Family medicine
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Primary care physicians can spend 24% of their ambulatory care work day on patient care duties outside the office visit (ie, nonvisit care [NVC]). Resident work hours must be performed within duty hour restrictions defined by the Accreditation Council for Graduate Medical Education, making it crucial for program directors to understand how much time residents spend on NVC tasks. Little information is available on resident work hours dedicated to NVC generated in the continuity clinic. We designed this study to look at an objective measure of the time family medicine residents spend on NVC. ⋯ This study quantified the amount of time residents spend on NVC, allowing program directors to plan curriculum so that residents can keep their work time within duty hour requirements.
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The purpose of this study was to examine the impact of racism experienced by physicians of color in the workplace. ⋯ Physicians of color are likely to experience significant racism while providing health care in their workplace settings, and they are likely to feel unsupported by their institutions when these experiences occur. Institutions seeking a more equitable workplace environment should intentionally include diversity and inclusion as part of their effort.
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Health advocacy has been declared an essential physician skill in numerous professional physician charters. However, there is limited literature on whether, and how, family medicine residencies teach this skill. Our aim was to determine the prevalence of a formal mandatory advocacy curriculum among US family medicine residencies, barriers to implementation, and what characteristics might predict its presence. ⋯ In a national survey of family medicine PDs, only one-third of responding PDs reported a mandatory advocacy curriculum, most focusing on community advocacy. The largest barrier to implementation was curricular flexibility. More research is needed to explore the best strategies to implement these types of curricula and the long-term impacts of formal training.
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While family medicine has been one of the first specialties to implement competency-based medical education (CBME) in residency, the nature and level of its integration with continuing professional development (CPD) is neither well understood nor well studied. The purpose of this review was to examine the current state of CBME implementation in family medicine residency and CPD programs in the North American education literature, with the aim of identifying implementation concepts and strategies that are generalizable to other medical settings to inform the design and implementation of residency training and CPD. ⋯ Given that the implementation of CBME is in its relative infancy, the pattern of implementation activities described in this scoping review reflected a limited focus on a broad range of issues related to fidelity of implementation of this complex intervention.
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Burnout is prevalent among clinicians and entails negative personal, professional, and organizational consequences. Assessments of burnout are typically anonymous to facilitate psychological safety. This limits the capacity of leadership to help struggling providers and reduces the level of demographic detail. Nonanonymous, confidential assessments may facilitate outreach to individuals or targeted interventions for at-risk populations. ⋯ Most participants chose to respond confidentially. There was no significant difference in the level of burnout between confidential and anonymous respondents. Our findings refute the conventional wisdom that clinicians require anonymity to respond to burnout surveys. This finding has the potential to open a new line of inquiry regarding burnout, its drivers and potential solutions.