Family medicine
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Teaching medical trainees evidence-based medicine (EBM) is required by the Accreditation Council for Graduate Medical Education. Most published graduate EBM curricula focus on critical appraisal over point-of-care information mastery. Faculty at the University of Rochester Family Medicine Residency implemented a clinically integrated, cyclical EBM curriculum juxtaposing information mastery with expert-level skills such as critical appraisal. We administered the Evidence-Based Medicine Environment Survey (EBMES) to learners before and after the yearlong curriculum. ⋯ Resident perception of the EBM learning environment improved after participation in a yearlong curriculum. Nearly all of the content covered in the "Science of Family Medicine" curriculum and measured by EBMES improved in a statistically significant manner. We propose that EBM curricula should combine traditional literature search and critical appraisal skills with information mastery to maximize effectiveness. Our curriculum can be modified to fit other graduate family medicine contexts.
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To better understand the current use of simulation and barriers to its use in family medicine resident education, we surveyed US family medicine residency (FMR) program directors (PDs) about opinions and use of simulation-based medical education (SBME) in their programs. A number of specialties have incorporated or required simulation-based educational techniques in residency education over the past 10 years, but little is known about the current use of SBME in family medicine graduate medical education. We also evaluated associations between program characteristics and the use of SBME in FMR education. ⋯ Use of SBME in family medicine resident education has increased since 2011. PDs value simulation for education and remediation, and most programs have introduced some degree of simulation despite barriers. The results of this study can inform resources to support the continued integration of SBME into family medicine resident education.
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Diversity, inclusion, and health equity (DIHE) are integral to the practice of family medicine. Academic family medicine has been grappling with these issues in recent years, particularly with a focus on racism and health inequity. We studied the current state of DIHE activities in academic family medicine departments and suggest a framework for departments to become more diverse, inclusive, antiracist, and focused on health equity and racial justice. ⋯ The majority of family medicine department chairs rate their departments highly on DIHE. However, only 50% of departments have formally assessed climate in the past 3 years, fewer have diversity officers, and even fewer invest resources in their diversity officers. This disconnect should motivate academic family medicine departments to undertake formal self-assessment and implement a strategic plan that includes resource investment in DIHE, measurable outcomes, and sustainability.
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In 2018, the 25 x 2030 Collaborative was created. Its goal is to "increase the proportion of US medical school graduates who choose family medicine (FM) to 25% by 2030." The purpose of this study was to take a deeper look at the history of medical student interest in FM from the earliest data to the present, both after the match and those who are FM interns after July 1. ⋯ The 25 x 30 Collaborative will likely fail to reach its goal.