Postgraduate Training In Family Medicine Research Articles

Registrars' experience with research in family medicine training programmes in South Africa.

Completion of a research assignment is a requirement for specialist training in South Africa. Difficulty with completion delays graduation and the supply of family physicians. The aim of this study was to explore the experience of registrars with their research in postgraduate family medicine training programmes. An explorative descriptive qualitative study. Extreme case purposive sampling selected registrars who had and had not completed their research on time, from all nine training programmes. Saturation was achieved after 12 semi-structured interviews. The framework method was used for data analysis, assisted by ATLAS.ti software. The assumption of prior learning by teachers and supervisors contributed to a sense of being overwhelmed and stressed. Teaching modules should be more standardised and focussed on the practical tasks and skills, rather than didactic theory. Lengthy provincial and ethics processes, and lack of institutional support, such as scholarly services and financial support, caused delays. The expertise of the supervisor was important, and the registrar-supervisor relationship should be constructive, collaborative and responsive. The individual research experience was dependent on choosing a feasible project and having dedicated time. The balancing of personal, professional and academic responsibilities was challenging. Training programmes should revise the teaching of research and improve institutional processes. Supervisors need to become more responsive, with adequate expertise. Provincial support is needed for streamlined approval and dedicated research time.Contribution:The study highlights ways in which teaching, and completion of research can be improved, to increase the supply of family physicians to the country.

Development of entrustable professional activities for family medicine in South Africa.

South Africa is undergoing a significant shift towards implementing enhanced workplace-based assessment methodologies across various specialist training programmes, including family medicine. This paradigm involves the evaluation of Entrustable Professional Activities (EPAs) through comprehensive portfolios of evidence, which a local and national clinical competency committee then assesses. The initial phase of this transformative journey entails the meticulous development of EPAs rooted in discrete units of work. Each EPA delineates the registrar's level of entrustment for autonomous practice, along with the specific supervision requirements. This concise report details the collaborative effort within the discipline of family medicine in South Africa, culminating in the consensus formation of 22 meticulously crafted EPAs for postgraduate family medicine training. The article intricately outlines the systematic structuring and rationale behind the EPAs, elucidating the iterative process employed in their development. Notably, this marks a groundbreaking milestone as the first comprehensive documentation of EPAs nationally for family medicine training in Africa.

Empathy in family medicine postgraduate education: A mixed studies systematic review

Purpose Empathy is an important construct in patient-physician relationships, particularly critical in family physicians’ daily practice. We aimed to understand how empathy has been conceived and integrated into family medicine postgraduate training. Materials and Methods Medline, PsyINFO, and Embase were searched in this systematic mixed studies systematic review. Two independent reviewers screened abstracts and full texts. Disagreements were solved through research team consensus-based discussion. Included studies were synthesized thematically. Results A total of 18 studies were included. Four themes were identified. (1) Empathy definition. Included studies stressed the cognitive component of empathy, paired either with a behavioural or an affective response. (2) Empathy modifiers. Starting residency right after medical school, having a role model, having high empathy levels before residency, having children, being married, and being exposed to patient involvement in education were found to have a positive impact on empathy. (3) Empathy-burnout relationship. Whereas greater burnout was related to lower empathy levels, excess empathy seems to favour burnout through ‘compassion fatigue.’ (4) Educational programs for empathy development. Five programs were identified: a communication workshop, a patient-led program, a mindfulness program, a family-oriented intervention, and an arts-based program. Conclusions Studies mostly measured the cognitive component of empathy. The moral component of empathy was underrepresented in the conceptualization of empathy and the development of educational interventions. Conflicting evidence exists regarding the decline of empathy levels during the family medicine residency. Longitudinal designs should be privileged when exploring the evolution of empathy levels across the continuum of medical education.

Pioneering family physicians and the mechanisms for strengthening primary health care in India-A qualitative descriptive study.

India has one of the most unequal healthcare systems globally, lagging behind its economic development. Improved primary care and primary health care play an integral role in overcoming health disparities. Family medicine is a subset of primary care-delivered by family physicians, characterized by comprehensive, continuous, coordinated, collaborative, personal, family and community-oriented services-and may be able to fill these gaps. This research aims to understand the potential mechanisms by which family physicians can strengthen primary health care. In this qualitative descriptive study, we interviewed twenty family physicians, identified by purposeful and snowball sampling, who are among the first family physicians in India who received accredited certification in FM and were identified as pioneers of family medicine. We used the Contribution of Family Medicine to Strengthening Primary Health Care Framework to understand the potential mechanisms by which family medicine strengthens primary health care. Iterative inductive techniques were used for analysis. This research identifies multiple ways family physicians can strengthen primary health care in India. They are skilled primary care providers and support mid and low-level health care providers' ongoing training and capacity building. They develop relationships with specialists, ensure appropriate referral systems are in place, and, when necessary, work with governments and organizations to access the essential resources needed to deliver care. They motivate the workforce and change how care is delivered by ensuring providers' skills match the needs of communities and engage communities as partners in healthcare delivery. These findings highlight multiple mechanisms by which family physicians strengthen primary health care. Investments in postgraduate training in family medicine and integrating family physicians into the primary care sector, particularly the public sector, could address health disparities.

Are early career family physicians prepared for practice in Canada? A qualitative study

BackgroundIn Canada, the College of Family Physicians of Canada (CFPC) introduced Competency Based Medical Education to prepare and train family medicine residents to be competent to enter and adapt to the independent practice of comprehensive family medicine. Despite its implementation, the scope of practice is narrowing. This study aims to understand the degree to which early career Family Physicians (FPs) are prepared for independent practice.MethodA qualitative design was used for this study. A survey and focus groups were conducted with early-career FPs who completed residency training in Canada. The survey and focus groups examined the degree of preparedness of early career FPs in relation to 37 core professional activities identified by the CFPC’s Residency Training Profile. Descriptive statistics and qualitative content analysis were conducted.ResultsSeventy-five participants from across Canada participated in the survey, and 59 participated in the focus groups. Early career FPs reported being well prepared to provide continuous and coordinated care for patients with common presentations and deliver various services to different populations. FPs were also well prepared to manage the electronic medical record, participate in team-based care, provide regular and after-hours coverage, and assume leadership and teaching roles. However, FPs reported being less prepared for virtual care, business management, providing culturally safe care, delivering specific services in emergency care hospitals, obstetrics, self-care, engaging with the local communities, and conducting research activities.ConclusionsEarly career FPs do not feel fully prepared for practice in all 37 core activities in the Residency Training Profile. As part of the introduction of the three-year program by the CFPC, the postgraduate family medicine training should consider providing more exposure to learning opportunities and developing curricula in the areas where FPs are unprepared for practice. These changes could facilitate the production of a FP workforce better prepared to manage the dynamic and complex challenges and dilemmas faced in independent practice.

Snapshot of family medicine around the world: Introducing the global family medicine website.

To develop an interactive, living map of family medicine training and practice; and to appreciate the role of family medicine within, and its effect on, health systems across the world. A subgroup of the College of Family Physicians of Canada's Besrour Centre for Global Family Medicine developed connections with selected international colleagues with expertise in international family medicine practice and teaching, health systems, and capacity building to map family medicine globally. In 2022, this group received support from the Foundation for Advancing Family Medicine's Trailblazers initiative to advance this work. In 2018 groups of Wilfrid Laurier University (Waterloo, Ont) students conducted broad searches of relevant articles about family medicine in different regions and countries around the world; they conducted focused interviews and then synthesized and verified information, developing a database of family medicine training and practice around the world. Outcome measures were age of family medicine training programs and duration and type of family medicine postgraduate training. To approach the question of how delivery of the family medicine model of primary care can affect health system performance, relevant data on family medicine were collated-the presence, nature, duration, and type of training and role within health care systems. The website https://www.globalfamilymedicine.org now has up-to-date country-level data on family medicine practice around the world. This publicly available information will allow such data to be correlated together with health system outputs and outcomes and will be updated as necessary through a wiki-type process. While Canada and the United States only have residency training, countries such as India have master's or fellowship programs, in part accounting for the complexity of the discipline. The maps also identify where family medicine training does not yet exist. Mapping family medicine around the world will allow researchers, policy makers, and health care workers to have an accurate picture of family medicine and its impact using relevant, up-to-date information. The group's next aim is to develop data on parameters by which performance in various domains can be measured across settings and to display these in an accessible form.

Developing entrustable professional activities for family medicine training in South Africa.

Workplace-based assessment (WPBA) is becoming part of high-stake assessments in specialist training. Entrustable professional activities (EPAs) are a recent addition to WPBA. This is the first South African publication on developing EPAs for postgraduate family medicine training. An EPA is a unit of practice, observable in the workplace, constituting several tasks with underlying knowledge, skills and professional behaviours. Entrustable professional activities allow for entrustable decisions regarding competence in a described work context. A national workgroup representing all nine postgraduate training programmes in South Africa has developed 19 EPAs. This new concept needs change management to understand the theory and practice of EPAs. Family medicine departments with large clinical workloads are small, necessitating navigating logistical issues to develop EPAs. It has unmasked existing workplace learning and assessment challenges.Contribution:This article contributes new thinking to developing EPAs for family medicine in an effort to understand more authentic WPBA nationally.

Evaluating postgraduate family medicine supervisor feedback in registrars’ learning portfolios

Postgraduate supervision forms a vital component of decentralised family medicine training. While the components of effective supervisory feedback have been explored in high-income countries, how this construct is delivered in resource-constrained low- to middle-income countries has not been investigated adequately. This article evaluated supervisory feedback in family medicine registrars' learning portfolios (LPs) as captured in their learning plans and mini-Clinical Evaluation Exercise (mini-CEX) forms and whether the training district or the year of training affected the nature of the feedback. Registrars' LPs from 2020 across five decentralised sites affiliated with the University of the Witwatersrand in South Africa were analysed. Two modified tools were used to evaluate the quantity of the written feedback in 38 learning plans and 57 mini-CEX forms. Descriptive statistics, Fisher's exact and Wilcoxon rank-sum tests were used for analysis. Content analysis was used to derive counts of areas of feedback. Most learning plans (61.2%) did not refer to registrars' clinical knowledge or offer an improvement strategy (86.1%). The 'extent of supervisors' feedback' was rated as 'poor' (63.2%), with only 14.0% rated as 'good.' The 'some' and 'no' feedback categories in the mini-CEX competencies (p 0.001 top= 0.014) and the 'extent of supervisors' feedback' (p 0.001) were significantly associated with training district. Feedback focused less on clinical reasoning and negotiation skills. Supervisors should provide specific and constructive narrative feedback and an action plan to improve registrars' future performance.Contribution:Supervisory feedback in postgraduate family medicine training needs overall improvement to develop skilled family physicians.

Perceptions of resources available for postgraduate family medicine training at a South African university

Clinical training is one of the roles of family physicians (FPs) in decentralised postgraduate training. Effective training requires skilled trainers and sufficient resources. Little is known about the resources available for decentralised clinical training in district health systems in low- to middle-income countries, especially in sub-Saharan Africa. To explore FPs' and registrars' perceptions of the available resources in a decentralised postgraduate family medicine (FM) training programme. Five decentralised training sites affiliated with the University of the Witwatersrand across two provinces in South Africa. This qualitative study forms part of a broader project evaluating a FM registrar training programme using the logic model. Semistructured interviews were conducted with a purposive sample of 11 FPs and 11 registrars. The interviews were transcribed verbatim and analysed thematically. Three themes were identified: 'Impact of resource constraints', 'Family physicians' skills and knowledge could be further improved' and 'Family physicians need additional support to optimise their training role'. The additional resources needed include more FPs, equipment, infrastructure and funding. Knowledge and skills of FPs were reported variable and needed further improvement. Additional support was required from peers, the district management and the university. Well-resourced decentralised training environments with sufficient skilled trainers and adequate resources are needed to positively influence FP training and supervision, especially in middle-income countries like South Africa.Contribution:Clinical trainers need adequate resources and support from peers, district management and the university for effective decentralised clinical training.

Factors influencing HINTS exam usage by Canadian Emergency Medicine Physicians.

The HINTS examination (head impulse, nystagmus, test of skew) is a bedside physical examination technique that can distinguish between vertigo due to stroke, and more benign peripheral vestibulopathies. Uptake of this examination is low among Emergency Medicine (EM) physicians; therefore, we surveyed Canadian EM physicians to determine when the HINTS exam is employed, and what factors account for its low uptake. We designed and tested a 26-question online survey, and disseminated it via email to EM physicians registered with the Canadian Association of Emergency Physicians (CAEP), with 3 and 5-week reminder emails to increase completion. This anonymous survey had no incentives for participation, and was completed by 185 EM physicians, with post-graduate medical training in either Emergency Medicine or Family Medicine. The primary outcomes were the frequencies of various responses to survey questions, with secondary outcomes being the associations between participant characteristics and given responses. 88 respondents (47.8%) consistently use the HINTS examination in the work-up of vertigo, and 117 (63.7%) employ it in scenarios where its clinical utility is limited. The latter is more common among physicians working in non-academic settings, without 5-year EM residency training, and with greater years of practice (p < 0.01). The most frequent explanations for non-use were a lack of need for the HINTS examination, the lack of validation of the exam among EM physicians, and concerns surrounding the head-impulse test. Though HINTS exam usage is common, there is a need for education on when to apply it, and how to do so, particularly as concerns the head-impulse test. Our attached rubric may assist with this, but quality-improvement initiatives are warranted. Low uptake is partly due to the lack of validation of this examination among EM physicians, so effort should be made to conduct well-designed HINTS trials exclusively involving EM physicians.

Bridging the Gap Between Competencies and Uncertainties in Postgraduate Training in Family Medicine: Results and Psychometric Properties of a Self-Assessment Questionnaire.

PurposeOne of the reasons for postgraduate trainees not to choose working in a rural area is uncertainty related to the lack of competencies. The aim of this study was to investigate the concept of uncertainty by measuring competencies and to examine the psychometric properties of an instrument that measures competencies related to uncertainty in the self-assessment of postgraduate trainees in family medicine.Patients and MethodsA questionnaire was created based on pre-existing instruments. It was distributed to participants of postgraduate training seminars in the federal states of Baden-Württemberg and Schleswig-Holstein, Germany in 2016. Descriptive statistics and a partial correlation analysis were calculated for measuring the degree of association between year of postgraduate training and items’ responses. Psychometric properties were assessed by calculating descriptive item analysis, factor analysis and internal consistency.ResultsThe response rate was 85% (105/124). More than one-fifth of the participants stated to show only seldom or sometimes the following skills: ability to balance work and life (N=25, 24%), letting a mild disorder run its own way (N=24, 23%) and ability to conduct interventions that decreased aggression from the patient (N=22, 21%). More than half of the participants felt (very) insecure in performing routine child check-ups, the application of a below elbow backslab and the partial removal of a toenail. Nine out of 21 items showed positive statistically significant correlation between level of competence and progress in training. Factor analysis led to a final instrument with 12 items (Cronbach’s α=0.736) and a three-factor-structure: “doctor well-being and resilience”, “communication” and “skills”.ConclusionIn order to reduce uncertainty with all its consequences, a focus on teaching of competencies regarding the physicians’ well-being and resilience, communication and skills has to be continued in postgraduate training.

Development, Implementation, and Meta-Evaluation of a National Approach to Programmatic Assessment in Canadian Family Medicine Residency Training.

The growing international adoption of competency-based medical education has created a desire for descriptions of innovative assessment approaches that generate appropriate and sufficient information to allow for informed, defensible decisions about learner progress. In this article, the authors provide an overview of the development and implementation of the approach to programmatic assessment in postgraduate family medicine training programs in Canada, called Continuous Reflective Assessment for Training (CRAFT). CRAFT is a principles-guided, high-level approach to workplace-based assessment that was intentionally designed to be adaptable to local contexts, including size of program, resources available, and structural enablers and barriers. CRAFT has been implemented in all 17 Canadian family medicine residency programs, with each program taking advantage of the high-level nature of the CRAFT guidelines to create bespoke assessment processes and tools appropriate for their local contexts. Similarities and differences in CRAFT implementation between 5 different family medicine residency training programs, representing both English- and French-language programs from both Western and Eastern Canada, are described. Despite the intentional flexibility of the CRAFT guidelines, notable similarities in assessment processes and procedures across the 5 programs were seen. A meta-evaluation of findings from programs that have published evaluation information supports the value of CRAFT as an effective approach to programmatic assessment. While CRAFT is currently in place in family medicine residency programs in Canada, given its adaptability to different contexts as well as promising evaluation data, the CRAFT approach shows promise for application in other training environments.

Natural Language Processing to Identify Digital Learning Tools in Postgraduate Family Medicine: Protocol for a Scoping Review

BackgroundThe COVID-19 pandemic has highlighted the growing need for digital learning tools in postgraduate family medicine training. Family medicine departments must understand and recognize the use and effectiveness of digital tools in order to integrate them into curricula and develop effective learning tools that fill gaps and meet the learning needs of trainees.ObjectiveThis scoping review will aim to explore and organize the breadth of knowledge regarding digital learning tools in family medicine training.MethodsThis scoping review follows the 6 stages of the methodological framework outlined first by Arksey and O’Malley, then refined by Levac et al, including a search of published academic literature in 6 databases (MEDLINE, ERIC, Education Source, Embase, Scopus, and Web of Science) and gray literature. Following title and abstract and full text screening, characteristics and main findings of the included studies and resources will be tabulated and summarized. Thematic analysis and natural language processing (NLP) will be conducted in parallel using a 9-step approach to identify common themes and synthesize the literature. Additionally, NLP will be employed for bibliometric and scientometric analysis of the identified literature.ResultsThe search strategy has been developed and launched. As of October 2021, we have completed stages 1, 2, and 3 of the scoping review. We identified 132 studies for inclusion through the academic literature search and 127 relevant studies in the gray literature search. Further refinement of the eligibility criteria and data extraction has been ongoing since September 2021.ConclusionsIn this scoping review, we will identify and consolidate information and evidence related to the use and effectiveness of existing digital learning tools in postgraduate family medicine training. Our findings will improve the understanding of the current landscape of digital learning tools, which will be of great value to educators and trainees interested in using existing tools, innovators looking to design digital learning tools that meet current needs, and researchers involved in the study of digital tools.Trial RegistrationOSF Registries osf.io/wju4k; https://osf.io/wju4kInternational Registered Report Identifier (IRRID)DERR1-10.2196/34575

Need of the Hour: Family Medicine in India.

Family medicine practitioners can manage a wide range of health problems, either directly or through referral to other specialists, thereby optimizing the cost-effectiveness of the healthcare system. For most health problems, family medicine practitioners serve as an entry point for individualized healthcare. Providing comprehensive care for most specialties for all ages is the hallmark of family medicine. It is recognized as a distinct specialty in many developed countries, and training is provided through organized residency programs. Family medicine has been incorporated in the foundation course of Bachelor of Medicine, Bachelor of Surgery (MBBS) and is planned to be adopted in all medical institutes in India; however, the MBBS syllabus includes no mention of it. In medical schools in India, fully functioning family medicine departments should be established on an urgent scale. It is necessary to take the required measures to introduce the subject into the undergraduate MBBS program and to generalize it across India. It is recommended that the number of medical schools offering postgraduate residency training in family medicine be increased to meet current community health needs.

Clinical skills of general practitioners in Nairobi, Kenya: a cross-sectional study.

Quality service delivery in primary care requires motivated and competent health professionals. In the Kenyan private sector, GPs with no postgraduate training in family medicine offer primary care. There is a paucity of evidence on the ability of primary care providers to deliver comprehensive care and no such evidence is available for GPs practising in the private sector in Kenya. To evaluate GPs' training and experience in the skills required for comprehensive primary care. A cross-sectional descriptive survey in 13 primary care clinics in the private sector of Nairobi, Kenya. A questionnaire, originally designed for a national survey of primary care doctors in South Africa, was adapted. The study collected self-reported data on performance of clinical skills by 25 GPs. Data were analysed using the Statistical Package for Social Sciences (SPSS, version 25). GPs were mostly aged <40 years, with ≤10 years of experience, and there was an equal sex distribution. GPs reported moderate performance with adult health, communication and consultation, and clinical administration; and weak performance with emergencies, child health, surgery, ear, nose, and throat (ENT) and eyes, women's health, and orthopaedics. The GPs lacked training in specific skills such as proctoscopies, contraceptive devices, skin procedures, intra-articular injections, red reflex tests, and use of genograms. GPs lacked training and performed poorly in some of the essential skills required in primary care. Continuing professional development, training in family medicine, broadening the model of care, and deployment of family physicians to the clinics could improve care comprehensiveness.

Компетентісний підхід як основний пріоритет викладання первинної спеціалізації та перепідготовки лікарів за спеціальністю загальна практика-сімейна медицина

Пріоритетним напрямом модернізації системи вищої медичної освіти є необхідність підвищення якості підготовки медичних кадрів. Компетентісний підхід вимагає від освітянської спільноти подальшої активізації модернізаційних процесів в системі безперервного професійного навчання і розвитку. Мета роботи є обгрунтування актуальності танеобхідності компетентісного підходу як засобу модернізації викладання на етапі первинної спеціалізації та перепідготовки лікарів загальної практики-сімейної медицини. Матеріали та методи дослідження. Проаналізовано наукові публікації, що визначають компетенції сімейного лікаря. Висвітлено напрями роботи та досвід кафедри терапії і сімейної медицини післядипломної освіти у підготовці висококомпетентних фахівців первинної ланки. езультати дослідження та їх обговорення. У статті визначено актуальність і доцільність застосування основних принципів компетентісного підходу при викладанні первинної спеціалізації та перепідготовки лікарів загальної практики-сімейної медицини. Висновки: компетентісний підхід до викладання первинної спеціалізації та перепідготовки є одним з пріоритетних в післядипломній освіті лікарів, професійна компетентність є показником професіоналізму, фахової майстерності, належної готовності до роботи. Перспективи подальшого вивчення теми. Вивчення досвіду інших кафедр післядипломної освіти щодо подальшого удосконалення викладання первинної спеціалізації з акцентом на ті життєві і професійні компетентності, що необхідні в професійній діяльності та перепідготовки лікарів загальної практики - сімейної медицини.

Awareness, Availability and Use of Teaching Aids and Skills Acquisition Materials in Family Medicine Training Centres in West Africa

Introduction: Teaching aids and skills acquisition tools are rapidly forming an integral part of Family Medicine postgraduate training worldwide. While some training centres in West Africa have made concerted efforts to ensure their use, many still have a lot to improve on. Hence, there is a need to objectively determine its level of awareness, availability, and use in the sub-region.&#x0D; Methods: This was a descriptive cross-sectional study involving all consenting Heads of Department and Training Coordinators of all centres with current West Africa College of Physicians Family Medicine accreditation. The Google link to a questionnaire comprising socio-demographic variables, questions on awareness, availability and use of various teaching aids and skill acquisition tools was sent to the respondents via WhatsApp message. Continuous variables were expressed as mean ± standard deviation and categorical variables as frequencies and percentages. Chi-square test and logistic regression analysis were used to determine factors associated with and predictors of availability and use of teaching aids/skills acquisition tools.&#x0D; Results: The response rate was 107(84.3%) from all currently accredited West Africa College of Physicians Family Medicine training centres. Their mean age was 54±7 years; they were predominantly 93(86.9%) certified as trainers. All the respondents felt the use of teaching aids/skills acquisition materials will enhance learning in their departments. However, most were aware and used traditional resources (97.2%) and non-electronic (96.3%) resources. Only 10 (9.3%) respondents had mannequins for training Resident Doctors.&#x0D; Conclusion: Most Family Medicine Trainers in West Africa are aware and support the use of teaching aids/skills acquisition materials. However, the uptake is currently very low. There is an urgent need for the Postgraduate College and all stakeholders to look into ways of improving the use of teaching aids/skills acquisition materials in the sub-region.&#x0D; Keywords: Awareness; Family Medicine; Skills acquisition; Teaching aids; West Africa.

The contribution of family medicine to community-orientated health services in Mali: A short report.

Family medicine has not received appropriate attention in the sub-Saharan African context. In particular, family medicine is rarely recognised as a medical speciality and most African countries are silent on the role of family medicine in their health systems. There is, however, an emerging interest in developing family medicine as a key component of primary healthcare. Postgraduate training in family medicine is progressing and many countries have already established specific training programmes. In addition, there have been attempts to define the importance of family medicine, which, we expect, this short report contributes to. Interviews were conducted with physicians, partners and beneficiaries of two international development projects funded by the Canadian government. The one project supports training of health professionals and the other education of healthy women and girls in the community. The objective was to document the strengthening of primary healthcare through the creation and adaptation of a new family and community medicine postgraduate medical programme (which includes both family and community medicine) emphasising field training, immersion in local communities and interdisciplinary collaboration. This article underlines the importance of family medicine in Mali by documenting how what is now termed family and community medicine can promote community-orientated health services. To do so, we use the examples of initiatives and actions done through two international health development projects.

1486Preference for person-centered care model, perceptions of family physicians and patients of East Mediterranean Region

Abstract Background Person-centered care is one of the vital components of a health care system and signifies the concept of health promotion and disease prevention. This study aimed to identify the perceptions of patients and physicians regarding person-centered care in the Eastern Mediterranean Region (EMR). Methods A cross-sectional study was conducted in six countries of EMR during June 2019 to August 2019. In first phase, 190 family physicians (FPs) practicing for atleast six months were recruited. In the next phase, the recruited FPs then approached their patients aged more than 18 years. Multinomial regression analysis was conducted using SPSS version 20. Results Of a total of 300 patients, 25% were aged 40 years or above and the majority 56% were females. Among physicians, 62.8% were between 25 to 35 years and 88% had a postgraduate training in Family Medicine. Thirty six percent of patients and 62.6% of physicians, preferred a person-centered care model of care. Among physicians, field of specialization (ORadj= 0.7; 95% C.I: 0.3-0.9) and regularity in continuing medical education sessions (ORadj= 0.3; 95% C.I: 0.1-0.5) while, among patients, educational status was significantly associated with preference for person-centered care model. Conclusions The transition towards person centered care model has already started and most care providers endorse it. However, there is a need to apply this approach consistently, keeping the cultural aspects in mind. Key messages There is a need for intensive research on the development of integrated primary care models to improve access to person-centered care.

How to plan and perform E-learning in family medicine vocational training lessons learned in the KWBW-verbundweiterbildungplus

As of the start of the COVID-19-pandemic, basis undergraduate, postgraduate as well as continuous medical education had often been switched to e-learning. This is a chance and a challenge at the same time. In this work, we describe the e-learning experiences of the competence center for postgraduate medical education in Baden-Wurttemberg. We aim to support broad implementation of e-learning by the exchange of educational as well as organizational approaches. In March 2020, we planned synchronic (live) webinars with asynchronic preparation and postprocessing (flipped classroom). We focused on elements to improve interaction. All the process was managed with respect to the program curriculum in a multicentered team. In 2020, n = 263 postgraduate trainees in family medicine (FM trainees) participated in n = 12 online single seminar days of the KWBW Verbundweiterbildungplus. Due to multiple participation, they induced n = 379 participations. N = 353 evaluations could be included (93,1 % response rate). 77 % (n = 182/236) assessed the use of the software Zoom® with satisfying or very satisfying, 75 % (n = 122/163) the use of the software Heiconf® with satisfying or very satisfying. 59 % (n = 208) wanted to continue with seminar days during workdays, whereas 26 % (n = 91) wished for trainings on Saturdays. A technical check was rated as very helpful. From the organizational point of view, an additional lecturer (= moderator) was necessary. Some lecturers needed extra support in advance of the e-learning. We provide didactic elements that can help to improve the interaction between participants which have to be planned ahead. We present a successful approach to face the educational and organizational challenges of e-learning. E-learning was broadly accepted which supports permanent implementation. However, social and collegial interaction is both, most challenging and most important for postgraduate training in family medicine. Therefore, approaches supporting the interaction in e-learning should be developed and implemented. © 2021, Deutscher Arzte-Verlag GmbH. All rights reserved.