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Training Standards Statements of Family Medicine Postgraduate Training - A Review of Existing Documents Worldwide.

ABSTRACT: INTRODUCTION:For the effective and safe management of complex care needs for patients in community settings, high quality family medicine (FM) training programmes are needed. In less primary care oriented countries, training standards statements for FM postgraduate training are less commonly found. The aim of this study was to review international training standards statements in FM postgraduate training and to catalogue these statements to be used as a best practice standard guide for FM training programs in Germany. MATERIALS AND METHODS:A structured three-tiered search was performed: a systematic literature search in MEDLINE®; a search of international indicator databases; and a search in grey literature, consisting of a survey of international experts and a search in "Google (Scholar)". From all identified documents, training standards statements were extracted, translated and summarized into categories referring to the same quality aspect. RESULTS:The search strategy revealed 25 relevant documents (MEDLINE® n = 15, databases n = 2, experts n = 7, "Google" n = 1), containing 337 training standards statements. These were summarized into 80 statements. They covered structure quality (n = 35); process quality (n = 43); and two training standards statements referred to outcome quality (n = 2). CONCLUSION:A broad range of internationally sourced training standards statements for FM postgraduate training could be identified from countries with well-established primary care systems. Only few statements internationally referred to outcome quality, expressing the difficulty in assessing outcome. The resulting inventory of training standards statements for FM postgraduate training can serve as a resource for institutions seeking to formalise and systematise FM training at regional or national levels.

SUBMITTER: Flum E

PROVIDER: S-EPMC4961452 | biostudies-literature | 2016

REPOSITORIES: biostudies-literature

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Training Standards Statements of Family Medicine Postgraduate Training - A Review of Existing Documents Worldwide.

Flum Elisabeth E Berger Sarah S Szecsenyi Joachim J Marquard Sabine S Steinhaeuser Jost J

PloS one 20160726 7

<h4>Introduction</h4>For the effective and safe management of complex care needs for patients in community settings, high quality family medicine (FM) training programmes are needed. In less primary care oriented countries, training standards statements for FM postgraduate training are less commonly found. The aim of this study was to review international training standards statements in FM postgraduate training and to catalogue these statements to be used as a best practice standard guide for F ...[more]

PMID: 27459714

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Project description:ObjectiveAnalyze the content of documents used to guide mandatory fortification programs for cereal grains.MethodsLegislation, standards, and monitoring documents, which are used to mandate, provide specifications for, and confirm fortification, respectively, were collected from countries with mandatory wheat flour (n=80), maize flour (n=11), and/or rice (n=6) fortification as of January 31, 2015, yielding 97 possible country-grain combinations (e.g., Philippines-wheat flour, Philippines-rice) for the analysis. After excluding countries with limited or no documentation, 72 reviews were completed, representing 84 country-grain combinations. Based on best practices, a criteria checklist was created with 44 items that should be included in fortification documents. Two reviewers independently scored each available document set for a given country and food vehicle (a country-grain combination) using the checklist, and then reached consensus on the scoring. We calculated the percentage of country-grain combinations containing each checklist item and examined differences in scores by grain, region, and income level.ResultsOf the 72 country-grain combinations, the majority of documentation came from countries in the Americas (46%) and Africa (32%), and most were from upper and lower middle-income countries (73%). The majority of country-grain combinations had documentation stating the food vehicle(s) to be fortified (97%) and the micronutrients (e.g., iron) (100%), fortificants (e.g., ferrous fumarate) (88%), and fortification levels required (96%). Most (78%) stated that labeling is required to indicate a product is fortified. Many country-grain combinations described systems for external (64%) monitoring, and stated that industry is required to follow quality assurance/quality control (64%), though detailed protocols (33%) and roles and responsibilities (45%) were frequently not described.ConclusionsMost country-grain combinations have systems in place for internal, external, and import monitoring. However, documentation of other important items that would influence product compliance to national standard, such as roles and responsibilities between agencies, the cost of regulating fortification, and enforcement strategies, are often lacking. Countries with existing mandatory fortification can improve upon these items in revisions to their documentation while countries that are beginning fortification can use the checklist to assist in developing new policies and programs.

Project description:BackgroundWithin the 52 health districts in South Africa, the family physician is seen as the clinical leader within a multi-professional district health team. Family physicians must be competent to meet 90% of the health needs of the communities in their districts. The eight university departments of Family Medicine have identified five unit standards, broken down into 85 training outcomes, for postgraduate training. The family medicine registrar must prove at the end of training that all the required training outcomes have been attained. District health managers must be assured that the family physician is competent to deliver the expected service. The Colleges of Medicine of South Africa (CMSA) require a portfolio to be submitted as part of the uniform assessment of all registrars applying to write the national fellowship examinations. This study aimed to achieve a consensus on the contents and principles of the first national portfolio for use in family medicine training in South Africa.MethodsA workshop held at the WONCA Africa Regional Conference in 2009 explored the purpose and broad contents of the portfolio. The 85 training outcomes, ideas from the WONCA workshop, the literature, and existing portfolios in the various universities were used to develop a questionnaire that was tested for content validity by a panel of 31 experts in family medicine in South Africa, via the Delphi technique in four rounds. Eighty five content items (national learning outcomes) and 27 principles were tested. Consensus was defined as 70% agreement. For those items that the panel thought should be included, they were also asked how to provide evidence for the specific item in the portfolio, and how to assess that evidence.ResultsConsensus was reached on 61 of the 85 national learning outcomes. The panel recommended that 50 be assessed by the portfolio and 11 should not be. No consensus could be reached on the remaining 24 outcomes and these were also omitted from the portfolio. The panel recommended that various types of evidence be included in the portfolio. The panel supported 26 of the 27 principles, but could not reach consensus on whether the portfolio should reflect on the relationship between the supervisor and registrar.ConclusionA portfolio was developed and distributed to the eight departments of Family Medicine in South Africa, and the CMSA, to be further tested in implementation.

Project description:BackgroundIn South Africa it is compulsory to submit a satisfactory portfolio of learning to gain entrance to the national exit examination of the College of Family Physicians and to qualify as a family physician. A paper-based portfolio has been implemented thus far and the need for an electronic portfolio (e-portfolio) was identified. The aim of the study was to describe and evaluate the implementation of an e-portfolio for the training of family medicine registrars in the Western Cape province of South Africa.MethodsMixed methods were used. A quasi-experimental study evaluated paper- and e-portfolios from the same 28 registrars in 2015 compared to 2016. Semi-structured interviews were conducted with 11 registrars or supervisors to explore their experiences of using the e-portfolio. Quantitative data was analysed in the Statistical Package for Social Sciences and qualitative data in Atlas.ti.ResultsMost respondents found the e-portfolio easier to use and more accessible. It made progress easier to monitor and provided sufficient evidence of learning. Feedback was made easier and more explicit. There were concerns regarding face-to-face feedback being negatively affected. It was suggested to have a feedback template to further improve feedback. Several aspects were significantly better in the e-portfolio such as feedback on the registrar's general behaviour, alignment with learning outcomes, less feedback based on hearsay and acknowledgement of the feedback by the registrar. Although not statistically significant, there was an increase in the usage of the e-portfolio, compared to the paper portfolio.ConclusionIn general, the e-portfolio is an improvement on the paper-based portfolio. It is easier to access, more user-friendly and less cumbersome. It makes feedback and monitoring of progress and development of registrars easier and more visible and provides sufficient evidence of learning. Its implementation throughout South Africa is recommended.

Project description:BackgroundMolding competent clinicians capable of applying ethics principles in their practice is a challenging task, compounded by wide variations in the teaching and assessment of ethics in the postgraduate setting. Despite these differences, ethics training programs should recognise that the transition from medical students to healthcare professionals entails a longitudinal process where ethics knowledge, skills and identity continue to build and deepen over time with clinical exposure. A systematic scoping review is proposed to analyse current postgraduate medical ethics training and assessment programs in peer-reviewed literature to guide the development of a local physician training curriculum.MethodsWith a constructivist perspective and relativist lens, this systematic scoping review on postgraduate medical ethics training and assessment will adopt the Systematic Evidence Based Approach (SEBA) to create a transparent and reproducible review.ResultsThe first search involving the teaching of ethics yielded 7669 abstracts with 573 full text articles evaluated and 66 articles included. The second search involving the assessment of ethics identified 9919 abstracts with 333 full text articles reviewed and 29 articles included. The themes identified from the two searches were the goals and objectives, content, pedagogy, enabling and limiting factors of teaching ethics and assessment modalities used. Despite inherent disparities in ethics training programs, they provide a platform for learners to apply knowledge, translating it to skill and eventually becoming part of the identity of the learner. Illustrating the longitudinal nature of ethics training, the spiral curriculum seamlessly integrates and fortifies prevailing ethical knowledge acquired in medical school with the layering of new specialty, clinical and research specific content in professional practice. Various assessment methods are employed with special mention of portfolios as a longitudinal assessment modality that showcase the impact of ethics training on the development of professional identity formation (PIF).ConclusionsOur systematic scoping review has elicited key learning points in the teaching and assessment of ethics in the postgraduate setting. However, more research needs to be done on establishing Entrustable Professional Activities (EPA)s in ethics, with further exploration of the use of portfolios and key factors influencing its design, implementation and assessment of PIF and micro-credentialling in ethics practice.

Project description:BackgroundThe COVID-19 pandemic has highlighted the growing need for digital learning tools in postgraduate family medicine training. Family medicine departments must understand and recognize the use and effectiveness of digital tools in order to integrate them into curricula and develop effective learning tools that fill gaps and meet the learning needs of trainees.ObjectiveThis scoping review will aim to explore and organize the breadth of knowledge regarding digital learning tools in family medicine training.MethodsThis scoping review follows the 6 stages of the methodological framework outlined first by Arksey and O'Malley, then refined by Levac et al, including a search of published academic literature in 6 databases (MEDLINE, ERIC, Education Source, Embase, Scopus, and Web of Science) and gray literature. Following title and abstract and full text screening, characteristics and main findings of the included studies and resources will be tabulated and summarized. Thematic analysis and natural language processing (NLP) will be conducted in parallel using a 9-step approach to identify common themes and synthesize the literature. Additionally, NLP will be employed for bibliometric and scientometric analysis of the identified literature.ResultsThe search strategy has been developed and launched. As of October 2021, we have completed stages 1, 2, and 3 of the scoping review. We identified 132 studies for inclusion through the academic literature search and 127 relevant studies in the gray literature search. Further refinement of the eligibility criteria and data extraction has been ongoing since September 2021.ConclusionsIn this scoping review, we will identify and consolidate information and evidence related to the use and effectiveness of existing digital learning tools in postgraduate family medicine training. Our findings will improve the understanding of the current landscape of digital learning tools, which will be of great value to educators and trainees interested in using existing tools, innovators looking to design digital learning tools that meet current needs, and researchers involved in the study of digital tools.Trial registrationOpen Science Framework osf.io/wju4k 10.17605/OSF.IO/WJU4K.International registered report identifier (irrid)DERR1-10.2196/34575.

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Training Standards Statements of Family Medicine Postgraduate Training - A Review of Existing Documents Worldwide.

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Training Standards Statements of Family Medicine Postgraduate Training - A Review of Existing Documents Worldwide.

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