Family medicine
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In 2010, the College of Family Physicians of Canada (CFPC) launched its competency-based medical education (CBME) approach to residency curriculum and assessment. Named Triple C, this innovation was developed to ensure graduates of family medicine training programs are competent to begin unsupervised practice. Further, Triple C was intended to promote interest in practicing comprehensive family medicine. A program evaluation plan was launched by the CFPC alongside the implementation of Triple C to explore if intended outcomes were achieved. ⋯ Family medicine graduates report an increase in intention to include a broader range of clinical domains after implementation of Triple C. While a causal relationship cannot be determined, using a historical control in the form of survey data that predates Triple C implementation could support future approaches to evaluation of education reform.
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Only about one-third of adult Americans have completed advance directives for end-of-life care, and primary care physicians report that they are not always comfortable discussing advance care planning (ACP) with patients. Current approaches to teaching clinicians about ACP have limited evidence of effectiveness. With the objective of improving residents' comfort and skill discussing ACP with patients, we developed a curriculum that involved clinicians and attorneys working together to teach first-year family medicine residents (R1) about leading ACP discussions with patients. ⋯ Based on our initial experience, using medical-legal partnerships to teach residents about ACP may be more effective than previously reported approaches. Validation of our results with a larger sample is needed.
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The program director (PD) position is challenging. PDs are faced with many competing priorities and risk of burnout. Short PD tenure may contribute to training program challenges. The tenure of family medicine residency directors has not been rigorously studied. Our objective was to study family medicine program director tenure and change in tenure over time, and compare these to available Accreditation Council for Graduate Medical Education (ACGME) data. ⋯ Mean family medicine PD tenure is 6.5 years and median tenure is 4.5 years. The short tenure and large number of new PDs annually may impact program quality and suggests more resources and support may be needed for PDs new in their position.