A pilot curriculum to integrate community health into internal medicine residency training.
Ontology highlight
ABSTRACT:
SUBMITTER: Catalanotti J
PROVIDER: S-EPMC3886472 | biostudies-other | 2013 Dec
REPOSITORIES: biostudies-other
Similar Datasets
Project description:China formally established a system of national standardized medical residency training in 2014, which affects the health of its 1.4 billion people. Accompanying this system were new guidelines and standards for internal medicine residency training. However, the majority of the standards focused on process measurements, such as minimum case requirements of diseases and procedural skills, rather than describing broader physician competencies in the domains of professionalism, patient care, communication, teamwork, quality improvement, and scholarship. While China has taken a large step forward with standardization of certain aspects of internal medicine residency training, the next step should focus on outcome measures and creating a system that is competency-based.
| S-EPMC5807259 | biostudies-other
Project description:BackgroundEmergency Medicine (EM) is a rapidly developing specialty in Africa with several emergency medicine residency-training programs (EMRPs) established across the continent over the past decade. Despite rapid proliferation of the specialty, little is known about emergency care curriculum structure and content. We provide an overview of Africa's EMRPs.MethodsThis was a descriptive cross-sectional survey conducted of EMRPs in Africa between January 2017 and December 2017. Data were prospectively collected using a structured survey that was developed and administered through online data capture software, REDCap (Version 7.2.2, Vanderbilt, Nashville, TN, USA). Survey questions focused on curriculum structure and design, including clinical rotations, didactics, research, and evaluation. Data are summarized with descriptive statistics.ResultsThe survey was sent to the leadership of 15 EMRPs in 12 different African countries and 11 (73%) responded. Five (46%) of the responding programs were started by local non-EM trained faculty, two (18%) were started by international partners, and the remainder by a combination of local non-EM faculty and international partners. Overall, Seven (64%) of the countries offer a 4-year EMRP. In General, 40% of curriculums are influenced the contents developed by African Federation for Emergency Medicine. All programs offer resident led-didactics, with a median of 12?h (Interquartile range 9-6?h) per month. All EMRPs have a mandatory research requirement. All EMRPs offer clinical rotations in the ED, Paediatrics, and Obstetrics and Gynaecology, while only 2 programs offer rotations in radiology and neonatal intensive care units. Only 46% of EMRPs have in-ED clinical supervision by specialist.ConclusionThe EMRPs in Africa were started by non-EM trained local faculty alone or collaboration with international partners. The curriculum offers most exposure to ED, and less exposure in radiology and neonatal intensive care. Residents are highly involved in leading didactics and less than half of the programs have in-ED specialist supervision of patient care.
| S-EPMC6670225 | biostudies-literature
Project description:ImportanceHealth disparities continue to exist despite the call to increase education of health care practitioners. An assessment of health disparities education has not been previously studied in a national cohort.ObjectiveTo describe and compare the curriculum on health disparities from the perspective of program directors and perceptions of training among internal medicine residents.Design, setting, and participantsThis cross-sectional survey study used a survey of US internal medicine program directors, the 2015 Association of Program Directors in Internal Medicine annual survey, which included questions about health disparities curriculum, and a 1-time survey of US internal medicine residents that asked questions related to their training in health disparities on the American College of Physicians 2015 Internal Medicine In-Training Examination. All internal medicine program directors who were members of Association of Program Directors in Internal Medicine (368 of 396 accredited programs), and internal medicine residents who took the Internal Medicine In-Training Examination were eligible. Final analysis of the merged data set was completed in 2018.ExposuresQuestions were included on the annual Association of Program Directors in Internal Medicine survey and the Internal Medicine In-Training Examination.Main outcomes and measuresProgram directors reported on presence of health disparities curriculum, educational methods, quality, barriers and challenges to curriculum, and Clinical Learning Environment Review. Residents reported whether they received training and quality of the training in health disparities.ResultsA total of 227 program directors (response rate, 61.7%) and 22 723 residents (response rate, 87.2%) responded to the surveys. A total of 90 program directors (39.6%) reported a curriculum in health disparities, but among these, only 16 program directors (17.8%) felt quality of their education was very good or excellent. In more than half of the programs (52 programs [55.9%]), outcomes of the curriculum were not measured. After merging, the combined data set included 18 883 residents from 366 APDIM member programs with 225 program director responses. Among these, 13 251 residents (70.2%) reported some training in caring for patients at risk for health disparities. Of residents who reported receiving training, 10 494 (79.2%) rated the quality as very good or excellent.Conclusions and relevanceThese findings suggest that that despite the Clinical Learning Environment Review mandate and Accreditation Council for Graduate Medical Education required competencies for training in health disparities, relatively few internal medicine programs in the US provided educational curriculum. Additionally, the existence of health disparities curricula in internal medicine training programs was not associated with resident's perception of training or its quality.
| S-EPMC7417967 | biostudies-literature
Project description:The Integrative Medicine in Residency (IMR) program, a 200-hour Internet-based, collaborative educational initiative was implemented in 8 family medicine residency programs and has shown a potential to serve as a national model for incorporating training in integrative/complementary/alternative medicine in graduate medical education.The curriculum content was designed based on a needs assessment and a set of competencies for graduate medical education developed following the Accreditation Council for Graduate Medical Education outcome project guidelines. The content was delivered through distributed online learning and included onsite activities. A modular format allowed for a flexible implementation in different residency settings.TO ASSESS THE FEASIBILITY OF IMPLEMENTING THE CURRICULUM, A MULTIMODAL EVALUATION WAS UTILIZED, INCLUDING: (1) residents' evaluation of the curriculum; (2) residents' competencies evaluation through medical knowledge testing, self-assessment, direct observations, and reflections; and (3) residents' wellness and well-being through behavioral assessments.The class of 2011 (n = 61) had a high rate of curriculum completion in the first and second year (98.7% and 84.2%) and course evaluations on meeting objectives, clinical utility, and functioning of the technology were highly rated. There was a statistically significant improvement in medical knowledge test scores for questions aligned with content for both the PGY-1 and PGY-2 courses.The IMR program is an advance in the national effort to make training in integrative medicine available to physicians on a broad scale and is a success in terms of online education. Evaluation suggests that this program is feasible for implementation and acceptable to residents despite the many pressures of residency.
| S-EPMC3312539 | biostudies-other
Project description:BackgroundAt teaching hospitals, bedside procedures (paracentesis, thoracentesis, lumbar puncture, arthrocentesis and central venous catheter insertion) are performed by junior residents and supervised by senior peers. Residents' perceptions about supervision or how often peer supervision produces unsafe clinical situations are unknown.ObjectiveTo examine the experience and practice patterns of residents performing bedside procedures.Design and participantsCross-sectional e-mail survey of 653 internal medicine (IM) residents at seven California teaching hospitals.MeasurementsSurveys asked questions in three areas: (1) resident experience performing procedures: numbers of procedures performed and whether they received other (e.g., simulator) training; (2) resident comfort performing and supervising procedures; (3) resident reports of their current level of supervision doing procedures, experience with complications as well as perceptions of factors that may have contributed to complications.ResultsThree hundred sixty-seven (56%) of the residents responded. Most PGY1 residents had performed fewer than five of any of the procedures, but most PGY-3 residents had performed at least ten by the end of their training. Resident comfort for each procedure increased with the number of procedures performed (p < 0.001). Although residents reported that peer supervision happened often, they also reported high rates of supervising a procedure before feeling comfortable with proper technique. The majority of residents (64%) reported at least one complication and did not feel supervision would have prevented complications, even though many reported complications represented technique- or preparation-related problems.ConclusionsResidents report low levels of comfort and experience with procedures, and frequently report supervising prior to feeling comfortable. Our findings suggest a need to examine best practices for procedural supervision of trainees.
| S-EPMC2842555 | biostudies-literature
Project description:Introduction:Obesity and diabetes are common diagnoses in the primary care population, especially in urban settings. Physicians providing preventive culinary and nutrition education to patients may be able to uniquely address these medical issues; however, culinary and nutrition education among medical residency programs is insufficient. Methods:We describe a pilot of a novel interactive approach to culinary and nutrition education focused on preventive medicine residents who were trained to provide culinary and nutrition skills to community members in three separate workshops. We developed and implemented a series of three culinary education workshops with 11, eight, and nine preventive medicine residents in each respective workshop. A total of 16 residents were invited to participate. A physician-chef facilitated each workshop with the residents within a community church kitchen and meeting area. We evaluated self-reported data on confidence level with culinary education and resident attitudes toward effects of culinary education on patient behaviors, as well as frequency of home-cooked meals and personal cooking competency, as indicators of resident proficiency. Results:A significant increase was noted in self-reported cooking competency after culinary workshops when evaluating change from the first workshop to the final workshop (?p = .038). Increases in home-cooking frequency and belief that lifestyle medicine impacts patient behavior were also observed but did not achieve statistical significance. Discussion:Culinary workshops are a useful tool to enhance nutrition education in a residency curriculum and may be an effective way to improve resident perceptions regarding the impact of nutrition education in the community.
| S-EPMC7010195 | biostudies-literature
Project description:Cancer survivorship education is limited in residency training. The goal of this pilot curriculum was to teach medicine residents a structured approach to cancer survivorship care. During the 2020-2021 academic year, we held eight 45-min sessions in an ambulatory noon conference series for a community family medicine (FM) and internal medicine (IM) residency program. The curriculum used Project ECHO®, an interactive model of tele-education through Zoom video conferencing, to connect trainees with specialists. Each session had a cancer-specific focus (e.g., breast cancer survivorship) and incorporated a range of core survivorship topics (e.g., surveillance, treatment effects). The session format included a resident case presentation and didactic lecture by an expert discussant. Residents completed pre- and post-curricular surveys to assess for changes in attitude, confidence, practice patterns, and/or knowledge in cancer survivorship care. Of 67 residents, 23/24 FM and 41/43 IM residents participated in the curriculum. Residents attended a mean of 3 sessions. By the end of the curriculum, resident confidence in survivorship topics (surveillance, treatment effects, genetic risk assessment) increased for breast, colorectal, and prostate cancers (p < 0.05), and there was a trend toward residents stating they ask patients more often about cancer treatment effects (p = 0.07). Over 90% of residents found various curricular components useful, and over 80% reported that the curriculum would improve their practice of cancer-related testing and treatment-related monitoring. On a 15-question post-curricular knowledge check, the mean correct score was 9.4 (63%). An eight-session curriculum improved resident confidence and perceived ability to provide cancer survivorship care.
| S-EPMC8976217 | biostudies-literature
Project description:PurposeWhile undergoing a hospital residency training program, residents often suffer anxiety and stress. This study aims to evaluate the change in health-related quality of life and happiness among internal medicine residents, and identify prognostic factors.MethodsThirty-eight residents in the Ramathibodi Hospital internal medicine training program completed the World Health Organization Quality of Life-BREF and happiness Measures questionnaires at three time points: commencement, day 100, and the end of the second year of training. Confidence, expectations, anxiety, and general health were rated. Analyses were performed with mixed linear regression.ResultsFinancial problems were reported for 16 residents (42.1%). At baseline, most residents had moderate-to-very high confidence, expectations, and general health but also moderate-to-very high anxiety. The health-related quality of life score was highest in the social domain followed by the environmental, psychological, and physical domains. Their psychological, physical, social, and environmental scores significantly decreased after enrollment. Their happiness and general health scores were significantly reduced after enrollment. The training program duration was negatively associated with all domains. Residents with greater confidence had higher health-related quality of life scores in the physical, psychological, and environmental domains. Moreover, their general health was positively associated with the social and environmental domains.ConclusionA reduction in health-related quality of life and happiness under the internal medicine residency program is reported. High confidence and good physical health may counterbalance the decline in health-related quality of life and happiness.
| S-EPMC4439642 | biostudies-literature
Project description:Physicians who complete combined residency training in internal medicine and pediatrics (med-peds) have a variety of career options after training. Little is known about career transitions among this group or among other broadly trained physicians.To better understand these career transitions, we conducted semistructured, in-depth, telephone interviews of graduates of the University of North Carolina-Chapel Hill School of Medicine med-peds program who self-identified as having had a career transition since completing training. We qualitatively analyzed interview transcripts, to develop themes describing their career transitions.Of 106 physicians who graduated during 1980-2007, 20 participated in interviews. Participants identified factors such as personality, work environment, lifestyle, family, and finances as important to career transition. Five other themes emerged from the data; the following 4 were confirmed by follow-up interviews: (1) experiences during residency were not sufficient to predict future job satisfaction; work after the completion of training was necessary to discover career preferences; (2) a major factor motivating job change was a perceived lack of control in the workplace; (3) participants described a sense of regret if they did not continue to see both adult and pediatric patients as a result of their career change; (4) participants appreciated their broad training and, regardless of career path, would choose to pursue combined residency training again.We included only a small number of graduates from a single institution. We did not interview graduates who had no career transitions after training.There are many professional opportunities for physicians trained in med-peds. Four consistent themes surfaced during interviews about med-peds career transitions. Future research should explore how to use these themes to help physicians make career choices and employers retain physicians.
| S-EPMC3418526 | biostudies-literature
Project description:Quality Improvement Success Stories are published by the American Diabetes Association in collaboration with the American College of Physicians, Inc. (ACP), and the National Diabetes Education Program. This series is intended to highlight best practices and strategies from programs and clinics that have successfully improved the quality of care for people with diabetes or related conditions. Each article in the series is reviewed and follows a standard format developed by the editors of Clinical Diabetes. The following article describes an initiative of the Cleveland Clinic's internal medicine residents to improve diabetes care and outcomes within an underserved patient population at an East Cleveland, OH, health center.
| S-EPMC7164989 | biostudies-literature