Training family medicine residents to care for children

Canadian family physician Médecin de famille canadien, 2011

Problem addressed There is a lack of consensus around the optimal way to train family medicine residents to care for children. Objective of program Evaluation of an ambulatory versus an inpatient pediatrics rotation for family medicine residents. Program description A 4-week pediatrics rotation for second-year family medicine residents was introduced involving half-day ambulatory pediatric clinics. A nonequivalent control group evaluation study design was followed. Patient logbook entries, as well as residents' satisfaction, knowledge, and self-reported confidence outcomes were compared between family medicine residents completing the new ambulatory rotation and those completing a traditional inpatient-ambulatory pediatrics rotation. Conclusion An ambulatory rotation in pediatrics is a feasible option for facilitating family medicine resident learning in child health care. Residents report exposure to more patient cases that reflect a family practice office setting and the same ...

Medical education, 2002

Background There is controversy as to how best to train general practitioners for the paediatric challenges they will meet in practice, in particular what should be included in training, what should be left out and how long should it last? Subjects and methods All 615 general practice principals referring to 6 hospitals were surveyed (40% response rate). Setting West Midlands region of England. Study design Postal questionnaire. Statistics Quantitative and qualitative assessment of responses. Quantitative responses were analysed by hospital, decade of qualification, and duration of paediatric training. Qualitative responses were analysed using grounded theory. Results Satisfaction with training was directly related to its duration, with low levels of satisfaction for less than 6 months paediatrics, moderate levels for 6-11 months, and high levels with 12 months or more. The most important item of training was recognition of the sick child. Acute and chronic paediatrics was generally well covered. Psychosocial aspects, public health and immunisation were poorly addressed. Neonatal resuscitation and first day checks were seen as relevant, but neonatal intensive care was not. Conclusions At least 6 months of paediatrics is necessary for GPs in training, but longer paediatric exposure further increases their satisfaction with training. GPs have a biopsychosocial rather than biomedical approach to their child patients, suggesting potential benefits from a greater emphasis on psychosocial and public health aspects at the expense of neonatal intensive care. Recognition of the sick child is essential, and acute and chronic organic illness should be covered in breadth. Possible future models for GP training in paediatrics are discussed.

2009

Clinical Pediatrics, 2006

Pediatric residents on block community rotations completed journals and exit interviews regarding their perceptions of the rotation. Three common themes present in residents' responses were identified via qualitative analysis: enlightenment and attitude change, impact of direct participation, and rotation challenges. Advantages and disadvantages to block rotations in community pediatrics, and their relationship to learning child advocacy skills, are discussed. Finally, the use of journals as a tool to document systems-based practice competency is explored.

PubMed, 1981

A study was done of 15 residency training programs in primary care (not family practice residencies) to determine how the residents compared with their counterparts in conventional programs. Primary care residents are equally or more clinically skilled and equally or better grounded in the science of medicine. Their clinical research is directed toward different issues, and they are decidedly more psychosocially oriented.

Academic Pediatrics, 2009

Objective.--To assess parental experience of pediatric primary care at the level of physician practice and to determine what variation exists among practices.

Family Systems Medicine, 1985

This paper proposes that the primary reason for the failure of most family therapy training in family medicine is inadequacy in training design and delivery. A description of a failed attempt at training family practitioners in the proven McMaster Model described by Bishop, Epstein et al. is used to illustrate common problems in family therapy training design and delivery. The problems listed include: designing training unresponsive to family physicians' frames of reference, failing to take into account contextual variables in family medicine, lack of measurable training objectives, inappropriate content selection, and inappropriate delivery methods. Bishop, Epstein, Gilbert, van der Spuy, Levin, and McClemont described an attempt to evaluate the effectiveness of family physicians conducting family therapy (1). Their study involved eight family physicians intensively trained in a 9-hour course in family therapy designed using the well-researched and innovative Mc-Master Model of Family Functioning (4). The family physicians each agreed to identify five families from their respective practice with which to conduct family therapy. They further agreed to utilize data collection instruments designed by the authors to track the progress and outcome of the therapy. Assistance was available to the physicians to answer questions about the research forms and a psychiatrist was available for consultation. The family physicians failed to identify families for the study. Indeed, of the eight, only one physician recruited a single family for the study. However, when investigators explored with family physicians the reasons for their noncompliance, all reported there were families that could be candidates in their practices and that the training went well and was useful. Further, all reported "they were using the skills they had learned in their practices, though not in a systematic and documented way." Rather than treating families in traditional family therapy sessions, the family physicians did "informal treatment intervention in an irregular fashion." The family

The Journal of Pediatrics, 1988

2014

BACKGROUND AND OBJECTIVES Little is known about the impact of hospitalists on family medicine residencies. We surveyed family medicine residency directors to assess attitudes about hospitalists and their involvement in residency teaching. METHODS Questions were included in the 2012 Council of Academic Family Medicine Educational Research Alliance (CERA) survey of family medicine residency directors. Univariate statistics were used to describe programs, directors, and our questions on the use of hospitalists. Bivariate statistics were used to examine relationships between the use of hospitalists to teach and program characteristics. RESULTS Forty-one percent (n=175) of residency directors completed the hospitalist section of the CERA survey. Sixty-six percent of residency programs were community based/university affiliated. The majority of directors who have, or are planning to develop, a hospitalist service currently use an internal medicine service (92.5%), followed by family medic...

Academic Pediatrics, 2010

Objective.-The principles of evidence-based practice (EBP) are a mandated component of the pediatric residency curriculum; however, a pediatrics-based assessment tool validated with pediatric residents does not exist. Methods.-We designed an assessment instrument composed of items in 4 categories: 1) demographics; 2) comfort level; 3) selfreported practice of EBP; and 4) EBP knowledge. This last section required participants to identify best evidence and most appropriate study design by using pediatric-based scenarios, develop searchable questions, and use existing published research to address diagnostic and treatment issues. Four groups completed the instrument: preclinical medical students (MS-2), incoming pediatric interns (PGY-1), incoming second-and third-year pediatric residents (PGY2-3), and expert tutors (expert). We determined internal consistency, interrater reliability, content validity, item difficulty, and construct validity.