McWhinney's gift: academic family medicine.
Ontology highlight
ABSTRACT:
SUBMITTER: Duffin J
PROVIDER: S-EPMC3589318 | biostudies-literature | 2013 Mar
REPOSITORIES: biostudies-literature
Publications
McWhinney's gift: academic family medicine.
CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne 20130211 4
Similar Datasets
Project description:BackgroundSince the early 1990s former communist countries have been reforming their health care systems, emphasizing the key role of primary care and recognizing family medicine as a specialty and an academic discipline. This study assesses the level of academic development of the discipline characterised by education and research in central and eastern European (CEE) countries.MethodsA key informants study, using a questionnaire developed on the basis of a systematic literature review and panel discussions, conducted in 11 central and eastern European countries and Russia.ResultsFamily medicine in CEE countries is now formally recognized as a medical specialty and successfully introduced into medical training at undergraduate and postgraduate levels. Almost all universities have FM/GP departments, but only a few of them are led by general practitioners. The specialist training programmes in all countries except Russia fulfil the recommendations of the European Parliament. Structured support for research in FM/GP is not always available. However specific scientific organisations function in almost all countries except Russia. Scientific conferences are regularly organised in all the countries, but peer-reviewed journals are published in only half of them.ConclusionsFamily medicine has a relatively strong position in medical education in central and eastern Europe, but research in family practice is less developed. Although the position of the discipline at the universities is not very strong, most of the CEE countries can serve as an example of successful academic development for countries southern Europe, where family medicine is still not fully recognised.
| S-EPMC3608318 | biostudies-literature
Project description:BackgroundWith the onset of the COVID-19 pandemic, telemedicine was rapidly implemented in care settings globally. To understand what factors affect the successful completion of telemedicine visits in our urban, academic family medicine clinic setting, we analysed telemedicine visits carried out during the pandemic.MethodsWe conducted a retrospective chart review of telemedicine visits from 2 clinical units within a family medicine centre. To investigate the association between incomplete visits and various factors (age, gender, presenting complaints, physician level of training [resident or staff] and patient-physician relational continuity), we performed a multivariable logistic regression on data from August 2020, February 2021, and May 2021. An incomplete visit is one that requires a follow-up in-person visit with a physician within 3 days.ResultsOf the 2,138 telemedicine patient visits we investigated, 9.6% were incomplete. Patients presenting with lumps and bumps (OR: 3.84, 95% CI: 1.44, 10.5), as well as those seen by resident physicians (OR: 1.77, 95% CI: 1.22, 2.56) had increased odds of incomplete visits. Telemedicine visits at the family medicine clinic (Site A) with registered patients had lower odds of incomplete visits (OR: 0.24, 95% CI: 0.15, 0.39) than those at the community clinic (Site B), which provides urgent/episodic care with no associated relational continuity between patients and physicians.ConclusionIn our urban clinical setting, only a small minority of telemedicine visits required an in-person follow-up visit. This information may be useful in guiding approaches to triaging patients to telemedicine or standard in-person care.
| S-EPMC11461682 | biostudies-literature
Project description:Retention among academic medicine faculty is problematic, and there has been a decline in the number of physicians pursuing careers in academia. The education of future physicians relies upon physicians who pursue careers in academic medicine. Therefore, efforts must be taken to increase the percentage of physicians who conduct research and/or teach medical trainees. Recognizing this need, the New York Institute of Technology College of Osteopathic Medicine (NYITCOM) established the Academic Medicine Scholars Program ("Scholars Program"), which was designed to prepare outstanding osteopathic medical students for a career in academic medicine. Here we aim to determine the extent to which participants in NYITCOM's Scholars Program go on to pursue research and teaching endeavors during their residency and/or fellowship programs. An anonymous survey was administered to participants in the Scholars Program from 2012 through 2018 and asked about the participants' research and teaching experiences at the following time points: during the Scholars Program, residency, and fellowship, if applicable. Participation in the program led to a significant increase in survey respondents' teaching and research skills and an increased participation in scholarly activity as compared with the national average. The results also demonstrated that the program assisted alumni in securing positions in competitive residency and fellowship programs. As residents and fellows, alumni continued to pursue scholarly endeavors, primarily by publishing abstracts and posters, attending both regional and national conferences, and delivering lectures. We are hopeful that other medical schools will take part in producing capable academic medicine physicians by incorporating a similar program into their curriculum.
| S-EPMC8368134 | biostudies-literature
Project description: Not available
| S-EPMC521006 | biostudies-literature
Project description:BackgroundThere is pressing need to develop and evaluate clinically sound approaches to supporting the engagement between patients who have inherited cancer susceptibility and their relatives who may share it. Identifying and engaging patients with an inherited cancer susceptibility in the community is a potentially powerful strategy to reduce the gap in genetic risk evaluation for their families. The goal of the Genetic Information and Family Testing (GIFT) Study is to engage patients about inherited cancer susceptibility and provide support and services to their relatives to initiate genetic risk evaluation (including choice of home genetic testing).Methods/designWe are conducting a population-based, 2 × 2 factorial cluster-randomized clinical trial to implement and evaluate a direct-to-family, virtual, personalized, family-centered communication and decision-making tool: the Family Genetic Health Program. We use a unique SEER-based data infrastructure that we pioneered to identify patients diagnosed with cancer in the states of Georgia and California who carry a pathogenic variant (PV) in clinically tested cancer susceptibility gene. Eligible patients are offered enrollment into the trial and can invite their eligible first- and second-degree relatives to enroll. The index subject is randomized, and relatives are then cluster randomized by family. Participants in all arms receive some level of intervention, including at least the web-based platform with information about genetic testing and, for the relatives, an option to receive genetic testing through the study platform. We study the effects of two intervention design features: (1) the level of personalized family genetic risk navigation support: a technology-assisted, personally tailored patient and family member education and communication tool vs. the tool plus direct assistance from a lay human navigator); and (2) the cost of the genetic test offered to the relatives ($50 vs. free).DiscussionGIFT is a blueprint for how a virtual cascade genetic risk program can be delivered in the community, through a population-based approach to patients and relatives in families with hereditary cancer syndromes. The vision, experiences, and findings from GIFT will inform next-generation implementation science and the results will pertain to stakeholders interested in a population-based approach to cascade genetic risk evaluation.Trial registrationNCT05552664 registered at Clincaltrials.gov September 20, 2022.
| S-EPMC11869684 | biostudies-literature
Project description:Background and Objectives:The United States has seen an evolving perspective on the medical use of cannabis in recent years. Although a majority of states have enacted medical cannabis programs, physicians practicing in these states report a lack of knowledge, lingering concerns, and a need for more training regarding medical cannabis. This study provides a current snapshot of medical cannabis education in an academic family medicine department in a state with a medical cannabis program. Methods:An electronic survey was sent to all 134 faculty physicians and residents within a family medicine department to assess current knowledge and attitudes regarding medical cannabis. Study authors performed descriptive statistical analysis of the survey data. Results:Of the 61 individuals to complete the survey, 34 were residents and 27 were faculty. Overall, respondents displayed poor understanding of the state's medical cannabis program as well as cannabis regulations. A majority of both faculty and residents reported low self-rated competency levels for medical cannabis efficacy, adverse effects, and safety using Likert scales (1 to 5; 1=low competency, 5=high competency). A majority of faculty (56%) expressed that they did not intend to certify patients for medical cannabis compared to only 33% of residents. Residents were statistically more likely to think of a patient who might benefit from medical cannabis compared to faculty (39% vs 11%, P=.004, chi-square). Conclusions:Increasingly, family physicians will be called on to provide informed patient counseling regarding medical cannabis. These results highlight a knowledge gap for family medicine learners in a changing practice landscape.
| S-EPMC7490185 | biostudies-literature
Project description:ObjectivesTo review systematically the evidence about what factors influence the decision to choose or not choose a career in academic medicine.DesignA systematic review of relevant literature from 1990 to May 2005.Data sourcesSearches of The Cochrane Library, Medline (using Ovid and PubMed) from 1990 to May 2005, and EMBASE from 1990 to May 2005 were completed to identify relevant studies that explored the influential factors. Additional articles were identified from searching the bibliographies of retrieved articles.Selection of studiesWe attempted to identify studies that included residents, fellows, or staff physicians. No restrictions were placed on the study methodologies identified and all articles presenting empirical evidence were retrieved. For cohort, case-control, and cross-sectional studies, minimum inclusion criteria were the presence of defined groups, and the ability to extract relevant data. For surveys that involved case series, minimum inclusion criteria were a description of the population, and the availability of extractable data. Minimum inclusion criteria for qualitative studies were descriptions of the sampling strategy and methods.ResultsThe search identified 251 abstracts; 25 articles were included in this review. Completion of an MD with a graduate degree or fellowship program is associated with a career in academic medicine. Of the articles identified in this review, this finding is supported by the highest quality of evidence. Similarly, the completion of research and publication of this research in medical school and residency are associated with a career in academic medicine. The desire to teach, conduct research, and the intellectual stimulation and challenge provided in academia may also persuade people to choose this career path. The influence of a role model or a mentor was reported by physicians to impact their decision making. Trainees' interest in academic medicine wanes as they progress through their residency.ConclusionsIn order to revitalize academic medicine, we must engage trainees and retain their interest throughout their training. Research opportunities for medical students, and fellowships or graduate training can meet this challenge and influence career choice. Initiatives to stimulate and maintain interest in academic medicine should be evaluated in prospective studies across multiple sites.
| S-EPMC1924755 | biostudies-literature
Project description: Not available
| S-EPMC381120 | biostudies-literature
Project description:Researchers examined the correlation between the physician's subjective assessment of health literacy rates and actual health literacy rates among patients as determined by the Newest Vital Sign (NVS). A sample of n = 150 patients, 18 years of age or older, were verbally interviewed using NVS tool before seeing their physician. After the physician met with the patient, the physician was asked to measure that patient's level of health literacy on a Likert-type scale and a "yes/no" scale. Frequency and percentage statistics were performed in SPSS to describe the distributions of patient and physician responses. Between-subjects statistics were used. Analysis of the patient surveys revealed one in 4 patients has a high likelihood of low health literacy. Analysis revealed there were significant positive correlations between physician response to perception of a patient's low health literacy risk and NVS survey responses. Despite the risk of limited literacy, 97.3% of physicians perceived the patient to understand what the physician was saying. Physicians should use teach-back and other health literacy principles with each patient, regardless of perceived risk.
| S-EPMC10722918 | biostudies-literature
Project description:BackgroundMinimising the effects of unconscious bias in selection for clinical academic training is essential to ensure that allocation of training posts is based on merit. We looked at the effect of anonymising applications to a training programme for junior doctors on the scores of the applications and on gender balance; and whether female candidates were more likely to seek gender-concordant mentors.MethodsApplications to the training programme were reviewed and scored independently by reviewers who received either an anonymised or named copy. Scores were compared using a paired t-test, and differences in scores compared by gender. The gender of named supervisors for male and female candidates was compared.ResultsScores of 101 applications were reviewed. When their identity was known, male candidates scored 1.72% higher and female candidates scored 0.74% higher, but these findings were not statistically significant (p value = 0.279 and 0.579). Following introduction of anonymisation, the proportion of successful female candidates increased from 27 to 46%. Female candidates were more likely to name a female supervisor compared to male (41% vs. 25% of supervisors).ConclusionsAnonymising applications did not significantly change scores, although gender balance improved. Gender-concordant mentoring initiatives should consider effects on mentors as well as mentees.
| S-EPMC10152728 | biostudies-literature