Family medicine
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Recent consensus guidelines have recommended uniformity in procedural training in family medicine residency programs. The consensus documentation suggestions are based on expectations of procedural training prior to residency. Few studies have evaluated the perceived baseline level of procedural competency prior to residency training. ⋯ The survey results showed that experience and comfort with procedures often performed in family medicine varies widely among incoming residents. This raises the question of whether documentation of resident competence in these procedures should be recommended as a baseline and monitored throughout residency training.
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A foundation of care within a Patient-centered Medical Home (PCMH) is respect for patients' values and preferences. Shared decision making (SDM) involves a set of principles and approaches to working with patients that integrates medical information and data with the preferences, values, and support systems of individual patients facing medical decisions. The value of SDM is increasingly evidenced by the incorporation of principles of SDM into the definitions of patient-centered care and PCMHs, accountable care organizations, and the language of the Health Reform Act of 2010. ⋯ As this curriculum has developed, we have acquired a deep appreciation of the benefits and challenges of attempting to teach sophisticated communication and decision-making precepts to medical students who are working to master fundamentals of clinical work and who may or may not see such precepts reinforced in practice.
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The Patient-centered Medical Home (PCMH) concept, essential functions of primary care, and an appropriate primary care workforce have been shown to improve health outcomes and reduce health care costs. This paper describes a curriculum that uses the PCMH and related health policy concepts as the foundation for didactic, clinical, and self-directed elements. The PCMH-focused curriculum improved overall student clerkship ratings and maintained student performance on the National Board of Medical Education subject exam.
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Currently available tools to measure teamwork, an essential component of primary care, are generally very resource intensive and thus cannot be administered frequently. To explore the possibility of developing a brief teamwork-assessment instrument, we first administered 29 questions about teamwork from the Practice Environment Checklist (PEC) to all members of six clinical teams in a residency outpatient practice (n=56). ⋯ It continued to have an acceptable internal consistency (Cronbach alpha=0.82) and that all five items had sizeable item-total correlations. The resulting short form of the PEC may be useful for frequent assessment of team function.