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2.
BMC Prim Care ; 23(1): 127, 2022 05 25.
Article in English | MEDLINE | ID: covidwho-1865279

ABSTRACT

BACKGROUND: The global COVID-19 pandemic led to rapid changes in both medical care and medical education, particularly involving the rapid substitution of virtual solutions for traditional face-to-face appointments. There is a need for research into the effects and impacts of such changes. The objective of this article investigates the perspectives of Family Medicine Residents in one university program in order to understand the impact of this transition to virtual care and learning. METHODS: This is a qualitative focus group study. Four focus groups, stratified by site type (Rural = 1; Semi-Urban = 1; Urban = 2) were conducted, with a total of 25 participants. Participants were either first or second-year Residents in Family Medicine. Focus group recordings were analyzed thematically, based upon a five-level socio-ecological model (individual, family, organization, community, environment and policy context). RESULTS: Two main themes were identified: (1) Residents' experiences of Virtual Learning and Virtual Care, and (2) Living and Learning in Pandemic Times. In the first theme, Residents reported challenges both individually, in their family context, and in their training organizations. Of particular concern was the loss of hands-on experience with clinical skills such as conducting physical examinations. In the second theme, Residents reported disruption of self-care routines and family life. These Residents were unable to engage in the relationships outside of the workplace with their preceptors and peers which they had expected, and which play key roles in social support as well as in future decisions about practice location. CONCLUSIONS: While many patients appreciated virtual care, in the eyes of these Residents it is not the ideal modality for learning the practice of Family Medicine, and they awaited a return to normal times. Despite this, the pandemic has pointed out important ways in which residency training needs to adapt to an evolving world.


Subject(s)
COVID-19 , Internship and Residency , COVID-19/epidemiology , Clinical Competence , Family Practice/education , Humans , Pandemics
3.
Fam Med ; 54(5): 343-349, 2022 05.
Article in English | MEDLINE | ID: covidwho-1836316

ABSTRACT

BACKGROUND AND OBJECTIVES: Public health training became particularly important for family medicine (FM) residency training programs amid the COVID-19 pandemic; the Accreditation Council for Graduate Medical Education (ACGME IV.C.19) requires a structured curriculum in which residents address population health. Our primary goal was to understand if, and to what extent, public health interventions trainings were incorporated into FM residency training programs amid the COVID-19 pandemic. We hypothesized programs with more resources (eg, university affiliates) would be better able to incorporate the training compared to those without such resources (ie, nonuniversity affiliates). METHODS: In 2021, we incorporated items addressing COVID-19 public health training competencies into the 2021 Council of Academic Family Medicine Educational Research Alliance national survey of FM residency program directors. The items addressed the type of training provided, mode of delivery, barriers to providing training, perceived importance of training, and support in delivering training. RESULTS: The overall survey response rate was 46.4% (n=287/619). All programs offered at least some training to residents. There were no statistically significant differences in training intensity between university and nonuniversity affiliates. The length of time an FM residency director spent in their position was positively associated with training intensity (r=0.1430, P=.0252). The biggest barrier to providing the trainings was the need to devote time to other curriculum requirements. CONCLUSIONS: FM residency programs were able to provide some public health interventions training during the pandemic. With increased support and resources, FM resident training curricula may better prepare FM residents now in anticipation of a future pandemic.


Subject(s)
COVID-19 , Internship and Residency , Curriculum , Education, Medical, Graduate , Family Practice/education , Humans , Pandemics , Surveys and Questionnaires
5.
Can Fam Physician ; 67(11): 872, 2021 11.
Article in English | MEDLINE | ID: covidwho-1529130
6.
Fam Med Community Health ; 9(3)2021 09.
Article in English | MEDLINE | ID: covidwho-1394130

ABSTRACT

OBJECTIVE: This research project examined the effects of the COVID-19 pandemic on the required curriculum in graduate medical education for family medicine residencies. DESIGN: Our questions were part of a larger omnibus survey conducted by the Council of Academic Family Medicine Educational Research Alliance. Data were collected from 23 September to 16 October 2020. SETTING: This study was set in the USA. PARTICIPANTS: Emails were sent to 664 family medicine programme directors in the USA. Of the 312 surveys returned, 35 did not answer our questions and were excluded, a total of 277 responses (44%) were analysed. RESULTS: The level of disruption varied by discipline and region. Geriatrics had the highest reported disruption (median=4 on a 5-point scale) and intensive care unit had the lowest (median=1 on a 5-point scale). There were no significant differences for disruption by type of programme or community size. CONCLUSION: Programme directors reported moderate disruption in family medicine resident education in geriatrics, gynaecology, surgery, musculoskeletal medicine, paediatrics and family medicine site during the pandemic. We are limited in generalisations about how region, type of programme, community size or number of residents influenced the level of disruption, as less than 50% of programme directors completed the survey.


Subject(s)
COVID-19 , Curriculum , Family Practice/education , Internship and Residency , Humans , Pandemics , SARS-CoV-2 , Surveys and Questionnaires
7.
Fam Pract ; 38(Suppl 1): i9-i15, 2021 Aug 27.
Article in English | MEDLINE | ID: covidwho-1376296

ABSTRACT

BACKGROUND: Family physicians have played a unique clinical role during the COVID-19 pandemic. We hypothesized that the pandemic would be associated with significant deleterious effects on clinical activity, educational training, personal safety and well-being. OBJECTIVE: We conducted a national survey to obtain preliminary data that would assist in future targeted data collection and subsequent evaluation of the impact of the pandemic on family medicine residents and teaching faculty. METHODS: An anonymous online survey of residents and faculty was distributed via the Association of Family Medicine Residency Directors list serve between 5/21/2020 and 6/18/2020. Survey questions focused on clinical and educational activities, safety and well-being. RESULTS: One hundred and fifty-three residents and 151 teaching faculty participated in the survey. Decreased clinical activity was noted by 81.5% of residents and 80.9% of faculty and the majority began conducting telehealth visits (97.9% of residents, 91.0% of faculty). Distance learning platforms were used by all residents (100%) and 39.6% noted an overall positive impact on their education. Higher levels of burnout did not significantly correlate with reassignment of clinical duties (residents P = 0.164; faculty P = 0.064). Residents who showed significantly higher burnout scores (P = 0.035) and a decline in levels of well-being (P = 0.031) were more likely to participate in institutional well-being support activities. CONCLUSIONS: Our preliminary data indicate that family medicine residents and teaching faculty were profoundly affected by the COVID-19 pandemic. Future studies can be directed by current findings with focus on mitigation factors in addressing globally disruptive events such as COVID-19.


Family physicians have played a unique clinical role during the COVID-19 pandemic. We hypothesized that the pandemic would be associated with significant deleterious effects on clinical activity, educational training, personal safety and well-being. Towards setting a foundation for further studies, we conducted a national survey to obtain preliminary data that would assist in future targeted data collection and subsequent evaluation of the impact of the pandemic on family medicine residents and teaching faculty. Our preliminary data indicate that family medicine residents and teaching faculty were profoundly affected by the COVID-19 pandemic in all domains studied. Future studies can be directed by current findings with focus on mitigation factors in addressing globally disruptive events such as COVID-19.


Subject(s)
COVID-19/epidemiology , Education, Medical, Graduate/trends , Family Practice/education , Adult , Aged , Cross-Sectional Studies , Female , Humans , Internship and Residency , Male , Middle Aged , Pandemics , SARS-CoV-2 , Surveys and Questionnaires , United States/epidemiology
9.
Fam Med ; 53(6): 461-466, 2021 Jun.
Article in English | MEDLINE | ID: covidwho-1257437

ABSTRACT

BACKGROUND AND OBJECTIVES: Scholarship is recognized as a challenge in many family medicine residency programs. Among evaluations of scholarship curricula, few describe resident experiences of such interventions. To bridge this gap in knowledge, we measured resident confidence, satisfaction, and participation before and after implementing a new scholarship curriculum. METHODS: The redesigned curriculum included a structured project timeline, resident research in progress meetings, faculty mentorship, scholarly skills workshops, and mentored journal clubs. We conducted a curriculum evaluation via surveys of residents prior to implementation and after years 1 and 2, measuring satisfaction with the scholarly environment and opportunities, and confidence and participation in specific scholarly activities using Likert scales from 1 (least confidence) to 5. RESULTS: Compared to baseline (n=28), after 2 years (n=27) of the curriculum, residents reported increased mean confidence in critical appraisal of scientific articles (2.6±1.1 to 3.3±0.7, P=.007), carrying out a scholarly project (2.5±0.8 to 3.4±1.0, P=.005), and writing an abstract (3.0±0.8 to 3.8±0.7, P=.002). As compared to the first year, more residents in the second year participated in quality improvement projects (7.1% vs 29.6%, P=.031) and wrote conference abstracts (10.7% vs 37.0%, P=.022). Over the same period, those very satisfied with the scholarly environment increased from 0 (0%) to 8 (29.6%, P=.017). The June 2020 survey identified increased interest in scholarship because of the antiracism movement (51.9%) and COVID-19 pandemic (40.7%). CONCLUSIONS: Implementation of a redesigned scholarship curriculum was associated with increases in family medicine resident scholarship confidence and satisfaction.


Subject(s)
Education, Medical, Graduate/organization & administration , Family Practice/education , Fellowships and Scholarships/organization & administration , Internship and Residency/organization & administration , Professional Competence , Biomedical Research/statistics & numerical data , Curriculum , Humans , Outcome Assessment, Health Care , Program Evaluation
10.
Postgrad Med J ; 97(1149): 423-426, 2021 Jul.
Article in English | MEDLINE | ID: covidwho-1247399

ABSTRACT

Little has been published regarding postgraduate assessments during the COVID-19 pandemic. There is an urgent need to graduate well-trained specialists including family physicians who play a key role in patient care. The successes and challenges encountered in mounting qualifying 2020 Family Medicine examinations during the COVID-19 pandemic at the University of the West Indies are described in this paper. Human resource, planning, use of technology and virtual environments are discussed, which enabled successful examinations at this multicampus regional site.


Subject(s)
COVID-19 , Certification , Education, Medical, Graduate/organization & administration , Educational Measurement , Family Practice/education , Physicians, Family/standards , Academic Performance , COVID-19/epidemiology , COVID-19/prevention & control , Certification/methods , Certification/standards , Educational Measurement/methods , Educational Measurement/statistics & numerical data , Educational Status , Educational Technology/methods , Humans , Needs Assessment , SARS-CoV-2 , Teaching/standards , Teaching/trends , West Indies
11.
J Prim Care Community Health ; 12: 21501327211017007, 2021.
Article in English | MEDLINE | ID: covidwho-1228977

ABSTRACT

INTRODUCTION: The COVID-19 pandemic is an unprecedented challenge to house officers training programs because of the safety measures. OBJECTIVE: This current study aimed to introduce the adaptation of family medicine training for house officers during COVID-19 pandemic and gauge their level of satisfaction with the training. METHODS: Unfortunately, more than one-fourth of the house officers attending the family medicine training turned out to be hospital-admitted or in obligatory home isolation. A time-sensitive plan was proposed to maintain a competent training guaranteeing safety and support of house officers and fulfilling the training objectives in a virtual setting. Three mentors were assigned to each 10 house officers to provide continuous support and monitoring. Tutor and house officer interaction and reflection were maintained through a virtual clinical training session via Zoom application and a daily online discussion of a clinical scenario. Peer interaction was provided through post-webinar and small-group online discussion sessions. RESULTS: The adapted training was applied on thirteen cohorts of house officers. The response rate was 70% (666 out of 950). Most of them were satisfied with the training (84.6%). Their satisfaction with each modality of the training was encouraging. CONCLUSIONS: During COVID-19 pandemic, successful adaptation of family medicine training has succeeded in fulfilling the training objectives and providing psychological support and engagement for house officers without burdening the hospital-admitted and home-isolated house officers.


Subject(s)
COVID-19 , Family Practice/education , Internship and Residency , Pandemics , Physicians, Family/education , Adult , Attitude of Health Personnel , Egypt , Female , Humans , Male , SARS-CoV-2
12.
Fam Med ; 53(4): 282-284, 2021 04.
Article in English | MEDLINE | ID: covidwho-1197755

ABSTRACT

BACKGROUND AND OBJECTIVES: On March 17, 2020, the Association of American Medical Colleges recommended temporary suspension of all medical student clinical activities due to the COVID-19 pandemic, which required a rapid development of alternatives to traditional teaching methods. This study examines education changes spurred by COVID-19. METHODS: Data were collected via a Council of Academic Family Medicine Educational Research Alliance survey of family medicine clerkship directors. Participants answered questions about didactic and clinical changes made to clerkship teaching due to the COVID-19 pandemic, how positive the changes were, whether the changes would be made permanent, and how prepared clerkship directors were for the changes. RESULTS: The response rate was 64%. The most frequent change made to didactic teaching was increasing online resources. The most frequent change made to clinical teaching was adding clinical simulation. Greater changes were made to clinical teaching than to didactic teaching. Changes made to didactic teaching were perceived as more positive for student learning than the changes made to clinical teaching. Clerkship directors felt more prepared for changes to didactic teaching than for clinical teaching, and were more likely to make the didactic teaching changes permanent than the clinical teaching changes. CONCLUSIONS: The COVID-19 pandemic caused nearly all clerkship directors to make changes to clerkship teaching, but few felt prepared to make these changes, particularly changes to clinical teaching. Clerkship directors made fewer changes to didactic teaching than clinical teaching, however, didactic changes were perceived as more positive than clinical changes and were more likely to be adopted long term.


Subject(s)
COVID-19 , Clinical Clerkship/methods , Education, Distance/methods , Education, Medical, Undergraduate/methods , Family Practice/education , Simulation Training/methods , Communicable Disease Control , Humans , SARS-CoV-2 , Surveys and Questionnaires , Telemedicine/methods
13.
Pan Afr Med J ; 35(Suppl 2): 126, 2020.
Article in English | MEDLINE | ID: covidwho-1106499

ABSTRACT

Family medicine residency training programs should put in place COVID-19 action plan in conjunction with other clinical departments, employee health personnel, and infection control leads. Programs should develop coping strategies that balance resident and patient safety, resident wellbeing, clinical training services, and resident education.


Subject(s)
COVID-19 , Family Practice/education , Internship and Residency , SARS-CoV-2 , Humans , Pandemics , Qatar/epidemiology
15.
J Am Board Fam Med ; 34(Suppl): S222-S224, 2021 Feb.
Article in English | MEDLINE | ID: covidwho-1099998

ABSTRACT

BACKGROUND: Since December 2019, the dramatic escalation in coronavirus (COVID-19) cases worldwide has had a significant impact on health care systems. Family physicians (FPs) have played a critical role in the coordination of care. MATERIALS AND METHODS: In April 2020, we performed an online prospective survey to assess the impact of the pandemic on FPs' practices. RESULTS: Three hundred FPs were included. Mean age was 53.6 ± 13.5 years. Before the pandemic, 60.2% reported >75 outpatient visits/week, which reduced down to an average of <20/week for 79.8% of FPs; 24.2% of FPs discontinued home visits, while for 94.7% of FPs there was a >50% increase in the number of telephone consultations. Concern related to the risk of contagion was elevated (≥3/5 in 74.6%) and even higher to the risk of infecting relatives and patients (≥3/5 in 93.3%). The majority of FPs (87%) supported the role of telemedicine in the near future. Satisfaction regarding the network with hospitals/COVID-19-dedicated wards received a score ≤2/5 in 46.9% of cases. CONCLUSIONS: The COVID-19 pandemic has had a significant impact on the working practices of FPs. A collaboration is needed with well-established networks between FPs and referral centers to provide new insights and opportunities to inform future working practices.


Subject(s)
Attitude of Health Personnel , COVID-19/epidemiology , Family Practice/organization & administration , Practice Patterns, Physicians'/statistics & numerical data , Adult , Aged , COVID-19/psychology , COVID-19/transmission , Family Practice/education , Family Practice/statistics & numerical data , Female , Humans , Italy/epidemiology , Male , Middle Aged , Pandemics , Personal Protective Equipment , Prospective Studies , SARS-CoV-2 , Telemedicine
16.
J Am Board Fam Med ; 34(Suppl): S217-S221, 2021 Feb.
Article in English | MEDLINE | ID: covidwho-1099985

ABSTRACT

The University of Colorado family medicine residency watched along with the rest of the nation as the first cases of COVID-19 were being reported in the United States in March 2020. Concern grew as epidemiological models began to predict alarming hospital bed shortages for the state. Massive scheduling adjustments were needed as faculty and residents found themselves in groups at high risk for severe COVID-19 and residents found themselves dismissed from nonessential learning experiences in an effort to conserve personal protective equipment and limit exposures. A dedicated surge team was formed to tackle these issues while continuing to support our goals of maximizing patient safety, resident education, and physician wellness. The surge team created a plan that was implemented in 2 main phases. Phase 1 assumed business as usual with increased layers of backup for both residents and faculty. Phase 2 redistributed unassigned residents and inpatient faculty to increase capacity for adult medicine and COVID-19 patients on our essential services. Lessons learned from these surge efforts may help inform similar decisions being made by other residency programs presently and in the future.


Subject(s)
COVID-19/therapy , Capacity Building , Family Practice/education , Internship and Residency/organization & administration , COVID-19/epidemiology , Colorado/epidemiology , Humans , Interdisciplinary Communication , Pandemics , Personnel Staffing and Scheduling/organization & administration , SARS-CoV-2
18.
Afr J Prim Health Care Fam Med ; 12(1): e1-e3, 2020 Jun 03.
Article in English | MEDLINE | ID: covidwho-1089008

ABSTRACT

The novel coronavirus disease 2019 (COVID-19) pandemic has disrupted many lives worldwide. Training programmes in academic institutions have also been affected by the pandemic. Teaching and learning family medicine and public health medicine in the COVID-19 era require adjustments to training activities. At the University of Botswana, the pandemic presented an opportunity to steer training programmes in the Department of Family Medicine and Public Health Medicine more towards service-learning. The department collaborated with the Ministry of Health and Wellness as well as the District Health Management teams in the national response to the pandemic as essential service providers. The increased demands for service provision were balanced with educational opportunities for trainees during the COVID-19 public health emergency. Including structured ongoing reflections for trainees involved in the COVID-19 response helps to connect service and the academic curriculum.


Subject(s)
Coronavirus Infections/epidemiology , Family Practice/education , Pandemics , Pneumonia, Viral/epidemiology , Public Health/education , Botswana/epidemiology , COVID-19 , Curriculum , Humans , Universities/organization & administration
19.
Afr J Prim Health Care Fam Med ; 12(1): e1-e3, 2020 Nov 06.
Article in English | MEDLINE | ID: covidwho-1073606

ABSTRACT

The health-service redesign that came with the preparation for the surge of COVID-19 had a potential of disrupting the Family Medicine internship programme like it did to many other health and academic programmes. A team of Cape-Town based Community Health Centre (CHC) doctors mitigated this challenge by designing an innovative tool that facilitated ongoing supervision of the interns in order to achieve the outcomes of the Health Professions Council of South Africa (HPCSA).


Subject(s)
Community Health Centers , Coronavirus Infections , Counseling , Family Practice/education , Internship and Residency , Pandemics , Pneumonia, Viral , Preceptorship , Betacoronavirus , COVID-19 , Coronavirus Infections/epidemiology , Coronavirus Infections/therapy , Coronavirus Infections/virology , Health Personnel , Humans , Physicians , Pneumonia, Viral/epidemiology , Pneumonia, Viral/therapy , Pneumonia, Viral/virology , SARS-CoV-2 , South Africa
20.
Afr J Prim Health Care Fam Med ; 12(1): e1-e4, 2020 Jun 09.
Article in English | MEDLINE | ID: covidwho-1073592

ABSTRACT

Ten family physicians and family medicine registrars in a South African semi-rural training complex reflected on the coronavirus disease 2019 (COVID-19) crisis during their quarterly training complex meeting. The crisis has become the disruptor that is placing pressure on the traditional roles of the family physician. The importance of preventative and promotive care in a community-oriented approach, being a capacity builder and leading the health team as a consultant have assumed new meanings.


Subject(s)
Betacoronavirus , Coronavirus Infections/therapy , Family Practice/organization & administration , Pneumonia, Viral/therapy , Practice Patterns, Physicians'/organization & administration , Primary Health Care/organization & administration , Attitude of Health Personnel , COVID-19 , Capacity Building/organization & administration , Clinical Competence , Family Practice/education , Humans , Pandemics , Physicians, Family/organization & administration , SARS-CoV-2 , South Africa
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