Family medicine
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Despite the requirements of the Accreditation Council for Graduate Medical Education (ACGME) to provide feedback, assessments are often not meeting the needs of resident learners. The objective of this study was to explore residents' approach to reviewing, interpreting, and incorporating the feedback provided in written faculty assessments. ⋯ Residents reported that narrative feedback gives more insight to performance and leads to actionable changes in behaviors. Programs should consider education for both faculty and residents on the usefulness, importance, and purpose of the ACGME Milestones in order to accurately determine resident competency and provide a summative assessment. Until the purpose of the ACGME Milestones is realized and utilized, it should be noted that the comment portion of evaluations will likely be the focus of the resident's interaction with their assessments.
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It is documented that some of the opioids prescribed to manage chronic pain are diverted and used for nonmedical purposes. We investigated whether a skill-based, chronic pain management (CPM) educational program could improve first-year family medicine residents' comfort, knowledge, and concerns in assessing and managing patients who use opioids for chronic noncancer pain. ⋯ A multiactivity CPM educational program for first-year residents was associated with improvement in perceived sense of comfort, knowledge, and concerns in assessing and managing patients who use opioids for chronic noncancer pain. CPM training interventions may be an effective tool to educate first-year residents to implement best practices for pain management with the goal of reducing the chances of inappropriately prescribing controlled substances or denying analgesia.
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Rural family medicine residency programs (RFMRPs) encounter unique hardships that threaten their sustainability and efficacy despite their recent success at addressing the rural physician shortage. The aim of this study was to explore strategies employed by RFMRP program directors from across the United States to strengthen their programs in the context of evolving paradigms in graduate medical education (GME). ⋯ Community enrichment and programs' ability to evolve to meet demands are important attributes of a successful RFMRP. Our findings highlight strategies utilized by RFMRPs to help meet the needs of the changing landscape of rural family medicine GME and help identify best practices for developing RFMRPs.
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Family medicine (FM) clerkships have learning objectives to define what students should learn by the end of their clerkship, but how do we know what larger lessons students are taking away? This study aimed to explore the FM clerkship explicit and hidden curriculum. ⋯ When compared to the FM clerkship learning objectives at both institutions, four code categories emerged that were not part of the explicit objectives: traits of a family doctor, challenges in FM care, personal impact, and life skills and tips. Conversely, some nuances of the learning objective of FM in the health care system regarding decreasing cost and improving health outcomes and equity were not represented in the coded categories of student responses. These findings could potentially help FM clerkships nationally define ways to improve messaging around challenges in FM care and help the 25 x 2030 initiative to produce more family physicians in the United States.
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Editorial Comment
Is There a Better Way to Produce a Health Workforce for the Population?