Family medicine
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Critical thinking (CT) skills are an important aspect of clinical reasoning and diagnosis. The goals of this study were to (1) examine levels of CT skills of practicing family physicians, (2) compare the CT skills of practicing family physicians to family medicine residents, and (3) identify individual variables and practice characteristics predictive of CT skills. . ⋯ As a group, practicing family physicians exhibited lower scores on the CCTST compared to family medicine residents. CT skills showed a decline with age, accelerating after approximately age 60 years. The results of the study have implications for continuing education and assessment of physicians' clinical skills. Further research is required to better understand what other predictors may be important for CT skills of practicing family physicians.
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In its landmark report, Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care, the Institute of Medicine concluded that unconscious or implicit negative racial attitudes and stereotypes contribute to poorer health outcomes for patients of color. We describe and report on the outcome of teaching a workshop on the tool of racial affinity caucusing to address these issues. ⋯ This study demonstrated the first exploration in medical education of racial affinity caucusing and illustrated that it can be easily implemented in residency programs as an effort to address racial health inequities. Though the participating educators were mostly unfamiliar with it, the workshop was an effective introduction to this tool and by the end, educators reported increased comfort and enthusiasm for racial affinity caucusing, regardless of their preexisting levels of knowledge of or comfort with the tool. In addition, the overwhelming majority of the participants felt they could implement it at their respective institutions.
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The majority of medical students receive some of their training with a community preceptor. Nearly all of these preceptors are motivated by a desire to give back to their profession through teaching and they want to learn how to teach more effectively. Designing effective educational programs to improve preceptor teaching is important to upholding the quality of medical education. ⋯ Our preceptor-improvement intervention led to demonstrable improvement in preceptor teaching, as measured by preceptor evaluation and evaluation by the standardized student. More research is needed to see if these results can be replicated and, in particular, to determine which aspects of the intervention were most useful.
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Academic family medicine departments have traditionally promoted faculty using research and scholarship criteria augmented by teaching, clinical care, and service. Clinic-focused faculty who spend significant time in direct patient care may not have enough time to meet promotion criteria, although they are critical for training future family physicians and for rebalancing the system of academic promotion. ⋯ Promotion rates are higher for faculty with protected time for scholarship than for clinic-focused faculty for promotion to both associate and full professor. Clinic demands on faculty may reduce the likelihood of engaging in scholarship or research that in many academic family medicine departments is necessary for promotion.
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Medication-assisted treatment (MAT) for opioid use disorder with buprenorphine in primary care is effective and patient-accessible yet remains underutilized, including among residency training programs. One concern in residency programs is that MAT patients must be seen at least monthly and will overwhelm residents' clinic schedules and dilute their clinical experience. Our family medicine residency initiated an MAT program integrated into residents' continuity clinic schedules. After 2 years we assessed the chronic medical comorbidities we were managing in our MAT population. ⋯ MAT integrated into family medicine resident continuity clinics provides a broad and substantial primary care clinical experience for residents.