Association Of Family Medicine Residency Directors Research Articles

Evaluation of Family Medicine Residency Programs for Diversity, Equity, and Inclusion Milestones.

In 2020, the Association of Family Medicine Residency Directors (AFMRD) Diversity and Health Equity (DHE) Task Force developed and piloted a framework to measure diversity, equity, and inclusion (DEI) initiatives in medical residencies across five domains: curriculum, evaluation, institution, resident pathway, and faculty pathway. The objectives were (1) to measure DEI initiatives across multiple domains in family medicine residencies using the DEI milestones and (2) to obtain current national baseline data providing criteria against which to measure effectiveness of initiatives and create tailored benchmarks. We developed a cross-sectional survey of 12 quantitative residency characteristic items and the five DEI milestone ratings, and distributed the survey to program directors of family medicine residencies accredited by the Accreditation Council for Graduate Medical Education in the spring of 2022. We generated descriptive statistics, including item frequencies and cross-tabulations, and completed subgroup comparisons with analysis of variance. We collected aggregate milestone data for 194 family medicine residencies of 588 eligible programs (33% response rate). Respondents represented 48 states and US territories: 107 community-based, university-affiliated; 48 community-based; 34 university-based; and 5 military/other programs. Overall, the curriculum milestone was rated the highest (mean=2.54, SD=1.03), whereas the faculty pathway (mean=1.94, SD=1.04) and resident pathway (mean=2.02, SD=1.06) milestones were rated lowest. DEI milestone data may support residency programs as they assess their institution's developmental progress across five key domains. Additionally, aggregate data may shed light on collective strengths and areas for improvement.

A DESCRIPTION OF THE 2021 AFMRD SALARY SURVEY AND NEXT STEPS.

The Association of Family Medicine Residency Directors (AFMRD) biannually conducts a Salary Survey of membership as a member benefit. The survey asks program directors (PDs) to report total taxable annual income for themselves, associate program directors, core faculty, program coordinators/

Diversity, Equity, and Inclusion Milestones: Creation of a Tool to Evaluate Graduate Medical Education Programs.

As the Accreditation Council for Graduate Medical Education (ACGME) began to ask programs to report their efforts surrounding diversity, equity, and inclusion (DEI), program directors felt ill prepared to evaluate their programs and measure change. To develop a tool that would allow graduate medical education (GME) programs to evaluate the current state of DEI within their residencies, identify areas of need, and track progress; to evaluate feasibility of using this assessment method within family medicine training programs; and to analyze and report pilot data from implementation of these milestones within family medicine residency programs. The Association of Family Medicine Residency Directors (AFMRD) Diversity and Health Equity (DHE) Task Force developed a tool for program DEI evaluation modeled after the ACGME Milestones. These milestones focus on DEI assessment in 5 key domains: Institution, Curriculum, Evaluation, Resident Personnel, and Faculty Personnel. After finalizing a draft, a pilot implementation of the milestones was conducted by a convenience sample of 10 AFMRD DHE Task Force members for their own programs. Scores varied widely across surveyed programs for all milestones. Highest average scores were seen for the Curriculum milestone (2.65) and the lowest for the Faculty Personnel milestone (2.0). Milestone assessments were completed within 10 to 40 minutes using various methods. The AFMRD DEI Milestones were developed for program assessment, goal setting, and tracking of progress related to DEI within residency programs. The pilot implementation showed these milestones were easily used by family medicine faculty members in diverse settings.

CAFM LEADERSHIP DEMOGRAPHICS.

In 2016, recognizing the need for a more robust and diverse leadership pipeline for academic family medicine, the Council of Academic Family Medicine (CAFM), comprised of the Association of Departments of Family Medicine (ADFM), the Association of Family Medicine Residency Directors (AFMRD), the

REFLECTIONS OF THREE HEALTH EQUITY FELLOWS.

The Association of Family Medicine Residency Directors (AFMRD) is committed to delivering Health Equity education to residency directors and faculty. Over the past year, the AFMRD sponsored 3 individuals for the 2019-2020 AAFP Health Equity Fellowship. This yearlong fellowship develops family

Making Sense of Family Medicine Resident Wellness Curricula: A Delphi Study of Content Experts.

The Association of Family Medicine Residency Directors (AFMRD) Physician Wellness Task Force released a comprehensive Well-Being Action Plan as a guide to help programs create a culture of wellness. The plan, however, does not offer a recommendation as to which elements may be most important, least resource intensive, or most feasible. This study sought to identify the most essential components of the AFMRD's Well-Being Action Plan, as rated by expert panelists using a modified Delphi technique. Sixty-eight selected experts were asked to participate; after three rounds of surveys, the final sample included 27 participants (7% residents, 38% MD faculty, 54% behavioral science faculty). Fourteen elements were rated as essential by at least 80% of the participants. These components included interventions at both the system and individual level. Of those elements ranked in the top five by a majority of the panel, all but one do not mention specific curricular content, but rather discusses the nature of a wellness curriculum. The expert consensus was that an essential curriculum should begin early, be longitudinal, identify a champion, and provide support for self-disclosure of struggles.

Developing the National Family Medicine Graduate Survey.

Developing the National Family Medicine Graduate Survey.

Quality assessment and improvement of post graduate family medicine training in the USA

Background: In 2013, the World Organisation of Family Doctors published training standards for post-graduate medical education (GME) in Family Medicine/General Practice (FP/GP). GME quality has not been well-defined, other than meeting accreditation standards. In 2009, the Association of Family Medicine Residency Directors (AFMRD) developed a tool that would aid in raising the quality of family medicine residency training in the USA. Objective: We describe the development of this quality improvement tool, which we called the residency performance index (RPI), and its first three years of use by US family medicine residency (FMR) programmes. The RPI uses metrics specific to family medicine training in the USA to help programmes identify strengths and areas for improvement in their educational activities. Our review of three years of experience with the RPI revealed difficulties with collecting data, and lack of information on graduates’ scope of practice. It also showed the potential usefulness of the tool as a programme improvement mechanism. Conclusions: The RPI is a nationwide, standardised, programme quality improvement tool for family medicine residency programmes in the USA, which was successfully launched as part of AFMRD’s strategic plan. Although some initial challenges need to be addressed, it has the promise to aid family medicine residencies in their internal improvement efforts. This model could be adapted in other post-graduate training settings in FM/GP around the world.

THE NATIONAL GRADUATE SURVEY FOR FAMILY MEDICINE.

The Association of Family Medicine Residency Directors (AFMRD) is excited to announce the rollout of a standardized national graduate survey. Beginning in 2016, the survey will be conducted through the American Board of Family Medicine (ABFM) Maintenance of Certification process. Understanding the

STFM LAUNCHES PROGRAMS AND SERVICES FOR RESIDENCY PROGRAMS

STFM’s strategic plan challenges the Society to be the leader in developing programs and services to help residencies improve family medicine education and teaching. STFM members have emphasized the need for cost-and time-effective ways to offer learning opportunities, meet ACGME requirements, and enhance the knowledge and skills of faculty. To meet this need, STFM introduced the Residency Faculty Boot Camp. This series of online, interactive learning experiences covers the most-requested teaching topics, including Dealing With Difficult Residents, Pearls of Precepting, and Providing Feedback to Learners. Each module includes a presentation, videos, and interactive quizzes. Residency programs that purchase the package receive instant updates as participants complete each course. For details, visit http://www.stfm.org/bootcamp. The new ACGME program requirements in family medicine (Milestones) will require competency assessment of residents. Residencies are being asked to focus more on resident performance and less on the numbers of procedures performed. In early 2012, STFM launched a Resident Competency Assessment Toolkit. The toolkit contains the background, tools, and training to help residency programs demonstrate resident competence and ensure that graduates have the knowledge, skills, and abilities required to perform their roles in society. More information can be found at http://www.stfm.org/rctoolkit. STFM has offered and will continue to offer train-the-trainer workshops on competency assessment at family medicine conferences and through personalized faculty development training, such as STFM’s On-the-Road workshops. STFM and the Association of Family Medicine Residency Directors (AFMRD) recently launched a multi-year collaborative to build an online resource of peer-reviewed, competency-based curriculum on core topics taught in family medicine residency programs. The Residency Curriculum Resource, which will be organized by post-graduate year (PGY), will serve as a repository of materials that can be implemented and used to satisfy ACGME requirements. Content will be managed by a senior editor and a 6-member editorial board. The project will include 2 phases. Phase 1 will convert AAFP’s “Recommended Core Curriculum Guidelines for Family Medicine Residents” into a dynamic web interface organized by PGY, with links to content to address core-learning objectives. Faculty will be able to use the content to standardize teaching and to ensure residents gain competence in the areas outlined in the guidelines. Phase 1 content will be free to all STFM and AFMRD members. During phase 2, AFMRD and STFM members will submit teaching materials they have developed for lectures and presentations or that they have created specifically for the Residency Curriculum Resource. Submissions will be peer reviewed and refined. Authors with accepted publications will update their content annually. Access to Phase 2 content will be subscription-based. Subscription fees will cover the costs of website updates, the editorial process, and the purchase of licensed content. In addition, STFM offers a number of valuable resources to help residency programs with faculty development, scholarship, and leadership: All levels of faculty can receive up-to-date faculty development training by attending the STFM Annual Spring Conference. It offers hundreds of presentations specifically geared for residency program faculty. The Conference on Practice Improvement offers residencies an opportunity to learn as teams about topics central to practice redesign and the patient-centered medical home. Faculty and residents can access tools and mentoring to meet ACGME scholarly activity requirements using the CAFM Educational Research Alliance. The STFM Resource Library offers instant access to more than 700 residency-specific resources on a variety of topics, including the patient-centered medical home and practice redesign. The Resource Library also offers interactive wikis on family medicine research, teaching teen health, and behavioral science basics. Residencies can develop faculty leaders through enrollment in one of STFM’s leadership development opportunities, such as the Emerging Leaders and the Behavioral Science/Family Systems Educator Fellowship. These leadership opportunities provide education and experience to help future faculty leaders rise to the next level. Current research on residency innovation is available through Family Medicine’s recent dedicated issue on residency redesign. TeachingPhysician.org connects residency programs with community preceptors. The web resource streamlines training with videos, tips, answers to frequently asked questions, and links to in-depth information on precepting. STFM is strengthening its offerings to help residencies successfully meet today’s challenges as they train tomorrow’s family physicians. We invite residency faculty to explore the wealth of STFM offerings and offer feedback on challenges that are not yet being met. We strive to be the go-to resource for all family medicine educators.

THE COUNCIL OF ACADEMIC FAMILY MEDICINE (CAFM): WHERE ACADEMIC FAMILY MEDICINE SPEAKS AND ACTS AS ONE

Academic family medicine in the United States is primarily represented by 4 organizations, each with their own mission, vision, goals, and membership criteria: the Association of Departments of Family Medicine (ADFM), the Association of Family Medicine Residency Directors (AFMRD), the North American

QUALITY IN RESIDENCY EDUCATION

The Association of Family Medicine Residency Directors (AFMRD) was founded 20 years ago to address the unique needs of family medicine residency directors. The founding principles included providing a forum for program directors to mutually assist each other. The organizational symbol of AFMRD has

FAMILY MEDICINE RESIDENT AWARD FOR SCHOLARSHIP

The need for capacity building in family medicine research is well recognized. One strategy for accomplishing this goal is to mentor and recognize residents for their accomplishments in scholarly activities. The Association of Family Medicine Residency Directors (AFMRD), the North American Primary Care Research Group (NAPCRG), and the College of Family Physicians of Canada (CFPC) have developed the AFMRD / NAPCRG / CFPC Family Medicine Resident Award for Scholarship to both recognize resident scholarly activity and, by doing so, promote increased capacity building in family medicine research and scholarly activity. One award will be made by each family medicine residency program annually. The AFMRD / NAP-CRG / CFPC Boards have suggested that each program create a committee to review resident scholarly activity applications and make the award recommendation to the program director. AFMRD / NAPCRG / CFPC does not select the honorees; departments or programs will inform the organizations who should be honored from their program. AFMRD / NAPCRG / CFPC supply the certificate that will be presented to the resident receiving the award to the program. As developed by the participating organizations, the following restrictions apply: No resident may win the award more than once, only one award per program will be awarded annually, the scholarly activity for consideration must have been completed while the resident was in residency training, the nature of the scholarly activity and whether it “qualifies” is at the discretion of the program’s award committee, jointly-done scholarly activity between 2 or more residents may be eligible for a joint award (each resident will receive a certificate), and scholarly activity must be in large measure performed by the resident—this activity includes most, but not necessarily all, of the following: the inception of the idea, development of the project, gathering data, presenting the results, or writing a report or publication. The AFMRD / NAPCRG / CFPC Family Medicine Resident Award for Scholarship was first available last year to residency programs. Further information regarding deadlines for submission of nominees will be provided to program directors later this year.

A PROCESS FOR CHANGE: A METHODOLOGY FOR ACADEMIC FAMILY MEDICINE

The Association of Family Medicine Residency Directors (AFMRD) Board of Directors recently rekindled the discussion pertaining to maternity care education in family medicine residency programs. At present, the ACGME-RRC for family medicine requires programs to provide 2 months of educational

FRONTLINE: DIABETES SUPPLEMENTING EDUCATION AND QUALITY IMPROVEMENT IN FAMILY MEDICINE RESIDENCY TRAINING

In 2004, Frontline: Diabetes was created by the Association of Family Medicine Residency Directors (AFMRD) with an unrestricted educational grant from Novo Nordisk, as an educational forum used to provide family medicine residents the opportunity to expand their knowledge and patient care skills in

FRONTLINE: DIABETES AND FRONTLINE: BETTER BONES--IMPLEMENTING THE CORE COMPETENCIES THROUGH EDUCATION AND RESEARCH

As previously announced, the Board of Directors of the Association of Family Medicine Residency Directors (AFMRD) is launching a project that combines resident education and research. Frontline: Diabetes is a project that offers residents a novel, integrated approach to the prevention and treatment