Medical Education In Primary Care Research Articles

Barriers and facilitators to the uptake of the Concussion Awareness Training Toolas continuing medical education in primary care.

Continuing medical education (CME) informs physicians on current research. The Concussion Awareness Training Tool (CATT) provides education on concussion diagnosis and treatment. The aims of this study were to explore physician CME practices and preferences, understand barriers and facilitators to implementing the CATT as CME, and provide recommendations. Physicians in British Columbia, Canada participated in an online survey and telephone interview. Descriptive analysis of quantitative data, and text-based data analysis were undertaken to identify themes. Barriers included lack of time and awareness of the resource. Facilitators were its ease of use, accessibility, concisenessand comprehensiveness. The perceptions of barriers and facilitators reported by physicians are important to understand and better promote the use of the CATT.

Can a training hub deliver undergraduate medical education with patient educators?

ABSTRACT Background Medical schools may find it difficult to coordinate GP practices to support undergraduate medical education in primary care. In England, every Integrated Care System area now has a funded training hub to plan and upskill the primary care and community health workforce. We evaluated whether a training hub could help deliver undergraduate medical education, co-facilitated by patient educators. No published research has evaluated this model before. Methods We used before and after surveys (617 students), interviews (28) and focus groups (20 people) with undergraduate medical students, patient educators and training hub and medical school team members. Findings It was feasible for a training hub to develop and co-deliver a workshop with patient educators. 61% of Year 4 undergraduate students (first clinical year) took part, a high attendance rate during the COVID-19 pandemic. 80% of students said they learnt a lot about managing conditions in primary care and the community as a result. They particularly valued engaging with patient educators and seeing interprofessional working between GPs and pharmacists, which were cornerstones of the training hub approach. The hub was able to recruit and retain patient educators more effectively than the medical school alone. Patient educators said they felt valued and developed new skills. Conclusions Working with training hubs may be part of the solution to issues medical schools face when organising undergraduate education about primary care. This small evaluation suggests that this model could be tested further.

Virtual teaching of undergraduate primary care small groups during Covid-19

ABSTRACT The impact of the COVID-19 pandemic required Higher Educational Institutions to redesign and implement new ways of delivering core-learning outcomes for medical students. Much of this change resulted in a transition to virtual teaching across medical schools. Medical education in primary care is often delivered as part of GP-facilitated small group teaching and with this came unique challenges for the transition to online education. Transition to virtual small group teaching utilised blended learning and flipped classroom methodologies alongside the use of virtual teaching platforms. This quality improvement project describes the educational approaches used when transitioning medical education, and compares student experience from receiving small group teaching using face-to-face and virtual teaching methods before and during the COVID-19 pandemic, respectively. Analysis of student feedback found an ongoing delivery of high-quality primary care education using virtual small group teaching, and that there was no attrition in student experience when compared to face-to-face teaching delivered before COVID-19 for the same learning outcomes. These findings are reassuring and suggest that the transition to virtual small group teaching, using methods such as flipped classrooms and blended learning, enables continued and sustained delivery of high-quality education and student experiences in primary care.

Rural Obesity Medical Education for Primary Care in West Virginia: A Needs Assessment

ABSTRACT INTRODUCTION Obesity is a serious disease associated with adverse health effects and costs, West Virgini(WV) has one of the highest obesity rates in the nation. Addressing obesity largely falls on primary care practitioners, but many feel ill -equipped to counsel patients on weight loss. It is critical for clinicians to be adequately trained to treat obesity, We conducted this study to assess the obesity medical education needs of WV primary care practices. METHODS Data was collected from 17 health systems through W/V Practice-Based Research Network's Collective Outreach and Research Engagement survey. Survey results were analyzed using descriptive statistics to summarize demographics; obesity treatment knowledge and confidence, topics of interest; and preferred educational delivery methods. RESULTS The majority of respondents agreed that medical training in obesity should be strengthened (96.4%). Relatively low confidence levels were reported for prescribing anti-obesity medications (49,4%), optimizing chronic medications for weight (61.0%), and counseling/managing patients before/after bariatric surgery (52,4%). Highest reported interest levels were in strategies for discussing weight with patients (87.2%), food and nutrition (85.7%), physical activity plans (84.4%), motivational interviewing (84.0%), and optimizing chronic medications for weight (79,2%). The highest rated educational delivery method was virtual Continuing Medical Education (91.5%) with lecture format (89.0%). CONCLUSIONS These results can be used to develop obesity medical education for primary care that can ultimately help to reduce health disparities in rural WV. An educational plan should ideally be delivered in virtual lecture format and should address lifestyle modifications, motivational interviewing, bariatric surgery, and obesity pharmacotherapy.

Reimagining medical education for primary care in the time of COVID-19: a world view

ABSTRACT This article sets out to highlight the challenges and opportunities for medical education in primary care realised during the COVID-19 pandemic and now being enacted globally. The themes were originally presented during a webinar involving educationalists from around the world and are subsequently discussed by members of the WONCA working party for education. The article recognises the importance of utilising diversity, addressing inequity and responding to the priority health needs of the community through socially accountable practice. The well-being of educators and learners is identified as priority in response to the ongoing global pandemic. Finally, we imagine a new era for medical education drawing on global connection and shared resources to create a strong community of practice.

Medical education for primary care: Is the paradigm shifting?

Medical education for primary care: Is the paradigm shifting?

The Wass report: moving forward 3 years on

The editorial by Lawson and Kumar1 on the lack of progress in implementing the recommendations of the 2016 Wass report is timely and welcome.2 We would like to highlight the response in Scotland. In early 2018, Scottish Government Health Workforce Directorate established a short-life working group on increasing undergraduate medical education in primary care. The membership comprised senior civil servants from …

Compassion, medical humanities and medical education

Compassion is central to person centred clinical care. Medical Humanities have developed both as an academic discipline and as a resource for education over the past 30 years. The article will discuss what compassion is in a clinical context, and explore whether compassionate clinical practice can be enhanced by using the humanities in medical education in primary care.

Improving Type 2 Diabetes Patient Health Outcomes with Individualized Continuing Medical Education for Primary Care.

IntroductionThis study provided physicians with continuing medical education (CME) related to type 2 diabetes and evaluated the effect on patient health outcomes.MethodsPhysicians participated in multi-platform CME (live and online programs) and completed a 25 item questionnaire for patient baseline (3-months pre-CME activity) and follow-up visits (≥6-months post-CME activity). Changes in physician knowledge and patient health outcomes were evaluated.Results34 physicians completed both phases of the CME curricula and submitted data for 264 patients. Significant improvements were observed in physician knowledge after the live (p < 0.05) and online programs (p < 0.0005). Mean patient glycated hemoglobin (HbA1c) absolute reduction of 1.15% (p < 0.0001) was reported.ConclusionsCME is an effective tool to close established practice gaps and potentially help improve patient health outcomes.

Medical education practice-based research networks: Facilitating collaborative research

Background: Research networks formalize and institutionalize multi-site collaborations by establishing an infrastructure that enables network members to participate in research, propose new studies, and exploit study data to move the field forward. Although practice-based clinical research networks are now widespread, medical education research networks are rapidly emerging.Aims: In this article, we offer a definition of the medical education practice-based research network, a brief description of networks in existence in July 2014 and their features, and a more detailed case study of the emergence and early growth of one such network, the Association of Pediatric Program Directors Longitudinal Educational Assessment Research Network (APPD LEARN).Methods: We searched for extant networks through peer-reviewed literature and the world-wide web.Results: We identified 15 research networks in medical education founded since 2002 with membership ranging from 8 to 120 programs. Most focus on graduate medical education in primary care or emergency medicine specialties.Conclusions: We offer four recommendations for the further development and spread of medical education research networks: increasing faculty development, obtaining central resources, studying networks themselves, and developing networks of networks.

What Medical Education can do to Ensure Robust Language Development in Deaf Children

The typical medical education curriculum does not address language development for deaf and hard-of-hearing (DHH) children. However, this issue is medical because of the frequency with which DHH children as a population face health complications due to linguistic deprivation. The critical period for language development is early; if a child does not acquire an intact language before age five, the child is unlikely to ever have native-like use of any language. Such linguistic deprivation carries risks of cognitive delay and psycho-social health difficulties. Spoken language is inaccessible for many DHH children despite assistive-technology developments. But sign languages, because they are visual, are accessible to most DHH children. To ensure language development, DHH children should have exposure to a sign language in their early years, starting at birth. If they also receive successful training in processing and producing a spoken language, they will have the many benefits of bimodal bilingualism. Undergraduate medical education curricula should include information about early language acquisition so that physicians can advise families of deaf newborns and newly deafened young children how to protect their cognitive health. Graduate medical education in primary care, pediatrics, and otolaryngology should include extensive information about amplification/cochlear implants, language modality, and the latest research/practices to promote the development and education of DHH children. Training in how to establish connections with local authorities and services that can support parents and child should be included as well. Further, students need to learn how to work with sign language interpreters in caring for DHH patients. We offer suggestions as to how medical curricula can be appropriately enriched and point to existing programs and initiatives that can serve as resources.

Obesity management and continuing medical education in primary care: results of a Swiss survey

BackgroundThe worldwide increase in obesity is becoming a major health concern. General practitioners (GPs) play a central role in managing obesity. We aimed to examine Swiss GPs self-reported practice in diagnosis and treatment of obesity with a special focus on the performance of waist measurement.MethodsA structured self-reported questionnaire was mailed to 323 GPs recruited from four urban physician networks in Switzerland. Measures included professional experience, type of practice, obesity-related continuing medical education (CME) and practice in dealing with obesity such as waist measurement. We assessed the association between the performance of waist measurement and obesity-related CME by multivariate ordered logistic regression controlling for GP characteristics as potential confounders.ResultsA total of 187 GPs responded to the questionnaire. More than half of the GPs felt confident in managing obesity. The majority of the GPs (73%) spent less than 4 days in the last 5 years on obesity-related CME. More than half of GPs gave advice to reduce energy intakes (64%), intakes of high caloric and alcoholic drinks (56%) and to increase the physical activity (78%). Half of the GPs seldom performed waist measurement and documentation. The frequency of obesity-related CME was independently associated with the performance of waist measurement when controlled for GPs' characteristics by multivariate ordered logistic regression.ConclusionsThe majority of GPs followed guideline recommendations promoting physical activity and dietary counselling. We observed a gap between the increasing evidence for waist circumference assessment as an important measure in obesity management and actual clinical practice. Our data indicated that specific obesity-related CME might help to reduce this gap.

Integrating Addiction Medicine Into Graduate Medical Education in Primary Care: The Time Has Come

Substance use disorders create an enormous burden of medical, behavioral, and social problems and pose a major and costly public health challenge. Despite the high prevalence of substance use and its consequences, physicians often do not recognize these conditions and, as a result, provide inadequate patient care. At the center of this failure is insufficient training for physicians about substance use disorders. To address this deficit, the Betty Ford Institute convened a meeting of experts who developed the following 5 recommendations focused on improving training in substance abuse in primary care residency programs in internal medicine and family medicine: 1) integrating substance abuse competencies into training, 2) assigning substance abuse teaching the same priority as teaching about other chronic diseases, 3) enhancing faculty development, 4) creating addiction medicine divisions or programs in academic medical centers, and 5) making substance abuse screening and management routine care in new models of primary care practice. This enhanced primary care residency training should represent a major step forward in improving patient care.

The Continuing Medical Education for Primary Care in Yugoslavia

The Continuing Medical Education for Primary Care in Yugoslavia

Undergraduate medical education for primary care: a case study in New Mexico.

To address the dual problems of maldistribution of physicians and an increasing need for physicians who are lifelong learners, an experimental curricular track was developed at the University of New Mexico School of Medicine. Increased student responsibility for learning is encouraged by student-centered, small-group, problem-based tutorial learning, and early, primary care role modeling is offered during an early, lengthy, rural preceptorship. Preliminary outcomes reveal there is reinforcement of career interest in rural primary care with important linkages forged between the university and communities as a program by-product. Further, the experimental students, as compared to students in the conventional track, showed a greater appreciation of their learning environment, showed less stress, and failed to become cynical. The reorientation of undergraduate medical education toward the future health care needs of communities and the learning needs of physicians may require major modifications of curriculum design and role modeling experiences.

MEDICAL EDUCATION FOR PRIMARY CARE

Teaching primary care is an important, but as yet, incompletely fulfilled responsibility of medical schools. The current surge of interest will not provide the needed personnel if primary care is defined too broadly, and if it is made everybody's business, but nobody's in particular. Primary care must not neglect first-contact care; it must be taught by an independent department which itself practices the full range of primary care services in settings which exemplify such care and which exhibit a team approach. It may be useful to consider a special track leading to primary care which differs from preparation for specialist care.