An Analysis of a Family Medicine Residency Program's Social Media Engagement During the 2021-2022 Match Cycle.

Introduction: The COVID-19 pandemic affected the 2021 and 2022 residency recruitment cycles. Many programs rapidly shifted their recruitment efforts to include a greater presence on social media (SoMe), assuming that applicants would use these avenues as supplemental sources of information. As this represents a deviation from traditional recruitment efforts, our research team sought to analyze social media trends during the 2021-2022 family medicine virtual Match. Methods: We obtained social media analytics from our program's Facebook, Instagram, and Twitter accounts to trend user engagement as well as sources of traffic to our program's website. Results: Our study shows the ratio of users reached per post correlated with Instagram and Twitter more than Facebook. The most users reached per post were in June, October, and February, corresponding to when Electronic Residency Application Service (ERAS) application opened, when interview invitations were mostly extended, and rank order list submission. GME website traffic sources revealed that Google was the greatest driver to our website, more than the three SoMe platforms combined. Discussion: Our findings suggest Instagram and Twitter engage more users per post compared to Facebook, and user engagement appeared more aligned with the Match cycle timeline than the number of posts generated. It is important to continue to explore effective ways for applicants and programs to engage with one another in the ongoing uncertainty of virtual interviewing.

Assessing the wellbeing of family caregivers of multimorbid and homebound older adults-A scoping literature review.

BACKGROUND: The prevalence of homebound older adults in the United States more than doubled during the COVID-19 pandemic with greater burden on family caregivers. Higher caregiver burden, more specifically higher treatment burden, contributes to increased rates of nursing home placement. There exist a multitude of tools to measure caregiver well-being and they vary substantially in their focus. Our primary aim was to perform a scoping literature review to identify tools used to assess the facets of caregiver well-being experienced by caregivers of persons with multiple chronic conditions (MCC) with a special focus on those caregivers of homebound adult patients. METHODS: The search was conducted in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) extension for scoping reviews. After refining search terms, searches were performed of the peer-reviewed and gray literature. RESULTS: After removal of duplicate studies, a total of 5534 total articles were screened for relevance to our study. After all screening and review were completed, 377 total articles remained for full review which included 118 different quantitative tools and 20 different qualitative tools. We identified the 15 most commonly utilized tools in patients with MCC. The Zarit Burden Interview was the most commonly used tool across all of the studies. Of the 377 total studies, only eight of them focused on the homebound population and included 13 total tools. CONCLUSIONS: Building on prior categorization of well-being tools, our work has identified several tools that can be used to measure caregiver well-being with a specific focus on those caregivers providing support to older adults with MCC. Most importantly, we have identified tools that can be used to measure caregiver well-being of family caregivers providing support to homebound older adults, an ever-growing population who are high cost and high utilizers of health care services.

How Clinicians Discuss Medications During Primary Care Encounters Among Older Adults with Cognitive Impairment.

BACKGROUND: People with cognitive impairment experience high rates of polypharmacy and potentially inappropriate medication use. How clinicians communicate about medications may affect to what extent patients and family companions understand and participate in decisions about medication use. OBJECTIVE: To characterize how primary care clinicians discuss medications during encounters with older adults with cognitive impairment and their companions. DESIGN: Qualitative content analysis of audio-recorded clinical encounters from SAME Page, a randomized controlled trial to examine the effects of a patient-family agenda setting checklist on primary care visit communication among patients with cognitive impairment. Visits occurred between August 2016 and August 2017. PARTICIPANTS: Patients were 65 or older, had > 1 incorrect answer on a cognitive screener, and attended visits with a relative or unpaid companion. Clinicians were physicians, nurse practitioners, or physician assistants at participating practices. APPROACH: The encounters were transcribed verbatim. We used qualitative content analysis to identify major themes. KEY RESULTS: Patients were on average 79.9 years of age. The average MMSE score was 21.6. About half of clinicians reported practicing for 15 or more years (n = 8). We identified three major themes. First, we found numerous instances in which primary care clinicians introduced patients and companions to key principles of optimal prescribing and deprescribing. Second, clinicians used a variety of approaches to foster shared decision-making about medication use. Third, several challenges prevented clinicians from working together with patients and companions to optimize prescribing and deprescribing. CONCLUSIONS: This study offers insight into key language clinicians can use to initiate discussions about optimizing prescribing, as well as barriers they face in doing so. Examples identified in these transcripts should be tested with patients and caregivers to examine how such communications are received and interpreted. Future research should develop and test interventions that seek to overcome obstacles to optimizing prescribing for older adults with cognitive impairment.