Undergraduate Family Medicine Research Articles

Investigating the Use of Simulated Patient Ratings in Objective Structured Clinical Examinations to Enhance Undergraduate Medical Assessments in Riyadh, Saudi Arabia.

Objective structured clinical examinations (OSCE) are the gold standard of clinical assessment, and are used to conduct undergraduate family medicine clinical assessment at King Faisal Specialist Hospital and Research Centre (KFSHRC). Some studies have suggested that simulated patient (SP) ratings could provide a better measure of empathy and communication skills than physician scores. The objective of this study is to further explore the effectiveness of simulated patient (SP) ratings inundergraduate OSCE assessments. The research employed a mixed-method approach. Three OSCE assessments for final-year students were selected. Both physicians and SPsevaluated each student, providing global ratings across four domains. The quantitative aspect involved comparing physician and SP scores and assessing correlation. The qualitative aspect involved interviewing SPs to establish what student behaviours led to higher or lower scores. Moderate correlation was found between physician ratings and SP ratings (r=0.53, p<0.01). Internal consistency of the SP ratings was lower than physician scores. SPs considered themselves to be patient advocates and were keen to give formative feedback. The ability of the trainee to truly listen was a major concern. Scoring for SPs was relatively holistic in nature. The results demonstrate that SP scores have slightly weaker reliability but are still relevant and offer a completely different perspective, enriching the assessment data. Assessment should take patientor SP perspectives into account, and not rely solely on the expert physician. Changing the assessment methods will lead to necessary changes in student approach to the OSCE and improve authenticity and validity.

Promoting clinical reasoning in undergraduate Family Medicine curricula through concept mapping: a qualitative approach.

Clinical reasoning is a crucial skill for physicians, enabling them to bridge theoretical knowledge with practical application. The gap between basic sciences and clinical practice persists as a challenge, with traditional teaching methods yet to effectively bridge it. Concept maps (CMs), visual tools for organizing and connecting knowledge, hold promise for enhancing clinical reasoning in the undergraduate medical curriculum. However, further research is required to ascertain if CMs facilitate clinical reasoning development in medical students transitioning from basic sciences to clinical practice. This study aims to delineate how CMs can facilitate clinical reasoning in patients with multimorbidity within undergraduate Family Medicine curricula, as perceived by students and tutors, and to understand the implementation process and resources required. This exploratory qualitative study formed a part of an action research project. While introducing an educational intervention to 5th-year medical students, we conducted a qualitative evaluation. Subsequently, semi-structured group interviews were conducted with students, and a focus group was conducted with tutors. Three main educational impacts were identified: integration of clinical information, support for patient management and care plan, and collaborative learning. Key aspects for successful CM implementation included clear instructions for map construction, using user-friendly software, allocating sufficient time for the task, encouraging group discussion of CMs, and incorporating tutor feedback. CMs are pedagogical tools that facilitate clinical information integration and support management and treatment plans, helping students better understand multimorbidity patients and promoting some components of clinical reasoning in undergraduate medical education.

Development, implementation, and evaluation of an undergraduate family medicine program in the United Arab Emirates

BackgroundHealthcare systems rely on well-trained family medicine physicians who can offer continuous quality services to their communities and beyond. The American Academy of Family Physicians and the World Organization of Family Doctors recommend that medical curricula should have adequately supervised education and training of the learners in family medicine during their preclinical and clinical placements. However, some medical schools don’t have a comprehensive family medicine program to prepare graduates who can meet the community needs. This work aims to report the essential steps for the development, implementation, and evaluation of the family medicine program at the College of Medicine at the University of Sharjah in United Arab Emirates.MethodsWe used the Kern’s 6-step model to describe the development, implementation, and evaluation of the family medicine program. This includes problem identification, needs assessment, goals setting, educational strategies, implementation, and evaluation. During 2014–2022, we longitudinally collected essential information about the family medicine program from different stakeholders including the feedback of clinical coordinators, adjunct clinical faculty, and medical students at the end-of-clerkship. All responses were analysed to determine the effective implementation and evaluation of the family medicine program.ResultsOver the course of 8 academic years, 804 medical students, 49 adjunct clinical faculty and three College of Medicine faculty participated in the evaluation of the family medicine program. The majority of respondents were satisfied with various aspects of the family medicine program, including the skills gained, the organisation of program, and the variety of clinical encounters. The medical students and adjunct clinical faculty suggested the inclusion of e-clinics, faculty development program, and the expansion of more clinical sites for the effectiveness of the family medicine program.ConclusionsWe report a successful development, implementation, and evaluation of the family medicine program in United Arab Emirates with a positive and impactful learning experience. More attention should be paid towards a suitable representation of family medicine program in the medical curriculum with focused and targeted educational plans for medical students.

A Comparison of Checklist and Domain-Based Ratings in the Assessment of Objective Structured Clinical Examination (OSCE) Performance.

The Objective Structured Clinical Examination (OSCE) is the mainstay of clinical assessment in the final-year undergraduate Family Medicine clerkship at King Faisal Specialist Hospital and Research Centre (KFSHRC). The gold standard for OSCE assessment is the checklist rating, completed by physician examiners. Numerous studies have suggested that global or domain-based OSCE ratings may be a better indicator of competence than checklist ratings. The aim of this study was to examine the utility of domain-based OSCE ratings in the context of final-year, undergraduate, Family Medicine OSCE examinations in Riyadh, Saudi Arabia. This is akin to an exercise in quality improvement, as we continuously look for ways to improve our OSCE assessment processes. This study utilised a quantitative methodology. Three final year OSCE exams were chosen. Physicians rated each student using a checklist score and using a more holistic domain-based score. Physician checklist scores and physician domain-based scores were then compared, and correlation was assessed. We also looked at the internal consistency of the scoring methods. A significant correlation was found between checklist and domain-based scores by physicians for all exams (r=0.858, p<0.01), with a good internal consistency for these methodologies for all exams. The results demonstrate that both checklist and domain-based scores offer some benefit to the assessment, with a similar internal consistency and strong correlation. Domain-based ratings should be utilised for softer skills that are not easily assessed by checklists. There is clearly a need to rethink our OSCE assessment. The assessment should combine checklist and domain-based physician scores. As trainees become more experienced, checklist OSCE may penalise directness and efficiency, while domain-based ratings would offer a better appraisal of competence, and have been shown to be more sensitive to the level of training and expertise. Changing the assessment methods will lead to necessary changes in the student approach to the OSCE and improve authenticity and validity.

Using team-based learning to optimize undergraduate family medicine clerkship training: mixed methods study

BackgroundTeam-Based Learning (TBL) is an established educational strategy which has become increasingly popular in the training of healthcare professionals. TBL is highly suitable for teaching Family Medicine (FM) especially that teamwork and collaborative care, in this medical discipline, are at the core of safe and effective practice. Despite the established suitability of TBL for teaching FM, there are no empirical studies that capture the students’ perception of a TBL in FM undergraduate learning experience in the Middle East and North Africa region (MENA).ObjectiveThe overall objective of this study was to investigate the perception of students regarding a TBL in FM intervention (in Dubai, United Arab Emirates), that was designed and implemented in alignment with a constructivist learning theory.MethodsA convergent mixed methods study design was utilized to develop a thorough understanding of the students’ perceptions. Qualitative and quantitative data were concurrently collected and independently analyzed. The output of thematic analysis was systematically merged with the quantitative descriptive and inferential findings using the iterative joint display process.ResultsThe qualitative findings shed light on the students’ perception of TBL in FM, and the interplay between team cohesion and engagement with the course. As for the quantitative findings, they showed that the percentage of the total average of the Satisfaction with TBL in FM score was 88.80%. As for change in impression of FM discipline, the percentage of the total average was 83.10%. The perception of team cohesion, with a mean of agreement of 8.62(1.34), seemed to be significantly associated with the students’ perception of the team test phase component, only (P < 0.05). As for the perception of the level of engagement with the course, with a mean of agreement of 9.29(0.84), it turned out to be significantly associated with the change in impression of FM discipline (P < 0.05). Lastly, the joint display analysis showed how the quantitative and qualitative findings built upon each other, revealing how best to leverage TBL in FM trainings.ConclusionThe current study showed that TBL embedded in a FM clinical clerkship was well-received by students. It is worth leveraging the lessons learned from the first-hand experience reported upon in the current study to optimize the utilization of TBL in FM.

Using Ultrasound to Augment Exam Skills Among Clerkship Students.

Point-of-care ultrasound (POCUS) is becoming more common as a diagnostic and clinical tool. Some medical schools have incorporated POCUS training in their curriculum. A family medicine clerkship during the third year of undergraduate medical education is appropriate for incorporating musculoskeletal (MSK) education. Musculoskeletal ultrasound (MSKUS) is a potential tool for augmenting this teaching. Third-year undergraduate family medicine clerkship students were given prework related to ultrasound physics, terminology, and sonographic appearance of MSK structures. This was followed by a 2-hour session in the first week of their clerkship covering the shoulder and knee MSK exams, and incorporated hands-on scanning. Students practiced MSK exams during their 8-week clerkship and POCUS was available in clinic. They were administered a postsession survey to rate the MSKUS curriculum. Objective, structured clinical exam (OSCE) testing, including performance evaluation of the knee examination during the final clerkship week, was compared to prior-year OSCE scores. Third-year medical students felt the use of MSKUS was helpful and enhanced overall understanding of MSK exams. We did not see an improvement in OSCE scores. Students reported a desire for more POCUS training. POCUS is a powerful tool within the clinical and academic setting. We were able to develop a curriculum using MSKUS to augment teaching the shoulder and knee exams to third-year family medicine clerkship students. While we did not see an improvement in OSCE scores evaluating the performance of a knee exam, students reported greater understanding of the exams with the MSKUS instruction added. Students desire more POCUS training in the undergraduate medical curriculum.

The predictive validity of admission criteria for the results of clinical competency assessment with an emphasis on family medicine in the fifth year of medical education: an observational study

BackgroundIn many countries, the number of applicants to medical schools exceeds the number of available places. This offers the need, as well as the opportunity to medical schools to select those applicants most suitable for later work as a doctor. However, there is no generally accepted definition of a ‘good doctor’. Clinical competencies may serve as surrogates. The aim of this study was to compare medical students in Germany selected based either on their pre-university grade point average alone or based on the result of a university-specific selection procedure regarding their clinical competencies with an emphasis on family medicine in the later years of training.MethodsWe used the ‘Allgemeinarztbarometer Ausbildung’ (Undergraduate Family Medicine Barometer), an instrument developed to assess clinical competencies with an emphasis on family medicine, to compare students in the pre-university grade point average admission-quota and the university-specific selection procedure admission-quota in the fifth year of training. Students were judged by their supervising general practitioners after a two-week practical course. Competencies were rated on a five-point Likert-scale (1 = ‘totally agree’ i.e. the student is very competent to 5 = ‘totally disagree’ i.e. the student is not competent at all).ResultsWe included 94 students (66% female). Students in the university-specific selection procedure quota (n = 80) showed better mean scores in every item of the Undergraduate Family Medicine Barometer. We found a statistically significant difference between the two groups for the item assessing communication skills (M [university-specific selection procedure quota] = 1.81, SD = 0.84 vs. M [pu-GPA quota] = 2.38, SD = 0.96; t[91] = -2.23, p = .03; medium effect size). Logistic regression revealed no statistically significant age or gender contribution.ConclusionsDespite the small sample-size, our results indicate, that students selected via an university-specific selection procedure show better communicative competencies in the later years of training.

Study of a COVID-19 induced transition from Face-to-Face to Online Team-Based Learning in Undergraduate Family Medicine.

The COVID-19 pandemic has been presenting new challenges for medical schools worldwide. Medical educators are coming-up with creative solutions to address those unprecedented challenges. The purpose of this study is to reflect upon an experience of an online TBL in a Family Medicine Clerkship. This study relied on a qualitative descriptive design. A phenomenological approach was adapted to capture the perception of students regarding online TBL as part of Family Medicine clerkship, using a survey of open-ended questions. The data were inductively analysed using thematic analysis. The results of the study revealed that the students, overall, reacted positively to the experience. Five themes of text fragments emerged from the analysis: Equivalency of experience, Efficiency and Ease-of-use, Organization, Novelty, and Design. The students also noted some minor difficulties, that they faced at the beginning of their experience, indicating the existence of a learning curve. They also identified a few opportunities for improvement. This study demonstrated that combining videoconferencing and lesson delivery software together for TBL enables remote facilitation of the Family Medicine curriculum, and that the students value the experience as such. From the COI perspective, all three factors, namely: social presence, teaching presence, and cognitive presence, are met by such a set-up for distance learning. The students also felt validated and that their voice is heard. The central coordination of the TBL process proved to be crucial to ensure continuity, and also to support individuals' mental health and team spirit. This study concludes that TBL enables rapid transition to distance learning; it promotes analytical and self-directed learning even in extreme circumstances. Moreover, the TBL sessions allow for the facilitators, including the Discipline Lead, to get to know the students, on a personal level, and to monitor and evaluate their performance, over time.

Evaluation of the undergraduate family medicine programme of Faculty of Medicine, University of Kelaniya: quantitative and qualitative student feedback

BackgroundWorldwide there is an increasing emphasis on the importance of primary care. The ministry of health Sri Lanka issued a directive in 2016 that training of doctors in primary care should be strengthened.Medical students of the Faculty of Medicine, University of Kelaniya follow a 1 month long clinical appointment in family medicine in their fourth year of study.MethodsFeedback is taken from students on completion of the appointment. Half the students from each group complete a pre tested structured feedback questionnaire that consists of answers to questions based on a likert scale with a space for free comments. The other half provide qualitative feedback.In this evaluation data were gathered from 185 (98%) students from all eight clinical groups throughout the year 2016.Quantitative data were analysed using SPSS version 22. Inductive thematic analysis was used to analyse the qualitative data from the Round Robin activity and free comments from the questionnaire.ResultsThe qualitative feedback provided a richer indepth overview of student ideas on the appointment compared to the quantitative data.In reflection of a desire for learning to be of relevance students wanted clinically oriented teaching focused on management. They preferred active teaching learning methods such as the opportunity to conduct consultations and receive immediate feedback. Students had a high regard for the teaching sessions by general practitioners at their clinics.The appointment had created an interest in the discipline of family medicine which could have an impact on future choice of career. There were indications to suggest that student attitudes towards patients may have evolved to be more patient centred.Students appreciated the inclusive and low stress ambience of the learning environment.Conclusions and recommendationsRegular evaluation of teaching programmes helps maintain accountability of faculty and paves the way for more student centred teaching through the incorporation of students’ views in devising teaching methods. This evaluation found that qualitative feedback provided more descriptive material to reflect on and therefore improve teaching on the programme. It is recommended that more use should be made of qualitative methodologies in programme evaluations.

Knowledge and perception of Family Medicine among medical students at University of Ibadan, Nigeria

Background: Postgraduate training in Family Medicine in Nigeria began over three decades ago, but it was not until recently that the National University Commission (NUC) made it a policy for all Nigerian universities to include undergraduate Family Medicine training in their curriculum. This study aimed to assess the awareness and perception of Family Medicine among medical students at the University College Hospital (UCH), Ibadan.Method: A descriptive cross-sectional study was conducted over a period of four weeks (June 11–July 6, 2018) among 131 fourth-year, 118 fifth-year and 163 sixth-year medical students at UCH, Ibadan. Data were obtained using a self-administered questionnaire.Results: Data were collected from 309 (75% of the target population). The mean age of the respondents was 22.3 ± 2.3 years. The majority (74.4%) did not have a family member who was a doctor and only 2.3% had a family member who was specialising inFamily Medicine. Most of the participants (68.9%) had good knowledge of Family Medicine, while 57.3% had good perception of Family Medicine as a specialty. Importantly, an increase in year of clerkship was associated with an increase in the knowledge of Family Medicine among the respondents.Conclusion: It was observed that with increase in length of exposure to Family Medicine as a specialty, knowledge and perception of the specialty improved among the medical students. It is imperative that all the medical schools in Nigeria implement the NUC directive and start undergraduate Family Medicine training.

Community Preceptors’ Motivations and Views about Their Relationships with Medical Students During a Longitudinal Family Medicine Experience: A Qualitative Case Study

Phenomenon: Although current evidence emphasizes various benefits of community-oriented programs, little is still known about the nature of the relationships that students and family physicians develop in this educational setting. Our aim in this study was twofold: to identify family physicians’ motivations to enroll as preceptors in a longitudinal undergraduate family medicine program and to explore the nature of the student–preceptor relationships built during the course. Approach: This was a qualitative exploratory case study. The case was the first edition of a longitudinal family medicine experience (LFME), a course that makes up part of the novel Medicinae Doctor et Chirurgiae Magister curriculum in place in a Canadian medical school since August 2013. All 173 family physician community preceptors of the academic year 2013–2014 were considered key informants in the investigation. Forty-three preceptors finally participated in one of six focus groups conducted in the spring of 2014. Several organizational documents relative to the LFME course were also gathered. Inductive semantic thematic analysis was performed on verbatim interview transcripts. Documents helped contextualize the major themes emerging from the focus groups discussions. Findings: Enjoying teaching, promoting family medicine, and improving medical education where salient motivations for family physicians to become LFME preceptors. The findings also pointed out the complexity of the student–preceptor exchanges that unfolded over the academic year, and the ambiguous and changing nature of the role that LFME preceptors adopted in their relationships with students: from simply being facilitators of students’ clinical observership to behaving as their mentors. Insights: Family physicians were highly motivated to become LFME preceptors of 1st-year medical students. Whereas they consistently valued the relationships built during the academic year with the students assigned to them, they also considered that exchanges did not always happen without difficulties, and gauged the roles they played as complex, ambiguous, and necessarily evolving over time.

Conference report: Undergraduate family medicine and primary care training in Sub-Saharan Africa: Reflections of the PRIMAFAMED network.

Internationally, there is a move towards strengthening primary healthcare systems and encouraging community-based and socially responsible education. The development of doctors with an interest in primary healthcare and family medicine in the African region should begin during undergraduate training. Over the last few years, attention has been given to the development of postgraduate training in family medicine in the African region, but little attention has been given to undergraduate training. This article reports on the 8th PRIMAFAMED (Primary Care and Family Medicine Education) network meeting held in Nairobi from 21 to 24 May 2016. At this meeting the delegates spent time presenting and discussing the current state of undergraduate training at 18 universities in the region and shared lessons on how to successfully implement undergraduate training. This article reports on the rationale for, information presented, process followed and conclusions reached at the conference.

Family Medicine in Egypt From Medical Students' Perspective: A Nationwide Survey

Phenomenon: Attitudes of medical students toward family medicine as a specialty choice can provide information on the future supply of family physicians. Due to the current worldwide shortage of family physicians, these attitudes, with their subsequent effects on the state and dynamics of the healthcare system, are important to investigate. Approach: A web-based questionnaire was sent to 600 medical students, selected by a systematic random sampling technique, in 7 Egyptian medical schools. Participants were surveyed to assess their perception of the family medicine specialty as a future career and explore the impact of different factors, including undergraduate family medicine clerkships, on their attitudes toward family medicine. Findings: We had a response rate of 75.2% (n = 451). Although 90.7% of students believed in the vital role that family medicine can play in Egypt's healthcare system, only 4.7% showed an intention to choose it as a future career. Students choosing family medicine as a first-career choice were more likely to have a prior contact with family physicians as consumers. Exposure to an undergraduate family medicine curriculum was associated with increased knowledge about family medicine but not the intentions to pursue it as a career. Insights: Medical students in Egypt have a positive perception of family medicine as an important specialty but low interest in its choice as a future career.

Assessing medical student empathy in a family medicine clinical test: validity of the CARE measure

IntroductionThe Consultation and Relational Empathy (CARE) measure developed and validated in primary care settings and used for general practitioner appraisal is a 10-item instrument used by patients to assess doctors’ empathy. The aim of this study is to investigate the validity of the CARE measure in assessing medical students’ empathy during a formative family medicine clinical test.MethodAll 158 final-year medical students were assessed by trained simulated patients (SPs) – who completed the CARE measure, the Jefferson Scale of Patient Perceptions of Physician Empathy (JSPPPE), and a global rating score to assess students’ empathy and history-taking ability.ResultsExploratory and confirmatory factor analysis identified a unidimensional structure. The CARE measure strongly correlated with both convergent measures: global rating (ρ=0.79 and <0.001) and JSPPPE (ρ=0.77 and <0.001) and weakly correlated with the divergent measure: history-taking score (ρ=0.28 and <0.001). Internal consistency was excellent (Cronbach’s α=0.94).ConclusionThe CARE measure had strong construct and internal reliability in a formative, undergraduate family medicine examination. Its role in higher stakes examinations and other educational settings should be explored.

40 years of biannual family medicine research meetings – The European General Practice Research Network (EGPRN)

Objective. To document family medicine research in the 25 EGPRN member countries in 2010. Design. Semi-structured survey with open-ended questions. Setting. Academic family medicine in 23 European countries, Israel, and Turkey. Subjects. 25 EGPRN national representatives. Main outcome measures. Demographics of the general population and family medicine. Assessments, opinions, and suggestions. Results. EGPRN has represented family medicine for almost half a billion people and > 300 000 general practitioners (GPs). Turkey had the largest number of family medicine departments and highest density of GPs, 2.1/1000 people, Belgium had 1.7, Austria 1.6, and France 1.5. Lowest GP density was reported from Israel 0.17, Greece 0.18, and Slovenia 0.4 GPs per 1000 people. Family medicine research networks were reported by 22 of 25 and undergraduate family medicine research education in 20 of the 25 member countries, and in 10 countries students were required to do research projects. Postgraduate family medicine research was reported by 18 of the member countries. Open-ended responses showed that EGPRN meetings promoted stimulating and interesting research questions such as comparative studies of chronic pain management, sleep disorders, elderly care, healthy lifestyle promotion, mental health, clinical competence, and appropriateness of specialist referrals. Many respondents reported a lack of interest in family medicine research related to poor incentives and low family medicine status in general and among medical students in particular. It was suggested that EGPRN exert political lobbying for family medicine research. Conclusion. Since 1974, EGPRN organizes biannual conferences that unite and promote primary care practice, clinical research and academic family medicine in 25 member countries.

Oncology education in Canadian undergraduate and postgraduate medical programs: A survey of educators and learners.

e16558 Background: Deficiencies in undergraduate (UG) oncology education have been documented and there is a lack of data on the quality and quantity of oncology education in postgraduate (PG) family medicine (FM) and internal medicine (IM) training programs. Methods: A self-administered web-survey was created to obtain information regarding the current oncology curriculum at medical schools and PG FM and IM training programs. Survey requests were sent to educators (undergraduate medical education curriculum committee members (UMECCM), family medicine (FMPD) and internal medicine program directors (IMPD), oncologists) and learners (final year medical students (MS), family medicine (FMR) and internal medicine residents (IMR)) at all 17 of Canada’s medical schools. Results: 159 of 961 educators (19 UMECCM, 7 FMPD, 10 IMPD, 54 medical oncologists, 67 radiation oncologists and 2 hematologic oncologists) and 518 of 1966 learners (342 MS, 95 FMR and 81 IMR) completed the survey. Overall response rate was 23% (educators 17%, learners 26%). Responses were received from at least one educator or learner from all 17 medical schools. The amount of oncology education was thought to be inadequate in their respective programs by 58% UMECCM, 57% FMPD and 50% IMPD. 82% of oncologists believed that oncology education was inadequate in their UG and PG FM and IM programs. For learners, oncology education was thought to be inadequate in their respective programs by 67% MS, 86% FMR and 63% IMR. Of 10 different categories of medical illness all groups agreed that their trainees were least adequately prepared to manage cancer. A standard set of oncology objectives was thought to be useful for UG learners by 59% of respondents and 61% for PG learners. The 3 topics considered most important as core competencies in oncology for both UG and PG learners are: cancer diagnosis, breaking bad news and cancer screening. Conclusions: Oncology education at the UG medical and PG FM and IM levels are currently thought to be inadequate by a majority of educators and learners. Developing a standard set of oncology objectives focusing on topics believed to be most important by educators may improve the quality of oncology education for learners.

Development of undergraduate family medicine teaching in China

China is the most highly-populated country in the world with increasing demand for health care.1 Family medicine can improve health care in China, and can supply good health outcomes, equitably and economically. Family medicine education in China currently exists in three models – resident training, on-the-job training, and undergraduate teaching2 – but only undergraduate teaching may provide more competent family physicians in China.1 A general description of undergraduate family medicine teaching in the last two decades is lacking and to determine the situation in China we sent a questionnaire to every Chinese medical school enquiring about family medicine teaching and analysed the results. Family medicine teaching has undergone several milestones in China.3 In 1992, the undergraduate family medicine teaching programme was initiated in the Capital Medical University in Beijing. In November 1993, family medicine was recognised as a new academic discipline by the Chinese Medical Association. The Chinese Society of General Practice was founded in 1995. In 1999, ‘Directives on Chinese family medicine education’ was issued by the Ministry of Health.4 In 2006, the Chinese government adopted new strategies for the development of family medicine teaching and community health service.3 Over the last two decades, the number of medical schools with family medicine teaching has significantly increased. Whether the quantity was compatible and well distributed was not known. We decided to investigate the number, growth, and variation of family medicine teaching …

Long-term evaluation of undergraduate family medicine curriculum in Slovenia

In 1994, as a result of curriculum reform, the Ljubljana medical school established its first department of family medicine and introduced its first curriculum of family medicine. The new subject was well accepted by the students and the medical school. Nevertheless, there was no comprehensive analysis of the curriculum during this period. Our aims were to assess the quality of teaching based on fulfilled expectations, pre-defined learning objectives and satisfaction in a 10-year period, and to measure changes in career preference towards family medicine. An analysis of two sets of questionnaires, routinely given to medical students in academic years 1997/1998 and 2006/2007, was made. Most of the students' expectations were met, and the level increased over ten years. The level of achievement of learning objectives has been high and increased over the ten-year period. Family medicine still receives high scores in students' satisfaction. Although there is evidence that the family medicine curriculum is well accepted and that it improves some of the attitudes towards family medicine, it does not influence the career choice of students. The level of achievement of learning objectives increased with the experiences of the teachers. We improved the attitude of medical students toward general practice and general practitioners. We have not been successful in influencing career choice of students, which is an objective that is probably outside our reach.

Students evaluation of a traditional and an innovative family medicine course in Saudi Arabia.

This study compares students' evaluation of a traditional and an innovative undergraduate family medicine (FM) courses. The old curriculum was traditional and teacher-centered. Changes in-line with the innovative learning concepts were introduced. While innovative course (IC) students had significant improvement in both their attitude towards innovative learning methods and self-assessment of knowledge, traditional course students had improvement only in self-assessment of knowledge. Students in both courses did not show post-cycle improvement in perception of their own skills and were dissatisfied with the Health Center (HC) tutors' training. The need to recruit trained family physicians at the affiliated HC became evident. IC students valued the exercise of adding their generated learning needs as part of the curriculum. Other lessons learned were presented. We hope that findings of this study would encourage medical colleges in the region to critically review their FM courses.

Comparison of volunteer and full‐time faculty performance in a required third‐year family medicine clerkship

The increased number of required family medicine clerkships has created the need for more qualified faculty to serve as preceptors. One solution to the faculty shortage is to use volunteer faculty practicing in the private setting. This article describes how volunteer faculty at one institution were selected and trained and compares the performance of volunteer and full‐time faculty using several parameters. Student perception of their level of involvement in patient care activities was comparable between private practices and the university site. Students also rated general teaching skills of volunteer and full‐time faculty similarly. However, students placed at private practices felt less confident about their acquisition of fundamental clinical skills than did students placed at the university site, and volunteer faculty tended to grade more leniently than did full‐time faculty. In general, however, we conclude that volunteer faculty, properly selected and trained, can be a useful and valuable resource in undergraduate family medicine education.