Medical Education Programs Research Articles

Practice Intention: Addressing the Needs of Diverse Underserved Communities in Medical Education

Background and Objectives: The US physician workforce is at a critical juncture, with a projected shortage and misdistribution of primary care physicians. Culturally and linguistically diverse states, such as California, are challenged to search for innovative approaches in medical education to address the physician needs of diverse underserved communities. The University of California recognizes this imperative and supports Programs in Medical Education (PRIME), including PRIME Leadership and Advocacy (PRIME-LA) at University of California Los Angeles (UCLA). This study examines medical education outcomes for PRIME-LA graduates versus a comparator group. Methods: We conducted a secondary data analysis of the graduation questionnaire responses from UCLA graduates between 2018 and 2023. Our study included 97 PRIME-LA graduates and 811 comparator graduates. Primary outcomes included intentions to practice in underserved areas and intentions to care for underserved populations. Secondary outcomes included participation in experiences related to health disparities, health education, providing mentorship, and specialty of interest. Results: A higher proportion of PRIME-LA graduates reported an intention to practice in underserved areas than the comparator group (89% vs 32%, P<.001). Intentions to care for underserved populations were higher among PRIME-LA graduates than those in the comparator group (93% vs 44%, P<.001). Family medicine is the most common specialty among PRIME-LA graduates in contrast to graduates of the comparator group (26.4% vs 6.3%, P<.001). Conclusions: Mission-based medical education programs play a critical role in addressing the physician workforce gap in underserved communities. The PRIME-LA program may equip students with additional skills and training to address California’s physician workforce needs.

Program Evaluation of the Clinical Education Based on Four-Component Instructional Design (4C/ID) Model

Background: Clinical education is a key step in medical education. The study aimed to evaluate clinical education in undergraduate medical education programs based on the Four-Component Instructional Design (4C/ID) model. Methods: The cross-sectional study was conducted at Shahid Sadoughi University of Medical Sciences in 2023-2024. Fifteen departments where medical students studied the clerkship and internship courses were evaluated. An evaluation checklist was used including four domains, 23 questions, and 100 items. The evaluation was implemented in three steps including "Preparation of evaluation", "Execution of evaluation" and "Preparation of evaluation report and application of results". Data were analyzed using descriptive tests (mean, standard deviation, SD, and frequency). Results: The findings showed that the status of the departments in the "educational goals and learning tasks" domain in the clerkship and internship courses were 48.33 and 49.26, which achieved the highest level of compliance. The lowest compliance reported in the domain of "practice opportunities" was 14.30 and 15.77 in the clerkship and internship courses. The compliance in the domain of "procedural information in educational events" in the clerkship courses was 33.15 and in the internship courses was 36.17 and in the domain of "supportive information" in the clerkship courses was 24.36 and internship was 23.46, indicating a medium to a low level of compliance. Conclusion: Clinical learning is recognized as a complex learning, which requires supportive information and practice opportunities for learning. The results showed that lower compliance was reported in the domains of "practice opportunities" and "supportive information" in the educational department clerkship and internships. Therefore, it is recommended to plan for the development of support resources on various platforms. It also requires an appropriate educational design to deliver practice opportunities in simulation and workplace environments in undergraduate medical education.

A Literature Review of the Educational Gaps and Needs in Migraine Management: An Asian Perspective Within a Global Context.

Migraine is a common neurological disorder that presents considerable challenges to healthcare systems worldwide. These changes are especially relevant in rapidly developing regions such as Asia, with an increasingly productive population and ongoing advancements in healthcare systems and infrastructure. Despite its substantial impact, migraine management remains inadequate, potentially due to deficiencies in medical education. We hypothesized that significant gaps in basic and advanced medical training and continuing professional education contribute to the suboptimal management of migraine in various healthcare settings across Asia. A comprehensive literature review was conducted using PubMed and Google databases. The search focused on cross-sectional studies published in English from inception until September 2024 that examined educational needs among medical trainees and clinicians and clinical gaps in migraine management in Asia. These studies were then contextualized within a global perspective. The review identified significant shortcomings in migraine education at all levels of educational training in Asia, which also translated to poor management of migraines in clinical practice. Undergraduate medical curricula in Asia inadequately address headache disorders, while postgraduate training programs provide insufficient guidance in headache management, especially for complex cases. Primary care clinicians exhibited variable levels of understanding and frequently incorrectly diagnosed and managed migraine.Additionally, many Asian countries lack standardized clinical practice guidelines (CPGs) and specialized training programs for headache management. A multidimensional approach is required to tackle the pre-existing educational and clinical practice limitations. The approach should include improving the medical school curriculum, providing focused continuing medical education programs or developing migraine modules for primary care physicians (PCPs), and developing region-specific CPGs. Besides educational initiatives, integrating and coordinating systems of care, where primary and specialist services complement each other, are crucial for improving patient care. Robust education combined with comprehensive referral and linkage protocols ensures continuity of care across healthcare levels. Moreover, collaboration, communication, and cooperation among healthcare providers (HCPs) and organizations are vital to enhancing the quality of life and productivity of migraine patients in the region.A synergistic approach that combines robust collaboration with innovative educational delivery can catalyze the widespread adoption of evidence-based medicine (EBM).

Assessing the level of patient rights awareness among expectant women attending antenatal care clinics in primary health facility in Kirinyaga County, Kenya

Expectant women are recipients of poor quality of care including fear of abuse and disrespect which is a clear violation of their rights. These experiences influence women’s decisions to seek antenatal care. Even though Kenya’s Patients’ rights charter of 2013 empowers them to demand quality care, there is limited information concerning their knowledge on patients rights and responsibilities and this study intends to explore this gap. This was a cross-sectional study where expectant women were drawn from two primary healthcare facilities, attending their monthly routine antenatal care clinics. Data was gathered using a questionnaire during a 2-month period from January to March 2024. Descriptive statistical methods, paired t-test, and repeated measure analysis of variance at significant level P<0.05 were used. Participants’ mean age was 28.14 + 6.43 years. Most patients (78.6%) did not know about the patients’ rights charter and the majority of them (97%) had never received any form of education concerning patient rights. Of those who had knowledge of patient rights, 69.4% of them mentioned healthcare providers to be the source of information. The most practiced patient rights are quality of care (83%) and dignity and respect (97%). The patient’s level of awareness of patients’ rights and responsibilities is low and there is need to enhance this awareness through proper implementation of patient rights through dissemination of relevant content, continuous medical education programs and proper sensitization of healthcare providers on the right content to disseminate as this can lead to improved quality of antenatal care services.

Barriers and facilitators to point-of-care ultrasound use in an academic emergency department by perceived usability

BackgroundWhile use of point-of-care ultrasound (POCUS) has become widespread in emergency medicine, its adoption and usage among emergency clinicians is variable. In this study, we explored the barriers and facilitators to POCUS use among emergency medicine clinicians in a tertiary care emergency department in the United States by clinical role and perceived usability of POCUS. MethodsWe initially administered a quantitative survey via REDCap and used a validated technology usability scale to categorize clinicians into tertiles of low, moderate, and high, based on perceived utility of POCUS. Subsequently, a purposeful sample in each category participated in semi-structured interviews until thematic saturation was reached (9–10 per category, 29 total). The qualitative interviews were analyzed using Braun and Clark's content analysis approach. A coding scheme was developed through initial review of 20 % of the transcripts, followed by operational definitions of codes, concept and category development, and selection of representative quotes. Analysis was supported by Dedoose software. ResultsWe identified 41 % (12/29) as high POCUS users, 31 % (9/29) as moderate, and 28 % (8/29) as low, based on perceived usability. Interviewees consisted of 24 % (7/29) attendings, 28 % (8/29) residents and 48 % (14/29) advanced practice providers (APPs). Attendings made up 50 % in the high POCUS group and 75 % of the low POCUS group were APPs. In the low group, the lack of prior and present POCUS training was a major barrier to POCUS use. The lack of time during clinical shifts was a major barrier to POCUS utility in the high and low groups. Availability of POCUS machines in clinical spaces was identified as a facilitator to POCUS use in the medium group. ConclusionsParticipants reported that POCUS facilitates patient disposition and clinical supervision enhances its use. Early POCUS education in professional school and continued POCUS training in clinical practice could facilitate POCUS use clinically. Structured POCUS courses and continued medical education programs may provide protected time to learn and practice POCUS. Moreover, accessible and standardized machines in the clinical environment could improve POCUS usage.

The Influence of The Independent Learning System on Student Achievement in The Medical Education Program

The Indonesian government launched the Independent Campus Learning (MBKM) policy in 2020. This policy aims to provide greater autonomy to universities and students in designing learning that is innovative and in line with the needs of the times. The aim of this research is to determine the influence of the Merdeka Belajar system on student achievement in the medical education study program. This research uses quantitative research methods. Data was collected through surveys using questionnaires and literature studies. The data that has been collected is then analyzed using a regression test using the SPSS program. The research results show that there is a significant influence between the MBKM system on the achievement of students in the Medical Education study program. The group of students who took part in the MBKM program showed higher learning achievement compared to the group of students who did not take part in the MBKM program. This program provides students with the opportunity to learn and develop more optimally, thereby producing graduates who are more qualified and ready to face the challenges of an increasingly complex world of work.

Training a diverse physician workforce: a survey of alumni of a medical education program focused on underserved populations

Training a diverse physician workforce: a survey of alumni of a medical education program focused on underserved populations

A Comprehensive Analysis of the Factors Influencing Absenteeism among Medical Students at the University of Zawia, Libya

Attendance of undergraduate medical students is crucial for their medical education, but absenteeism is a growing problem globally due to academic and personal challenges. This study at the University of Zawia surveyed 302 undergraduate medical students, primarily female, to understand the factors influencing their attendance. The study found that, external factors like traffic congestion and high costs of private transportation impacted attendance, while pedagogical factors like preferring home-based learning and dissatisfaction with teaching methods were significant. Social factors like peer influence were less influential, suggesting commitment to the field. Institutional factors like inadequate classroom resources, poor infrastructure, scheduling, and security were major concerns. The college's response to absenteeism was moderate, suggesting that institutional issues may be less critical. The study underscores the complex interplay of external, academic, and personal factors affecting student participation in medical education. Factors like traffic congestion, high costs of transportation, and inadequate infrastructure significantly hinder attendance, while dissatisfaction with traditional teaching methods and the belief that non-attendance does not affect grades are notable academic factors. Faculty-related issues, such as unclear explanations and ineffective teaching methods, greatly influence attendance decisions. Study recommendations include improving public transportation, updating teaching tools and classroom facilities, and enhancing teaching quality and engagement to address the complex interplay of factors affecting student attendance in medical education programs.

The evolution of medical education in the era of Covid-19 and beyond: a longitudinal study

BackgroundThe COVID-19 pandemic has brought about profound transformations in nearly all aspects of life, leaving its impact on the global community as a whole. Nowhere has this transformation been more pronounced than in the sphere of education, including medical education. Healthcare professionals and educators faced the daunting task of preparing the next generation of practicing physicians amid the ongoing public health crisis.MethodsThe study involved students from three different Chinese medical universities (groups A, B, and C, respectively). The research employed two instruments: a Scale of Satisfaction with Simulation-Based Education and a Scale of Satisfaction with Telemedicine Competency Education. Data were collected at three different time points: 2020–2021 (online/distance learning), 2021–2022 (hybrid learning), and 2022–2023 (traditional face-to-face learning).ResultsIt was revealed that students demonstrated the highest level of satisfaction during the hybrid learning period (Time Point 2), while online/distance learning (Time Point 1) received the lowest ratings. Statistical analysis indicated significant differences in satisfaction levels across the various time points.ConclusionsHybrid learning emerged as the preferred method among students, yielding the highest level of satisfaction. Online/distance learning during the 2020–2021 academic year and traditional face-to-face instruction in 2022–2023 exhibited lower satisfaction levels. The research findings underscore the practical significance of hybrid learning for students in medical educational programs, suggesting its potential for optimizing educational curricula and resources within academic institutions.

Continuing medical education program completion and influencing factors: a cross-sectional study in Sichuan Province, China.

This cross-sectional study was designed to explore the completion of continuing medical education (CME) programs and identify the factors influencing their completion. The data for this study were generated from the National CME Program Application and Information Feedback Online System and the Sichuan CME Administrative Platform. The data were processed using descriptive analysis, Chi-square test, and binary logistic regression methods. The completion of each CME program was determined by the research team members according to the criteria created by the Office of the Sichuan CME Commission. A total of 180 hospitals and 3,622 CME programs were included. Among the 3,622 CME programs, 2,936 (81.1%) were determined to be completed. Comparative analysis showed that in terms of hospital characteristics, specialist hospitals, county hospitals, hospitals with 500-1,000 beds, and hospitals in the regions with government medical expenditure input equal to or more than 3,000 million RMB displayed the highest completion rates. For program attributes, national programs, programs in the field of pharmacy, and programs with 1-3 duration days demonstrated the highest completion rates. The binary logistic regression analysis showed that hospital region with different government medical expenditure input had the strongest positive association with the completion of CME programs [OR = 2.922, 95%CI (1.642-5.198)], while the duration time showed the strongest negative association [OR = 0.235, 95%CI (0.141-0.393)]. This is the first study in China to analyze the completion of CME programs and identify its influencing factors at the provincial level. It is recommended that the government in the region should pay great attention to the construction of measures regarding the factors affecting the completion of CME programs. This includes providing more financial support to CME providers to ensure the formal operation of their CME activities, formulating guidelines on the application of CME programs to reasonably allocate and control the distribution of accredited CME programs across different hospital scales and disciplines, especially offering more training support to county hospitals, promulgating administrative documents to raise attention to the completion of CME programs, and special scrutiny on CME programs with longer durations to provide and protect training opportunities for those in need.

Psychocutaneous Medicine: Current Global Understanding and Imperatives for Continuing Medical Education and Training Opportunities: A Systematic Review.

The intersection of dermatology and psychiatry has gained significant attention in recent years. Psychocutaneous disease affect patient population, who have undiagnosed and undertreated ailments related to the body and mind. These patients suffer a reduce quality of life due to knowledge gaps and reduce awareness about psycho dermatology. This review aims to assess the integration of psychopharmacology topics in continuing medical education programs (CME) and its relevance in clinical practice, it's impact on healthcare professionals' quality of care, and existing knowledge gaps among trainees and young dermatologists. To identify data from inception up to December 2023, a systematic literature review and search was conducted following PRISMA guidelines. Pubmed, Cochrane, and Embase databases were searched using predefined terms including "continuing medical education", "dermatology", "psychology", "psychodermatology", "psychocutaneous", "awareness" and "practice patterns". Inclusion criteria comprised studies evaluating CME programs, clinical studies and reviews published in English language. Studies were excluded if they were single case reports. A total of 93 studies were identified and 12 were included in this review following screening, removal of duplicates, and application of inclusion criteria. Studies revealed lower level of confidence among professionals in handling psycho cutaneous conditions, limited awareness of available resources and high interest in CME programs. Initiatives like video mentoring and clinical skills lessons showed promise but are currently scarce. Examined data from selected studies demonstrate that current CME programs in psychodermatology lack depth, leaving practitioners feeling ill equipped and unaware of available resources. There is substantial global interest in enhancing these programs. Given the breadth of conditions covered, educating dermatologists is crucial for enhanced patient outcomes and satisfaction. Addressing resource scarcity and patient stigma is imperative to develop specialized programs. Improvement to education can drive stronger outcomes and holistic patient care. Future efforts should prioritize refining program strategies and conducting thorough assessments to maximize impact.

Exploring clinician perspectives of systems-based practice: A physician training challenge.

Systems-based practice (SBP) has been a competency in US graduate medical education for over 20 years, but it is not well implemented. SBP is loosely defined as physician's responsiveness to the larger system of healthcare. The aim of this study was to describe healthcare professionals' perspectives regarding: (1) their knowledge and beliefs about SBP and (2) their beliefs regarding factors in clinical learning environments (CLE) that facilitate or hinder operationalisation and learning of SBP. Semi-structured interviews were conducted between November 2020 and April 2021 with 42 individuals from four health systems. Participants were healthcare professionals involved in graduate medical education, including physicians and interprofessional clinicians (e.g., nursing staff). Interviews were transcribed and coded using a social constructivist, codebook thematic analysis approach and themes were agreed upon through discussion amongst the research team. Five themes were constructed: (1) SBP remains a challenge to define, (2) SBP may be intuitively understood, particularly when framed at the microsystem level, (3) SBP aligns with the Health Systems Science framework, (4) SBP learning must be intentionally integrated into the CLE, through training such as onboarding and (5) multidisciplinary settings and work processes are critical to engage in SBP. Workload compression is a barrier to SBP implementation. Healthcare professionals highlighted that current CLEs are not designed to prioritise SBP. Graduate medical education programmes may benefit from focusing systems content at the microsystem level and purposefully integrating onboarding procedures, clinical settings and rotations specifically designed to teach SBP into their residencies.

Turnover intention and continuing professional development of rural doctors from targeted admission medical education program in China: a cross-sectional study in the post-COVID-19 era

BackgroundTurnover intention (TI) indicates an employee’s intention to depart from their current role within a defined timeframe. In China, the Targeted Admission Medical Education (TAME) program, initiated in 2010, offers tuition-free education to cultivate rural doctors. Despite continuous professional development (CPD) being considered a viable retention strategy, TI of alumni doctors from the TAME program remains high in recent years. This study aims to describe the prevalence of “turnover intention” among alumni doctors of the TAME program doctors in rural placements, and associated factors that predict high turnover intention.MethodsA snowball sampling method was adopted to collect survey responses from 1,369 alumni doctors of the TAME program in Jiangxi Province, China. Based on the survey data, a binary variable was constructed to measure the turnover intention, and multivariate binary logistic regression models were used to investigate the relationship between doctors’ turnover intention and demographic characteristics, work environment characteristics, and CPD activities. Results were presented using adjusted odds ratios with 95% confidence intervals.ResultsAmong the 1,369 alumni doctors of the TAME program surveyed in this study, 392 (28.6%) expressed intentions to leave their current positions. Of the respondents, 620 (45.3%) were female, and 930 (67.9%) were married. Additionally, 1,232 respondents (90%) indicated that their fathers were engaged in farm work. Strong associations with turnover intention were notably found among individuals who had undergone training at a higher-level healthcare institution for more than three months (aOR = 6.810, 95% CI: 3.333 to 13.909, p-value < 0.001), particularly those who had participated in CPD through a graduate degree program (aOR = 1.818, 95% CI: 1.272 to 2.597, p-value < 0.001).ConclusionRural doctors in China from the tuition-free medical education program exhibit high turnover intention, especially those in graduate degree programs as CPD. To retain these highly qualified rural doctors, it is vital to offer competitive efficiency wages aligned with their skills and provide ample long-term career growth opportunities within the rural healthcare system.

How to … navigate specialised programmes for early-career doctors in medical education.

Investing in early-career medical education programmes for aspiring clinician-educators, scholars and leaders offers a strategic approach to shaping the future of health professions education internationally. This paper explores the design and impact of a nationally funded Specialised Foundation Programme (SFP) within the United Kingdom. Drawing on existing literature and insights from local trainees, we provide practical guidance for early-career doctors navigating entry into the field of health professions education. Additionally, we discuss the programme's potential to enhance professional development through structured mentorship, formal qualifications and active participation in scholarly activities, while also addressing the challenges inherent in navigating clinical and academic identities. This paper will be valuable to doctors embarking on early-career medical education pathways, programme leaders and international stakeholders seeking to establish similar initiatives to support the next generation of health care educators and scholars.

Standardizing and Enhancing the Tracking of Continuing Medical Education (CME) within Graduate Medical Education (GME) Programs: A Comprehensive Analysis

Standardizing and Enhancing the Tracking of Continuing Medical Education (CME) within Graduate Medical Education (GME) Programs: A Comprehensive Analysis

Growing Need for Web-Based Simulation in Low and Middle-Income Countries: A Narrative Review

Web-based simulation programs are poised to offer a productive means of delivering asynchronous training in healthcare professionals’ education. Similarly, web-based simulation programs could also sponsor specialty-specific, web-based fellowships for clinicians of low- and middle-income countries. Web-Based Simulation has been utilized for instruction in critical care fields such as emergency medicine and pediatric anesthesia. Studies have shown that enhanced self-reported knowledge and confidence have been achieved through tele simulation which is in line with in-person simulation. During the COVID-19 pandemic, simulations have helped clinicians hone their use of personal protective equipment and other infection control measures. Additionally, it has helped them in learning new and expanded roles, like processing equipment and assisting infected patients in prone position experiencing respiratory failure. However, web-based simulation programs also have unique challenges that must be satisfied: reliable broadband internet network access, multilingual capability, and programming quality. Studies indicate that cost-effective simulation training can be delivered to learners in remote, low-resource areas worldwide, including South Asia, where access to such education is limited. We aimed to explore the effectiveness, challenges, and strategies for implementing web-based simulation education in low- and middle-income countries, based on a thorough PubMed search focused on web-based simulation programs in medical education.

Factors Influencing the Skill Level of Primary Healthcare Workers in Managing Paediatric Emergencies

Paediatric emergencies continue to be a significant public health concern in Nigeria, particularly in rural areas where primary healthcare centers (PHCs) often serve as the sole source of medical care. The ability of healthcare workers in these settings to effectively manage paediatric emergencies is crucial for improving child health outcomes. This study aimed to assess the factors influencing the skill level of primary healthcare workers in managing paediatric emergencies in Zaria, Nigeria. A cross-sectional descriptive study was conducted among 139 randomly selected healthcare workers in Sabon Gari and Zaria Local Government Areas. A pre-tested questionnaire was used to collect data on socio-demographic characteristics, work experience, and skills in managing paediatric emergencies. Data were analyzed using SPSS version 21. The results revealed that healthcare workers in PHCs in Zaria exhibited varying levels of skills in managing paediatric emergencies. Several factors were identified as influencing their skill levels. Healthcare workers with higher academic qualifications demonstrated significantly better skills in managing paediatric emergencies. This suggests that formal education plays a crucial role in developing the necessary competencies. While experience can be a valuable asset, the study did not find a strong association between years of experience and skill levels. This may indicate that experience alone is not sufficient for developing the necessary skills, and additional training and support may be required. Healthcare workers who had received recent training or participated in continuing medical education (CME) programs related to paediatric emergency management tended to have higher skill levels. This highlights the importance of ongoing professional development in maintaining and improving skills. The findings of this study suggest that a combination of factors influences the skill level of primary healthcare workers in managing paediatric emergencies. While academic qualifications are important, ongoing training and access to resources are also essential. It is crucial to address these factors through targeted interventions to improve the skills of healthcare workers and enhance the quality of care provided to children in need. This study highlights the critical need for targeted interventions to improve the skills of primary healthcare workers in managing paediatric emergencies in Zaria, Nigeria. By addressing factors such as academic qualifications, training, resource availability, and work environment, policymakers and healthcare providers can significantly enhance the quality of care provided to children in need.

Who's at the Table? A Scoping Review of Stakeholder Engagement in Medical Education Program Evaluation.

Program evaluation is essential for medical schools to demonstrate social accountability and identify areas for improvement in medical education (MEd). Although stakeholder engagement is crucial in program evaluation, no previous review has specifically examined the stakeholders involved in MEd program evaluation. This scoping review addresses this gap by identifying the stakeholders, their roles, and their levels of engagement in evaluating MEd programs, along with the facilitators and barriers to their participation. Through a systematic search across four databases, we identified 53 relevant studies out of 7206 screened. Our findings reveal seven primary stakeholder groups, with students and program directors being the most frequent participants. However, a significant gap exists in the representation of community members and patients, indicating a need for greater inclusion of these key stakeholders. Additionally, we found that stakeholders are primarily engaged as passive participants providing feedback rather than actively shaping the evaluation process. Facilitators and barriers to participation were identified from the participants' perspective, highlighting the need for further research to understand the viewpoints of active stakeholders, such as faculty and administrators. Future studies should also explore the impact of different evaluation approaches on stakeholder engagement to develop more inclusive and effective MEd program evaluations.

Development and validation of a training course on proton pump inhibitor deprescription for general practitioners in a rural continuing medical education program: a pilot study

BackgroundDespite being cornerstone medications for managing gastrointestinal disorders, proton pump inhibitors (PPI) have raised concerns due to inappropriate prescribing and overutilization, their potential side effects, and interactions with other medications. General practitioners (GPs) provide long-term patient follow-up and are targets to promote PPI deprescribing to reach the widest possible population. GPs practicing in rural settings encounter unique challenges as their numbers dwindle and their workload increases. Hence, targeted educational interventions are crucial to promote appropriate prescribing practices in such underserved areas.MethodsWe developed a continuing medical education (CME) program focused on PPI deprescribing for GPs in rural settings. The program comprised of an interactive training session featuring clinical cases, an open discussion, and distribution of educational materials. We assessed the program’s effectiveness using a two-level Kirkpatrick model, evaluating participant satisfaction and knowledge levels through pre- and post-course questionnaires.ResultsThirty-three GPs participated, with 61.9% working in semi-rural and 38.1% in rural areas (21 responded to the 1st questionnaire, 14 to the 2nd ). Median medical experience was 6 years, with 61.9% serving as internship supervisors. Despite 95.2% acknowledging PPI overprescription, none had previously participated in dedicated PPI CME programs. The open discussion session provided valuable insights into various topics related to PPI use and gastrointestinal health. Participants expressed high satisfaction with the program (average rating of 9.1/10) and 92.9% reported changes in practice, including increased awareness of inappropriate PPI prescriptions. Indeed, 92.9% of GPs identified inappropriate PPI use following the course. 57.1% of participants utilized the provided educational materials. The main practice changes observed included an increased reassessment rate of PPI indications (71.4% at each renewal after vs. 19% before, 28.6% non-systematically after vs. 66.8% before, 0% rarely after vs. 14.3% before; p = 0.006), the necessity for more than one consultation to deprescribe (64.3% after vs. 23.8% before; p = 0.021), systematic utilization of gradual cessation of PPI (100% vs. 61.9%; p = 0.039) and more frequent use of additional medication (92.9% vs. 57.1%; p = 0.022), primarily antiacids (92.3%).ConclusionsOur study underscores the effectiveness of targeted CME programs in promoting appropriate prescribing practices and enhancing knowledge among GPs in rural settings. Despite the challenges encountered in deprescribing PPI, the program facilitated proactive approaches in managing treatment discontinuation failures. Tailored educational interventions are essential for mitigating medication prescribing challenges and improving patient outcomes in rural primary care settings.Trial registrationsNot applicable.

Key themes of community-oriented primary care projects from a longitudinal, rural interprofessional health professions curriculum (1997–2023)

BackgroundThe Community Oriented Primary Care Project Model (COPC) has been well studied globally as well as in the United States as a way to provide both community-centered primary care and to engage in community based research. Rural trainees through the University of Illinois College of Medicine’s Rural Medical Education Program (RMED) and Rural Pharmacy Education Program (RPHARM) students through the University of Illinois Chicago College of Pharmacy have participated in a COPC project as a capstone to a four month longitudinal, immersive community-based experience in a rural primary care setting. The purpose of this study was to assess the type of projects implemented through a rural health professions curriculum over a 30 year project period. .MethodsA research team reviewed projects on 30 elements; including topic and demographics. Patterns in COPC topics and rurality of the location in which the COPC project were also examined by using 2021 U.S. Census Bureau population data and Rural Urban Commuting Area (RUCA) Code.ResultsCOPC projects were categorized into 31 main topic areas with mental health being the most prevalent topic area covered by projects (n = 67, 15.7%) followed by 43 (10.1%) projects that focused on nutrition/exercise, and 41 (9.6%) focused on substance use (presented as a separate category from mental health in this analysis).ConclusionsFor three decades, COPC themes reflect priority health issues in rural communities while providing a scholarly activity for health profession student trainees Past projects have also been implemented in highly rural areas where research is not often conducted. The COPC research process can be easily replicated in other trainee models such as to fulfill ACGME requirements of scholarly activity and can provide a template for trainees of this model to implement community-engaged research in the future.