Family medicine
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A personal physician and enhanced access to care are principles of the patient-centered medical home. Despite the importance of these concepts, measuring and improving interpersonal continuity of care and access to care in academic family medicine centers has received little attention. The authors describe their program's methods and results to maximize continuity of care and minimize delays for care using proven principles from improvement science. ⋯ Despite multiple challenges in academic teaching practices, the continuous use of improvement methods to apply proven change concepts minimizes delay for care and maximizes continuity of care. The residency continuity practice can and should be a cornerstone of residency curriculum.
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Prevalence of chronic disease is rising at unprecedented rates with associated costs that account for 84% of US health care spending. Physicians have the opportunity to guide patients to make lifestyle changes for preventing and self-managing chronic diseases. However, current medical education offers limited training opportunities in behavioral change counseling approaches. Motivational interviewing (MI) is an increasingly well-recognized intervention in the medical community that addresses both behavior change and self-management support. While evidence to support training in motivational interviewing for medical students is growing, more studies are needed. The purpose of this study is to evaluate changes in third-year medical students' knowledge, skills, and attitudes as a result of a 4-hour MI training. ⋯ The study provides promising evidence that a short 4-hour training can render positive changes among medical students, which supports integration in medical student education programs. Future studies may include evaluation of curriculum enhancements with a more rigorous research design and development of additional training opportunities.
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Although there are reports of short-term benefits of health literacy curricula for improving health care professionals' communication with patients, no studies have included long-term follow-up. We sought to determine (1) whether a pre-clerkship health literacy training can improve medical students' perceived knowledge and intended behaviors vis-á-vis communication with patients who have low health literacy, (2) the longevity of any such impact at 12 months, and (3) the impact of a follow-up training 1 year later. ⋯ Among a cohort of pre-clerkship medical students, improvements in perceived knowledge and planned behavior vis-á-vis health literacy training largely did not persist at 12-month follow-up. Efforts to teach medical students about health literacy principles and practices should include a longitudinal or integrated format, rather than a one-time lecture format.
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Learners in medical education are often inadequately prepared to address the underlying social determinants of health and disease. The objective of this article is to describe the development, implementation, and evaluation of a Health Policy and Advocacy curriculum incorporated into our family medicine clerkship. ⋯ Training in health care policy and advocacy can be successfully implemented into a medical school curriculum with positive outcomes in students' self-reported knowledge and confidence in their abilities. Work remains on providing advocacy role models for students.
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Many factors influence a medical student's decision to choose a family medicine career. The impact of participation in extracurricular programs sponsored by family medicine departments is currently unclear. Medical student participation in four University of Washington Department of Family Medicine-sponsored programs (Community Health Advancement Program, Family Medicine Interest Group, Rural Underserved Opportunity Program, and the Underserved Pathway) could be associated with becoming a family physician. ⋯ Certain demographic factors and high initial interest in family medicine is associated with entering the specialty. Some, but not all, family medicine department-sponsored extracurricular programs were associated with choosing family medicine.