Family Medicine Education Research Articles

The diversity of opinion among general practitioners regarding the threat and measures against COVID-19 – Cross-sectional survey

Background After the ‘first wave’ in spring 2020, opinions regarding the threat and measures against COVID-19 seemed to vary among German general practitioners (GPs). Objectives To systematically investigate opinions and to identify subgroups of GPs sharing similar views. Methods A questionnaire was sent to all 210 practices accredited for undergraduate teaching of family medicine at the Medical Faculty of the Technical University of Munich. Questions addressed personal opinions regarding risks, dilemmas, restrictions and their relaxation associated with COVID-19, and personal fears, symptoms of depression and anxiety. Patterns of strong opinions (‘archetypes’) were identified using archetypal analysis, a statistical method seeking extremal points in the multidimensional data. Results One hundred and sixty-one GPs sent back a questionnaire (response rate 77%); 143 (68%) with complete data for all 38 relevant variables could be included in the analysis. We identified four archetypes with subgroups of GPs tending in the direction of these archetypes: a small group of ‘Sceptics’ (n = 12/8%) considering threats of COVID-19 as overrated and measures taken as exaggerated; ‘Hardliners’ (n = 34/24%) considering threats high and supporting strong measures; ‘Balancers’ (n = 77/54%) who also rated the threats high but were more critical about potentially impairing the quality of life of elderly people and children; and ‘Anxious’ GPs (n = 20/14%) tending to report more fear, depressive and anxiety symptoms. Conclusion Among the participants in this survey, opinions regarding the threat and the measures taken against COVID-19 during the ‘first wave’ in Germany in spring 2020 varied greatly.

Are we prepared for the future? A mixed-method study on quality management in decentralized family medicine teaching

ABSTRACT In Germany, two-week clinical clerkships in university-associated general practices have existed since 2002. Approximately 10,000 medical students participate in these decentral clerkships each year. Empirical information on quality management strategies in decentral learning environments is sparse. This nationwide study aims to describe the current quality management efforts of German family medicine departments in response to negative events. A nationwide three-part mixed methods study on the quality management of family medicine clerkships was conducted. First, individuals from n = 37 family medicine departments involved in the organization of family medicine clerkships were interviewed. Interview transcripts were analyzed with qualitative content analysis. Second, a questionnaire on quality management of decentralized learning environments based on the categories of the analysis was developed and sent to the departments. Three negative event cases in family medicine clerkships were included in the questionnaire. Third, interview and survey data were integrated based on respondents’ process descriptions of how each department handled the cases. Of the 37 contacted departments, n = 12 (32%) performed an interview. Major categories of negative events included problems in the student-teacher interaction, didactical challenges, and problematic student behavior. Twenty departments answered at least one questionnaire (54%). Most respondents indicated that their department conducts quality management in decentralized teaching. Negative events in decentral family medicine clerkships occurred at a rate of 66.4 to 179.5 events per 10,000 Students per semester. The mixed-method analysis showed that departments are conscious about quality management issues in decentral learning environments but adhere to heterogeneous local standards. Negative events occur regularly in decentral learning environments. Local quality management processes exist but lack national harmonization. Further outcome-based research is needed to explore the effectiveness and feasibility of quality management strategies. This will become increasingly relevant with an expected upscaled family medicine content.

Changing Pharmaceutical Industry Interaction in US Family Medicine Residencies: A CERA Study.

Pharmaceutical interaction in US residencies is common. This study explores the extent and type of learner interactions in US family medicine residencies with the pharmaceutical industry and compares interactions from 2008, 2013, and 2019. We surveyed program directors of 628 family medicine residencies with 8 questions using the 2019 Council of Academic Family Medicine Educational Research Alliance Survey and compared the responses to 2008 and 2013 results. The survey response rate was 39%; 81% of responding residencies did not allow food or gifts, 86% did not allow drug samples, 84% did not allow industry to interact with medical students or residents, and 81% did not allow industry-sponsored residency activities. These numbers were statistically significantly higher than both 2008 and 2013. In 2019, 151 responding programs (64%) were pharma-free, that is, they answered "No" to all 4 questions about interactions. Pharma-free residencies were increased in 2019 compared with 26% in 2008% and 49% in 2013. University-based family medicine programs were more likely to be pharma-free. Only 21% of responding programs had a formal curriculum that explores the interaction between physicians and the pharmaceutical industry. Factors cited for decreasing interaction included: institutional policy, ethical concerns, faculty input, and local response to national legislation. Interaction between trainees in US family medicine residencies and the pharmaceutical industry continued to decrease. A changing national legislative landscape combined with institutional policies and concerns about industry influence on prescribing habits may be important factors driving the limiting of interactions.

Providing culturally safe care to Indigenous people living with diabetes: Identifying barriers and enablers from different perspectives.

In recent years, cultural safety has been proposed as a transformative approach to health care allowing improved consideration of Indigenous patient needs, expectations, rights and identities. This community‐based participatory study aimed to identify potential barriers and enablers to cultural safety in health care provided to Atikamekw living with diabetes in Québec, Canada. Based on a qualitative descriptive design, the study uses talking circles as a data collection strategy. Three talking circles were conducted with Atikamekw living with diabetes and caregivers, as well as with health professionals of the family medicine teaching clinic providing services to the community. Two team members performed deductive thematic analysis based on key dimensions of cultural safety. Results highlight four categories of barriers and enablers to cultural safety for Atikamekw living with diabetes, related to social determinants of health (including colonialism), health services organization, language and communication, as well as Atikamekw traditional practices and cultural perspectives of health. This study is one of the few that provides concrete suggestions to address key aspects of diabetes care in a culturally respectful way. Our findings indicate that potential enablers of cultural safety reside at different (from individual to structural) levels of change. Solutions in this matter will require strong political will and policy support to ensure intervention sustainability.Patient or public contributionPartners and patients have been involved in identifying the need for this study, framing the research question, developing the data collection tools, recruiting participants and interpreting results.

Assessing the remote management of Family Medicine education during the SARS-CoV-2 Pandemic

Introduction: The SARS-CoV-2 (COVID-19) coronavirus pandemic has changed lifestyles, work styles and, of course, training and teaching. Objective: To evaluate the telematic training of the subject of family medicine at the University of Castilla la Mancha. Methods: it was proposed to implement a methodology of telematic classes, allowing the student to self-manage their time and receive the contents at distance. The acceptance of the new methodology was subsequently evaluated through satisfaction surveys and the effect of the methodology on the students’ grades was evaluated comparatively. Results: Favorable results were obtained with a global average for the course of 4.95 out of 5 for the year 2020 and 4.85 and 4.87 for the years 2018 and 2019. The specks obtained above all in the theory exam are higher than that of these years. Conclusion: It is concluded that the telematic approach is a learning methodology valued positively by the students with a favorable impact on their academic results.

Cancer survivorship training in family medicine residency programs.

The objective of the study was to examine current family medicine residency education in cancer survivorship and barriers to cancer survivorship education in the residency curriculum. Family medicine residency program directors (n=628) were surveyed electronically between September 2019 and November 2019 through the Council of Academic Family Medicine Educational Research Alliance (CERA) annual program directory survey. Respondents (n=250) answered questions regarding eventual cancer survivorship curriculum in their residency program, including interest and barriers to implementation. Program characteristics were assessed using univariate and multivariate analyses. Only 9.2% of family medicine residency program directors reported having a cancer survivorship curriculum. Sixty-nine percent of program directors reported they would implement a cancer survivorship curriculum if one was available. The most significant barrier to implementation of a cancer survivorship curriculum was insufficient time (39.6%) followed by lack of faculty expertise (26.9%). Respondents that reported lack of faculty expertise as a barrier to implementation of cancer survivorship training were more likely be report that they would be willing to implement a cancer survivorship curriculum (p< 0.01). Despite the majority of primary care physicians providing care to cancer survivors, few family medicine residency programs have formal training in cancer survivorship care. There is interest in expanding family medicine residency training in cancer survivorship care among program directors. Gaining insight into the current educational curriculum and barriers to cancer survivorship training will lead to opportunities to improve residency training, and ultimately provide better care to cancer survivors in primary care settings.

Awareness and Attitudes Around the New Subspecialty Within Ob/Gyn Called Complex Family Planning: A CERA Survey of Family Medicine Chairs.

Family physicians play an important role in delivery of family planning services, but many factors impact scope of practice. One important factor is the development of subspecialties, such as the new subspecialty within obstetrics and gynecology called complex family planning (CFP). In 2019, we conducted a survey of family medicine department chairs as part of the Council of Academic Family Medicine Educational Research Alliance survey. We used descriptive statistics and logistic regression to test for associations between program and chair characteristics, knowledge of CFP, and attitudes regarding family planning services (complex contraceptive counseling, pregnancy options counseling, first trimester miscarriage management, and pregnancy termination). The survey response rate was 54% (105/193). Only 8% of respondents were aware of the CFP subspecialty. The majority of chairs considered all queried family planning services as part of family medicine's scope of practice, including pregnancy termination by medication abortion (77%) and by uterine aspiration (60%). Chairs of departments with a faculty champion in family planning had higher odds of advocating for all queried family planning services as part of family medicine scope of practice (OR 3.0, 1.1-8.2) than those without a faculty champion. Few chairs are aware of the new subspecialty of CFP, but most would advocate to maintain some form of abortion care in family medicine's scope of practice. Given family medicine's role in the health care safety net, supporting faculty champions in family planning is important to preserve access to family planning services for marginalized communities.

Education and Attitudes on Medical Cannabis in Family Medicine Residency Programs

Medical cannabis has become increasingly prevalent in the United States, however the extent of family medicine resident education on this topic remains unknown. The objective of this study was to ascertain the current state of medical cannabis education across this population and identify patterns in education based on state legality and program director (PD) practices. Survey questions were part of the Council of Academic Family Medicine Educational Research Alliance (CERA) omnibus survey from May 2019 to July 2019. PDs from all Accreditation Council for Graduate Medical Education (ACGME)-accredited US family medicine residency programs received survey invitations by email. A total of 251 (40.7%) PDs responded, with 209 (83.6% [209/250]) reporting at least 1 hour of didactic curriculum regarding cannabis. The most common context was substance misuse (mean 3.0±4.1 hours per 3 years), followed by pain management (2.7±3.4 hours), and management of other conditions (2.1±2.7 hours). Thirty-eight programs (15.2% [38/250]) offered clinical experiences related to medical cannabis, and PDs who had previously prescribed or recommended medical cannabis were more likely to offer this experience (P&lt;.0001). Experiences peaked after 3 to 5 years of medical cannabis legality. PD confidence in resident counseling skills was low overall, but did increase among programs with clinical experiences (P=.0033). The current trajectory of medical cannabis use in the United States makes it likely that residents will care for patients interested in medical cannabis, therefore it is important residents be prepared to address this reality. Opportunities exist for improving medical cannabis education in family medicine residency programs.

Continuum in the acquisition of competencies for work in family medicine in Croatia

Integration of new scientific knowledge into the medical schools, family medicine specialty training programmes, and achievement of the competencies acquired with the real health needs of the population are the challenges of the medical doctors’ education in the 21st century. It is necessary to ensure well-structured family physicians’ education because this kind of medical professionals is the basis of a well-organized health care system. The aim of this study is to describe the education of family physicians in Croatia and compare it with EU member states. The European Academy of Teachers in General Practice/Family Medicine prepared a minimal core curriculum for family medicine in undergraduate medical education and educational training requirements for family medicine specialty training. In Croatia curricula of all medical schools have the subject Family Medicine. Subject Family Medicine at the School of Medicine in Zagreb entirely includes a minimal core curriculum for family medicine in undergraduate medical education, direct observation of procedural skills, e-portfolio and experience based learning. Subject Family Medicine at the School of Medicine in Split entirely includes a minimal core curriculum for family medicine in undergraduate medical education, and organization of clinical teaching in urban and island teaching family medicine practices. Teaching of family medicine at the School of Medicine in Rijeka includes theoretical and practical teaching and written answers to a selected clinical question based on clinical experiences. Teaching of family medicine at the School of Medicine in Osijek includes a combination of clinical teaching in family medicine and exercises in the skills lab. The four-year competency based family medicine specialty training programme in Croatia implies that the residents spend half time of the specialty training in the mentors’ family medicine office accredited for specialty training.Therefore,education of family physicians in Croatia is in line with European and global recommendations.

Reliability of Peer Review of Abstracts Submitted to Academic Family Medicine Meetings.

To assess the reliability of peer review of abstracts submitted to academic family medicine meetings in North America. We analyzed reviewer ratings of abstracts submitted: 1) as oral presentations to the North American Primary Care Research Group (NAPCRG) meeting from 2016 to 2019, as well as 2019 poster session or workshop submissions; and 2) in 12 categories to the Society of Teachers of Family Medicine (STFM) Spring 2018 meeting. In each category and year, we used a multi-level mixed model to estimate the abstract-level intraclass correlation coefficient (ICC) and the reliability of initial review (using the abstract-level ICC and the number of reviewers per abstract). We analyzed review data for 1554 NAPCRG oral presentation abstracts, 418 NAPCRG poster or workshop abstracts, and 1145 STFM abstracts. Across all years, abstract-level ICCs for NAPCRG oral presentations were below 0.20 (range, 0.10 in 2019 to 0.18 in 2016) and were even lower for posters and workshops (range, 0.00-0.10). After accounting for the number of reviewers per abstract, reliabilities of initial review for NAPCRG oral presentations ranged from 0.24 in 2019 to 0.30 in 2016 and 0.00 to 0.18 for posters and workshops in 2019. Across 12 STFM submission categories, the median abstract-level ICC was 0.21 (range, 0.12-0.50) and the median reliability was 0.42 (range, 0.25-0.78). For abstracts submitted to North American academic family medicine meetings, inter-reviewer agreement is often low, compromising initial review reliability. For many submission categories, program committees should supplement initial review with independent postreview assessments.

What Will It Take to Recruit and Train More Underrepresented Minority Physicians in Family Medicine? A CERA Survey Analysis.

Both the Society of Teachers of Family Medicine (STFM) and the American Academy of Family Physicians have developed strategic plans to increase the training of underrepresented minority in medicine (URMM) family physicians to meet the needs of an increasingly diverse patient population in the United States. This study examines data from the 2017 Council of Academic Family Medicine (CAFM) Educational Research Alliance (CERA) Program Directors (PD12) Survey to assess whether recruitment strategies increase the diversity of underrepresented minority physicians in family medicine. Data were collected from an online electronic survey administered by the CERA of family medicine program directors in 2018. The data included specific questions about the diversity of URMM residents in family medicine programs and about initiatives that were used in their recruitment. We analyzed the data using the Pearson χ2 criteria for cause and effect of two variables. Family medicine residency programs that have initiatives dedicated to increasing resident diversity have a higher percentage of URMM residents. Specifically, residency programs that have URMM recruitment strategies are 2.5 to 4 times more likely to have a diverse residency population than those programs without strategies (P&lt;.001-.015). Striving to improve diversity in family medicine residency training in accordance with the ideals of STFM will require programs to design and implement initiatives to increase recruitment of URM residents.

Utilizing Practice-Based Research Networks to Teach and Implement Quality Improvement in Academic Medicine.

A 2019 study found that between 2014 and 2017, family medicine residents had little improvement in self-assessed preparedness to lead quality improvement projects. This study explored the effectiveness of leveraging a practice-based research network (PBRN) across multiple family medicine residencies not only for implementing quality improvement projects, but also as a teaching tool designed to improve knowledge, attitudes, beliefs, and leadership skills in family medicine faculty and residents. Residents in family medicine residency programs and one community internal medicine program and family medicine teaching faculty participated in a PBRN-led quality improvement project (QIP) to improve colon cancer screening in their clinic. Of 101 participants, 79 (78%) were residents and 22 (22%) were faculty or attending physicians. Questions surveying participants' knowledge and confidence related to QIP before and after the QIP were given. Overall, participants reported an improvement in their basic understanding of QI concepts (P=.004). They also reported having sufficient staff and ancillary support to meaningfully participate (P=.033). Participants indicated they had more confidence in their ability to participate in a QI project (P=.002), initiate, design, and lead such a project (P=.001), and teach their peers and staff basic QI concepts (P&lt;.001). PBRNs appear to be a unique way to subjectively improve residents' confidence in their quality improvement skills. PBRNs should be further explored as a method for educating family medicine residents in quality improvement.

Teaching Racial Affinity Caucusing as a Tool to Learn About Racial Health Inequity Through an Experiential Workshop.

In its landmark report, Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care, the Institute of Medicine concluded that unconscious or implicit negative racial attitudes and stereotypes contribute to poorer health outcomes for patients of color. We describe and report on the outcome of teaching a workshop on the tool of racial affinity caucusing to address these issues. Applying the framework described by Crossroads Antiracism Organizing and Training, we developed a 90-minute workshop teaching racial affinity caucusing to family medicine educators interested in racial health disparities. The workshop included didactic and experiential components as well as a panel discussion. We administered pre- and posttests. Participants' (n=53) impression of and confidence in implementing racial affinity caucusing significantly increased following the workshop from a mean pretest score of 5.40 to a mean posttest score of 7.12 (P&lt;.01) on a scale of 1 to 9. Ninety-two percent of participants indicated that the workshop made them more likely to think about implementing this tool at their home institutions (P&lt;.01). This study demonstrated the first exploration in medical education of racial affinity caucusing and illustrated that it can be easily implemented in residency programs as an effort to address racial health inequities. Though the participating educators were mostly unfamiliar with it, the workshop was an effective introduction to this tool and by the end, educators reported increased comfort and enthusiasm for racial affinity caucusing, regardless of their preexisting levels of knowledge of or comfort with the tool. In addition, the overwhelming majority of the participants felt they could implement it at their respective institutions.

Compassion, gratitude and awe: The role of pro-social emotions in training physicians for relational competence.

On April 28, 2019, Dr. Beat Steiner, president of the Society of Teachers of Family Medicine (STFM), proposed that we as family medicine educators focus on increasing kindness and compassion in our lives and the world around us. As teachers of Family Medicine, we are poised in the intersections among healing, teaching, training, and caregiving. Faculty are held accountable for ensuring that our learners achieve certain milestones by demonstrating defined clinical competencies. We have a long list of topics, biomedical and psychosocial, to be sure our learners understand, and procedures of all types that our learners must do. This paper discusses the importance of extending kindness to ourselves, our colleagues, and patients, and explores three "pro-social" emotions-compassion, gratitude, and awe, which health professions educators can model for trainees in the service of developing self-aware, relationally competent, and well-rounded clinicians.

Attending an Alcoholics Anonymous Meeting: A Pilot Study of an Experiential Learning Activity on the Family Medicine Clerkship.

Physicians frequently treat patients struggling with addiction, including alcohol abuse. The Society of Teachers of Family Medicine's National Clerkship Curriculum lists necessary learning for all future physicians and includes several core objectives related to identifying community resources, the role of support groups in treating patients, and identifying and managing substance abuse. During the family medicine clerkship at the Florida International University Herbert Wertheim College of Medicine, students learn about resources for treating alcohol abuse by attending a 12-step Alcoholics Anonymous (AA) meeting and answering brief reflective questions about the experience. For the 2018-2019 academic year, students completed an anonymous, optional, computer-based, pre-/postactivity survey to assess the students' perceived impact of attending an AA meeting. After the AA meeting, there was an increase in the percentage of students who agreed or strongly agreed that AA meetings are a useful resource. Students perceived that they would be likely to refer a patient with alcohol abuse to AA in the future, were confident in their ability to explain AA to a patient, were knowledgeable about community resources for patients with alcohol addiction, and were confident in their ability to assess patients for alcohol abuse. Attendance at a single AA meeting increased students' awareness of community resources, including AA, for patients who abuse or misuse alcohol. Because students also reported increased perceived self-confidence regarding explaining AA to patients and assessing patients for alcohol addiction, attendance at an AA meeting has the potential to affect future patient care.

The state of family medicine training programmes within the Primary Care and Family Medicine Education network.

The 2019 Primary Care and Family Medicine Education network (Primafamed) meeting in Kampala, Uganda, included a workshop that aimed to assess the state of postgraduate family medicine training programmes in the Primafamed network. Forty-six people from 14 African and five other countries were present. The evaluation of programmes or countries according to the stages of change model was compared to a previous assessment made 5 years ago. Most countries have remained at the same stage of change. Two countries appeared to have reversed their readiness to change as Rwanda moved from relapse to pre-contemplation and Mozambique moved from action to contemplation. Malawi, Zambia and Zimbabwe increased their readiness to change and moved from contemplation to action. Countries in the region remain quite diverse in terms of their commitment to family medicine training. Within Primafamed, it is possible for countries with a more advanced stage of change to assist countries with an earlier stage. Primafamed is also supported by a variety of partners outside of Africa. Five years after the previous country-level assessment, family medicine in Africa continues to span across all levels of the stages of change model. Stage-matched interventions aligned with the needs of individual countries should follow. Consequently, this workshop report will serve as a mandate and compass for Primafamed’s actions over the next few years, aimed at designing and delivering these interventions. As reiterated in the 2019 Kampala commitment, we should continue developing the discipline of family medicine (the medical ‘specialty’ of primary care), through alignment of our training programmes to the health needs in the African region.

A cross-sectional study of United States family medicine residency programme director burnout: implications for mitigation efforts and future research.

Academic physician burnout is concerning. Too little is known about factors associated with residency programme director burnout. Continued uncertainty risks adverse outcomes including graduate medical education leadership turnover and negative impact on recruiting and retaining under-represented minority residency programme directors. This study assessed symptoms of burnout (emotional exhaustion, depersonalization) and depression along with evidence-based individual and environmental risk factors in a U.S. sample of family medicine residency programme directors. The omnibus 2018 Council of Academic Family Medicine Education Research Alliance survey was used to contact programme directors at all Accreditation Council for Graduate Medical Education accredited U.S. family medicine residency programmes via email. Descriptive data included programme director and programme characteristics, Areas of Worklife (workload, values and control), loneliness (lack companionship, feel left out and feel isolated), burnout (emotional exhaustion, depersonalization) and depressive symptoms. Chi-square tests contrasted descriptive variables with burnout and depressive symptoms. Logistic regression (LR) modelled associations between significant descriptive variables and burnout and depressive symptoms. The survey response rate was 45.2% (268/590). Programme directors reported: emotional exhaustion (25.0%), depersonalization (10.3%) and depressive symptoms (25.3%). LR models found significant associations with emotional exhaustion (Workload: lacking time and other work-related resources); lack of companionship, depersonalization (North West Central residency region; Workload and lack of companionship) and depressive symptoms (Black/African American ethnicity). One-quarter of U.S. programme directors report burnout or depressive symptoms. Future research should consider associated variables as possible intervention targets to reduce programme director distress and turnover.

Assessing Family Medicine Residency Programs’ Training on Human Trafficking: A National Survey of Program Directors

ABSTRACT Background Human trafficking (HT) affects millions globally, and is linked to significant health effects. Studies suggest victims interact with the healthcare system while exploited, yet go unrecognized. We sought to determine the content and extent of HT training in family medicine residency programs and to identify barriers to providing formal training. Methodology Participation in the Council of Academic Family Medicine Educational Research Alliance (CERA) Program Director (PD) survey in 2018. Results Almost half of program directors stated their program had no HT training (45.8%), 35.4% had required training and 18.8% offer electives. HT was primarily taught via lectures (77.1%) vs. experiential learning (21.5%); the majority of programs dedicated 1–3 hours total during residency (79.5%) to HT. Nearly 2/3 of residents have reported “basic” competency (60.9%) but only 6% had advanced competency. Required training was associated with higher odds of residents graduating with an advanced level. Programs with institutional protocols were 10 times more likely to have residents with advanced competency. Conclusion Gaps remain in U.S. Family Medicine Residency Programs' HT education, though it is unclear how that compares to other specialties. HT knowledge and practice should be linked to Accreditation Council Graduate Medical Education competencies and integrated into residency curricula.

Helping medical educators worldwide to pivot curricula online: pivotmeded.com.

The coronavirus disease 2019 (COVID-19) pandemic has resulted in the implementation of restrictions on group gatherings and educational events in many countries, creating imperatives for medical educators to move curricula online at short notice. Within medical schools and health sciences programmes, this urgency was compounded by competing priorities of health care delivery as many medical educators are also clinicians. To support medical educators, faculty development leaders in Canadian medical schools (FacDevCanada) collaborated to curate medical education resources in three categories: guidance on pivoting to online curriculum (classroom and clinical) delivery; discipline-specific learning resources, and general resources (including basic science, Indigenous health, patient safety and leadership development resources). The FacDevCanada developed PIVOTMeded (Partners in Virtual and Online Teaching in Medical Education), found at pivotmeded.com. Members of FacDevCanada crowdsourced resources in the three categories described above. Resource nominations were reviewed according to the following criteria: open accessibility; lack of evident bias; lack of (or minimal) personal information gathering, and relevance to the likely needs of learners and medical educators. A Google Site platform (Google LLC, Mountain View, CA, USA) was utilised in view of: (a) the platform's relative programming ease; (b) user navigation ease; (c) the platform's facilitation of responsive and dynamic displays compatible with computers, tablets and mobile devices, and (d) the curators' familiarity with the platform. Initially, one person reviewed nominations from contributors and sought materials for inclusion. Two additional medical educators with adeptness in curating resources and configuring the website became co-editors. Two administrative staff supported resource posting and website maintenance. Each resource's post includes a link and a customised annotation. PIVOTMeded launched on 17 March 2020. By 28 April (at the time of writing), the site had 2007 unique users. This indicates a high rate of utilisation; in comparison, a well-established open-access resource for family medicine educators, ‘learnfm.ca,’1 had 1265 unique users in the same 6 weeks. To date, we have curated 84 open-access resources, which support medical educators to pivot curricula online. Content comes from a variety of authors and multiple countries. Users come from 74 countries; the largest cohorts are from Canada (48%) and the USA (24%), followed by Portugal, the United Kingdom and Mexico (3% each). Half of website users visited directly (eg, by typing ‘pivotmeded.com’ into a browser), which suggests awareness of this website by name. One-third of users came through social media links and posts by individuals and organisations including the Association for Medical Education in Europe, the Royal College of Physicians and Surgeons of Canada, the College of Family Physicians of Canada, the Harvard Macy Institute, and faculty development units (all utilisation data from Google Analytics [Google LLC, Mountain View, CA, USA]). Key lessons learned refer to: (a) the value of an easily memorable name and URL (uniform resource locator) for this kind of project; (b) the importance of curating site content selectively rather than providing links to a large number of resources (as evidenced by spontaneous feedback and tweets about our project); (c) the need to have multiple people collaborate on this type of project (to ensure high-quality curation within a tight time frame), and (d) the value of tweets, posts and emails from established individuals and organisations in building awareness. Beyond COVID-19, pivotmeded.com will continue to curate open-access materials supporting online medical education.

STFM Podcasts Launch With a Celebration of Family Medicine’s Critical Front Line Leadership (STFM)

In STFM’s inaugural podcast series, Academic Medicine Leadership Lessons: COVID-19 , family medicine educators are rising to the challenges of the COVID-19 pandemic by redesigning health systems, inventing new ways to train learners, and providing the best possible care to patients. Much has been