STFM and Stanford's HEA3RT Receive Commonwealth Fund Grant to Advance AI Education in Safety Net Primary Care.

There is a clear consensus that primary care needs to be at the center of a reformed US health care system. The Patient-centered Medical Home (PCMH) has emerged as the key strategy for the redesign of primary care. The PCMH model builds upon the core concepts of primary care that include accessible

BackgroundSuccessful implementation of evidence-based treatments (EBT) for posttraumatic stress disorder (PTSD) in primary care may address treatment access and quality gaps by providing care in novel and less stigmatized settings. Yet, PTSD treatments are largely unavailable in safety net primary care. We aimed to collect clinician stakeholder data on organizational, attitudinal, and contextual factors relevant to EBT implementation.MethodsOur developmental formative evaluation was guided by the Consolidated Framework for Implementation Research (CFIR), including (a) surveys assessing implementation climate and attitudes towards EBTs and behavioral health integration and (b) semi-structured interviews to identify barriers and facilitators to implementation and need for augmentation. Participants were hospital employees (N = 22), including primary care physicians (n = 6), integrated behavioral health clinicians (n = 8), community wellness advocates (n = 3), and clinic leadership (n = 5). We report frequency and descriptives of survey data and findings from directed content analysis of interviews. We used a concurrent mixed-methods approach, integrating survey and interview data collected simultaneously using a joint display approach. A primary care community advisory board (CAB) helped to refine interview guides and interpret findings.ResultsStakeholders described implementation determinants of the EBT related to the CFIR domains of intervention characteristics (relative advantage, adaptability), outer setting (patient needs and resources), inner setting (networks and communication, relative priority, leadership engagement, available resources), and individuals involved (knowledge and beliefs, cultural considerations). Stakeholders described strong attitudinal support (relative advantage), yet therapist time and capacity restraints are major PTSD treatment implementation barriers (available resources). Changes in hospital management were perceived as potentially allowing for greater access to behavioral health services, including EBTs. Patient engagement barriers such as stigma, mistrust, and care preferences were also noted (patient needs and resources). Recommendations included tailoring the intervention to meet existing workflows (adaptability), system alignment efforts focused on improving detection, referral, and care coordination processes (networks and communication), protecting clinician time for training and consultation (leadership engagement), and embedding a researcher in the practice (available resources).ConclusionsOur evaluation identified key CFIR determinants of implementation of PTSD treatments in safety net integrated primary care settings. Our project also demonstrates that successful implementation necessitates strong stakeholder engagement.

The Society of Teachers of Family Medicine (STFM; http://www.stfm.org) is a community of professionals devoted to teaching family medicine through undergraduate, graduate, and continuing medical education. This multidisciplinary group of physicians, educators, behavioral scientists, and researchers works to further STFM's mission of improving the health of all people through education, research, patient care, and advocacy. STFM holds an annual conference each spring and a predoctoral education conference each winter. STFM held its 34th Predoctoral Education Conference in Portland, Oregon, from January 24 to 27, 2008. The theme was “Igniting Students' Passion for Serving the Underserved.” Christine Stabler, MD, Lancaster General Hospital, Lancaster, Pennsylvania, opened the conference with a plenary presentation on the passion for patient care, medical education, and advocacy that have defined her own career and continue to inspire medical trainees. Kenneth Ginsburg, MD, The Children's Hospital of Philadelphia and the University of Pennsylvania, continued the theme of igniting students' passion by exploring the ways in which socialization in medical education can teach students to suppress their feelings and humorously illustrated how accessing a full range of emotions can lead to satisfying lives and practices. Tanya Page, MD, a recent residency graduate practicing in a homeless clinic in Portland, Oregon, described her own passion for caring for the underserved. Participants shared ideas and learned new skills in more than 65 workshops, seminars, and discussions as well as 65 educational research and curriculum evaluation papers. The unifying theme was incorporating care of the underserved in medical education. From the educational research or curriculum evaluation papers presented at the conference, the STFM Education Committee selected 8 papers felt to be of interest to readers of Teaching and Learning in Medicine.

The Society of Teachers of Family Medicine (STFM; http://www.stfm.org) is a community of professionals devoted to teaching family medicine through undergraduate, graduate, and continuing medical education. This multidisciplinary group of physicians, educators, behavioral scientists, and researchers works to further STFM's mission of improving the health of all people through education, research, patient care, and advocacy. The STFM held its 37th Conference on Medical Student Education in Houston, Texas, from January 20 to 23, 2011. The unifying theme of the conference was sustaining and cultivating innovations in family medicine education. Kevin Eva, Ph.D., from the University of British Columbia opened the conference with a plenary presentation discussing diagnostic error from an educational perspective. Catherine Florio Pipas, M.D., from Dartmouth Medical School continued with a plenary presentation on the Patient-centered Medical Home Model and its role in an academic medical center. Finally, Jerry Kruse, M.D., M.S.P.H., from Southern Illinois University concluded the conference with a plenary session analyzing the legislative and educational opportunities and challenges presented by the Patient-centered Medical Home concept. Participants shared ideas and learned new skills in more than 70 workshops, seminars, and discussions as well as 90 educational research and curriculum evaluation papers. The STFM Education Committee selected 10 papers from the educational research and curriculum evaluation papers, felt to be of interest to readers of Teaching and Learning in Medicine. Two of the papers deal with preclerkship education, 5 with 3rd- and 4th-year education, 2 with longitudinal experiences across all years of medical school, and 1 with faculty development.

The Society of Teachers of Family Medicine (STFM; http://www.stfm.org) is a community of professionals devoted to teaching family medicine through undergraduate, graduate, and continuing medical education. This multidisciplinary group of physicians, educators, behavioral scientists, and researchers works to further STFM's mission of improving the health of all people through education, research, patient care, and advocacy. The STFM held its 38th Conference on Medical Student Education in Long Beach, California, from February 2 to 5, 2012. The unifying theme of the conference was meeting the demands of high-quality education in a changing health care delivery environment. Kevin Grumbach, MD, from the University of California–San Francisco opened the conference with a plenary presentation emphasizing the importance of educating leaders and followers for health system improvement. Throughout the conference, participants shared ideas and learned new skills in more than 70 workshops, seminars, and discussions as well as 90 educational research and curriculum evaluation papers. Finally, Jeffrey Brenner, MD, from Camden Coalition of Healthcare Providers, New Jersey concluded the conference with a plenary session discussing how a citywide coalition can improve the quality, capacity, and accessibility of healthcare for one of America's poorest cities, all while reducing overall health care costs. The STFM Education Committee selected 9 papers from the educational research and curriculum evaluation papers, felt to be of interest to readers of Teaching and Learning in Medicine. One of the papers deals with preclerkship education, three with 3rd- and 4th-year education, two with longitudinal experiences across all years of medical school, and three with assessment.

The Society of Teachers of Family Medicine (STFM) is an organization made up of educators devoted to teaching family medicine to learners of all levels. This multidisciplinary group of physicians, behavioral scientists, researchers, and educators from other health professions works to further STFM's mission of improving the health of all people through education, research, patient care, and advocacy. STFM held its 43rd Conference on Medical Student Education in Anaheim, California from February 9 to 12, 2017. Abstracts for conference sessions can be viewed online.1 The conference was held concurrently with the 2017 Society of Student-Run Free Clinics Annual Conference. This partnership empowered many passionate medical students to participate in STFM sessions and present their posters. A wide variety of topics were explored by STFM conference presenters and attendees. The plenary speakers addressed physician wellness (Dike Drummond, MD), family medicine as a career (Wanda Filer, MD), and the future of family medicine (Aaron Michelfelder, MD, and Michelle Byrne, MD). The STFM Education Committee reviewed and selected eight exemplary abstracts from 22 presented educational research papers. Criteria for selection included strength of contribution to medical student education, topic of interest within and beyond family medicine, and quality of study, including well-described rationale, appropriate methods, clear results, and thoughtful conclusions. The areas covered are related to new educational methods and tools, faculty development, and interprofessional learning and assessment.

From January 31 through February 3, 2019 the Society of Teachers of Family Medicine (STFM) held its 45th annual Conference on Medical Student Education in Jacksonville, Florida. STFM is a collaborative organization composed of members who are dedicated to teaching the discipline to learners of any level. The conference brings together members including physicians, administrators, behavioral scientists, researchers, residents, and students to learn from one another and improve the quality of family medicine education in the United States and Canada. Abstracts for all conference submissions can be found on the STFM website.1 Plenary speakers addressed topics related to health equity (Joanne Rooney, JD, LLM, EdD); discrimination and bias in the medical workplace (Roberto E. Montenegro, MD, PhD); and mentoring in family medicine (Beat Steiner, MD, MPH, STFM President). The STFM Committee on Medical Student Education reviewed the 14 completed educational research projects and selected six exemplary abstracts as the best of the conference. Criteria for inclusion included relevance to medical student education with a focus on family medicine education, study quality, and meaningful conclusions. Five of the abstracts appear in this collection. One has been published in the intervening time.2.

The Society of Teachers of Family Medicine (STFM; http://www.stfm.org) is a community of professionals devoted to teaching family medicine through undergraduate, graduate, and continuing medical education. This multidisciplinary group of physicians, educators, behavioral scientists, and researchers works to further STFM's mission of improving the health of all people through education, research, patient care, and advocacy. The STFM held its 41st Conference on Medical Student Education in Atlanta, Georgia from February 5-8, 2015. The conference this year was met with record attendance and student scholarship winners. The STFM Education Committee selected 10 abstracts, of which five are presented below.

Recommended Integrative Medicine Competencies for Family Medicine Residents

The prevalence of chronic disease in the United States is rapidly increasing, with a disproportionate number of underserved, vulnerable patients sharing the burden. The Patient-Centered Medical Home (PCMH) is a care delivery model that has shown promise to improve primary care and address the burden of chronic illness. The purpose of this study was to (1) understand patient characteristics that might influence perceived patient experience in a large primary care safety net undergoing PCMH transformation; (2) identify community-level quality improvement opportunities to support ongoing transformation activities; and (3) establish a baseline of patient experience across the primary care safety net that could be used in repeated evaluations over the course of transformation. A cross-sectional study design was used to conduct this research. A total of 351 racially and ethnically diverse patients of 4 primary care safety net organizations in Broward County, Florida, were surveyed regarding their experience with access to care and coordination of care. Reported access to care and coordination of care. Patients with chronic disease who reported having visited the clinic 3 or more times in the past 12 months reported a better coordination of care experience than patients who had fewer than 3 visits in the past 12 months (odds ratio = 3.57; 95% confidence interval, 1.76-7.24). Patients without chronic disease who had been receiving care at the clinic for 2 or more years of care reported worse experience with access to care than patients with less than 2 years of care (odds ratio = 0.26; 95% confidence interval, 0.11-0.60.) Race, ethnicity, language, and education were not significant predictors of patient experience. Findings support ongoing efforts to improve patient engagement among all patients and to enhance resources to manage chronic disease, including community-based self-management programs, in primary care safety nets undergoing PCMH transformation.

Presentations of research are important in the dissemination of new knowledge, but they do not reach the same audience as research published in journals. The purpose of this study was to evaluate the proportion of presentations at recent major primary care research conferences that have become published. Oral and poster presentations for completed and work-in-progress projects from the 2007 and 2008 North American Primary Care Research Group (NAPCRG) and Society of Teachers of Family Medicine (STFM) annual conferences were included in the analysis. The first presenter for each presentation was searched on PubMed, and titles and abstracts for presentations were compared for content to titles and abstracts of potential matches found on PubMed. We analyzed the proportion of presentations that were published in peer-reviewed journals, mean time to publication, and the proportions of the type of journal in which the article appeared (family medicine vs other) were analyzed. There were 1,329 presentations included in the study. Overall, 34.4% of projects presented were also published. More oral presentations (42.9%) were published than were poster presentations (25.3%) (P <.001). Mean time to publication was 15.4 months. Oral presentations were published more quickly (13.7 months) than poster presentations (18.6 months) (P <.001). Published reports appeared in 192 different journals. Family medicine journals accounted for 36.5% of published. More than one-third of all presentations at STFM and NAPCRG conferences were published in journals indexed in PubMed. Time to publication was comparable to that of other specialties. Fewer than 2 of every 5 reports were published are in a family medicine journal, suggesting vast breadth in family medicine research. Family medicine academicians need to refocus efforts on transforming presentations into published articles in peer-reviewed journals for broader dissemination of research findings.

In late 2015, the Society of Teachers of Family Medicine (STFM) was charged with Family Medicine for America's Health's (FMAHealth) Workforce Education and Development Core Team's task of identifying, developing, and disseminating resources for community preceptors. The charge from FMAHealth came at a time when STFM was discussing strategies to address the critical shortage of clinical training sites for medical students. STFM hosted a summit to identify the most significant reasons for the shortage of community preceptors and shape the priorities, leadership, and investments needed to ensure the ongoing education of the primary care workforce. Summit participants were asked to propose solutions to achieve the following aims: (1) decrease the percentage of primary care clerkship directors who report difficulty finding clinical preceptor sites, and (2) increase the percentage of students completing clerkships at high-functioning sites. The outcome of the summit was an action plan with five tactics that are being implemented now: Tactic 1: Work with the Centers for Medicare and Medicaid Services (CMS) to revise student documentation guidelines. Tactic 2: Integrate interprofessional/interdisciplinary education into ambulatory primary care settings through integrated clinical clerkships. Tactic 3: Develop a standardized onboarding process for students and preceptors and integrate students into the work of ambulatory primary care settings in useful and authentic ways. Tactic 4: Develop educational collaboratives across departments, specialties, professions, and institutions to improve administrative efficiencies for preceptors. Tactic 5: Promote productivity incentive plans that include teaching and develop a culture of teaching in clinical settings.

Less than 10 years after the incorporation of the Society of Teachers of Family Medicine (STFM) the STFM Foundation was established primarily to provide the 501c3 tax status necessary for STFM members to make contributions in support of their professional organization. To ensure that the tie to STFM

The Society of Teachers of Family Medicine (STFM) antiracism task force created and led an Antiracism Learning Collaborative (ALC) to help STFM members identify racist structures and behaviors within their academic institutions and develop projects to become leaders for change. The Robert Graham Center for Policy Studies in Family Medicine and Primary Care was tasked with evaluating whether the 2-year program's goals were met. Through a call for applications, 20 dyads were accepted for participation. At least one dyad member had to be of a racial or an ethnic population that is underrepresented in the medical profession. Participant involvement took place from January 2022 through September 2023. The following data sources were evaluated: project plans, four survey sets, anecdotal meeting notes, mentor meeting forms, and final reports and presentations from the dyads. A total of 34 participants (17 dyads) completed the study from 17 institutions. Generally, participants learned several antiracism concepts and how to take steps to counter racist structures and behaviors through actionable approaches and language use. Strengths of the program were the tools and resources offered to dyads for their project implementation. Two major challenges were institutional opposition or lack of support and lack of time (both for dyads and for various local community partners). Overall, ALC met each goal. Future evaluations of similar initiatives should consider defining what success for individual projects looks like and provide a predefined rubric to gauge success.

The 3P model proposes that predisposing, precipitating, and perpetuating factors all play a role in sleep disturbance. The purpose of the current study is to investigate social determinants of sleep disturbance by applying the 3P model to a safety-net primary care setting, specifically by evaluating the role of classism and unmet needs as precipitating factors for sleep disturbance, and anxiety as a perpetuating factor for sleep disturbance. Participants (N = 210) were a convenience sample of racially/ethnically diverse adults over the age of 18 (age M = 44.7 years) recruited from a safety-net primary care clinic in an urban area. The study employed a cross-sectional design. Participants completed a survey assessing sleep disturbances, anxiety, unmet needs, classism, social support, and a researcher-generated demographic form. The unmet need for affordable long-term housing and greater experiences of classism were associated with more sleep disturbance, suggesting that both acted as precipitating factors. In a structural equation model with adequate fit indices, anxiety mediated the relationships with sleep disturbance for both the unmet need for affordable long-term housing and classism, suggesting that it serves as a perpetuating factor. Medical providers are recommended to explore these potential needs in safety-net primary care when patients present with sleep disturbance or anxiety. Assisting with connections to long-term housing and helping patients counteract and cope with classist discrimination may be effective in improving sleep in safety-net primary care.