Family medicine
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Shared decision making (SDM) is part of a larger movement for patient-centered approaches to care. SDM can be facilitated through the use of decision aids (DA), which are evidence-based tools designed to transmit information on topics suitable for SDM. They are intended to facilitate the process of patients arriving at an informed, values-based choice in partnership with physicians. Research indicates that SDM and the use of DA are underutilized. This study evaluated SDM and DA in primary care. ⋯ Even when shared decision making occurs, DAs are rarely used. Research is needed to identify and reduce barriers to using DAs in primary care.
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Six family medicine residency programs in the United States collaborated on the development and implementation of an integrative family medicine (IFM) program, which is a postgraduate training model that combines family medicine residency training with an integrative medicine fellowship. This paper reports on effects of IFM on residency programs and clinical systems in which it was implemented. ⋯ Our mixed-methods strategy for evaluation of IFM showed that implementing the program increased acceptance of IM, did not affect residency fill rates, and increased use of IM in clinical practice. The combination of quantitative and qualitative methods was an effective strategy for documenting the "systems level" effects of a new educational program.