Family medicine
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Research into the rates of burnout among nonclinical workers is nonexistent at medical education centers (MECs). The first goal of this study was to explore the prevalence of burnout among nonclinical faculty and staff working at a local MEC. The second goal was to identify predictors of burnout using job satisfaction dimensions-supervision, coworkers, contingency rewards, and nature of work. ⋯ Nonclinical workers at a local MEC were generally satisfied with their job and showed a moderate degree of burnout. Compared to the general population, our sample reported less burnout.
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Observational Study
A Time-Motion Study of Primary Care Physicians' Work in the Electronic Health Record Era.
Electronic health records (EHRs) have had mixed effects on the workflow of ambulatory primary care. In this study, we update previous research on the time required to care for patients in primary care clinics with EHRs. ⋯ Primary care physicians spent more time working in the EHR than they spent in face-to-face time with patients in clinic visits.
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There is a push to use classroom technology and active teaching methods to replace didactic lectures as the most prevalent format for resident education. This multisite collaborative cohort study involving nine residency programs across the United States compared a standard slide-based didactic lecture, a facilitated group discussion via an engaged classroom, and a high-fidelity, hands-on simulation scenario for teaching the topic of acute dyspnea. The primary outcome was knowledge retention at 2 to 4 weeks. ⋯ Compared to standard lecture, both engaged classroom and high-fidelity simulation were associated with a statistically significant improvement in knowledge retention. Knowledge retention after engaged classroom and high-fidelity simulation did not significantly differ. More research is necessary to determine if different teaching methods result in different levels of comfort and skill with actual patient care.
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Numerous organizations are calling for the expansion of graduate medical education (GME) positions nationally. Developing new residency programs and expanding existing programs can only happen if financial resources are available to pay for the expenses of training beyond what can be generated in direct clinical income by the residents and faculty in the program. The goal of this study was to evaluate trended data regarding the finances of family medicine residency programs to identify what financial resources are needed to sustain graduate medical education programs. ⋯ For this study group of family medicine programs, data suggests a cost per resident per year, excluding federal and state GME funding streams, of about $180,000. This excess expense compared to revenue must be met by other agencies, whether from CMS, the Health Resources and Services Administration (HRSA), state expenditures or other sources, through stable long-term commitments to these funding mechanisms to ensure program viability for these essential family medicine programs in the future.
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Population health management (PHM) is an important function of primary care with potential to improve outcomes and decrease costs, but is also among the most difficult strategies to implement in both practices and residency training. Our objective was to determine resident and residency program characteristics associated with graduates' reported preparation to perform PHM. ⋯ Similar to a study of practicing physicians, we found that IMGs are more likely to report preparedness to perform PHM. This suggests that elements of international medical education may better inculcate PHM principles, and that these elements could be used to produce physicians better prepared to manage population health.