Family medicine
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Patients' health literacy is increasingly recognized as a critical factor affecting patient-physician communication and health outcomes. We reviewed research on health literacy, examined its impact on patient-physician communication, and offer recommendations to enhance communication with patients who have poor health literacy. ⋯ Future research needs to address identification of optimal methods for communicating with patients who have low literacy skills. This should focus on the effect of poor health literacy on patients' ability to communicate their history and physicians' ability to solicit information, as well as identifying the most-effective techniques to educate patients.
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More than 9 million Latino children currently live in the United States. Latinos will soon be the largest minority group in the country, but little is known about access barriers to health care faced by Latino children. We reviewed the literature to define specific barriers to care for Latino children, identify methodologic problems, and highlight the clinical and research implications of the identified barriers. ⋯ Lack of health insurance and lack of a regular source of care are major access barriers for Latino children, but many other barriers were identified that also can have a substantial effect on health care. In addition, the behaviors and practices of both health care providers and parents can affect access to care. Too little is known about what parents perceive to be the major barriers, access differences among Latino subpopulations, the roles of language and culture, and the causes of obstacles resulting from the actions of providers.
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Since their inception, family practice residency programs have been designed on a rotation-based format. It has been assumed that by having residents rotate through a series of educational experiences, they would assimilate the skills necessary to effectively serve as a family physician. An alternative approach is based on the attainment of competency, rather than on the completion of a set of experiences. ⋯ In response to the growing need to discuss these and other related issues, the Society of Teachers of Family Medicine (STFM) Board created the Task Force on Competency-based Education. Its mission is to disseminate this educational theory to STFM's membership. This article reviews the theory of competency-based education, describes development of a competency-based curriculum model, and discusses the academic issues surrounding adaptation of this form of education to family practice residency programs.
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The complex and unique challenge of academic medicine requires that faculty possess both organizational and leadership skills. This article presents a framework of leadership and organizational skills in family medicine. ⋯ Organizational and leadership development is occurring in the context of both individual and organizational initiatives. We propose a cycle-of-learning framework that provides one model for development of these essential skills.
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This article examines the declining interest in family practice by US medical students and trends in specialty selection over the past decade. Four factors affecting specialty choice (medical student characteristics, medical school, residencies, and certain aspects of the health care system) are discussed, and a research agenda is developed for each area. Researchers and funding agencies are urged to begin an exploration of these issues to better understand the dynamics behind current specialty choices so that successful policies to increase the number of students entering family practice can be developed.