The reflecting team: an innovative approach for teaching clinical skills to family practice residents.

BACKGROUND AND OBJECTIVES: This paper provides a description and evaluation of the reflecting team approach as a teaching method for family practice residents. We have used the reflecting team approach in our longitudinal behavioral health program for 6 years. Our purpose in using this approach is to 1) teach listening and interviewing skills, 2) teach systems-oriented psychosocial interventions, and 3) provide behavioral health consultations for patients. METHODS: A five-item, self-administered, open-ended questionnaire evaluating the reflecting team approach was administered to a sample of family practice residents. RESULTS: Completed questionnaires were received from 18 of the 22 family practice residents participating in the longitudinal behavioral health program (a response rate of 82%). Responses to the questionnaire items indicated that the residents understood the purpose of the reflecting team approach and felt that they had acquired a variety of clinical skills from the approach, including listening and interviewing skills, positive reframing of patients' problems, how to give positive feedback to promote behavioral change, and increased knowledge of psychosocial assessment procedures and treatment methods. CONCLUSIONS: The residents' responses to the questionnaire items indicated that they perceived the reflecting team approach to be a practical and useful method for learning a variety of clinical skills.

Multicultural curricula in family practice residencies.

BACKGROUND AND OBJECTIVES: In 1985, results from a national survey indicated that 25% of family practice residencies taught about multicultural issues in their programs. Our current study identified the current status and content of the curricula and determined facilitating and impeding factors to multicultural curricula. METHODS: In 1998, the Society of Teachers of Family Medicine's Group on Multicultural Health Care and Education conducted a cross-sectional mail survey of all 476 family practice residency programs. RESULTS: With a 59% response rate, 58% of responding programs have an informal curriculum on multicultural issues, 28% have a formal curriculum, and 14% have no curriculum. Programs with a formal curriculum teach more content, employ more educational methods, use more evaluation techniques, and feel more successful than programs with an informal curriculum. Important factors that facilitate curricula include cultural diversity of communities and residents, multicultural interests of faculty and residents, and faculty's multicultural expertise. Factors that impede curricula include lack of time, money, resources, faculty expertise, and cultural diversity in the community. Programs with formal, informal, and no curriculum identify different facilitators and impediments. CONCLUSION: There was a marked increase in the prevalence of multicultural curricula in family practice residencies from 1985 to 1998.