation’s Quality Indicator set for Osteoarthritis. Summary achievement rates for hip, knee, or hand osteoarthritis, as well as for the total sample, were calculated. Results. The mean achievement rate for all 14 quality indicators obtained from medical records was 74%, and 77% obtained from patient interview. The quality indicators concerning referral for weight reduction (23% and pharmacological treatment (24% had the lowest achievement rates, whereas the highest achievement rates were related to physical examination (100%, pain and functional assessment (100%, and education (90.8%. Patients physical functioning was significantly associated with the quality indicator achievement rate (p = 0.001. Conclusion. Pharmacological therapy and the referral of osteoarthritis patients in need of weight reduction seem to have the greatest potential for improvement in primary health care.

  17. Family strategies for managing childhood cancer: using complementary and alternative medicine in Jordan.

    Science.gov (United States)

    Al-Qudimat, Mohammad R; Rozmus, Cathy L; Farhan, Nemah

    2011-03-01

    This paper is a report of a study that examined the use of complementary and alternative medicine therapies among children with cancer in Jordan. Complementary and alternative medicine use by oncology patients has been gaining acceptance in the developed countries and developing countries. Healthcare professionals are becoming increasingly aware that patients use complementary and alternative medicine either covertly or overtly. A descriptive cross-sectional design was used with parents of children with cancer under treatment and follow-up in a paediatric oncology department in Jordan between August 2007 and April 2008. Parents of 69 children with cancer in Jordan were surveyed for their use of complementary and alternative medicine with their children. A total of 65.2% of the sample had used at least one type of complementary and alternative medicine during the course of their child's treatment. The use of biological and nutritional complementary and alternative medicine was 70.5% among the users. Use of body and soul complementary and alternative medicine strategies was reported for 22.2% of the children using complementary and alternative medicine. Twenty per cent of the sample used body movement complementary and alternative medicine for their children. A total of 45.5% of complementary and alternative medicine users perceived benefits in using complementary and alternative medicine for their children with cancer. However, 40% of complementary and alternative medicine users had stopped using complementary and alternative medicine for multiple reasons. Parents used complementary and alternative medicine to support their children's medical treatment and to use all possible methods to cure their children. The reason for parents not using complementary and alternative medicine included not being aware of complementary and alternative medicine. Most of the patients have not discussed the issue of using complementary and alternative medicine with the medical staff.

  18. Content and conceptual frameworks of psychology and social work preceptor feedback related to the educational requests of family medicine residents.

    Science.gov (United States)

    Côté, Luc; Rocque, Rhéa; Audétat, Marie-Claude

    2017-06-01

    Supervision of communication competency in clinical settings in medicine is an important component of professional training. The purpose of this study was to describe the content and rationale of psychology and social work preceptor feedback to family medicine residents who express educational needs during case-based written vignettes. We conducted a qualitative study with 25 psychology and social work preceptors from family medicine departments of the three French-speaking universities in the province of Quebec, Canada. During an individual interview, preceptors were asked to respond to three short case-based written vignettes depicting resident educational issues regarding communication and to explain their responses. Authors analyzed the content of responses and the conceptual frameworks reported. The three vignettes elicited 475 responses, including 58 distinct responses and 33 distinct conceptual frameworks. Therapeutic alliance and stages of grief were the two most reported conceptual frameworks. The vignettes stimulated a wealth of responses and conceptual frameworks among psychology and social work preceptors in family medicine. The complete list of responses could be useful for faculty development activities by stimulating preceptors' reflexive practice with regard to their responses, the educational goals of these responses and the conceptual frameworks underlying their feedback. Copyright © 2017 Elsevier B.V. All rights reserved.

  19. Using field notes to evaluate competencies in family medicine training: a study of predictors of intention

    Directory of Open Access Journals (Sweden)

    Miriam Lacasse

    2013-03-01

    Methods: This mixed-methods study involved clinical teachers (CT and residents from two family medicine units. Main outcomes were: 1 intention (and its predictors: attitude, perceived behavioural control (PBC and normative belief to use FN, assessed using a 7-item Likert scale questionnaire (1: strongly disagree to 7: strongly agree and 2 related salient beliefs, explored in focus groups three and six months after FN implementation. Results: 27 CT and 28 residents participated. Intention to use FN was 6.20±1.20 and 5.74±1.03 in CT and residents respectively. Predictors of this intention were attitude and PBC (mutually influential: p = 0.04, and normative belief (p = 0.007. Focus groups identified underlying beliefs regarding their use (perceived advantages/disadvantages and facilitators/barriers. Conclusion: Intention to adopt field notes to document competency is influenced by attitude, perceived behavioural control and normative belief. Implementation of field notes should be preceded by interventions that target the identified salient beliefs to improve this competency-based evaluation strategy.

  20. Effectiveness of a Formal Mentorship Program in Family Medicine Residency: The Residents’ Perspective

    Directory of Open Access Journals (Sweden)

    Marie Andrades

    2013-01-01

    Full Text Available Introduction. Mentoring is a recognized form of teaching learning strategy in postgraduate medical education. This paper describes the effectiveness of a formal mentorship program from the residents’ perspective after a year of implementation. Methods. The Aga Khan University Family Medicine Residency Program is the first program in Pakistan to our knowledge to implement formal mentorship for all four years of residency. A mentorship program was developed, implemented, and evaluated a year later using a rating scale. The 10-point Likert scale consisted of questions on academics, clinical work, research, administrative issues, and personal/social issues. Results. The response rate was 95% (. Eighty percent ( were women. Satisfaction level in seeking help was the highest for academics (75%. Residents scored mentorship as low in helping to tackle their personal problems (20%. Barriers reported in rapport building with mentor were time constraints and gender difference. The most useful attributes of the mentor which helped rapport building were accessibility, active listening, support for emotional needs, and trustworthiness. Conclusion. Mentoring has a role in trainees’ personal and professional growth especially when their needs are addressed. The effectiveness of the mentorship program in residency can improve if the residents are allowed to choose their own mentors.

  1. Can self-declared personal values be used to identify those with family medicine career aspirations?

    Science.gov (United States)

    Beach, Renée A; Eva, Kevin W; Reiter, Harold I

    2008-05-01

    Self-declaration of personal values has been suggested as a means of identifying students with greater predilection for future primary care careers. While statistically significant differences have been demonstrated, absolute differences between those interested in primary care and those interested in specialist careers tend to be small. This study's objective was to determine whether limited differences can nevertheless be used to identify those with particular interest in primary care. Schwartz' values were submitted to a paired comparison design in which respondents were asked to identify the value they held most dearly for possible pairings of values. 88 medical school applicants, 57 first year medical students, 78 final year medical students, and 34 admissions interviewers participated. Applicant and medical student subgroups were analyzed as a whole and as a function of self-identified career interest (i.e., primarily interested in Family medicine or other specialty careers). The values statements were remarkably consistent (r > 0.90) between groups, regardless of which subgroups were analyzed. Despite apparent differences in the literature between those interested in primary care and those interested in other specialist careers, the differences are small and do not correlate with career aspirations in a way that could inform admissions decisions.

  2. Attitude and knowledge of family medicine practitioners towards the association between periodontal disease and obesity.

    Science.gov (United States)

    Akram, Z; Abduljabbar, T; Hanif, A; Khan, A; Vohra, F

    2017-05-01

    To assess the attitude and knowledge of family medicine practitioners (FMPs) towards the association between periodontal disease and obesity. A cross-sectional study was performed and a 13-item survey questionnaire was given to FMPs practicing in 12 different teaching hospitals in Karachi, Pakistan. The questions were aimed at exploring the knowledge of FMP's regarding the association of obesity and periodontal disease and their attitude towards the association of obesity and periodontal disease. Chi-square and Spearman co-efficient were conducted to compare subgroups and correlate factors with the knowledge score of FMPs. A total of 314 questionnaires were completed (response rate = 92%). Median age of participants was 41 years and 57% were females. Almost 61% of FMPs answered all the knowledge questions correctly and 64% reported moderate understanding of the association between periodontal health and obesity. Nearly 73% FMPs inquired from obese patients regarding the periodontal disease and more than half (58%) refer patients to a dentist for evaluation. More than half of FMPs perform periodontal disease screening. Nearly all FMPs considered informing obese patients regarding periodontal disease as one of their roles. FMP's play an important role in the early diagnosis, prevention and treatment of periodontal conditions in obese patients. More than two thirds of FMPs showed good knowledge of the association of obesity and periodontal disease. The attitudes of FMPs towards assessing and referring obese patients at a risk of having periodontal disease were reassuring.

  3. [Knowledge, experience and behavior at climacteric and menopause stages among family medicine female users at IMSS].

    Science.gov (United States)

    Velasco-Murillo, Vitelio; Fernández-Gárate, Irma H; Ojeda-Mijares, Rosalba I; Padilla-Vallejo, Isabel; de la Cruz-Mejía, Leticia

    2007-01-01

    To identify knowledge, experiences and behaviors of climacteric and menopause women users of family medicine services of Instituto Mexicano del Seguro Social (IMSS). A descriptive study that included a 37 questions survey about climacteric and menopause was conducted in a national representative sample of 4162 women aged 45 to 59 years between September 2004 and January 2005. The analysis was made by using descriptive statistics and chi2. 82.9 % Of women knew about menopause or its significance; 82.1 % identified hot flushes as a climacteric symptom; 46.1 % knew about pharmacologic treatment and 25.6 % knew about postmenopausal complications such as osteoporosis. Only 26.6 % mentioned preventive measures as physical exercise or consumption of food with high calcium content. Their main information sources were media communication. Mean age at menopause was 46.8 years old; 57.7 % had symptoms at interview and 18.4 % were taking pharmacologic treatment, mainly (53.3 %) hormones. 11.1 % of treated women had had side effects. 10.7 % had received pharmacologic treatment and 39.4 % had withdrawn from medication either for medical indications or for side effects (23 %). Knowledge about climacteric was scarce and obtained from non-medical sources; use of pharmacological treatment and preventive behavior was low. We recommended reinforcing the information and education about treatment and favorable life styles by health personal.

  4. Overcoming early barriers to PCMH practice improvement in family medicine residencies.

    Science.gov (United States)

    Fernald, Douglas H; Deaner, Nicole; O'Neill, Caitlin; Jortberg, Bonnie T; degruy, Frank Verloin; Dickinson, W Perry

    2011-01-01

    Residency programs face inevitable challenges as they redesign their practices for higher quality care and resident training. Identifying and addressing early barriers can help align priorities and thereby augment the capacity to change. Evaluation of the Colorado Family Medicine Residency PCMH Project included iterative qualitative analysis of field notes, interviews, and documents to identify early barriers to change and strategies to overcome them. Nine common but not universal barriers were identified: (1) a practice's history reflected some negative past experiences with quality improvement or routines incompatible with transformative change, (2) leadership gaps were evident in unprepared practice leaders or hierarchical leadership, (3) resistance and skepticism about change were expressed through cynicism aimed at change or ability to change, (4) unproductive team processes were reflected in patterns of canceled meetings, absentee leaders, or lack of accountability, (5) knowledge gaps about the Patient-centered Medical Home (PCMH) were apparent from incomplete dissemination about the project or planned changes, (6) EHR implementation distracted focus or stalled improvement activity, (7) sponsoring organizations' constraints emerged from staffing rules and differing priorities, (8) insufficient staff participation resulted from traditional role expectations and structures, and (9) communication was hampered by ineffective methods and part-time faculty and residents. Early barriers responded to varying degrees to specific interventions by practice coaches. Some barriers that interfere with practices getting started with cultural and structural transformation can be addressed with persistent attention and reflection from on-site coaches and by realigning the talents, leaders, and priorities already in these residency programs.

  5. Patient perception and knowledge of acetaminophen in a large family medicine service.

    Science.gov (United States)

    Herndon, Christopher M; Dankenbring, Dawn M

    2014-06-01

    The use of acetaminophen is currently under increased scrutiny by the US Food and Drug Administration (FDA) due to the risk of intentional and more concerning, unintentional overdose-related hepatotoxicity. Acetaminophen is responsible for an estimated 48% of all acute liver failure diagnoses. The purpose of this study is to evaluate patient perception and knowledge of the safe use and potential toxicity of acetaminophen-containing products. The authors conducted a descriptive, 2-week study using a convenience sample from a large family medicine clinic waiting room. Survey questions assessed ability to identify acetaminophen, knowledge of the current recommended maximum daily dose, respondent acetaminophen use patterns, common adverse effects associated with acetaminophen, and respondent self-reported alcohol consumption. Acetaminophen safety information was provided to all persons regardless of participation in the study. Of the 102 patients who chose to participate, 79% recognized acetaminophen as a synonym of Tylenol, whereas only 9% identified APAP as a frequently used abbreviation. One third of respondents thought acetaminophen was synonymous with ibuprofen and naproxen. Approximately one fourth of patients correctly identified the then maximum recommended daily acetaminophen dose of 4 g. Seventy-eight percent of patients correctly identified hepatotoxicity as the most common serious adverse effect. We conclude that patient deficiencies in knowledge of acetaminophen recognition, dosing, and toxicity warrant public education by health professionals at all levels of interaction. Current initiatives are promising; however, further efforts are required.

  6. Knowledge and confidence in the diagnosis and management of leprosy among Family Medicine Specialists in Malaysia

    Directory of Open Access Journals (Sweden)

    Felix Boon-Bin Yap

    2016-01-01

    Full Text Available Background: Family Medicine Specialists (FMS play a pivotal role in the detection of leprosy in primary care. This study determines the knowledge and confidence among FMS in Malaysia. Method: Pre-intervention questionnaire was conducted followed by a 3 day educational intervention. Post-intervention questionnaire was conducted again 2 months thereafter. The questionnaire assessed knowledge and confidence in the diagnosis and management of leprosy. Results: The mean total mark for the pre-intervention knowledge questionnaires was 35.4 out of 50 and the mean confidence was 4.0 out of 10 for diagnosis and 3.3 out of 10 for management. Knowledge improved 24.0% post-intervention (p < 0.001. Knowledge on pathogenesis and clinical features improved the most with 38.5% and 32.4% respectively whereas knowledge on leprosy reactions improved the least with only 15.1%. The confidence level improved 85% to 7.4 for diagnosis and 118.2% to 7.2 for management post-intervention (p < 0.001. FMS with more experience, seeing more than 5 patients in their working life, had better confidence pre-intervention but it became insignificant post-intervention. Conclusion: Knowledge of FMS was good but their confidence was low pre-intervention. They improved significantly post-intervention. It is hoped that the improvement can allow for earlier detection of leprosy to prevent clinical and epidemiological sequelae.

  7. Win/win: creating collaborative training opportunities for behavioral health providers within family medicine residency programs.

    Science.gov (United States)

    Ruddy, Nancy Breen; Borresen, Dorothy; Myerholtz, Linda

    2013-01-01

    Integrating behavioral health into primary healthcare offers multiple advantages for patients and health professionals. This model requires a new skill set for all healthcare professionals that is not emphasized in current educational models. The new skills include interprofessional team-based care competencies and expanded patient care competencies. Health professionals must learn new ways to efficiently and effectively address health behavior change, and manage behavioral health issues such as depression and anxiety. Learning environments that co-train mental health and primary care professionals facilitate acquisition of both teamwork and patient care competencies for mental health and primary care professional trainees. Family Medicine Residency programs provide an excellent opportunity for co-training. This article serves as a "how to" guide for residency programs interested in developing a co-training program. Necessary steps to establish and maintain a program are reviewed, as well as goals and objectives for a co-training curriculum and strategies to overcome barriers and challenges in co-training models.

  8. Reflective practice and social responsibility in family medicine: Effect of performing an international rotation in a developing country.

    Science.gov (United States)

    Loignon, Christine; Gottin, Thomas; Valois, Carol; Couturier, François; Williams, Robert; Roy, Pierre-Michel

    2016-11-01

    To explore the perceived effect of an elective international health rotation on family medicine resident learning. Qualitative, collaborative study based on semistructured interviews. Quebec. A sample of 12 family medicine residents and 9 rotation supervisors (N = 21). Semistructured interviews of residents and rotation supervisors. Residents and supervisors alike reported that their technical skills and relationship skills had benefited. All increased their knowledge of tropical pathologies and learned to expand their clinical examinations. They benefited from having very rich interactions in other care settings, working with vulnerable populations. The rotations had their greatest effect on relationship skills (communication, empathy, etc) and the ability to work with vulnerable patients. All of the participants were exposed to local therapies and local interpretations of disease symptoms and pathogenesis. The findings of this study will have a considerable effect on pedagogy. The residents' experiences of their international health rotations and what they learned in terms of medical skills and pedagogic approaches in working with patients are described. Using a collaborative approach with the rotation supervisors, the data were triangulated and the benefits of an international rotation on academic training were more accurately defined. The findings can now be used to enrich academic programs in social and preventive medicine and more adequately prepare future family physicians for work in various social and cultural settings. Copyright© the College of Family Physicians of Canada.

  9. [Opportunity cost for men who visit family medicine units in the city of Querétaro, Mexico].

    Science.gov (United States)

    Martínez Carranza, Edith Olimpia; Villarreal Ríos, Enrique; Vargas Daza, Emma Rosa; Galicia Rodríguez, Liliana; Martínez González, Lidia

    2010-12-01

    To determine the opportunity cost for men who seek care in the family medicine units (FMU) of the Mexican Social Security Institute (IMSS, Instituto Mexicano del Seguro Social) in the city of Querétaro. A sample was selected of 807 men, ages 20 to 59 years, who sought care through the family medicine, laboratory, and pharmacy services provided by the FMU at the IMSS in Querétaro. Patients referred for emergency services and those who left the facilities without receiving care were excluded. The sample (n = 807) was calculated using the averages for an infinite population formula, with a confidence interval of 95% (CI95%) and an average opportunity cost of US$5.5 for family medicine, US$3.1 for laboratory services, and US$2.3 for pharmacy services. Estimates included the amount of time spent on travel, waiting, and receiving care; the number of people accompanying the patient, and the cost per minute of paid and unpaid job activities. The opportunity cost was calculated using the estimated cost per minute for travel, waiting, and receiving care for patients and their companions. The opportunity cost for the patient travel was estimated at US$0.97 (CI95%: 0.81-1.15), while wait time was US$5.03 (CI95%: 4.08-6.09) for family medicine, US$0.06 (CI95%: 0.05-0.08) for pharmacy services, and US$1.89 (CI95%: 1.56-2.25) for laboratory services. The average opportunity cost for an unaccompanied patient visit varied between US$1.10 for pharmacy services alone and US$8.64 for family medicine, pharmacy, and laboratory services. The weighted opportunity cost for family medicine was US$6.24. Given that the opportunity cost for men who seek services in FMU corresponds to more than half of a minimum salary, it should be examined from an institutional perspective whether this is the best alternative for care.

  10. Status of neurology medical school education: results of 2005 and 2012 clerkship director survey.

    Science.gov (United States)

    Carter, Jonathan L; Ali, Imran I; Isaacson, Richard S; Safdieh, Joseph E; Finney, Glen R; Sowell, Michael K; Sam, Maria C; Anderson, Heather S; Shin, Robert K; Kraakevik, Jeff A; Coleman, Mary; Drogan, Oksana

    2014-11-04

    To survey all US medical school clerkship directors (CDs) in neurology and to compare results from a similar survey in 2005. A survey was developed by a work group of the American Academy of Neurology Undergraduate Education Subcommittee, and sent to all neurology CDs listed in the American Academy of Neurology database. Comparisons were made to a similar 2005 survey. Survey response rate was 73%. Neurology was required in 93% of responding schools. Duration of clerkships was 4 weeks in 74% and 3 weeks in 11%. Clerkships were taken in the third year in 56%, third or fourth year in 19%, and fourth year in 12%. Clerkship duration in 2012 was slightly shorter than in 2005 (fewer clerkships of ≥4 weeks, p = 0.125), but more clerkships have moved into the third year (fewer neurology clerkships during the fourth year, p = 0.051). Simulation training in lumbar punctures was available at 44% of schools, but only 2% of students attempted lumbar punctures on patients. CDs averaged 20% protected time, but reported that they needed at least 32%. Secretarial full-time equivalent was 0.50 or less in 71% of clerkships. Eighty-five percent of CDs were "very satisfied" or "somewhat satisfied," but more than half experienced "burnout" and 35% had considered relinquishing their role. Trends in neurology undergraduate education since 2005 include shorter clerkships, migration into the third year, and increasing use of technology. CDs are generally satisfied, but report stressors, including inadequate protected time and departmental support. © 2014 American Academy of Neurology.

  11. Instructions to authors of the Brazilian Journal of Family and Community Medicine

    Directory of Open Access Journals (Sweden)

    Sociedade Brasileira de Medicina de Familia e Comunidade SBMFC

    2010-11-01

    Full Text Available Instructions to authors of the Brazilian Journal of Family and Community Medicine   The Brazilian Journal of Family and Community Medicine (BJFCM is a three-monthly publication of the Brazilian Society of Family and Community Medicine, aimed at sensitizing professionals and health authorities to this field of interest, stimulating and disseminating Primary Health Care (PHC issues and investigations, and facilitating interchange between academic institutions, health care services and organized social movements. The periodical also aims to promote an interdisciplinary approach to this area and to serve as a vehicle for continued and permanent education in the field of Family and Community Health, with emphasis to the central subject PHC. Manuscripts will be reviewed by members of the Scientific and Editorial Board as well as by outside referees. This peer-review process safeguards the identity of authors and their institutions of origin, which only will be revealed to the Editorial Board in the end of the evaluation process. All manuscripts should be prepared in Portuguese language. Foreign authors, not living in Brazil, can submit their papers in English or Spanish. Categories and formats of papers The journal is divided into the following sections: Editorial Original articles Review articles Directives in Family and Community Medicine Essays Case reports Theses Letters to the Editor The Editorial is responsibility of the editor of the journal, but can be prepared by third persons on his request. The section Original Articles is dedicated to reports on scientific investigations, presenting original data on findings from experiments or observation with emphasis to qualitative or quantitative studies in fields of interest for PHC. Original articles are criticisms or creations on science, technology and the art of health sciences, contributing to the evolution of knowledge about Man, nature and social and cultural inclusion. The papers - including

  12. Status and progress of family health in Latin America and the Caribbean: the Ibero-American Confederation of Family Medicine (ICPM perspective

    Directory of Open Access Journals (Sweden)

    María Inez Padula Anderson

    2013-01-01

    Full Text Available In the XXI century, much of humanity does not have access to comprehensive health care, or even basic equitable health care. If studies show that countries with organized health systems based on a qualified and inclusive model of Primary Health Care (PHC and family physicians as permanent staff are achieving unquestionable results, why a large part of the countries with lower socio-economic development have not committed strongly to implement an efficient reform of their health systems based on PHC and family medicine (FM? These issues are at the core of the Latin American Confederation of Family Medicine’s concerns, an international non-profit organization composed of national associations of countries of FM from Latin America, Spain and Portugal. Its primary mission is to drive the implementation of a proper PHC system in all countries of the region and to ensure that family medicine, as a specialty, is considered critical to health systems, thereby transforming it into a public policy.

  13. Satisfaction with civilian family medicine residency training: Perspectives from serving general duty medical officers in the Canadian Armed Forces.

    Science.gov (United States)

    Wolfrom, Brent; Hodgetts, Geoff; Kotecha, Jyoti; Pollock, Emily; Martin, Mary; Han, Han; Morissette, Pierre

    2016-09-01

    To evaluate satisfaction with civilian residency training programs among serving general duty medical officers within the Canadian Armed Forces. A 23-item, cross-sectional survey face-validated by the office of the Surgeon General of the Canadian Armed Forces. Canada. General duty medical officers serving in the Canadian Armed Forces as of February 2014 identified through the Directorate of Health Services Personnel of the Canadian Forces Health Services Group Headquarters. Satisfaction with and time spent in 7 domains of training: trauma, critical care, emergency medicine, psychiatry, occupational health, sports medicine, and base clinic training. Overall preparedness for leading a health care team, caring for a military population, working in isolated and challenging environments, and being deployed were evaluated on a 5-point Likert scale. Among the survey respondents (n = 135, response rate 54%), 77% agreed or strongly agreed that their family medicine residency training was relevant to their role as a general duty medical officer. Most respondents were either satisfied or very satisfied with their emergency medicine training (77%) and psychiatry training (63%), while fewer were satisfied or very satisfied with their sports medicine (47%), base clinic (41%), and critical care (43%) training. Even fewer respondents were satisfied or very satisfied with their trauma (26%) and occupational health (12%) training. Regarding overall preparedness, 57% believed that they were adequately prepared to care for a military patient population, and 52% of respondents believed they were prepared for their first posting. Fewer respondents (38%) believed they were prepared to work in isolated, austere, or challenging environments, and even fewer (32%) believed that residency training prepared them to lead a health care team. General duty medical officers were satisfied with many aspects of their family medicine residency training; however, military-specific areas for improvement

  14. Relevance of Chronic Lyme Disease to Family Medicine as a Complex Multidimensional Chronic Disease Construct: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Liesbeth Borgermans

    2014-01-01

    Full Text Available Lyme disease has become a global public health problem and a prototype of an emerging infection. Both treatment-refractory infection and symptoms that are related to Borrelia burgdorferi infection remain subject to controversy. Because of the absence of solid evidence on prevalence, causes, diagnostic criteria, tools and treatment options, the role of autoimmunity to residual or persisting antigens, and the role of a toxin or other bacterial-associated products that are responsible for the symptoms and signs, chronic Lyme disease (CLD remains a relatively poorly understood chronic disease construct. The role and performance of family medicine in the detection, integrative treatment, and follow-up of CLD are not well studied either. The purpose of this paper is to describe insights into the complexity of CLD as a multidimensional chronic disease construct and its relevance to family medicine by means of a systematic literature review.

  15. Relevance of chronic lyme disease to family medicine as a complex multidimensional chronic disease construct: a systematic review.

    Science.gov (United States)

    Borgermans, Liesbeth; Goderis, Geert; Vandevoorde, Jan; Devroey, Dirk

    2014-01-01

    Lyme disease has become a global public health problem and a prototype of an emerging infection. Both treatment-refractory infection and symptoms that are related to Borrelia burgdorferi infection remain subject to controversy. Because of the absence of solid evidence on prevalence, causes, diagnostic criteria, tools and treatment options, the role of autoimmunity to residual or persisting antigens, and the role of a toxin or other bacterial-associated products that are responsible for the symptoms and signs, chronic Lyme disease (CLD) remains a relatively poorly understood chronic disease construct. The role and performance of family medicine in the detection, integrative treatment, and follow-up of CLD are not well studied either. The purpose of this paper is to describe insights into the complexity of CLD as a multidimensional chronic disease construct and its relevance to family medicine by means of a systematic literature review.

  16. Challenges in transformation of the "traditional block rotation" medical student clinical education into a longitudinal integrated clerkship model.

    Science.gov (United States)

    Heddle, William; Roberton, Gayle; Mahoney, Sarah; Walters, Lucie; Strasser, Sarah; Worley, Paul

    2014-01-01

    Longitudinal integrated clerkships (LIC) in the first major clinical year in medical student training have been demonstrated to be at least equivalent to and in some areas superior to the "traditional block rotation" (TBR). Flinders University School of Medicine is starting a pilot changing the traditional teaching at the major Academic Medical Centre from TBR to LIC (50% of students in other locations in the medical school already have a partial or full LIC programme). This paper summarises the expected challenges presented at the "Rendez-Vous" Conference in October 2012: (a) creating urgency, (b) training to be a clinician rather than imparting knowledge, (c) resistance to change. We discuss the unexpected challenges that have evolved since then: (a) difficulty finalising the precise schedule, (b) underestimating time requirements, (c) managing the change process inclusively. Transformation of a "block rotation" to "LIC" medical student education in a tertiary academic teaching hospital has many challenges, many of which can be anticipated, but some are unexpected.

  17. Family Medicine Residents' Performance with Detected Versus Undetected Simulated Patients Posing as Problem Drinkers

    Directory of Open Access Journals (Sweden)

    Mark B. Sobell, PhD

    2004-01-01

    Full Text Available Background: Simulated patients are commonly used to evaluate medical trainees. Unannounced simulated patients provide an accurate measure of physician performance. Purpose: To determine the effects of detection of SPs on physician performance, and identify factors leading to detection. Methods: Fixty-six family medicine residents were each visited by two unannounced simulated patients presenting with alcohol-induced hypertension or insomnia. Residents were then surveyed on their detection of SPs. Results: SPs were detected on 45 out of 104 visits. Inner city clinics had higher detection rates than middle class clinics. Residents’ checklist and global rating scores were substantially higher on detected than undetected visits, for both between-subject and within-subject comparisons. The most common reasons for detection concerned SP demographics and behaviour; the SP “did not act like a drinker” and was of a different social class than the typical clinic patient. Conclusions: Multi-clinic studies involving residents experienced with SPs should ensure that the SP role and behavior conform to physician expectations and the demographics of the clinic. SP station testing does not accurately reflect physicians’ actual clinical behavior and should not be relied on as the primary method of evaluation. The study also suggests that physicians’ poor performance in identifying and managing alcohol problems is not entirely due to lack of skill, as they demonstrated greater clinical skills when they became aware that they were being evaluated. Physicians’ clinical priorities, sense of responsibility and other attitudinal determinants of their behavior should be addressed when training physicians on the management of alcohol problems.

  18. Training Standards Statements of Family Medicine Postgraduate Training - A Review of Existing Documents Worldwide.

    Directory of Open Access Journals (Sweden)

    Elisabeth Flum

    Full Text Available For the effective and safe management of complex care needs for patients in community settings, high quality family medicine (FM training programmes are needed. In less primary care oriented countries, training standards statements for FM postgraduate training are less commonly found. The aim of this study was to review international training standards statements in FM postgraduate training and to catalogue these statements to be used as a best practice standard guide for FM training programs in Germany.A structured three-tiered search was performed: a systematic literature search in MEDLINE®; a search of international indicator databases; and a search in grey literature, consisting of a survey of international experts and a search in "Google (Scholar". From all identified documents, training standards statements were extracted, translated and summarized into categories referring to the same quality aspect.The search strategy revealed 25 relevant documents (MEDLINE® n = 15, databases n = 2, experts n = 7, "Google" n = 1, containing 337 training standards statements. These were summarized into 80 statements. They covered structure quality (n = 35; process quality (n = 43; and two training standards statements referred to outcome quality (n = 2.A broad range of internationally sourced training standards statements for FM postgraduate training could be identified from countries with well-established primary care systems. Only few statements internationally referred to outcome quality, expressing the difficulty in assessing outcome. The resulting inventory of training standards statements for FM postgraduate training can serve as a resource for institutions seeking to formalise and systematise FM training at regional or national levels.

  19. Sleep duration, quality, or stability and obesity in an urban family medicine center.

    Science.gov (United States)

    Logue, Everett E; Scott, Edward D; Palmieri, Patrick A; Dudley, Patricia

    2014-02-15

    Inadequate sleep has negative metabolic consequences that may contribute to obesity. A priori hypotheses posit relationships between sleep characteristics, carbohydrate and lipid metabolism, appetite, fatigue, and obesity in laboratory, clinical, and population settings. There are few reports from primary care; and none that address sleep duration, quality, and stability. This study examines the relationship between three sleep characteristics-duration, quality, or stability-and obesity in our urban hospital affiliated family medicine center in Akron, Ohio. A systematic sampling process yielded 225 representative patients who completed the Pittsburgh Sleep Quality Index, the Berlin Apnea Questionnaire, and the Sleep Timing Questionnaire. Demographic, body mass, hypertension, and insurance data were obtained from the electronic medical record. Associations between self-reported sleep characteristics and obesity were examined via contingency tables and regression models. Seventy-eight percent (78%) reported poor quality sleep, 59% had elevated Berlin apnea-risk scores, 12% reported restless legs symptoms, and 9% reported a prior diagnosis of sleep apnea; 62% were obese. We found significant (p obesity. The association between sleep quality and obesity was negative and linear (69%, 72%, 56%, 43%), while the association between sleep duration and obesity was U-shaped (74%, 53%, 53%, 62%; linear term p = 0.02 and quadratic term p = 0.03). Less stable bedtimes during the week (OR = 2.3, p = 0.008) or on the weekend (OR = 1.8, p = 0.04) were also associated with obesity. The association between sleep quality and obesity was not explained by patient demographics or snoring (ORadj = 2.2; p = 0.008). This study adds to the sparse literature on the relationship between three self-reported sleep characteristics and obesity in urban primary care settings which typically differ from both general population and specialty outpatient settings.

  20. A Feminist Perspective of Family Medicine%家庭治疗的女性主义思考

    Institute of Scientific and Technical Information of China (English)

    徐振敏

    2011-01-01

    主要通过女性主义的眼光审视传统家庭治疗流派的理念,反映当前家庭治疗中存在的对女性经验的忽视等不足,探索治疗实践中治疗目标、治疗关系和使用的技术等方面所需要做出的改变,同时简要分析这一现状中家庭治疗师的责任和治疗理念变化的趋向。从家庭治疗自身演变发展的角度,展望未来家庭治疗的发展方向。%This paper adopts a feminist perspective to examine the neglect of women in the traditional theory and practice of family medicine that still prevails today. It investigates in necessary changes in the goals of medicine, relationships in treatment, and technolo- gy used. It also foresees the direction in which changes in responsibilities of family doctors and their perspective of treatment could be made. In so doing, the paper looks into the future development of family medicine.

  1. Telemedicine and E-Learning in a Primary Care Setting in Sudan: The Experience of the Gezira Family Medicine Project.

    Science.gov (United States)

    Mohamed, K G; Hunskaar, S; Abdelrahman, S H; Malik, E M

    2015-01-01

    Information and communication technology (ICT) is progressively used in the health sector (e-health), to provide health care in a distance (telemedicine), facilitate medical education (e-learning), and manage patients' information (electronic medical records, EMRs). Gezira Family Medicine Project (GFMP) in Sudan provides a 2-year master's degree in family medicine, with ICT fully integrated in the project. This cross-sectional study describes ICT implementation and utilization at the GFMP for the years 2011-2012. Administrative data was used to describe ICT implementation, while questionnaire-based data was used to assess candidates' perceptions and satisfaction. In the period from April 2011 to December 2012, 3808 telemedicine online consultations were recorded and over 165000 new patients' EMRs were established by the study subjects (125 candidates enrolled in the program). Almost all respondents confirmed the importance of telemedicine. The majority appreciated also the importance of using EMRs. Online lectures were highly rated by candidates in spite of the few challenges encountered by combining service provision with learning activity. Physicians highlighted some patients' concerns about the use of telemedicine and EMRs during clinical consultations. Results from this study confirmed the suitability of ICT use in postgraduate training in family medicine and in service provision.

  2. Instructions to authors of the Brazilian Journal of Family and Community Medicine

    Directory of Open Access Journals (Sweden)

    Sociedade Brasileira de Medicina de Familia e Comunidade SBMFC

    2010-11-01

    Full Text Available The Brazilian Journal of Family and Community Medicine (BJFCM is a three-monthly publication of the Brazilian Society of Family and Community Medicine, aimed at sensitizing professionals and health authorities to this field of interest, stimulating and disseminating Primary Health Care (PHC issues and investigations, and facilitating interchange between academic institutions, health care services and organized social movements. The periodical also aims to promote an interdisciplinary approach to this area and to serve as a vehicle for continued and permanent education in the field of Family and Community Health, with emphasis to the central subject PHC. Manuscripts will be reviewed by members of the Scientific and Editorial Board as well as by outside referees. This peer-review process safeguards the identity of authors and their institutions of origin, which only will be revealed to the Editorial Board in the end of the evaluation process. All manuscripts should be prepared in Portuguese language. Foreign authors, not living in Brazil, can submit their papers in English or Spanish. Categories and formats of papers The journal is divided into the following sections: Editorial Original articles Review articles Directives in Family and Community Medicine Essays Case reports Theses Letters to the Editor The Editorial is responsibility of the editor of the journal, but can be prepared by third persons on his request. The section Original Articles is dedicated to reports on scientific investigations, presenting original data on findings from experiments or observation with emphasis to qualitative or quantitative studies in fields of interest for PHC. Original articles are criticisms or creations on science, technology and the art of health sciences, contributing to the evolution of knowledge about Man, nature and social and cultural inclusion. The papers - including introduction, material or rationale, methods, results, discussion and conclusion

  3. Instructions to authors of the Brazilian Journal of Family and Community Medicine

    Directory of Open Access Journals (Sweden)

    Revista Brasileira de Medicina de Família e Comunidade RBMFC

    2010-11-01

    Full Text Available The Brazilian Journal of Family and Community Medicine (BJFCM is a three-monthly publication of the Brazilian Society of Family and Community Medicine, aimed at sensitizing professionals and health authorities to this field of interest, stimulating and disseminating Primary Health Care (PHC issues and investigations, and facilitating interchange between academic institutions, health care services and organized social movements. The periodical also aims to promote an interdisciplinary approach to this area and to serve as a vehicle for continued and permanent education in the field of Family and Community Health, with emphasis to the central subject PHC. Manuscripts will be reviewed by members of the Scientific and Editorial Board as well as by outside referees. This peer-review process safeguards the identity of authors and their institutions of origin, which only will be revealed to the Editorial Board in the end of the evaluation process. All manuscripts should be prepared in Portuguese language. Foreign authors, not living in Brazil, can submit their papers in English or Spanish. Categories and formats of papers The journal is divided into the following sections: Editorial Original articles Review articles Directives in Family and Community Medicine Essays Case reports Theses Letters to the Editor The Editorial is responsibility of the editor of the journal, but can be prepared by third persons on his request. The section Original Articles is dedicated to reports on scientific investigations, presenting original data on findings from experiments or observation with emphasis to qualitative or quantitative studies in fields of interest for PHC. Original articles are criticisms or creations on science, technology and the art of health sciences, contributing to the evolution of knowledge about Man, nature and social and cultural inclusion. The papers - including introduction, material or rationale, methods, results, discussion and conclusion

  4. Instructions to authors of the Brazilian Journal of Family and Community Medicine

    Directory of Open Access Journals (Sweden)

    Hamilton Lima Wagner

    2010-11-01

    Full Text Available The Brazilian Journal of Family and Community Medicine (BJFCM is a three-monthly publication of the Brazilian Society of Family and Community Medicine, aimed at sensitizing professionals and health authorities to this field of interest, stimulating and disseminating Primary Health Care (PHC issues and investigations, and facilitating interchange between academic institutions, health care services and organized social movements. The periodical also aims to promote an interdisciplinary approach to this area and to serve as a vehicle for continued and permanent education in the field of Family and Community Health, with emphasis to the central subject PHC. Manuscripts will be reviewed by members of the Scientific and Editorial Board as well as by outside referees. This peer-review process safeguards the identity of authors and their institutions of origin, which only will be revealed to the Editorial Board in the end of the evaluation process. All manuscripts should be prepared in Portuguese language. Foreign authors, not living in Brazil, can submit their papers in English or Spanish. Categories and formats of papers The journal is divided into the following sections: Editorial Original articles Review articles Directives in Family and Community Medicine Essays Case reports Theses Letters to the Editor The Editorial is responsibility of the editor of the journal, but can be prepared by third persons on his request. The section Original Articles is dedicated to reports on scientific investigations, presenting original data on findings from experiments or observation with emphasis to qualitative or quantitative studies in fields of interest for PHC. Original articles are criticisms or creations on science, technology and the art of health sciences, contributing to the evolution of knowledge about Man, nature and social and cultural inclusion. The papers - including introduction, material or rationale, methods, results, discussion and conclusion

  5. Instructions to authors of the Brazilian Journal of Family and Community Medicine

    Directory of Open Access Journals (Sweden)

    Sociedade Brasileira de Medicina de Família e Comunidade SBMFC

    2010-11-01

    Full Text Available The Brazilian Journal of Family and Community Medicine (BJFCM is a three-monthly publication of the Brazilian Society of Family and Community Medicine, aimed at sensitizing professionals and health authorities to this field of interest, stimulating and disseminating Primary Health Care (PHC issues and investigations, and facilitating interchange between academic institutions, health care services and organized social movements. The periodical also aims to promote an interdisciplinary approach to this area and to serve as a vehicle for continued and permanent education in the field of Family and Community Health, with emphasis to the central subject PHC. Manuscripts will be reviewed by members of the Scientific and Editorial Board as well as by outside referees. This peer-review process safeguards the identity of authors and their institutions of origin, which only will be revealed to the Editorial Board in the end of the evaluation process. All manuscripts should be prepared in Portuguese language. Foreign authors, not living in Brazil, can submit their papers in English or Spanish. Categories and formats of papers The journal is divided into the following sections: Editorial Original articles Review articles Directives in Family and Community Medicine Essays Case reports Theses Letters to the Editor The Editorial is responsibility of the editor of the journal, but can be prepared by third persons on his request. The section Original Articles is dedicated to reports on scientific investigations, presenting original data on findings from experiments or observation with emphasis to qualitative or quantitative studies in fields of interest for PHC. Original articles are criticisms or creations on science, technology and the art of health sciences, contributing to the evolution of knowledge about Man, nature and social and cultural inclusion. The papers - including introduction, material or rationale, methods, results, discussion and conclusion

  6. Institute of Medicine 2009 Gestational Weight Gain Guideline Knowledge: Survey of Obstetrics/Gynecology and Family Medicine Residents of the United States

    Science.gov (United States)

    Moore Simas, Tiffany A.; Waring, Molly E.; Sullivan, Gina M. T.; Liao, Xun; Rosal, Milagros C.; Hardy, Janet R.; Berry, Robert E.

    2014-01-01

    Background In 2009, the Institute of Medicine revised gestational weight gain recommendations; revisions included body mass index (BMI) category cut-point changes and provision of range of gain for obese women. Our objective was to examine resident prenatal care providers’ knowledge of revised guidelines. Methods Anonymous electronic survey of Obstetrics/Gynecology and Family Medicine residents across U.S. from January–April 2010. Results 660 completed the survey; 79% female and 69% aged 21–30 years. When permitted to select ≥1 response, 87.0% reported using BMI to assess weight status at initial visits, 44.4% reported using “clinical impression based on patient appearance”, and 1.4% reported not using any parameters. When asked the most important baseline parameter for providing recommendations, 35.8% correctly identified pre-pregnancy BMI, 2.1% reported “I don’t provide guidelines,” and 4.5% reported “I do not discuss gestational weight gain.” 57.6% reported not being aware of new guidelines. Only 7.6% selected correct BMI ranges for each category. Only 5.8% selected correct gestational weight gain ranges. Only 2.3% correctly identified both BMI cutoffs and recommended gestational weight gain ranges per 2009 guidelines. Conclusions Guideline knowledge is the foundation of accurate counseling, yet resident prenatal care providers were minimally aware of the 2009 Institute of Medicine gestational weight gain guidelines almost a year after their publication. PMID:24344704

  7. Global Cardiovascular Risk Assessment by Family Physicians in Suez Canal University-Family Medicine Centers-Egypt

    OpenAIRE

    Nour-Eldein, Hebatallah; Abdelsalam, Shimaa A.; Nasr, Gamila M.; Abdelwahed, Hassan A.

    2013-01-01

    Background: The close sustained contact of family physician with their patients and local community makes preventive care an integral part of their routine work. Most cardiovascular diseases (CVD) can be prevented by addressing their risk factors. There are several guidelines that recommend different CV risk assessment tools to support CV prevention strategies. Aim: This study aimed to assess awareness and attitude of global CV risk assessment and use of their tools by family physicians; aimi...

  8. The value of resident teaching to improve student perceptions of surgery clerkships and surgical career choices.

    Science.gov (United States)

    Whittaker, Lorin D; Estes, Norman C; Ash, Jennifer; Meyer, Lynne E

    2006-03-01

    A fundamental function of attending faculty is to teach and mentor medical students, but the benefit of the resident's role is recognized increasingly. Our Standardized Institutional Clinical Clerkship Assessment allows students to rate 27 factors relative to a clinical clerkship. Scores from 1998 to 2005 were used to evaluate our surgical clerkship program and to compare resident and attending teachers. Student surgery career choices also were monitored. Medical students routinely scored residents more highly than attending faculty. Attendings' scores did not improve; however, residents' teaching and overall clerkship scores improved during the study period and paralleled students' increased selection of a surgical career. Students perceived residents as teachers more than attendings. Residents may have significant influence over students' career choice by their teaching and mentoring activities, which benefit attending efforts.

  9. Development of Task-Based Learning Outcomes according to Clinical Presentations for Clinical Clerkships.

    Science.gov (United States)

    Roh, HyeRin; Rhee, Byoung Doo; Lee, Jong Tae; Bae, Sang Kyun

    2012-03-01

    The aim of the study was to introduce our experience of establish task-based learning outcomes for core clinical clerkships. We first define our educational goal and objectives of the clinical clerkship curriculum according to knowledge, cognitive function and skill, and attitude. We selected clinical presentations and related diseases with expert panels and allocated them to core clinical departments. We classified doctor's tasks into 6 categories: history taking, physical examination, diagnostic plan, therapeutic plan, acute and emergent management, and prevention and patient education. We described learning outcomes by task using behavioral terms. We established goals and objectives for students to achieve clinical competency on a primary care level. We selected 75 clinical presentations and described 377 learning outcomes. Our process can benefit medical schools that offer outcome-based medical education, especially for clinical clerkships. To drive effective clerkships, a supportive system including assessment and faculty development should be implemented.

  10. Psychiatry and Emergency Medicine: Medical Student and Physician Attitudes toward Homeless Persons

    Science.gov (United States)

    Morrison, Ann; Roman, Brenda; Borges, Nicole

    2012-01-01

    Objective: The purpose of the study was to explore changes in medical students' attitudes toward homeless persons during the Psychiatry and Emergency Medicine clerkships. Simultaneously, this study explored attitudes toward homeless persons held by Psychiatry and Emergency Medicine residents and faculty in an attempt to uncover the "hidden…

  11. Psychiatry and Emergency Medicine: Medical Student and Physician Attitudes toward Homeless Persons

    Science.gov (United States)

    Morrison, Ann; Roman, Brenda; Borges, Nicole

    2012-01-01

    Objective: The purpose of the study was to explore changes in medical students' attitudes toward homeless persons during the Psychiatry and Emergency Medicine clerkships. Simultaneously, this study explored attitudes toward homeless persons held by Psychiatry and Emergency Medicine residents and faculty in an attempt to uncover the "hidden…

  12. The Senior Mentor Program at Duke University School of Medicine

    Science.gov (United States)

    Heflin, Mitchell T.

    2006-01-01

    The Duke University School of Medicine has a unique curriculum in which students complete basic sciences in year 1 and clinical clerkships in year 2, making way for an entire year of independent study in year 3. Into this compact curriculum, education in geriatrics has been successfully introduced through focused exercises and activities…

  13. Writing tasks performed by doctor of pharmacy students during clerkship rotations.

    Science.gov (United States)

    Hobson, Eric H; Waite, Nancy M; Briceland, Laurie L

    2002-01-01

    The range of writing tasks undertaken by students during doctor of pharmacy clerkship rotations was studied. Data collection involved a review between August and November 1998 of writing samples selected by postbaccalaureate Pharm. D. students at Albany College of Pharmacy for inclusion in their required writing portfolios. The first 200 samples (accounted for by 35 students each submitting two documents for each of three clerkship rotations) were reviewed. Of these, 198 were coded to identify the four rhetorical components of clerkship location, document type, intended audience, and rhetorical purpose. Institutional sites served as the clerkship location for 164 (82.8%) of the 198 documents analyzed. The documents were placed in 28 categories; 5 of these accounted for 126 (63.6%) of the documents: 45 inservice presentations, 32 summaries, 18 patient case write-ups, 16 formulary reviews, and 15 newsletters. Students wrote most frequently to health care providers (34.8%), other pharmacists (32.3%), and teachers (16.7%), with the most frequent rhetorical purposes being informing (73.2%) and demonstrating (14.6%). Analysis of writing samples prepared by pharmacy students during clerkship rotations revealed a variety of clerkship sites, document types, audiences, and rhetorical purposes.

  14. Types of problem students encountered by clinical teachers on clerkships.

    Science.gov (United States)

    Hunt, D D; Carline, J; Tonesk, X; Yergan, J; Siever, M; Loebel, J P

    1989-01-01

    The teachers who play the all-important role of enabling students to learn on clinical clerkships must balance the two essential skills of being a good role model and maintaining objectivity in order to identify students with a variety of problems. This study describes the findings of a survey that identifies both the type of the problems that most bother teachers and the relative frequency of those problems. Non-cognitive problems (poor interpersonal skills and non-assertive, shy students) were identified by teachers as being seen at the same relative frequency but posing greater difficulty than cognitive problems (poor integration skills, disorganization, poor fund of knowledge, etc.). A variety of the types of interventions to these problems are discussed.

  15. Experience with using second life for medical education in a family and community medicine education unit

    Directory of Open Access Journals (Sweden)

    Melús-Palazón Elena

    2012-05-01

    Full Text Available Abstract Background The application of new technologies to the education of health professionals is both a challenge and a necessity. Virtual worlds are increasingly being explored as a support for education. Aim: The aim of this work is to study the suitability of Second Life (SL as an educational tool for primary healthcare professionals. Methods Design: Qualitative study of accredited clinical sessions in SL included in a continuing professional development (CPD programme for primary healthcare professionals. Location: Zaragoza I Zone Family and Community Medicine Education Unit (EU and 9 health centres operated by the Aragonese Health Service, Aragon, Spain. Method: The EU held two training workshops in SL for 16 healthcare professionals from 9 health centres by means of two workshops, and requested them to facilitate clinical sessions in SL. Attendance was open to all personnel from the EU and the 9 health centres. After a trail period of clinical sessions held at 5 health centres between May and November 2010, the CPD-accredited clinical sessions were held at 9 health centres between February and April 2011. Participants: 76 healthcare professionals attended the CPD-accredited clinical sessions in SL. Main measurements: Questionnaire on completion of the clinical sessions. Results Response rate: 42-100%. Questionnaire completed by each health centre on completion of the CPD-accredited clinical sessions: Access to SL: 2 centres were unable to gain access. Sound problems: 0% (0/9. Image problems: 0% (0/9. Voice/text chat: used in 100% (10/9; 0 incidents. Questionnaire completed by participants in the CPD-accredited clinical sessions: Preference for SL as a tool: 100% (76/76. Strengths of this method: 74% (56/76 considered it eliminated the need to travel; 68% (52/76 believed it made more effective use of educational resources; and 47% (36/76 considered it improved accessibility. Weaknesses: 91% (69/76 experienced technical problems, while; 9

  16. Global Cardiovascular Risk Assessment by Family Physicians in Suez Canal University-Family Medicine Centers-Egypt.

    Science.gov (United States)

    Nour-Eldein, Hebatallah; Abdelsalam, Shimaa A; Nasr, Gamila M; Abdelwahed, Hassan A

    2013-01-01

    The close sustained contact of family physician with their patients and local community makes preventive care an integral part of their routine work. Most cardiovascular diseases (CVD) can be prevented by addressing their risk factors. There are several guidelines that recommend different CV risk assessment tools to support CV prevention strategies. This study aimed to assess awareness and attitude of global CV risk assessment and use of their tools by family physicians; aiming to improve CV prevention service. The current study is a cross-sectional descriptive analytic. Sixty-five family physicians were asked to respond to, validated anonymous questionnaire to collect data about characteristics of family physicians, their awareness, attitude, current use, barriers, and recommendations of global CV risk assessment. Statistical Package for Social Sciences (SPSS) version 18 was used for data entry and analysis. Awareness of guidelines of global CV risk assessment was relatively higher regarding the American guidelines (30.8%) than that recommended by World Health Organization (WHO) for Egypt (20.2%). 50.8% of participants had favorable attitude. There was statistical significant relationship between attitude scores and physician characteristics; age (P = 0.003), qualification (P = 0.001) and number of patients seen per week (P = 0.009). Routine use of global CV risk assessment tools was reported only (23%) by family physicians. Relative higher attitude scores than use of global CV risk assessment tools in practice. The most frequent barriers were related to lack of resources and shortage in training/skills and the raised suggestions were towards training.

  17. Starting a family during medical studies? Results of a pilot study on family friendliness in the study of medicine at the University of Ulm.

    Science.gov (United States)

    Liebhardt, Hubert; Stolz, Katrin; Mörtl, Kathrin; Prospero, Katrin; Niehues, Johanna; Fegert, Jörg

    2011-01-01

    The Ulm pilot study aimed to explore factors for a successful combination of medical education and starting a family. The empirical data derived from this study constitutes the foundation for an evidence-based reform of the medical curriculum in Ulm. In 2009, qualitative interviews with 37 of the 79 medical students with children at University of Ulm were conducted and analyzed using content analysis. The detected problem areas were used to develop a quantitative questionnaire for studying parents and academic teaching members in medical education in Ulm. The parents were older, more often married and more likely to already have obtained a first training. One third of the students thought there was no ideal time to start a family during the years of medical education or specialist training. However, the majority of the students (61%) were convinced that parenthood is more compatible with medical studies than with specialist training. The interview data suggests that the end of medical school (4(th) to 6(th) year of studies), preferably during semester break, is especially suitable for child birth since it allows students to continue their studies without 'losing time'. The biography and career of studying parents in medicine have specific characteristics. Universities and teaching hospitals are required to no longer leave the compatibility of family and study responsibilities to the students themselves. Rather, flexible structures need to be implemented that enable students to start a family while continuing their education. This means providing more childcare and greater support regarding academic counselling and career development.

  18. Evaluation of the Learning Environment for Diploma in Family Medicine with the Dundee Ready Education Environment (DREEM) Inventory.

    Science.gov (United States)

    Khan, A Sattar; Akturk, Zekeriya; Al-Megbil, Tarek

    2010-11-29

    The primary healthcare system is at a turning point in Saudi Arabia. However, the sustainability of family medicine as the core element of that system is increasingly being called into question because of lack of family physicians. In keeping view this problem; a postgraduate diploma program in family medicine has started in 2008. A validated measure of educational environment i.e., Dundee Ready Education Environment (DREEM) questionnaire consisting of 50 questions having five domains of perception was administered to all 13 trainees of the diploma course at the completion of the program to check their perception about learning evironment. The trainees comprised of 4 males (40%) and 6 females (60%). The overall score showed more positive than negative side (147/200). There is no significant difference (P > 0.05) in the mean scores of five different domains of perception. The subclasses of five domains showed that teaching perceived as positive by 50%, moving towards right direction by 80%, feeling more positive by 50%, positive attitude by 80% and the 70% scored the course as not too bad. The overall high score and positive attitude towards the course assures the better teaching environment. However, there are areas to improve and it requires continuous evaluation.

  19. Eight years of building community partnerships and trust: the UCLA family medicine community-based participatory research experience.

    Science.gov (United States)

    Moreno, Gerardo; Rodríguez, Michael A; Lopez, Glenn A; Bholat, Michelle A; Dowling, Patrick T

    2009-10-01

    Acknowledging the growing disparities in health and health care that exist among immigrant families and minority populations in large urban communities, the UCLA Department of Family Medicine (DFM) sought a leadership role in the development of family medicine training and community-based participatory research (CBPR). Performing CBPR requires that academic medicine departments build sustainable and long-term community partnerships. The authors describe the eight-year (2000-2008) process of building sustainable community partnerships and trust between the UCLA DFM and the Sun Valley community, located in Los Angeles County.The authors used case studies of three research areas of concentration (asthma, diabetes prevention, and establishing access to primary care) to describe how they established community trust and sustained long-term community research partnerships. In preparing each case study, they used an iterative process to review qualitative data.Many lessons were common across their research concentration areas. They included the importance of (1) having clear and concrete community benefits, (2) supporting an academic-community champion, (3) political advocacy, (4) partnering with diverse organizations, (5) long-term academic commitment, and (6) medical student involvement. The authors found that establishing a long-term relationship and trust was a prerequisite to successfully initiate CBPR activities that included an asthma school-based screening program, community walking groups, and one of the largest school-based primary care clinics in the United States.Their eight-year experience in the Sun Valley community underscores how academic-community research partnerships can result in benefits of high value to communities and academic departments.

  20. Terror Medicine As Part of the Medical School Curriculum

    Directory of Open Access Journals (Sweden)

    Leonard A Cole

    2014-09-01

    Full Text Available Terror medicine, a field related to emergency and disaster medicine, focuses on medical issues ranging from preparedness to psychological manifestations specifically associated with terrorist attacks. Calls to teach aspects of the subject in American medical schools surged after the 2001 jetliner and anthrax attacks. Although the threat of terrorism persists, terror medicine is still addressed erratically if at all in most medical schools. This paper suggests a template for incorporating the subject throughout a 4-year medical curriculum. The instructional framework culminates in a short course for fourth year students, such as one recently introduced at Rutgers New Jersey Medical School, Newark, NJ. The proposed 4-year Rutgers curriculum serves as a model that could assist other medical schools contemplating the inclusion of terror medicine in pre-clerkship and clerkship training.

  1. Terror medicine as part of the medical school curriculum.

    Science.gov (United States)

    Cole, Leonard A; Wagner, Katherine; Scott, Sandra; Connell, Nancy D; Cooper, Arthur; Kennedy, Cheryl Ann; Natal, Brenda; Lamba, Sangeeta

    2014-01-01

    Terror medicine, a field related to emergency and disaster medicine, focuses on medical issues ranging from preparedness to psychological manifestations specifically associated with terrorist attacks. Calls to teach aspects of the subject in American medical schools surged after the 2001 jetliner and anthrax attacks. Although the threat of terrorism persists, terror medicine is still addressed erratically if at all in most medical schools. This paper suggests a template for incorporating the subject throughout a 4-year medical curriculum. The instructional framework culminates in a short course for fourth year students, such as one recently introduced at Rutgers New Jersey Medical School, Newark, NJ, USA. The proposed 4-year Rutgers curriculum serves as a model that could assist other medical schools contemplating the inclusion of terror medicine in pre-clerkship and clerkship training.

  2. Accelerating Momentum Toward Improved Health for Patients and Populations: Family Medicine as a Disruptive Innovation-A Perspective from the Keystone IV Conference.

    Science.gov (United States)

    Stream, Glen; DeVoe, Jennifer E; Hughes, Lauren S; Phillips, Robert L

    2016-01-01

    This paper was prepared in follow up to the G. Gayle Stephens Keystone IV Conference by authors who attended the conference and are also members of the Family Medicine for America's Health board of directors (FMAHealth.org). It connects the aspirations of the current strategic and communications efforts of FMAHealth with the ideas developed at the conference. The FMAHealth project is sponsored by 8 national family medicine organizations and seeks to build on the work of the original Future of Family Medicine project. Among its objectives are a robust family physician workforce practicing in a continually improving medical home model, supported by a comprehensive payment model sufficient to sustain the medical home and enable the personal physician relationship with patients.

  3. Approaching confidentiality at a familial level in genomic medicine: a focus group study with healthcare professionals

    Science.gov (United States)

    Dheensa, Sandi; Fenwick, Angela; Lucassen, Anneke

    2017-01-01

    Objectives Clinical genetics guidelines from 2011 conceptualise genetic information as confidential to families, not individuals. The normative consequence of this is that the family's interest is the primary consideration and genetic information is shared unless there are good reasons not to do so. We investigated healthcare professionals' (HCPs') views about, and reasoning around, individual and familial approaches to confidentiality and how such views influenced their practice. Method 16 focus groups with 80 HCPs working in/with clinical genetics services were analysed, drawing on grounded theory. Results Participants raised seven problems with, and arguments against, going beyond the individual approach to confidentiality. These problems fell into two overlapping categories: ‘relationships’ and ‘structures’. Most participants had never considered ways to—or thought it was impossible to—treat familial genetic information and personal information differently. They worried that putting the familial approach into practice could disrupt family dynamics and erode patient trust in the health service. They also thought they had insufficient resources to share information and feared that sharing might change the standard of care and make them more vulnerable to liability. Conclusions A familial approach to confidentiality has not been accepted or adopted as a standard, but wider research suggests that some of the problems HCPs perceived are surmountable and sharing in the interest of the family can be achieved. However, further research is needed to explore how personal and familial genetic information can be separated in practice. Our findings are relevant to HCPs across health services who are starting to use genome tests as part of their routine investigations. PMID:28159847

  4. Training Family Medicine Residents in Effective Communication Skills While Utilizing Promotoras as Standardized Patients in OSCEs: A Health Literacy Curriculum.

    Science.gov (United States)

    Pagels, Patti; Kindratt, Tiffany; Arnold, Danielle; Brandt, Jeffrey; Woodfin, Grant; Gimpel, Nora

    2015-01-01

    Introduction. Future health care providers need to be trained in the knowledge and skills to effectively communicate with their patients with limited health literacy. The purpose of this study is to develop and evaluate a curriculum designed to increase residents' health literacy knowledge, improve communication skills, and work with an interpreter. Materials and Methods. Family Medicine residents (N = 25) participated in a health literacy training which included didactic lectures and an objective structured clinical examination (OSCE). Community promotoras acted as standardized patients and evaluated the residents' ability to measure their patients' health literacy, communicate effectively using the teach-back and Ask Me 3 methods, and appropriately use an interpreter. Pre- and postknowledge, attitudes, and postdidactic feedback were obtained. We compared OSCE scores from the group that received training (didactic group) and previous graduates. Residents reported the skills they used in practice three months later. Results. Family Medicine residents showed an increase in health literacy knowledge (p = 0.001) and scored in the adequately to expertly performed range in the OSCE. Residents reported using the teach-back method (77.8%) and a translator more effectively (77.8%) three months later. Conclusions. Our innovative health literacy OSCE can be replicated for medical learners at all levels of training.

  5. Protective Effects of Some Medicinal Plants from Lamiaceae Family Against Beta-Amyloid Induced Toxicity in PC12 Cell

    Directory of Open Access Journals (Sweden)

    S Saeidnia

    2012-10-01

    Full Text Available Background: Excessive accumulation of beta-amyliod peptide (Aβ, the major component of senile plaques in Alzheimer's disease (AD, causes neuronal cell death through induction of oxidative stress. Therefore, antioxidants may be of use in the treatment of AD. The medicinal plants from the Lamiaceae family have been widely used in Iranian traditional medicine. These plants contain compounds with antioxidant activity and some species in this family have been reported to have neuroprotective properties. In the present study, methanolic extract of seven plants from salvia and satureja species were evaluated for their protective effects against beta-amyloid induced neurotoxicity.Methods: Aerial parts of the plants were extracted with ethyl acetate and methanol, respectively, by percolation at room temperature and subsequently, methanolic extracts of the plants were prepared. PC12 cells were incubated with different concentrations of the extracts in culture medium 1h prior to incubation with Aβ. Cell toxicity was assessed 24h after addition of Aβ by MTT assay.Results: Satureja bachtiarica, Salvia officinalis and Salvia macrosiphon methanolic extracts exhibited high protective effects against Aβ induced toxicity (P<0.001. Protective effects of Satureja bachtiarica and Salvia officinalis were dose-dependent.Conclusion: The main constituents of these extracts are polyphenolic and flavonoid compounds such as rosmarinic acid, naringenin, apigenin and luteolin which have antioxidant properties and may have a role in neuroprotection. Based on neuroprotective effect of these plants against Aβ induced toxicity, we recommend greater attention to their use in the treatment of Alzheimer disease.

  6. The standard of knowledge for cesarean section in women who applied to family medicine: Two centered cross-sectional study

    Directory of Open Access Journals (Sweden)

    Metin Canbal

    2014-06-01

    Full Text Available Purpose: We aimed to examine, mothers' level of knowledge about complications of cesarean section and the factors that influence preference for cesarean section in this study Methods: The universe of the study consisted of the women who admitted to the family medicine outdoor clinics in two different regions of Turkey namely Doğansehir State Hospital, Malatya and Kadışehri Entegrated State Hospital, Yozgat. Two hundred and one women included in the study who recruited the family medicine outdoor clinic irrespective of their primary complaint. The data was analyzed by the SPSS program. Results: Statistically significant difference was observed in terms of caesarean section operation rates in high school graduates. 29% of all the participants in this study had caesarean section operation in their first delivery. Conclusion: Personal predilections appear to be an influencing factor in deciding the type of the delivery currently. It is assumed that knowledge may be converted into the behaviors by giving the evidence based information to our patients in consistence with their perceptions along with the shared decision model in a collaborative manner.

  7. Training Family Medicine Residents in Effective Communication Skills While Utilizing Promotoras as Standardized Patients in OSCEs: A Health Literacy Curriculum

    Directory of Open Access Journals (Sweden)

    Patti Pagels

    2015-01-01

    Full Text Available Introduction. Future health care providers need to be trained in the knowledge and skills to effectively communicate with their patients with limited health literacy. The purpose of this study is to develop and evaluate a curriculum designed to increase residents’ health literacy knowledge, improve communication skills, and work with an interpreter. Materials and Methods. Family Medicine residents N=25 participated in a health literacy training which included didactic lectures and an objective structured clinical examination (OSCE. Community promotoras acted as standardized patients and evaluated the residents’ ability to measure their patients’ health literacy, communicate effectively using the teach-back and Ask Me 3 methods, and appropriately use an interpreter. Pre- and postknowledge, attitudes, and postdidactic feedback were obtained. We compared OSCE scores from the group that received training (didactic group and previous graduates. Residents reported the skills they used in practice three months later. Results. Family Medicine residents showed an increase in health literacy knowledge p=0.001 and scored in the adequately to expertly performed range in the OSCE. Residents reported using the teach-back method (77.8% and a translator more effectively (77.8% three months later. Conclusions. Our innovative health literacy OSCE can be replicated for medical learners at all levels of training.

  8. Is clinical competence perceived differently for student daily performance on the wards versus clerkship grading?

    Science.gov (United States)

    Wimmers, Paul F; Kanter, Steven L; Splinter, Ted A W; Schmidt, Henk G

    2008-12-01

    Clinical rotations play an important role in the medical curriculum and are considered crucial for student learning. However, competencies that should be learned can differ from those that are assessed. In order to explore which competencies are considered important for daily performance of student on the wards and to what extent clinical teachers consider the same competencies important for clerkship grading, a survey that consisted of 21 different student characteristics was administered to clinical teachers. Two independent factor analyses using structural equation modeling were conducted to abstract underlying latent relationships among the different student characteristics and to define a clinical competence profile for daily performance of students on the wards and clerkship grading. Differences between the degree of importance for student daily ward performance and clerkship grading are considered and discussed. The results of the survey indicate that the degree of importance of competencies are rated different for daily performance of students on the wards and clerkship grades. Competencies related to the diagnostic process are more important for clerkship grading, whereas interpersonal skills, professional qualities, and motivation are more important for daily ward performance. It is concluded that the components of clinical competence considered important for adequate performance are not necessarily in alignment with what is required for grading. Future research should focus on an explanation why clinical educators think differently about the importance of competencies for student examination in contrast to what is required for adequate daily performance on the wards.

  9. A Foundation for Vital Academic and Social Support in Clerkships: Learning Through Peer Continuity.

    Science.gov (United States)

    Chou, Calvin L; Teherani, Arianne

    2017-07-01

    Most medical students on clerkships currently experience lack of continuity of patient care, disjointed learning, and frequent changes in supervisors. Clerkship programs with continuity of care, curriculum, and supervisors appear to benefit student learning and patient-centeredness. A fourth form of continuity is proposed: continuity of peers, in which a stable cohort of students frequently meets to process their experiences on clerkships. This structure builds on benefits previously seen in peer-assisted learning, including enhanced knowledge, technical skills, and collegial peer relationships. Additional advantages of peer continuity in clerkships include facilitated integration into the workplace, social support, and enhanced clinical and professional learning. Practical components required for a successful peer continuity structure include intentional formation of peer cohorts; regular meetings that cover didactic or clinical skills learning; frequent opportunities for reflection on patient care, professional development, and well-being; and skilled facilitators without evaluative roles. Theoretical support for peer continuity comes from social cognitive theory, communities of clinical practice, and social comparison theory. Therefore, in conjunction with empirical programs that have shown benefits of developing these structures, peer continuity should become a formalized educational structure in clerkships.

  10. Interpreting values conflicts experienced by obstetrics-gynecology clerkship students using reflective writing.

    Science.gov (United States)

    Cohn, Felicia G; Shapiro, Johanna; Lie, Désirée A; Boker, John; Stephens, Frances; Leung, Lee Ann

    2009-05-01

    To examine students' responses to reflective practice assignments used in medical ethics and professionalism education. The study goals include an examination of what reflective writing reveals about students' personal and professional values, identification of the narrative typologies students use to tell stories of ethical dilemmas, and a determination of the usefulness of reflective writing in informing ethics/professionalism curricula assessment and development. This study employed a mixed-methods design generating both descriptive data and interpretive analysis. Students' reflective writing assignments, guided by a series of six questions designed to elicit students' perceptions of moral conflicts they have encountered and their personal and professional ethical values, were collected from three successive cohorts of third-year medical students (n = 299) from July 2002 to January 2006 during an obstetrics-gynecology clerkship at the University of California, Irvine, School of Medicine. Content, thematic, and global narrative analyses of students' reflective writing were conducted, drawing on content analysis, grounded theory, and narrative methodologies. Values conflicts usually were patient centered (181; 60.5%) and student centered (172; 57.5%), without much regard for important contextual issues such as patients' socioeconomic status, insurance coverage, or culture. Common personal values included religious beliefs (82; 27.4%), respect (72; 24.1%), and the Golden Rule (66; 22.1%); frequent professional values were respect (72; 25.1%), beneficence (71; 23.7%), nonmaleficence (69; 23.1%), and autonomy (65; 21.7%). Whereas 35.5% (106) claimed to have addressed conflicts, 23.4% (70) said they did nothing. Restitution narratives (113; 37.8%) dominated. This analytic approach facilitated assessment of student values, conflict sources, and narrative types. Findings reveal aspects of the influence of the hidden curriculum and can inform strategies for effective

  11. Self-reported colorectal cancer screening of Medicare beneficiaries in family medicine vs. internal medicine practices in the United States: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Higgins Angela Y

    2012-03-01

    Full Text Available Abstract Background The benefit of screening for decreasing the risk of death from colorectal cancer (CRC has been shown, yet many patients in primary care are still not undergoing screening according to guidelines. There are known variations in delivery of preventive health care services among primary care physicians. This study compared self-reported CRC screening rates and patient awareness of the need for CRC screening of patients receiving care from family medicine (FPs vs. internal medicine (internists physicians. Methods Nationally representative sample of non-institutionalized beneficiaries who received medical care from FPs or internists in 2006 (using Medicare Current Beneficiary Survey. The main outcome was the percentage of patients screened in 2007. We also examined the percentage of patients offered screening. Results Patients of FPs, compared to those of internists, were less likely to have received an FOBT kit or undergone home FOBT, even after accounting for patients' characteristics. Compared to internists, FPs' patients were more likely to have heard of colonoscopy, but were less likely to receive a screening colonoscopy recommendation (18% vs. 27%, or undergo a colonoscopy (43% vs. 46%, adjusted odds ratios [AOR], 95% confidence interval [CI]-- 0.65, 0.51-0.81 or any CRC screening (52% vs. 60%, AOR, CI--0.80, 0.68-0.94. Among subgroups examined, higher income beneficiaries receiving care from internists had the highest screening rate (68%, while disabled beneficiaries receiving care from FPs had the lowest screening rate (34%. Conclusion Patients cared for by FPs had a lower rate of screening compared to those cared for by internists, despite equal or higher levels of awareness; a difference that remained statistically significant after accounting for socioeconomic status and access to healthcare. Both groups of patients remained below the national goal of 70 percent.

  12. The perceived value of clinical pharmacy service provision by pharmacists and physicians: an initial assessment of family medicine and internal medicine providers.

    Science.gov (United States)

    Wietholter, Jon P; Ponte, Charles D; Long, Dustin M

    2016-10-24

    Few publications have addressed the perceptions of pharmacists and physicians regarding the value of clinical pharmacist services. A survey-based study was conducted to determine whether Internal Medicine (IM) and Family Medicine (FM) pharmacists and physicians differed in their attitudes regarding the benefits of collaboration in an acute care setting. The primary objective was to evaluate perceived differences regarding self-assessment of value between IM and FM pharmacists. The secondary objective was to evaluate perceived differences of clinical pharmacist benefit between IM and FM physicians. An eight-item questionnaire assessed the attitudes and beliefs of pharmacists and physicians regarding the value of clinical pharmacy services. Surveys were emailed and participants marked their responses using a 7-point Likert scale for each item. Demographic data and overall comments were collected from each participant. Overall, 167 surveys were completed. When comparing cumulative physician and pharmacist responses, none of the eight questions showed significant differences. Statistically significant differences were noted when comparing IM and FM clinical pharmacists on five of the eight survey items; for each of these items, FM pharmacists had more favourable perceptions than their IM counterparts. No statistically significant differences were noted when comparing responses of IM and FM physicians. This study found that FM pharmacists perceived a greater benefit regarding participation in inpatient acute care rounds when compared to their IM pharmacist counterparts. Future studies are necessary to determine if other medical specialties' perceptions of clinical pharmacy provision differ from our findings and to evaluate the rationale behind specific attitudes and behaviours. © 2016 Royal Pharmaceutical Society.

  13. Time to trust: longitudinal integrated clerkships and entrustable professional activities.

    Science.gov (United States)

    Hirsh, David A; Holmboe, Eric S; ten Cate, Olle

    2014-02-01

    Medical education shaped by the learning sciences can better serve medical students, residents, faculty, health care institutions, and patients. With increasing innovation in undergraduate and graduate medical education and more focused attention on educational principles and how people learn, this era of educational transformation offers promise. Principles manifest in "educational continuity" are informing changes in educational structures and venues and are enriching new discourse in educational pedagogy, assessment, and scholarship. The articles by Myhre and colleagues and Woloschuk and colleagues in this issue, along with mounting evidence preceding these works, should reassure that principle-driven innovation in medical education is not only possible but can be achieved safely. In this commentary, the authors draw from these works and the wider literature on longitudinal integrated educational design. They suggest that the confluences of movements for longitudinal integrated clerkships and entrustable professional activities open new possibilities for other educational and practice advancements in quality and safety. With the advent of competency-based education, explicit milestones, and improved assessment regimens, overseers will increasingly evaluate students, trainees, and other learners on their ability rather than relying solely on time spent in an activity. The authors suggest that, for such oversight to have the most value, assessors and learners need adequate oversight time, and redesign of educational models will serve this operational imperative. As education leaders are reassessing old medical school and training models, rotational blocks, and other barriers to progress, the authors explore the dynamic interplay between longitudinal integrated learning models and entrustment.

  14. Twelve tips for designing and running longitudinal integrated clerkships.

    Science.gov (United States)

    Ellaway, Rachel; Graves, Lisa; Berry, Sue; Myhre, Doug; Cummings, Beth-Ann; Konkin, Jill

    2013-12-01

    Longitudinal integrated clerkships (LICs) involve learners spending an extended time in a clinical setting (or a variety of interlinked clinical settings) where their clinical learning opportunities are interwoven through continuities of patient contact and care, continuities of assessment and supervision, and continuities of clinical and cultural learning. Our twelve tips are grounded in the lived experiences of designing, implementing, maintaining, and evaluating LICs, and in the extant literature on LICs. We consider: general issues (anticipated benefits and challenges associated with starting and running an LIC); logistical issues (how long each longitudinal experience should last, where it will take place, the number of learners who can be accommodated); and integration issues (how the LIC interfaces with the rest of the program, and the need for evaluation that aligns with the dynamics of the LIC model). Although this paper is primarily aimed at those who are considering setting up an LIC in their own institutions or who are already running an LIC we also offer our recommendations as a reflection on the broader dynamics of medical education and on the priorities and issues we all face in designing and running educational programs.

  15. Twenty-five years of the international Bled course for teachers of family medicine in Europe: Glancing back and looking forward.

    Science.gov (United States)

    Klemenc-Ketis, Zalika; Svab, Igor; Petek-Ster, Marija; Bulc, Mateja; Buchanan, Josephine; Finnegan, Henry; Correia de Sousa, Jaime; Yaphe, John

    2016-12-01

    The international Bled course for teacher training has played a central role in faculty development in family medicine for the past 25 years. The course was originally designed to promote faculty development for family medicine teachers in the new academic discipline of family medicine in Slovenia in 1990 and to introduce new topics into the family medicine curriculum. In this background paper, we perform a SCOT analysis (strengths, challenges, opportunities, and threats) of the current course, evaluating participant feedback and reviewing past topics and their impact on local and international teaching programmes. We also review the place of the course in the context of other teacher-training programmes in family medicine in Europe. We found that the structure and learning aims of the Bled course have remained stable over 25 years. It provides a safe, well-structured learning environment for the participants even though the course topic is different every year. The course has had a significant impact on curriculum development and teacher training in Slovenia as well as in many other countries in Europe and beyond. Because of the positive impact of the course and the high degree of satisfaction of the participants and course directors, it seems worthwhile to continue this endeavour. New directions for the course will depend on the learning needs of the participants and the evolving medical curricula in the countries they represent.

  16. Impact of the psychiatry clerkship on medical student attitudes towards psychiatry and to psychiatry as a career.

    Science.gov (United States)

    Lyons, Zaza

    2014-02-01

    The psychiatry clerkship forms part of the core curriculum of medical schools worldwide and provides psychiatric educators with an ideal opportunity to positively influence students. The aim of this paper is to systematically review literature on the impact of the psychiatry clerkship to determine the effect on attitudes towards psychiatry and to psychiatry as a career. A systematic review was undertaken. The following key search words were used to search a number of electronic databases: medical student/s, attitude/s, psychiatry and clerkship. Studies published in the English language from 1990 to the present were included. Studies were included if they were based on a pre-/post-design, i.e. the same students must have participated in the study both before and after the clerkship. Twenty-six studies from 19 countries were identified for the review. Sixteen studies reported an overall improvement in attitudes towards psychiatry post-clerkship, and ten found no change in attitudes. In terms of career choice, nine studies reported an increase in the number of students interested in psychiatry as a career post-clerkship, nine found no impact on career choice and, in eight studies, it was not assessed. A number of positive and negative factors regarding the clerkship were identified. Overall, the psychiatry clerkship has a positive impact on students' attitudes towards psychiatry, but does not improve interest in psychiatry as a career option. For those students particularly interested in psychiatry, the challenge is to maintain their enthusiasm post-clerkship. Charismatic teachers, mentorship and stigma reduction may be effective strategies. Future research needs to more clearly identify specific components of the clerkship that are viewed favorably by students.

  17. Predicting success of pharmacy students in basic science and clinical clerkship courses.

    Science.gov (United States)

    Kimberlin, C L; Hadsall, R S; Gourley, D R; Benedict, L K

    1983-04-01

    A number of studies on the ability of admissions variables to predict success in pharmacy schools have examined only success in the first professional year, which typically consists primarily of basic science courses. This study examined not only grades in basic science courses but also performance on clinical clerkships, for two classes of students. It also examined the ability of various personality variables to predict performance in clinical and basic science coursework. Previous grade point average (GPA) was the best single predictor of performance. In one class, the personality variable of Responsibility best predicted clinical clerkship performance. However, it only accounted for 13 percent of the variance in clerkship grades. Pharmacy College Admission Test (PCAT) Biology and PCAT Verbal Ability scores added to the predictive ability of previous GPA in one class, but none of the PCAT scales entered a prediction equation for the other class. The limitations on our ability to predict, with any consistency, academic performance in pharmacy school is discussed.

  18. [Development of a portfolio for competency-based assessment in a clinical clerkship curriculum].

    Science.gov (United States)

    Roh, HyeRin; Lee, Jong-Tae; Yoon, Yoo Sang; Rhee, Byoung Doo

    2015-12-01

    The purpose of this report was to describe our experience in planning and developing a portfolio for a clinical clerkship curriculum. We have developed a portfolio for assessing student competency since 2007. During an annual workshop on clinical clerkship curricula, clerkship directors from five Paik hospitals of Inje University met to improve the assessment of the portfolio. We generated templates for students to record their activities and reflection and receive feedback. We uploaded these templates to our school's website for students to download freely. Annually, we have held a faculty development seminar and a workshop for portfolio assessment and feedback. Also, we established an orientation program on how to construct a learning portfolio for students. Future actions include creating a ubiquitous portfolio system, extending the portfolio to the entire curriculum, setting up an advisor system, and managing the quality of the portfolio. This study could be helpful for medical schools that plan to improve their portfolio assessment with an outcome-based approach.

  19. Medical student intrauterine device knowledge and attitudes: an assessment of clerkship training.

    Science.gov (United States)

    Bartz, Deborah; Tang, Jennifer; Maurer, Rie; Janiak, Elizabeth

    2013-08-01

    Studies demonstrate that many clinician populations have poor knowledge of and harbor negative attitudes towards intrauterine devices (IUDs). We set out to assess the impact of the clinical clerkship in obstetrics and gynecology on medical student IUD knowledge and attitudes. In this prospective cohort study, students at seven diverse US medical schools were surveyed at the start and completion of their obstetrics and gynecology clinical clerkships regarding IUD exposure, knowledge and attitudes. Subject responses were compared pre- and postclerkship. One hundred six students returned completed paired surveys (response rate 82%). The preclerkship mean knowledge percent correct (54%, SD 17%) increased significantly at postclerkship assessment (72%, SD 18%) (p<.0001). The mean attitudes score also increased significantly from pre- (34%, SD 31%) to postclerkship (59%, SD 26%) (p<.0001). US medical student IUD knowledge and attitudes are significantly improved through the obstetrics and gynecology clerkship. However, significant gaps in knowledge persist postclerkship. Copyright © 2013 Elsevier Inc. All rights reserved.

  20. The importance of longitudinal studies in family medicine: experiences of two practice-based research networks.

    NARCIS (Netherlands)

    Weel, C. van; Weel-Baumgarten, E.M. van; Mold, J.

    2006-01-01

    BACKGROUND: For evidence-based decision making in family practice, it is essential to know the long-term (natural) course of common diseases and their outcomes under care and treatment. This article, based on a research methodology workshop, aims to raise awareness and interest in longitudinal resea

  1. Crew Resource Management Use in U.S. Air Force Flight and Family Medicine Clinics

    Science.gov (United States)

    2013-06-30

    The study was designed as a cross-sectional quantitative analysis. Inclusion criteria were active duty Air Force base-level flight surgeons and family...Remember the Titans [videorecording]. Burbank, CA: Walt Disney Home Video; 2001. 14 Distribution A: Approved for public release

  2. Chronic noncancer pain management in primary care: family medicine physicians' risk assessment of opioid misuse.

    Science.gov (United States)

    Kavukcu, Ethem; Akdeniz, Melahat; Avci, Hasan Huseyin; Altuğ, Mehmet; Öner, Mehmet

    2015-01-01

    The majority of patients with chronic noncancer pain (CNCP) are managed in the primary care settings. The primary care family physician (PCFP) generally has limited time, training, or access to resources to effectively evaluate and treat these patients, particularly when there is the added potential liability of prescribing opioids. The aim of this study is to make a favorable change in PCFPs' knowledge, attitudes, and practices about opioid use in CNCP via education on assessment of the risk of opioid misuse. The universe of this cross-sectional study comprised 36 family physicians working at Family Health Centers affiliated to Antalya Provincial Directorate of Health who volunteered to participate in the study. Initially, a survey on patients risk assessment was performed in both intervention and control groups; whereas the intervention group received education on assessment of the risk of opioid misuse, the control group did not. The survey was repeated after 6 months and the intervention group underwent a core examination. Data obtained were analyzed with Statistical Package for the Social Sciences 18.0 statistics program. Intervention and control groups were compared. Additionally, pre- and post-education results of the intervention group were also compared. About 61.1% of family physicians reported concern and hesitation in prescribing opioids due to known risks, such as overdose, addiction, dependence, or diversion, and agreed that family physicians should apply risk assessment before opioid use in CNCP. Only 16.6% of PCFP reported that risk assessment is not so necessary, whereas 22.2% of PCFP were undecided. Although 47.2% of the family physicians expressed a willingness to apply risk assessment before starting opioids, the rate of eagerness increased markedly to 77.7% after the education, but the rate of increase in practicing was not statistically significant. Knowledge and competency of the family physicians in managing CNCP were improved as was

  3. [Prevalence and factors associated with frequent attendence in family medicine clinic].

    Science.gov (United States)

    Parejo Maestre, N; Lendínez-de la Cruz, J M; Bermúdez-Torres, F M; Gónzalez-Contero, L; Gutierrez-Espinosa de Los Monteros, M P; Espejo-Almazán María, T

    2016-01-01

    The use of health services has seen a steep rise. The frequent users are responsible for significant economic, human and social impact. The objective is to analyze the characteristics of frequent attenders in our Health Center, in order to evaluate the possibility of taking corrective measures to improve the quality of care and efficiency in the use of resources. Descriptive observational study of a sample of 379 patients over 18 years old. The dependent variables were attendance (number of visits to their family doctor during the previous year), frequent attendance (10 or more visits to the family doctor in the last year), and persistent frequent attenders (10 or more visits to the family doctor in each of the last two years). Data were collected from medical records and by telephone interview. The mean attendance was 6.83 (95%CI: 6.13-7.53), frequent attendance reached 25.4% (95%CI: 21.4-29.6), and persistent frequent attenders, 1.6% (95%CI: 0.5-2.9). Frequent attendance was associated with sex, age, marital status, educational level, family structure, existence of chronic disease, use of anxiolytic and antidepressants, request for additional tests, and referrals to other specialists, proximity to the health center, and level of satisfaction with their family doctor. The low persistent frequent attenders found suggests that frequent attendance could be largely due to factors related to professional and organization. Studies are required to address the high level of consumption of psychotropic drugs, and improving professional skills in dealing with mental problems. Copyright © 2014 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  4. Acetylcholinesterase Inhibitory, Antioxidant and Phytochemical Properties of Selected Medicinal Plants of the Lamiaceae Family

    Directory of Open Access Journals (Sweden)

    Sanda Vladimir-Knežević

    2014-01-01

    Full Text Available The present study aimed to evaluate acetylcholinesterase (AChE inhibitory and antioxidant activities of Lamiaceae medicinal plants growing wild in Croatia. Using Ellman’s colorimetric assay all tested ethanolic extracts and their hydroxycinnamic acid constituents demonstrated in vitro AChE inhibitory properties in a dose dependent manner. The extracts of Mentha x piperita, M. longifolia, Salvia officinalis, Satureja montana, Teucrium arduini, T. chamaedrys, T. montanum, T. polium and Thymus vulgaris at 1 mg/mL showed strong inhibitory activity against AChE. The antioxidant potential of the investigated Lamiaceae species was assessed by DPPH• scavenging activity and total antioxidant capacity assays, in comparison with hydroxycinnamic acids and trolox. The extracts differed greatly in their total hydroxycinnamic derivatives content, determined spectrophotometrically. Rosmarinic acid was found to be the predominant constituent in most of the investigated medicinal plants (by RP-HPLC and had a substantial influence on their AChE inhibitory and antioxidant properties, with the exception of Teucrium species. These findings indicate that Lamiaceae species are a rich source of various natural AChE inhibitors and antioxidants that could be useful in the prevention and treatment of Alzheimer’s and other related diseases.

  5. Visiting medical student elective and clerkship programs: a survey of US and Puerto Rico allopathic medical schools

    Directory of Open Access Journals (Sweden)

    Beckman Thomas J

    2010-06-01

    Full Text Available Abstract Background No published reports of studies have provided aggregate data on visiting medical student (VMS programs at allopathic medical schools. Methods During 2006, a paper survey was mailed to all 129 allopathic medical schools in the United States and Puerto Rico using a list obtained from the Association of American Medical Colleges. Contents of the survey items were based on existing literature and expert opinion and addressed various topics related to VMS programs, including organizational aspects, program objectives, and practical issues. Responses to the survey items were yes-or-no, multiple-choice, fill-in-the-blank, and free-text responses. Data related to the survey responses were summarized using descriptive statistics. Results Representatives of 76 schools (59% responded to the survey. Of these, 73 (96% reported their schools had VMS programs. The most common reason for having a VMS program was "recruitment for residency programs" (90%. "Desire to do a residency at our institution" was ranked as the leading reason visiting medical students choose to do electives or clerkships. In descending order, the most popular rotations were in internal medicine, orthopedic surgery, emergency medicine, and pediatrics. All VMS programs allowed fourth-year medical students, and approximately half (58% allowed international medical students. The most common eligibility requirements were documentation of immunizations (92%, previous clinical experience (85%, and successful completion of United States Medical Licensing Examination Step 1 (51%. Of the programs that required clinical experience, 82% required 33 weeks or more. Most institutions (96% gave priority for electives and clerkships to their own students over visiting students, and a majority (78% reported that visiting students were evaluated no differently than their own students. During academic year 2006-2007, the number of new resident physicians who were former visiting medical

  6. Natural potentials of the medicinal plants from the Orchidaceae family with mucus as the main ingredients from Zlatar mountain

    Directory of Open Access Journals (Sweden)

    Matović, M.

    2010-12-01

    Full Text Available The spontaneous medicinal flora of Zlatar Mountain was studied in the aim of realizing the possibilities of its sustainable use for the needs of the pharmaceutical industry. The special attention was paid to genera Orchis, Ophrys, Plathanthera, Gimnadenia, etc. from the orchid family (Orchidaceae of which salep is made (Tuber salep. Salep is a typical mucous drug (contains over 50% of mucus, which is very beneficial and useful. The primary role of salep is to heal and strengthen the organism and urge the sexual and every other biological ability. Orchids of which salep is made (Orchis coriophora, Orchis laxiflora, Orchis morio, Orchis mascula, Orchis pallens, Orchis purpurea, Orchis simia, Orchis tridentata and Orchis ustulata are to be found on numerous habitats of Zlatar (in the bright forests, clearing areas and on forest meadows.

  7. [Learning concepts of diagnosis in family medicine: the "mark robinson sign" - the traces that should not be there].

    Science.gov (United States)

    Turabián, José Luis; Samarín-Ocampos, Elena; Minier, Luis; Pérez-Franco, Benjamín

    2015-11-01

    We review the mechanisms of the mental operation to identify the disease in family medicine, using five cases where the diagnosis process began in "the trace that should not be there" or "Robinson sign" as happened to Robinson Crusoe when he saw a human footprint on the beach of the "desert island". How could it be there?; It was a mystery, and based on metaphors, we framed the mechanism of "the trace that should not be there" mainly in the first phase of clinical or intuitive reasoning, but this intuition of the doctor should be accompanied by the diagnostic process, like the "basso continuo" of Baroque music, allowing improvisation and personal style, and in this way, eventually observing the footprint "that should not have been there" that may arise in the analytical, as well as in the verification phase of the assumptions made. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.

  8. Bending the cost curve and increasing revenue: a family medicine model that works!

    Science.gov (United States)

    Katz, Bernard J; Needham, Mark R

    2012-12-01

    This article attempts to illustrate ways in which family physician practices are able to demonstrate high value, enhanced quality, and streamlined costs, essential components of practice sustainability. Specific examples are provided to assist practices to consider questions and information that allow for skillful engagement during contract negotiations, consider increasing practice revenues by adopting practice enhancements that make sense for the location of the practice and community needs, develop workflow analyses, and review opportunities for expense reduction.

  9. Can credit systems help in family medicine training in developing countries? An innovative concept.

    Science.gov (United States)

    Raji, J Beulah; Velavan, Jachin; Anbarasi, Sahaya; Grant, Liz

    2014-07-01

    There is irrefutable evidence that health systems perform best when supported by a Family Physician network. Training a critical mass of highly skilled Family Physicians can help developing countries to reach their Millennium Development Goals and deliver comprehensive patient-centered health care to their population. The challenge in developing countries is the need to rapidly train these Family Physicians in large numbers, while also ensuring the quality of the learning, and assuring the quality of training. The experience of Christian Medical College (CMC), Vellore, India and other global examples confirm the fact that training large numbers is possible through well-designed blended learning programs. The question then arises as to how these programs can be standardized. Globally, the concept of the "credit system" has become the watch-word for many training programs seeking standardization. This article explores the possibility of introducing incremental academic certifications using credit systems as a method to standardize these blended learning programs, gives a glimpse at the innovation that CMC, Vellore is piloting in this regard partnering with the University of Edinburgh and analyses the possible benefits and pitfalls of such an approach.

  10. Attitudes and perceptions of medical students about family medicine in Spain: protocol for a cross-sectional survey

    Science.gov (United States)

    Alonso-Coello, Pablo; Villa, Josep Jiménez; Hijar, Antonio Monreal; Tuduri, Xavier Mundet; Puime, Ángel Otero

    2011-01-01

    Background Despite the fact that family medicine (FM) has become established as a specialty in the past 25 years, this has not been reflected in the inclusion of the specialty in the majority of medical schools in Spain. Almost 40% of the students will work in primary care but, in spite of this, most universities do not have an assessed placement as such. There are only specific practice periods in health centres or some student-selected components with little weight in the overall curricula. Objectives To evaluate the attitudes and perceptions of medical students about FM in the health system and their perception about the need for specific training in FM at the undergraduate level. To explore change over time of these attitudes and perceptions and to examine potential predictive factors for change. Finally, we will review what teaching activity in FM is offered across the Spanish schools of medicine. Methods Descriptive cross-sectional survey. Each one of the different analyses will consist of two surveys: one for all the students in the first, third and fifth year of medical school in all the Spanish schools of medicine asking about their knowledge, perceptions and attitudes in relation to primary care and FM. There will be an additional survey for the coordinating faculty of the study in each university about the educational activities related to FM that are carried out in their centres. The repetition of the study every 2 years will allow for an analysis of the evolution of the cohort of students until they receive their degree and the potential predictive factors. Discussion This study will provide useful information for strategic planning decisions, content and educational methodology in medical schools in Spain and elsewhere. It will also help to evaluate the influence of the ongoing changes in FM, locally and at the European level, on the attitudes and perceptions of the students towards FM in Spain. PMID:22189348

  11. Drug Testing Incoming Residents and Medical Students in Family Medicine Training: A Survey of Program Policies and Practices.

    Science.gov (United States)

    Bell, Paul F; Semelka, Michael W; Bigdeli, Laleh

    2015-03-01

    Despite well-established negative consequences, high rates of substance use and related disorders continue to be reported. Physicians in training are not immune from this, or the associated risks to their health and careers, while impaired physicians are a threat to patient safety. We surveyed family medicine residency programs' practices relating to drug testing of medical students and incoming residents. The survey asked about the extent to which residency programs are confronted with trainees testing positive for prohibited substances, and how they respond. The survey was sent to the directors of family medicine residency programs. A total of 205 directors (47.2%) completed the survey. A majority of the responding programs required drug testing for incoming residents (143, 68.9%). Most programs did not require testing of medical students (161, 81.7%). Few programs reported positive drug tests among incoming residents (9, 6.5%), and there was only 1 reported instance of a positive result among medical students (1, 3.3%). Respondents reported a range of responses to positive results, with few reporting that they would keep open training spots or offer supportive services for a medical student who tested positive. Changing laws legalizing certain drugs may require corresponding changes in the focus on drug testing and associated issues in medical training; however, many residency program directors were not aware of their institution's current policies. Programs will need to reexamine drug testing policies as new generations of physicians, growing up under altered legal circumstances concerning drug use, progress to clinical training.

  12. Intern evaluation strategies in family medicine residency education: what is-and is not-being done.

    Science.gov (United States)

    Yates, Jennifer E

    2013-06-01

    Family medicine interns often have deficiencies that are not initially appreciated. By recognizing those growth opportunities early, programs may be able to better meet their interns' training needs. This study provides a needs assessment to ascertain what evaluation tools are being utilized by residency programs to assess their incoming interns. A questionnaire was sent to all US family medicine residency program coordinators (439 programs) via Survey Monkey© inquiring about whether intern evaluation is performed and, if so, what strategies are used. A mixed mode methodology was used: mailing with incentive, email prompts, and telephone calls. Of 439 programs, 220 (50%) responded to the survey. Most respondents (145, 66%) think intern evaluation is needed. However, only 79 (36%) programs are actually doing intern evaluations-only 14 (6.4%) extensively. Most programs are performing simulations (81, 45%) and assessing knowledge/comfort levels (79, 36%); less than one third are considering personality/learning styles, and almost no programs are evaluating skills such as typing (three, 1.4%) and math (one, 0.5%). Many programs use evaluations to guide future planning, help with early identification of challenging learners, and to match training to the residents' needs. Several programs expressed concern about how they would use the information once obtained. The majority of respondents agreed that a baseline intern evaluation is useful; few are actually doing it. This area is not well-described in the literature; residency programs could benefit from information sharing. The next step is to encourage interest in and implementation of such strategies.

  13. Factors influencing the implementation, adoption, use, sustainability and scalability of eLearning for family medicine specialty training: a systematic review protocol.

    Science.gov (United States)

    Cotič, Živa; Rees, Rebecca; Wark, Petra A; Car, Josip

    2016-10-19

    In 2013, there was a shortage of approximately 7.2 million health workers worldwide, which is larger among family physicians than among specialists. eLearning could provide a potential solution to some of these global workforce challenges. However, there is little evidence on factors facilitating or hindering implementation, adoption, use, scalability and sustainability of eLearning. This review aims to synthesise results from qualitative and mixed methods studies to provide insight on factors influencing implementation of eLearning for family medicine specialty education and training. Additionally, this review aims to identify the actions needed to increase effectiveness of eLearning and identify the strategies required to improve eLearning implementation, adoption, use, sustainability and scalability for family medicine speciality education and training. A systematic search will be conducted across a range of databases for qualitative studies focusing on experiences, barriers, facilitators, and other factors related to the implementation, adoption, use, sustainability and scalability of eLearning for family medicine specialty education and training. Studies will be synthesised by using the framework analysis approach. This study will contribute to the evaluation of eLearning implementation, adoption, use, sustainability and scalability for family medicine specialty training and education and the development of eLearning guidelines for postgraduate medical education. PROSPERO http://www.crd.york.ac.uk/PROSPERO/display_record.asp?ID=CRD42016036449.

  14. Influence of feedback characteristics on perceived learning value of feedback in clerkships: does culture matter?

    Science.gov (United States)

    Suhoyo, Yoyo; Van Hell, Elisabeth A; Kerdijk, Wouter; Emilia, Ova; Schönrock-Adema, Johanna; Kuks, Jan B M; Cohen-Schotanus, Janke

    2017-04-05

    Various feedback characteristics have been suggested to positively influence student learning. It is not clear how these feedback characteristics contribute to students' perceived learning value of feedback in cultures classified low on the cultural dimension of individualism and high on power distance. This study was conducted to validate the influence of five feedback characteristics on students' perceived learning value of feedback in an Indonesian clerkship context. We asked clerks in Neurology (n = 169) and Internal Medicine (n = 132) to assess on a 5-point Likert scale the learning value of the feedback they received. We asked them to record whether the feedback provider (1) informed the student what went well, (2) mentioned which aspects of performance needed improvement, (3) compared the student's performance to a standard, (4) further explained or demonstrated the correct performance, and (5) prepared an action plan with the student to improve performance. Data were analyzed using multilevel regression. A total of 250 students participated in this study, 131 from Internal Medicine (response rate 99%) and 119 from Neurology (response rate 70%). Of these participants, 225 respondents (44% males, 56% females) completed the form and reported 889 feedback moments. Students perceived feedback as more valuable when the feedback provider mentioned their weaknesses (β = 0.153, p < 0.01), compared their performance to a standard (β = 0.159, p < 0.01), explained or demonstrated the correct performance (β = 0.324, p < 0.001) and prepared an action plan with the student (β =0.496, p < 0.001). Appraisal of good performance did not influence the perceived learning value of feedback. No gender differences were found for perceived learning value. In Indonesia, we could validate four out of the five characteristics for effective feedback. We argue that our findings relate to culture, in particular to the levels of individualism and power distance. The

  15. Communication skills of tutors and family medicine physician residents in Primary Care clinics.

    Science.gov (United States)

    Valverde Bolívar, Francisco Javier; Pedregal González, Miguel; Pérez Fuentes, María Francisca; Alcalde Molina, María Dolores; Torío Durántez, Jesús; Delgado Rodríguez, Miguel

    2016-12-01

    To determine the communicative profiles of family physicians and the characteristics associated with an improved level of communication with the patient. A descriptive multicentre study. Primary Healthcare Centres in Almeria, Granada, Jaen and Huelva. 119 family physicians (tutors and 4th year resident physicians) filmed and observed with patients. Demographic and professional characteristics. Analysis of the communication between physicians and patients, using a CICAA (Connect, Identify, Understand, Agree and Assist, in English) scale. A descriptive, bivariate, multiple linear regression analysis was performed. There were 436 valid interviews. Almost 100% of physicians were polite and friendly, facilitating a dialogue with the patient and allowing them to express their doubts. However, few physicians attempted to explore the state of mind of the patient, or enquire about their family situation or any important stressful events, nor did they ask open questions. Furthermore, few physicians summarised the information gathered. The mean score was 21.43±5.91 points (maximum 58). There were no differences in the total score between gender, city, or type of centre. The linear regression verified that the highest scores were obtained from tutors (B: 2.98), from the duration of the consultations (B: 0.63), and from the age of the professionals (B: -0.1). Physicians excel in terms of creating a friendly environment, possessing good listening skills, and providing the patient with information. However the ability to empathise, exploring the psychosocial sphere, carrying out shared decision-making, and asking open questions must be improved. Being a tutor, devoting more time to consultations, and being younger, results in a significant improvement in communication with the patient. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

  16. Early Signs of Atherogenesis in Adolescents in a Havana Family Medicine Catchment Area.

    Science.gov (United States)

    Valdés, Wendy; Díaz-Perera, Georgia; Espinosa, Tania M

    2015-10-01

    INTRODUCTION Atherosclerosis is the common underlying cause of cardiovascular diseases; the leading cause of morbidity and mortality globally. It is a major contributor to disability and poorer quality of life and is costly to health systems, individuals, families and society. Early signs of atherogenesis are manifestations of atherosclerosis and known atherogenic risk factors occurring at young ages and detectable by health professionals. Early detection of such signs in children and adolescents enables actions to prevent short- and long-term complications. OBJECTIVE Detect early signs of atherogenesis in adolescents in Family Doctor-and-Nurse Office No. 13 of the Raúl Gómez García Polyclinic in Havana's 10 de Octubre Municipality. METHODS An observational, cross-sectional descriptive study was conducted: the universe consisted of 110 adolescents and, once exclusion criteria were applied, the sample was made up of 96 adolescents in the office's geographical catchment area. Variables included sociodemographic data; measurements from physical and anthropometric examinations (weight, height, body mass index, waist circumference, blood pressure, presence of acanthosis nigricans); maternal history of diabetes mellitus and hypertension, smoking during pregnancy; birth weight and duration of exclusive breastfeeding; lifestyle (physical activity, dietary habits by frequency of consumption of fruits and vegetables, salt intake, and smoking); and a history of atherogenic risk factors and atherosclerotic diseases (hypertension, diabetes mellitus, heart disease, cerebrovascular disease, peripheral arterial disease and chronic kidney disease) in adolescents and their families. The number of early signs of atherogenesis was determined. Descriptive statistics and a chi-square test, with significance threshold set at p = 0.05, were used to examine differences by sex and age. RESULTS A total of 62.5% of participating adolescents were female and the same percent of the total

  17. A cultural diversity seen in Croatian family medicine: a lady from Janjevo.

    Science.gov (United States)

    Pavlov, Renata

    2014-12-01

    The role of cultural diversities in doctor's everyday work is going more and more important in globalised world, therefore it draws lots of attention in literature. Cultural differences that exist between people, such as language, dress and traditions, are usually distinguished from the term cultural diversity which is mainly understood as having different cultures respect each other's differences. The great effort is made to educate culturally competent practitioners, nurses or doctors. The presented case of lady from Janjevo was a good role model for work with all patients with culturally different background coming to family practice. This lady example could also help to other colleagues to learn from experience on systematic way.

  18. Student performance of the general physical examination in internal medicine: an observational study

    NARCIS (Netherlands)

    Haring, C.M.; Cools, B.M.; Meer, J.W.M. van der; Postma, C.T.

    2014-01-01

    BACKGROUND: Many practicing physicians lack skills in physical examination. It is not known whether physical examination skills already show deficiencies after an early phase of clinical training. At the end of the internal medicine clerkship students are expected to be able to perform a general phy

  19. Peer-support writing group in a community family medicine teaching unit: Facilitating professional development.

    Science.gov (United States)

    Al-Imari, Lina; Yang, Jaisy; Pimlott, Nicholas

    2016-12-01

    Aspiring physician writers need an environment that promotes self-reflection and can help them improve their skills and confidence in writing. To create a peer-support writing group for physicians in the Markham-Stouffville community in Ontario to promote professional development by encouraging self-reflection and fostering the concept of physician as writer. The program, designed based on a literature review and a needs assessment, was conducted in 3 sessions over 6 months. Participants included an emergency physician, 4 family physicians, and 3 residents. Four to 8 participants per session shared their projects with guest physician authors. Eight pieces of written work were brought to the sessions, 3 of which were edited. A mixed quantitative and qualitative evaluation model was used with preprogram and postprogram questionnaires and a focus group. This program promoted professional development by increasing participants' frequency of self-reflection and improving their proficiency in writing. Successful elements of this program include creating a supportive group environment and having a physician-writer expert facilitate the peer-feedback sessions. Similar programs can be useful in postgraduate education or continuing professional development. Copyright© the College of Family Physicians of Canada.

  20. Family medicine education in rural communities as a health service intervention supporting recruitment and retention of physicians

    Science.gov (United States)

    Soles, Trina Larsen; Ruth Wilson, C.; Oandasan, Ivy F.

    2017-01-01

    Abstract Objective To develop a pan-Canadian rural education road map to advance the recruitment and retention of family physicians in rural, remote, and isolated regions of Canada in order to improve access and health care outcomes for these populations. Composition of the task force Members of the task force were chosen from key stakeholder groups including educators, practitioners, the College of Family Physicians of Canada education committee chairs, deans, chairs of family medicine, experts in rural education, and key decision makers. The task force members were purposefully selected to represent a mix of key perspectives needed to ensure the work produced was rigorous and of high quality. Observers from the Canadian Medical Association and Health Canada’s Council on Health Workforce, and representatives from the Royal College of Physicians and Surgeons of Canada, were also invited to provide their perspectives and to encourage and coordinate multiorganization action. Methods The task force commissioned a focused literature review of the peer-reviewed and gray literature to examine the status of rural medical education, training, and practice in relation to the health needs of rural and remote communities in Canada, and also completed an environmental scan. Report The environmental scan included interviews with more than 100 policy makers, government representatives, providers, educators, learners, and community leaders; 17 interviews with practising rural physicians; and 2 surveys administered to all 17 faculties of medicine. The gaps identified from the focused literature review and the results of the environmental scan will be used to develop the task force’s recommendations for action, highlighting the role of key partners in implementation and needed action. Conclusion The work of the task force provides an opportunity to bring the various partners together in a coordinated way. By understanding who is responsible and the actions each stakeholder

  1. Incorporating Active Learning into a Psychiatry Clerkship: Does It Make a Difference?

    Science.gov (United States)

    Morreale, Mary; Arfken, Cynthia; Bridge, Patrick; Balon, Richard

    2012-01-01

    Objective: Medical students' satisfaction with the psychiatry clerkship, sense of preparedness for an institutional Objective Structured Clinical Exam (OSCE), expressed likelihood of choosing psychiatry as a specialty, and National Board of Medical Examiners (NBME) psychiatry shelf-examination scores were compared after a curriculum based on…

  2. Reliability of Objective Structured Clinical Examinations: Four Years of Experience in a Surgical Clerkship.

    Science.gov (United States)

    Mann, Karen V.; And Others

    1990-01-01

    Four years of experience with an objective structured clinical examination (OSCE) following an eight-week surgical clerkship (n=356 students) are reported, including data on mean student performance across years, reliability coefficients, and generalizability. Implications for improvement and development of OSCE are discussed. (Author/MSE)

  3. Alternating skills training and clerkships to ease the transition from preclinical to clinical training

    NARCIS (Netherlands)

    Van Hell, E.A.; Kuks, J.B.; Borleffs, J.C.; Cohen-Schotanus, J.

    2011-01-01

    Background: The transition from preclinical to clinical training is perceived as stressful with a high workload being the main difficulty. To ease this transition, we implemented a dual learning year, where just-in-time skills training and clerkships alternated. Aims: To examine the effect of the

  4. Integrated Lecturing within Clerkship Course: A New Learning Method in Nurse Anesthesia Teaching

    Directory of Open Access Journals (Sweden)

    Mahmood Akhlaghi

    2015-01-01

    Full Text Available Background and purpose: The conventional lecture-based teaching method that has been used to transit theoretical knowledge to the participants is inadequate. Due to some issues with this didactic approach, it is believed that integration of this approach with an active method may be more valuable in nursing education. In this study, we hypothesized that integrating lecture-based teaching within clerkship course would enhance the knowledge of nurse-anesthesia students. Methods: This prospective randomized study was conducted on 24 students of second-year nurse-anesthesia course. All students received either didactic lectures or integrated lectures within the clerkship course during a 4-month semester of their educational curriculum. Their knowledge of anesthesia course was assessed at the end of the course using the Wilcoxon Rank test. Results: The adopted integrated method improved the students’ final scores at the end of the semester (p=0.004. Moreover, their scores were much improved in taxonomy-2 questions (p=0.001. Conclusions: Incorporating a didactic lecture approach within anesthesia clerkship course improves the knowledge of the participants in the anesthesia course. Keywords: ANESTHESIA, LECTURE, KNOWLEDGE, NURSE-ANESTHESIA COURSE, CLERKSHIP COURSE

  5. Academic Performance in the Context of a "Three Excused Absences" Psychiatry Clerkship Policy

    Science.gov (United States)

    Schillerstrom, Jason E.; Lutz, Mary

    2013-01-01

    Objective: In order to better manage medical student absences during the psychiatry clerkship, a policy allowing students to miss up to 3 days without penalty was developed. The purpose of this study was to describe absence patterns and compare academic performance between students with and without absences. Method: Authors reviewed the academic…

  6. Influence of Clerkship on Attitudes of Medical Students toward Psychiatry across Cultures: United States and Qatar

    Science.gov (United States)

    Burgut, F. Tuna; Polan, H. Jonathan

    2013-01-01

    Objective: To assure adequate treatment for patients with mental illness worldwide, medical schools must impart positive attitudes toward psychiatry. The authors examined the effect of culture on changes in attitudes toward psychiatry among medical students receiving the same psychiatry clerkship curriculum in two different countries. Methods: A…

  7. Psychiatry in the Harvard Medical School-Cambridge Integrated Clerkship: An Innovative, Year-Long Program

    Science.gov (United States)

    Griswold, Todd; Bullock, Christopher; Gaufberg, Elizabeth; Albanese, Mark; Bonilla, Pedro; Dvorak, Ramona; Epelbaum, Claudia; Givon, Lior; Kueppenbender, Karsten; Joseph, Robert; Boyd, J. Wesley; Shtasel, Derri

    2012-01-01

    Objective: The authors present what is to their knowledge the first description of a model for longitudinal third-year medical student psychiatry education. Method: A longitudinal, integrated psychiatric curriculum was developed, implemented, and sustained within the Harvard Medical School-Cambridge Integrated Clerkship. Curriculum elements…

  8. Subspecialty Exposure in a Psychiatry Clerkship Does Not Improve Student Performance in the Subject Examination

    Science.gov (United States)

    Retamero, Carolina; Ramchandani, Dilip

    2013-01-01

    Objective: The authors compared the NBME subject examination scores and subspecialty profiles of 3rd-year medical students who were assigned to psychiatry subspecialties during their clerkship with those who were not. Method: The authors collated and analyzed the shelf examination scores, the clinical grades, and the child psychiatry and emergency…

  9. How and what do medical students learn in clerkships? Experience based learning (ExBL).

    Science.gov (United States)

    Dornan, Tim; Tan, Naomi; Boshuizen, Henny; Gick, Rachel; Isba, Rachel; Mann, Karen; Scherpbier, Albert; Spencer, John; Timmins, Elizabeth

    2014-12-01

    Clerkship education has been called a 'black box' because so little is known about what, how, and under which conditions students learn. Our aim was to develop a blueprint for education in ambulatory and inpatient settings, and in single encounters, traditional rotations, or longitudinal experiences. We identified 548 causal links between conditions, processes, and outcomes of clerkship education in 168 empirical papers published over 7 years and synthesised a theory of how students learn. They do so when they are given affective, pedagogic, and organisational support. Affective support comes from doctors' and many other health workers' interactions with students. Pedagogic support comes from informal interactions and modelling as well as doctors' teaching, supervision, and precepting. Organisational support comes from every tier of a curriculum. Core learning processes of observing, rehearsing, and contributing to authentic clinical activities take place within triadic relationships between students, patients, and practitioners. The phrase 'supported participation in practice' best describes the educational process. Much of the learning that results is too tacit, complex, contextualised, and individual to be defined as a set of competencies. We conclude that clerkship education takes place within relationships between students, patients, and doctors, supported by informal, individual, contextualised, and affective elements of the learned curriculum, alongside formal, standardised elements of the taught and assessed curriculum. This research provides a blueprint for designing and evaluating clerkship curricula as well as helping patients, students, and practitioners collaborate in educating tomorrow's doctors.

  10. The Integration of Psychomotor Skills in a Hybrid-PBL Dental Curriculum: The Clinical Clerkships.

    Science.gov (United States)

    Walton, Joanne N.; MacNeil, M. A. J.; Harrison, Rosamund L.; Clark, D. Christopher

    1998-01-01

    Describes the restructuring of clinical clerkships at the University of British Columbia (Canada) dental school as part of a new, hybrid, problem-based learning (PBL) curriculum, focusing on strategies for integrating development of psychomotor skills. Methods of achieving both horizontal and vertical integration of competencies through grouping…

  11. Alternating skills training and clerkships to ease the transition from preclinical to clinical training

    NARCIS (Netherlands)

    Van Hell, E.A.; Kuks, J.B.; Borleffs, J.C.; Cohen-Schotanus, J.

    2011-01-01

    Background: The transition from preclinical to clinical training is perceived as stressful with a high workload being the main difficulty. To ease this transition, we implemented a dual learning year, where just-in-time skills training and clerkships alternated. Aims: To examine the effect of the du

  12. The Performance of Female Medical Students in an Obstetrics and Gynecology Clerkship.

    Science.gov (United States)

    Miller, Joseph M.; Smith, Imogene K.

    1982-01-01

    A study showed that although female medical students had slightly lower National Board examination scores on part one and lower grade point averages, they performed significantly better in the obstetrics and gynecology clerkship. Possible factors include women students' interest in women's health care and female representation on the house staff.…

  13. General surgical interns contributing to the clerkship learning environment of medical students.

    Science.gov (United States)

    Yu, Tzu-Chieh; Lemanu, Daniel P; Henning, Marcus; Maccormick, Andrew D; Hawken, Susan J; Hill, Andrew G

    2013-08-01

    Junior doctors are increasingly promoted as clinical teachers but there is limited understanding of how they contribute to medical student clerkship learning. To describe contributions made by general surgical interns to the student clerkship learning environment. The mixed-methods study involved two focus groups attended by volunteer interns and Year 4 students, and a student questionnaire collecting quantitative data. Focus group transcripts were evaluated using a qualitative analysis system. Six interns and five students attended focus groups in June and August 2011. Qualitative analysis found that intern contributions to student learning can be grouped under four distinct roles: physician, supervisor, teacher and person. Data from 85 questionnaires (response rate 57%) revealed that intern-student encounters occurred daily in the surgical wards and emergency department. Interns demonstrated bedside procedures, clerical/administrative tasks and interpretation of laboratory and radiological investigations. Appreciated for approachability, friendliness and ability to relate to students, interns also played a crucial role in integrating students into the surgical team. This significantly correlated to clerkship enjoyment. Surgical interns improve clerkship learning environments by demonstrating "personal" skills such as friendliness, approachability and relatedness. This has important implications for preparing interns as clinical preceptors.

  14. Time spent on clerkship activities by students in relation to their perceptions of learning environment quality

    NARCIS (Netherlands)

    van Hell, Elisabeth A.; Kuks, Jan B. M.; Cohen-Schotanus, Janke

    2009-01-01

    Context Students' perceptions of their learning environment are of great importance to their learning process. In this study we assessed the time allocated by students to clerkship activities and the relationship between students' allocations of time and their perceptions of the quality of their cli

  15. Peer Evaluation in a Clinical Clerkship: Students' Attitudes, Experiences, and Correlations with Traditional Assessments

    Science.gov (United States)

    Levine, Ruth E.; Kelly, P. Adam; Karakoc, Tayfun; Haidet, Paul

    2007-01-01

    Objective: The authors performed this study to determine whether clerkship peer evaluations, initiated as part of our "team-based learning" curriculum in 2002, correlated with other student performance measures, and to determine what qualities students rate in their peer evaluations. Method: The authors correlated peer evaluation scores with other…

  16. Clinical clerkship course for medical students on lumbar puncture using simulators.

    Science.gov (United States)

    Adachi, Koji; Yoshimura, Akinobu; Aso, Ryoko; Miyashita, Tsuguhiro; Yoshida, Daizo; Teramoto, Akira; Shimura, Toshiro

    2012-01-01

    Lumbar puncture is a medical technique that physicians must learn and is, therefore, considered a basic medical procedure. The lumbar puncture simulators Lumbar-Kun (Lumbar Puncture Simulator) and Lumbar-Kun II (Lumbar Puncture Simulator II) (Kyoto Kagaku, Kyoto, Japan) are teaching aids designed for practicing spinal insertions. We describe and results of a lumbar puncture clerkship course, provided to 5th-year medical students during clinical clerkship activity. The aim of this study was to evaluate the effectiveness of the lumbar puncture clerkship course in the medical education program. Comprehension, technical achievement, and satisfaction were scored by students and instructors using a 6-point Likert scale. Scores for both comprehension and technical achievement were high, but technical achievement scores tended to be higher than comprehension scores. In addition, the scores students gave themselves were higher than the scores they were given by instructors. Student satisfaction was high. The lumbar puncture simulators, Lumbar-Kun and Lumbar-Kun II, achieved excellent overall impressions and represent useful tools for training in lumbar puncture procedures. In addition to the simulators, an appropriate preparatory text and a short lecture before training seemed to increase the educational effect of this lumbar puncture clerkship course for medical students.

  17. The impact of clerkships on students' specialty preferences: what do undergraduates learn for their profession?

    NARCIS (Netherlands)

    Maiorova, T.; Stevens, F.; Scherpbier, A.; Zee, J. van der

    2008-01-01

    OBJECTIVE: Clinical experiences and gender have been shown to influence medical students' specialty choices. It remains unclear, however, which aspects of experiences make students favour some specialties and reject others. This study aimed to clarify the effects of clerkships on specialty choice an

  18. Incorporating Active Learning into a Psychiatry Clerkship: Does It Make a Difference?

    Science.gov (United States)

    Morreale, Mary; Arfken, Cynthia; Bridge, Patrick; Balon, Richard

    2012-01-01

    Objective: Medical students' satisfaction with the psychiatry clerkship, sense of preparedness for an institutional Objective Structured Clinical Exam (OSCE), expressed likelihood of choosing psychiatry as a specialty, and National Board of Medical Examiners (NBME) psychiatry shelf-examination scores were compared after a curriculum based on…

  19. Enhancing Third-Year Medical Clerkships: Using Mobile Technology for Teaching and Learning

    Science.gov (United States)

    Hill, Janette R.; Nuss, Michelle A.; Cervero, Ronald M.; Gaines, Julie K.; Middendorf, Bruce

    2016-01-01

    The third year clerkship is one of the most exciting and challenging times for medical students (Cooke, Irby, & O'Brien, 2010) when students spend significant time in clinical settings (e.g., hospitals) assisting in the care of patients on a daily basis. Getting information and resources just-in-time and at point-of-care (Author, 2009) is one…

  20. CHEMICAL COMPOSITION AND ANTIBACTERIAL ACTIVITY OF SOME MEDICINAL PLANTS FROM LAMIACEAE FAMILY.

    Science.gov (United States)

    Kozłowska, Mariola; Laudy, Agnieszka E; Przybył, Jarosław; Ziarno, Małgorzata; Majewska, Ewa

    2015-01-01

    Chemical composition and antibacterial activity of aqueous (ethanolic and methanolic) extracts from herbs often used in Polish cuisine and traditional herbal medicine including thyme (Thymus vulgaris L.), rosemary (Rosmarinus officinalis L.), oregano (Origanum vulgare L.), peppermint (Mentha piperita L.) and sage (Salvia officinalis L.) were compared. The aqueous ethanolic extracts contained slightly higher levels of phenolics compared to the aqueous methanolic extracts. In turn, GC-MS analysis showed that the aqueous methanolic extracts of thyme, rosemary and sage contained several additional compounds such as eugenol or ledol. The present studies also indicated that the bacterial species applied in the experiment exhibited different sensitivities towards tested extracts. Staphylococcus aureus strains were found to be the most sensitive bacteria to aqueous (ethanolic and methanolic) rosemary and sage extracts and aqueous methanolic thyme extract. Klebsiella pneumoniae ATCC 13883 and Proteus vulgaris NCTC 4635 were more susceptible to the aqueous methanolic thyme extract. However, Listeria monocytogenes 1043S was the most sensitive to the aqueous ethanolic rosemary extract. Gram-positive bacteria were generally more sensitive to the tested extracts than Gram-negative ones.

  1. "Taibai seven medicine" is the buttercup family plant resources research%"太白七药"属毛茛科植物资源调查研究

    Institute of Scientific and Technical Information of China (English)

    白吉庆; 王小平; 王西芳

    2011-01-01

    Objective: To pass to "taibai seven medicine" is the buttercup family plant resources survey for reasonable development and application of the resources, provides the basis. Methods: using GPS satellite tracking elevation position determination field investigation and finishing material. Results: the buttercup family medicinal plants is "too white seven medicine" in one of the largest number of families, about 12. Conclusion: in "taibai seven medicine" resource should pay full attention to the buttercup family medical plant resource protection, and properly conducted wild resources in parenting or artificial cultivation, so as to realize the sustainable utilization of resources.%目的:通过对"太白七药"属毛茛科植物资源调查,为合理开发和应用该科资源提供依据.方法:应用GPS全球卫星定位仪测定海拔方位进行实地调查并整理资料.结果:毛茛科药用植物是"太白七药"中数量最多的科之一,约有12种.结论:在"太白七药"资源中应充分重视毛茛科药用植物资源的保护,并适当开展野生资源抚育或开展人工栽培,以实现资源可持续利用.

  2. Cross-cultural challenges for assessing medical professionalism among clerkship physicians in a Middle Eastern country (Bahrain: feasibility and psychometric properties of multisource feedback

    Directory of Open Access Journals (Sweden)

    Al Ansari A

    2015-08-01

    Full Text Available Ahmed Al Ansari,1–3 Khalid Al Khalifa,1 Mohamed Al Azzawi,1 Rashed Al Amer,1 Dana Al Sharqi,4 Anwar Al-Mansoor,5 Fadi M Munshi6 1Department of General Surgery, Bahrain Defense Force Hospital, 2Surgical Department, Arabian Gulf University, 3Medical Education Department, Royal College of Surgeons in Ireland - Bahrain, 4Department of Internal Medicine, 5Department of Dietetics and Nutrition, Bahrain Defense Force Hospital, Riffa, Kingdom of Bahrain; 6College of Medicine, King Fahad Medical City, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Kingdom of Saudi Arabia Background: We aimed to design, implement, and evaluate the feasibility and reliability of a multisource feedback (MSF system to assess interns in their clerkship year in the Middle Eastern culture, the Kingdom of Bahrain.Method: The study was undertaken in the Bahrain Defense Force Hospital, a military teaching hospital in the Kingdom of Bahrain. A total of 21 interns (who represent the total population of the interns for the given year were assessed in this study. All of the interns were rotating through our hospital during their year-long clerkship rotation. The study sample consisted of nine males and 12 females. Each participating intern was evaluated by three groups of raters, eight medical intern colleagues, eight senior medical colleagues, and eight coworkers from different departments.Results: A total of 21 interns (nine males and 12 females were assessed in this study. The total mean response rates were 62.3%. A factor analysis was conducted that found that the data on the questionnaire grouped into three factors that counted for 76.4% of the total variance. These three factors were labeled as professionalism, collaboration, and communication. Reliability analysis indicated that the full instrument scale had high internal consistency (Cronbach’s α 0.98. The generalizability coefficients for the surveys were estimated to be 0.78.Conclusion: Based on our

  3. Patient safety principles in family medicine residency accreditation standards and curriculum objectives

    Science.gov (United States)

    Kassam, Aliya; Sharma, Nishan; Harvie, Margot; O’Beirne, Maeve; Topps, Maureen

    2016-01-01

    Abstract Objective To conduct a thematic analysis of the College of Family Physicians of Canada’s (CFPC’s) Red Book accreditation standards and the Triple C Competency-based Curriculum objectives with respect to patient safety principles. Design Thematic content analysis of the CFPC’s Red Book accreditation standards and the Triple C curriculum. Setting Canada. Main outcome measures Coding frequency of the patient safety principles (ie, patient engagement; respectful, transparent relationships; complex systems; a just and trusting culture; responsibility and accountability for actions; and continuous learning and improvement) found in the analyzed CFPC documents. Results Within the analyzed CFPC documents, the most commonly found patient safety principle was patient engagement (n = 51 coding references); the least commonly found patient safety principles were a just and trusting culture (n = 5 coding references) and complex systems (n = 5 coding references). Other patient safety principles that were uncommon included responsibility and accountability for actions (n = 7 coding references) and continuous learning and improvement (n = 12 coding references). Conclusion Explicit inclusion of patient safety content such as the use of patient safety principles is needed for residency training programs across Canada to ensure the full spectrum of care is addressed, from community-based care to acute hospital-based care. This will ensure a patient safety culture can be cultivated from residency and sustained into primary care practice. PMID:27965349

  4. The protocol of chronic patient management in a family medicine practice

    Directory of Open Access Journals (Sweden)

    Vlasta Vodopivec Jamšek

    2013-12-01

    Full Text Available Health care of patients with chronic diseases is a major challenge faced by health care systems worldwide. Primary care can offer good quality care for a range of chronic diseases, at the same time providing continuity of care and management of comorbidity. In Slovenia, the primary care faces a dilemma of how to provide the recommended acute, chronic and preventive care, considering the shortage of primary care physicians. New models of primary care teams are thus necessary for redesigning health care delivery systems to improve the care for patients with chronic conditions. In 2011, new model practices were implemented in our county. In these practices, a part of preventive and chronic care services are delegated to the new members of family physicians’ teams – specially trained nurses who deliver care according to newly introduced protocols for the management of chronic diseases. The protocols provide guidelines for primary health care teams in terms of clinical care and organisational aspects of practice. Much emphasis is also given to self-management support for patients, which is essential for extending health care outside the doctor’s office into patient’s daily life.

  5. Early detection of ovarian cancer in FB&H - role of family medicine team

    Directory of Open Access Journals (Sweden)

    Dž. Ljuca

    2007-08-01

    Full Text Available Assessment of problems with ovarian malignancy in the Federation B&H requires a comprehensive and precise analysis of the population characteristics with particular focus on risk factors such as age, parity, hereditary factors, menstrual cycle characteristics (short cycle, early menarche, late menopause. A retrospective study of medical documentation involving 272 patients with ovarian cancer within the Federation of BiH in the period from 1996 to 2000 was conducted. Usual statistical methods were used (T- test, 2 -Test, Fisher exact test. The research showed that the disease was in most cases diagnosed too late, in the stages III and IV (60% whereas histology of the tissue showed epithelial cancer in 88,6% cases, most frequently between the age of 55 to 70. Out of 272 patients null-parity was recorded in 16,9 %, whereas 19,8 % of patients had just one pregnancy. Menstrual cycle duration shorter than 21 days was recorded in 26,5% cases. Approximately 1,8% patients had close relatives that suffered of cancer of breast, ovary or colon. Prerequisites for application of algorhithms in diagnostic procedures would be met by identification of risk groups consisting of those with one or more risk factors in their history. Bearing in mind the role of the family doctors in the future health system reform, it can be concluded that they could have an important role in the process.

  6. Results of chart reviews conducted to evaluate primary care patients seen by second and third year family medicine residents for potential adverse polypharmacy

    Directory of Open Access Journals (Sweden)

    Chang LF

    2007-06-01

    Full Text Available Objective: To determine the prescribing patterns of family medicine residents for patients aged more than 60 years with 2 or more chronic diseases and seen at least twice in a 12 month timeframe.Methods: This is a descriptive analysis which was based on chart reviews. The setting was the University of Illinois-Rockford Family Practice Residency. Patients aged 60 years with 2 or more chronic diseases who were seen at least twice by second and third year residents.Results: Findings from this chart review include: 28.8% of the prescribed medications were not effective for the documented condition, 26.3% of the prescribed doses were incorrect, and 44.5% of the drugs prescribed were not the least expensive alternative.Discussion: This preliminary study suggests a need for a focused intervention with family medicine residents regarding inappropriate polypharmacy issues with older patients.

  7. Lack of chart reminder effectiveness on family medicine resident JNC-VI and NCEP III guideline knowledge and attitudes

    Directory of Open Access Journals (Sweden)

    Upshur Ross EG

    2004-07-01

    Full Text Available Abstract Background The literature demonstrates that medical residents and practicing physicians have an attitudinal-behavioral discordance concerning their positive attitudes towards clinical practice guidelines (CPG, and the implementation of these guidelines into clinical practice patterns. Methods A pilot study was performed to determine if change in a previously identified CPG compliance factor (accessibility would produce a significant increase in family medicine resident knowledge and attitude toward the guidelines. The primary study intervention involved placing a summary of the Sixth Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC VI and the National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (NCEP III CPGs in all patient (>18 yr. charts for a period of three months. The JNC VI and NCEP III CPGs were also distributed to each Wayne State family medicine resident, and a copy of each CPG was placed in the preceptor's area of the involved clinics. Identical pre- and post- intervention questionnaires were administered to all residents concerning CPG knowledge and attitude. Results Post-intervention analysis failed to demonstrate a significant difference in CPG knowledge. A stastically significant post-intervention difference was found in only on attitude question. The barriers to CPG compliance were identified as 1 lack of CPG instruction; 2 lack of critical appraisal ability; 3 insufficient time; 4 lack of CPG accessibility; and 5 lack of faculty modeling. Conclusion This study demonstrated no significant post intervention changes in CPG knowledge, and only one question that reflected attitude change. Wider resident access to dedicated clinic time, increased faculty modeling, and the implementation of an electronic record/reminder system that uses a team-based approach are compliance factors that

  8. Integrating an internet-mediated walking program into family medicine clinical practice: a pilot feasibility study

    Directory of Open Access Journals (Sweden)

    Sen Ananda

    2011-06-01

    Full Text Available Abstract Background Regular participation in physical activity can prevent many chronic health conditions. Computerized self-management programs are effective clinical tools to support patient participation in physical activity. This pilot study sought to develop and evaluate an online interface for primary care providers to refer patients to an Internet-mediated walking program called Stepping Up to Health (SUH and to monitor participant progress in the program. Methods In Phase I of the study, we recruited six pairs of physicians and medical assistants from two family practice clinics to assist with the design of a clinical interface. During Phase II, providers used the developed interface to refer patients to a six-week pilot intervention. Provider perspectives were assessed regarding the feasibility of integrating the program into routine care. Assessment tools included quantitative and qualitative data gathered from semi-structured interviews, surveys, and online usage logs. Results In Phase I, 13 providers used SUH and participated in two interviews. Providers emphasized the need for alerts flagging patients who were not doing well and the ability to review participant progress. Additionally, providers asked for summary views of data across all enrolled clinic patients as well as advertising materials for intervention recruitment. In response to this input, an interface was developed containing three pages: 1 a recruitment page, 2 a summary page, and 3 a detailed patient page. In Phase II, providers used the interface to refer 139 patients to SUH and 37 (27% enrolled in the intervention. Providers rarely used the interface to monitor enrolled patients. Barriers to regular use of the intervention included lack of integration with the medical record system, competing priorities, patient disinterest, and physician unease with exercise referrals. Intention-to-treat analyses showed that patients increased walking by an average of 1493 steps

  9. Development of the quality assessment model of EHR software in family medicine practices: research based on user satisfaction

    Directory of Open Access Journals (Sweden)

    Damir Kralj

    2015-09-01

    Full Text Available Background Family medicine practices (FMPs make the basis for the Croatian health care system. Use of electronic health record (EHR software is mandatory and it plays an important role in running these practices, but important functional features still remain uneven and largely left to the will of the software developers.Objective The objective of this study was to develop a novel and comprehensive model for functional evaluation of the EHR software in FMPs, based on current world standards, models and projects, as well as on actual user satisfaction and requirements.Methods Based on previous theoretical and experimental research in this area, we made the initial framework model consisting of six basic categories as a base for online survey questionnaire. Family doctors assessed perceived software quality by using a five-point Likert-type scale. Using exploratory factor analysis and appropriate statistical methods over the collected data, the final optimal structure of the novel model was formed. Special attention was focused on the validity and quality of the novel model.Results The online survey collected a total of 384 cases. The obtained results indicate both the quality of the assessed software and the quality in use of the novel model. The intense ergonomic orientation of the novel measurement model was particularly emphasised.Conclusions The resulting novel model is multiple validated, comprehensive and universal. It could be used to assess the user-perceived quality of almost all forms of the ambulatory EHR software and therefore useful to all stakeholders in this area of the health care informatisation. 

  10. What basic clinical procedures should be mastered by junior clerkship students? Experience at a single medical school in Tanzania

    Directory of Open Access Journals (Sweden)

    Konje ET

    2016-03-01

    that lumbar punctures, abdominal paracentesis, and nasogastric tube insertion should be done under minimal supervision. A considerable number of students (25%, n=75 did not practice any procedure throughout their rotation. The majority of the students performed venipuncture independently (82.14%, n=56 and lumbar punctures (73.21%, n=56 under supervision. Less than 25% (n=56 of the students met the required number of exposures on the basic procedures. The procedures to be performed and the level of competency in the procedures are not specified in the current curriculum. Conclusion: The study identified the procedures that should be taught and practiced by students. It also highlighted the discrepancies in the existing curriculum and the need to monitor and supervise students’ practice. Keywords: basic procedures, internal medicine rotation, Tanzania, medical education, logbooks, procedural skills, clinical clerkship

  11. A clinical clerkship collaborative program in Taiwan: Acquiring core clinical competencies through patient care responsibility.

    Science.gov (United States)

    Wang, Yong A; Chen, Cheng-Feng; Chen, Chen-Huan; Wang, Ging-Long; Huang, Andrew T

    2016-06-01

    Traditionally, clinical clerkship training in Taiwan does not provide medical students with sufficient patient care responsibilities and often results in inadequate clinical skills. We implemented a pilot clerkship program at a comprehensive cancer center that emphasizes core clinical competency through direct patient care and dedicated faculty and mentors. Students were an integral part of the patient care team held accountable for providing coordinated and holistic care. Students' self-assessment of clinical competencies, faculty evaluation, and objective structured clinical examination were compared against their peers trained by traditional clerkship at a main teaching hospital. Fifty medical students completed the clerkship program in the first 3 years. At the end of the clerkship, participants rated themselves significantly higher than their peers in almost all patient care and clinical skill domains. The most significant areas included physical examination, clinical reasoning, developing management plan, holistic approach, handling ethical issues, and time management skills. The students rated their clerkship teachers significantly higher in time spent with students, skills and enthusiasm in teaching, as well as giving students appropriate patient care responsibilities. There was no significant difference in the end-of-clerkship objective structured clinical examination performance, but participants of the program achieved better grades in their subsequent internship. This pilot collaborative program presented a successful model for clinical education in the teaching of core clinical competencies through direct patient care responsibilities at the clerkship stage. It is hoped that the project will become a catalyst for medical education reform in Taiwan and regions with similar traditions. Copyright © 2015. Published by Elsevier B.V.

  12. A qualitative study of undergraduate clerkships in the intensive care unit: It's a brand new world.

    Science.gov (United States)

    O'Connor, Enda; Moore, Michael; Cullen, Walter; Cantillon, Peter

    2017-06-01

    While ICU clerkships are commonplace in undergraduate medical education, little is known about how students learn there. This study aimed to explore students' perceptions of the ICU as a learning environment, the factors influencing their learning and any perceived differences between learning in the ICU and non-ICU settings. We used interpretivist methodology, a social cognitive theoretical framework and a qualitative descriptive strategy. Ten medical students and four graduate doctors participated in four semi-structured focus group discussions. Data were analyzed by six-step thematic data analysis. Peer debriefing, audit trail and a reflexive diary were used. Social cognitive influences on learning were apparent in the discussions. Numerous differences emerged between ICU and non-ICU clinical clerkships, in particular an unfamiliarity with the environment and the complex illness, and difficulty preparing for the clerkship. A key emergent theme was the concept of three phases of student learning, termed pre-clerkship, early clerkship and learning throughout the clerkship. A social cognitive perspective identified changes in learner agency, self-regulatory activities and reciprocal determinism through these phases. The findings were used to construct a workplace model of undergraduate intensive care learning, providing a chronological perspective on the clerkship experience. The ICU, a rich, social learning environment, is different in many respects to other hospital settings. Students navigate through three phases of an ICU clerkship, each with its own attendant emotional, educational and social challenges and with different dynamics between learner and environment. This chronological perspective may facilitate undergraduate educational design in the ICU.

  13. Genome-wide analysis of auxin response factor gene family members in medicinal model plant Salvia miltiorrhiza

    Directory of Open Access Journals (Sweden)

    Zhichao Xu

    2016-06-01

    Full Text Available Auxin response factors (ARFs can function as transcriptional activators or repressors to regulate the expression of auxin response genes by specifically binding to auxin response elements (AuxREs during plant development. Based on a genome-wide strategy using the medicinal model plant Salvia miltiorrhiza, 25 S. miltiorrhiza ARF (SmARF gene family members in four classes (class Ia, IIa, IIb and III were comprehensively analyzed to identify characteristics including gene structures, conserved domains, phylogenetic relationships and expression patterns. In a hybrid analysis of the phylogenetic tree, microRNA targets, and expression patterns of SmARFs in different organs, root tissues, and methyl jasmonate or indole-3-acetic acid treatment conditions, we screened for candidate SmARFs involved in various developmental processes of S. miltiorrhiza. Based on this analysis, we predicted that SmARF25, SmARF7, SmARF16 and SmARF20 are involved in flower, leaf, stem and root development, respectively. With the further insight into the targets of miR160 and miR167, specific SmARF genes in S. miltiorrhiza might encode products that participate in biological processes as described for ARF genes in Arabidopsis. Our results provide a foundation for understanding the molecular basis and regulatory mechanisms of SmARFs in S. miltiorrhiza.

  14. Quality evaluation and pattern recognition analyses of marker compounds from five medicinal drugs of Rutaceae family by HPLC/PDA.

    Science.gov (United States)

    Zhao, Bing Tian; Kim, Eun Jung; Son, Kun Ho; Son, Jong Keun; Min, Byung Sun; Woo, Mi Hee

    2015-08-01

    To establish a standard of quality control and to identify different origins for the Rutaceae family [Citri Unshiu Peel (CU), Citri Unshiu Immature Peel (CI), Ponciri Immature Fructus (PI), Aurantii Immature Fructus (AI), and Aurantii Fructus (AU)], 13 standards including rutin (1), narirutin (2), naringin (3), hesperidin (4), neohesperidin (5), neoponcirin (6), poncirin (7), naringenin (8), isosinensetin (9), sinensetin (10), nobiletin (11), heptamethoxyflavone (12), and tangeretin (13) were determined by high performance liquid chromatography (HPLC)/photo-diode array (PDA) analysis. A YMC ODS C18 (250 × 4.6 mm, 5 µm) column was used and the ratio of mobile phases of water (A) and acetonitrile (B) delivered to the column for gradient elution was applied. This method was fully validated with respect to linearity, accuracy, precision, stability, and robustness. The HPLC/PDA method was applied successfully to quantify 13 major compounds in the extracts of CU, CI, PI, AI, and AU. The pattern recognition analysis combined with LC chromatographic data was performed by repeated analysis of 27 reference samples in the above five Rutaceae oriental medicinal drugs. The established HPLC method was rapid and reliable for quantitative analysis and quality control of multiple components in five Rutaceae species with different origins.

  15. A Brief Boot Camp for 4th-Year Medical Students Entering into Pediatric and Family Medicine Residencies

    Science.gov (United States)

    Adler, Mark; Mangold, Karen; Trainor, Jennifer

    2016-01-01

    The transition from medical student to intern is a challenging process characterized by a steep learning curve. Focused courses targeting skills necessary for success as a resident have increased self-perceived preparedness, confidence, and medical knowledge. Our aim was to create a brief educational intervention for 4th-year medical students entering pediatric, family practice, and medicine/pediatric residencies to target skills necessary for an internship. The curriculum used a combination of didactic presentations, small group discussions, role-playing, facilitated debriefing, and simulation-based education. Participants completed an objective structured clinical exam requiring synthesis and application of multiple boot camp elements before and after the elective. Participants completed anonymous surveys assessing self-perceived preparedness for an internship, overall and in regards to specific skills, before the elective and after the course. Participants were asked to provide feedback about the course. Using checklists to assess performance, students showed an improvement in performing infant lumbar punctures (47.2% vs 77.0%; p 4. A focused boot camp addressing key knowledge and skills required for pediatric-related residencies was well received and led to improved performance of targeted skills and increased self-reported preparedness in many targeted domains. PMID:27014522

  16. Simulation in Medical School Education: Review for Emergency Medicine

    OpenAIRE

    Shahram Lotfipour; T. Kent Denmark; Christopher Erik McCoy; Srinidhi Subraya Bhat; Elizabeth ter Haar; Bharath Chakravarthy

    2011-01-01

    Medical education is rapidly evolving. With the paradigm shift to small-group didactic sessions and focus on clinically oriented case-based scenarios, simulation training has provided educators a novel way to deliver medical education in the 21st century. The field continues to expand in scope and practice and is being incorporated into medical school clerkship education, and specifically in emergency medicine (EM). The use of medical simulation in graduate medical education is well documente...

  17. Predictors of Work-Family Role Conflict and Its Impact on Professional Women in Medicine, Engineering, and Information Technology in Nigeria.

    Science.gov (United States)

    Uzoigwe, Anthonia Ginika; Low, Wah Yun; Noor, Siti Nurani Mohd

    2016-10-01

    This study examines work-family role conflict and the factors predicting it, with a sample of 173 professional women in engineering and information technology (IT) firms, including 2 hospitals-1 public and 1 private. Our findings show no significant difference in the level of work-family role conflict encountered by women across medicine, engineering, and IT, whereas hours of work, family responsibilities, job demand, and work role overload were significantly correlated with work-family role conflict. Multiple linear regression analysis indicates that only work role overload, family responsibilities, and hours of work significantly predicted 45.9% of work-family role conflict. This implies that working women are burdened by work demands, which invariably affects the work-family role conflict they experience and leads to deterioration of their occupational health. It is suggested that employers should create a flexible work schedule and establish family-friendly policies in the workplace to promote a healthy work-life balance for women in science careers.

  18. Can enriching emotional intelligence improve medical students' proactivity and adaptability during OB/GYN clerkships?

    Science.gov (United States)

    Guseh, Stephanie H; Chen, Xiaodong P; Johnson, Natasha R

    2015-12-26

    The purpose of