Promotion Committees and Attending Meetings Improve Promotion Rates for Early Career Faculty.

INTRODUCTION: Academic promotion is an important goal in an academic physician's career trajectory. Understanding the factors that influence success in academic promotion is important in providing appropriate guidance and resources. METHODS: The Council of Academic Family Medicine Educational Research Alliance (CERA) conducted a large omnibus survey of family medicine department chairs. Participants were asked about recent promotion rates within their department, as well as about whether their department had a promotion committee, whether faculty regularly met with the chair regarding preparation for promotion, whether faculty had been assigned mentors, and whether faculty attended national academic meetings. RESULTS: The response rate was 54%. Most chairs were male (66.3%), White (77.9%), and aged 50 to 59 (41.3%) or 60 to 69 (42.3%) years. Attendance at professional meetings was associated with a higher rate of assistant-to-associate professor promotions. Departments with a committee to help faculty with promotions had higher rates of promotion for both assistant-to-associate and associate-to-full professor levels than departments without a committee. Promotion was not associated with assigned mentorship, support from the chair, departmental or institutional sponsorship of faculty development regarding promotion, or annual assessments of progress toward promotion. CONCLUSIONS: Attendance at professional meetings and the presence of a departmental promotions committee may be helpful factors in achieving academic promotion. An assigned mentor was not found to be a helpful factor.

People, Not Programs: Improving Diversity in the Family Medicine Workforce.

BACKGROUND AND OBJECTIVES: Patients are best served by a health care workforce that reflects the diversity of their community. Increasing diversity of family medicine requires a long-term effort to recruit more medical students from underrepresented in medicine (URiM, defined as people of Black/African American, Hispanic/Latino, Native American or Pacific Islander heritage) backgrounds into family medicine residencies. This paper examines factors that influence URiM medical students to choose family medicine residencies. METHODS: Data were collected via a Council of Academic Family Medicine Educational Research Alliance (CERA) survey of family medicine clerkship directors. Correlations examined associations between the percent URiM faculty, percent URiM preceptors, percent clerkship cases addressing health equity, and the percent of URiM students choosing family medicine residencies. t tests determined associations between clerkship director race, preclinical electives on health equity, department faculty champion for diversity, and department diversity activities; and the percentage of URiM students choosing family medicine residencies. RESULTS: Survey response rate was 49%. Two factors had a positive relationship with the percentage of graduating students who were URiM choosing family medicine residencies: having a higher percentage of faculty who were URiM (r=0.33, P=.004) and having a higher percentage of preceptors who are URiM (rs=.386, P=.001). We found no such association for having cases addressing health equity, offering preclinical electives, departments with a faculty champion for diversity, clerkship director race, or a department's diversity activities. CONCLUSIONS: The presence of teaching faculty and community preceptors from URiM backgrounds is correlated with the rate at which students who are URiM choose family medicine. People, rather than activities, seem to influence the career choices of students from URiM backgrounds.

Use of Telemedicine in the Family Medicine Clerkship: A CERA Study.

Background: In March 2020 with the onset of the COVID-19 pandemic, clinical rotations abruptly ceased, and telemedicine became an alternative to in-person patient care. This study investigates factors associated with long-term adoption of telemedicine during family medicine clerkships. Methods: Data were gathered from the 2021 CERA survey of family medicine clerkship directors. Participants answered questions about the use of telemedicine in the clerkship, adequacy of telemedicine resources, how well telemedicine visits helped students meet course objectives, quality of course evaluations, efficiency of students seeing patients using telemedicine, and likelihood of continuing use of telemedicine once in-person visits are reinstated. Results: The response rate was 48.8%. While most clerkship directors did not use telemedicine prior to the COVID-19 pandemic with their own patients, most had medical students utilize telemedicine during the pandemic. Clerkship directors were more likely to continue having students use telemedicine in the clerkship if it helped them meet clerkship objectives, if telemedicine visits were efficient, and if course evaluations were positive. Adequacy of resources was not associated with likelihood of retaining telemedicine in the clerkship. Conclusions: Family medicine clerkship directors will likely continue to have students see patients via telemedicine, particularly if feedback is positive. Family medicine educators need to develop and evaluate new telemedicine curriculum for learner benefit, patient acceptability, and overall care quality.

Promotion Preparation Tips for Academic Family Medicine Educators.

BACKGROUND AND OBJECTIVES: Promotion has historically valued the scholarship of discovery over the scholarship of teaching. The clinician-educator promotion pathway is an attractive option for academic family physicians engaged in significant teaching. However, clinician-educators are less often promoted than peers on other tracks. Family medicine educators face unique challenges in promotion due to clinical requirements and often less guidance on how to meet promotion criteria. Promotion recognizes achievements of faculty and is often tied to higher base salary. We aimed to identify promotion preparation tips for academic family medicine educators. METHODS: We surveyed members of the Society of Teachers of Family Medicine (STFM) Medical Student Education Collaborative electronically on promotion preparation lessons learned in (1) curriculum vitae preparation, (2) personal statement preparation, (3) selecting external reviewers, and (4) identifying measurable achievements. This qualitative study used grounded theory and constant comparison. RESULTS: Fourteen individuals from 13 medical institutions responded with tips for success in promotion preparation. The tips identified actionable steps for promotion preparation of academic family medicine educators. Several main themes emerged, including the importance of timely and thorough documentation, detailed planning, and being knowledgeable about institutional-specific criteria early. CONCLUSIONS: The tips provided in this study support family medicine educators in preparing for promotion and can be used as a tool for mentors, chairs and faculty development.

Active Learning Versus Traditional Teaching Methods in the Family Medicine Clerkship.

BACKGROUND AND OBJECTIVES: Active learning, defined as a variety of teaching methods that engage the learner in self-evaluation and personalized learning, is emerging as the new educational standard. This study aimed to evaluate how family medicine clerkship directors are incorporating active learning methods into the clerkship curriculum. METHODS: Data were collected via a Council of Academic Family Medicine Educational Research Alliance survey of family medicine clerkship directors. Participants answered questions about the number and type of teaching faculty in their department, the various teaching methods used in their family medicine clerkship, and what challenges they had faced in implementing active learning methods. RESULTS: The survey response rate was 64%; 97% of family medicine clerkships use active learning techniques. The most common were online modules, problem-based learning, and hands-on workshops. The number of teaching faculty was significantly correlated with hours spent in live (not online) active teaching. One-third of clerkship directors felt challenged by lack of resources for adopting active learning. Clerkship directors did not cite lack of expertise as a challenge to implementing active learning. Time dedicated to clerkship director duties or the presence of a dedicated educator in the department was not associated with the adoption of active learning. CONCLUSIONS: The use of active learning in the family medicine clerkship is required both by educational standards and student expectations. Clerkship directors may feel challenged by lack of resources in their attempts to adopt active learning. However, there are many methods of active learning, such as online modules, that are less faculty time intensive.

Changes in Family Medicine Clerkship Teaching Due to the COVID-19 Pandemic.

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.

Teaching Chronic Pain in the Family Medicine Clerkship: Changes From 2014.

BACKGROUND AND OBJECTIVES: The management of chronic pain is an important topic for training competent family physicians. The purpose of this study was to determine factors in teaching about chronic pain and whether state overdose death rates were associated with teaching chronic pain topics. METHODS: Data were collected as part of the 2019 Council of Academic Family Medicine Educational Research Alliance (CERA) Clerkship Directors' Survey. The response rate was 71%. Respondents answered questions about the amount of time spent teaching about chronic pain diagnoses, approach to chronic pain, opioid medications, nonopioid medications and nonpharmacologic treatments for chronic pain. RESULTS: The most frequent topic was chronic pain diagnoses, taught by 64% of clerkships with an average of 92 minutes spent on the topic. Each chronic pain topic was taught by nearly 50% of clerkships, and 72.3% of clerkships taught at least one topic. More clerkships were teaching about opioids, nonopioids, and nonpharmacological treatments for chronic pain than in 2014. Time currently spent teaching about opioids was positively correlated with clerkships' state 2014 drug overdose death rate. CONCLUSIONS: The majority of family medicine clerkships teach about chronic pain, and the amount of time dedicated to this topic has increased over the last 5 years. A state's opioid overdose rate correlates with the amount of time spent teaching about opioids, but does not correlate with the amount of time teaching about other chronic pain subtopics. It is possible that the opioid crisis is causing a shift in the subtopics of chronic pain teaching.

Learning Outcomes From Lecture and an Online Module in the Family Medicine Clerkship.

BACKGROUND AND OBJECTIVES: With younger generations of learners and readily available technology, medical educators are challenged to include active learning methods that may be better for student learning than traditional lecture. Some of these methods, like online modules, can also reduce the demands on clerkship faculty time. We examined how content delivered via interactive, online module compared to traditional lecture for student learning and satisfaction. METHODS: Third-year family medicine clerkship students completed questionnaires following either an online module or lecture on orofacial pain. We conducted the study over four consecutive rotations, alternating who received the content via classroom lecture or interactive online module. Students completed a questionnaire comprised of six multiple-choice knowledge questions, five questions with a clinical vignette format to assess application of knowledge, and six questions to assess satisfaction with elements of the course. The Centers of Excellence in Pain Education developed the online module and questionnaire. RESULTS: We found no differences in knowledge between the in-person lecture and the online module. However, students who completed the online module performed better on the application questions. Students in the lecture group reported greater satisfaction with the course than students in the online group. CONCLUSIONS: Lecture resulted in adequate knowledge recall, but the interactive method resulted in better scores on applying knowledge to new situations. Providing an online module where students can practice applying knowledge is important for higher levels of learning, but it should be noted that satisfaction ratings may decline.

Grade Inflation in the Family Medicine Clerkship.

BACKGROUND AND OBJECTIVES: Medical educators perceive grade inflation to be a serious problem. There is some literature discussing the magnitude of the problem and ways to remediate it, but little literature is available in the field of family medicine. We sought to examine what methods of remediating grade inflation have been tried by family medicine clerkship directors, and what factors influence the chosen method of addressing this problem. METHODS: We conducted a national Council of Academic Family Medicine's (CAFM) Educational Research Alliance (CERA) survey of family medicine clerkship directors, inquiring about their perceptions of the seriousness of grade inflation, whether it was perceived as a remediable problem, and what methods had been tried within the last 3 years to address this problem. RESULTS: The response rate was 69%. Clerkship directors' perceptions that grade inflation is a serious problem either nationally or in their own clerkship did not correlate with how they weighted the objective versus subjective portions of the clerkship grade. Clerkship directors who agreed that grade inflation was a remediable problem had a higher percentage of nonexamination objective criteria and a lower percentage of subjective criteria in their grading formula. Clerkship directors who agreed grade inflation is a problem in their clerkship were more likely to have tried giving feedback to graders on grade distribution than those who didn't think grade inflation was a problem. CONCLUSIONS: Family medicine clerkship directors perceive grade inflation to be a serious problem, both at a national level and in their clerkships. Various methods of addressing grade inflation have been tried by family medicine clerkship directors.