Postresidency Practice Setting and Clinical Care Features According to 3 Versus 4 Years of Training in Family Medicine: A Length of Training Pilot Study.

Background And Objectives: Factors associated with physician practice choice include residency location, training experiences, and financial incentives. How length of training affects practice setting and clinical care features postgraduation is unknown.

Methods: In this Length of Training Pilot (LoTP) study, we surveyed 366 graduates of 3-year (3YR) and 434 graduates of 4-year (4YR) programs 1 year after completion of training between 2013 and 2021.

Measuring Clinical Preparedness After Residency Training: Development of a New Instrument.

Background And Objectives: Research on preparedness for independent clinical practice typically uses surveys of residents and program directors near graduation, which can be affected by several biases. We developed a novel approach to assess new graduates more objectively using physician and staff member assessors 3 months after graduates started their first job.

Methods: We conducted a literature review and key informant interviews with physicians from varying practice types and geographic regions in the United States to identify features that indicate a lack of preparedness for independent clinical practice.

Resident Visit Productivity and Attitudes About Continuity According to 3 Versus 4 Years of Training in Family Medicine: A Length of Training Study.

Background And Objectives: Training models in the Length of Training Pilot (LOTP) vary. How innovations in training length affect patient visits and resident perceptions of continuity is unknown.

Methods: We analyzed resident in-person patient encounters (2013-2014 through 2018-2019) for each postgraduate year (PGY) and total visits at graduation derived from the Accreditation Council for Graduate Medical Education reports for each LOTP program.

An antidote to what's ailing healthcare workers: a new (old) way of relational leadership.

Purpose: The purpose of the study's mixed-methods evaluation was to examine the ways in which a relational leadership development intervention enhanced participants' abilities to apply relationship-oriented skills on their teams.

Design/methodology/approach: The authors evaluated five program cohorts from 2018-2021, involving 127 interprofessional participants. The study's convergent mixed-method approach analyzed post-course surveys for descriptive statistics and interpreted six-month post-course interviews using qualitative conventional content analysis.

The Association Between Length of Training and Family Medicine Residents' Clinical Knowledge: A Report From the Length of Training Pilot Study.

Background And Objective: The associations between training length and clinical knowledge are unknown. We compared family medicine in-training examination (ITE) scores among residents who trained in 3- versus 4-year programs and to national averages over time.

Methods: In this prospective case-control study, we compared the ITE scores of 318 consenting residents in 3-year programs to 243 who completed 4 years of training between 2013 through 2019.

An Exploratory Mixed Methods Study of Experiences of Interprofessional Teams Who Received Coaching to Simultaneously Redesign Primary Care Education and Clinical Practice.

Introduction/objectives: Coaching is emerging as a form of facilitation in health professions education. Most studies focus on one-on-one coaching rather than team coaching. We assessed the experiences of interprofessional teams coached to simultaneously improve primary care residency training and interprofessional practice.

Financial Considerations Associated With a Fourth Year of Residency Training in Family Medicine: Findings From the Length of Training Pilot Study.

Background And Objectives: The feasibility of funding an additional year of residency training is unknown, as are perspectives of residents regarding related financial considerations. We examined these issues in the Family Medicine Length of Training Pilot.

Methods: Between 2013 and 2019, we collected data on matched 3-year and 4-year programs using annual surveys, focus groups, and in-person and telephone interviews.

Conditions Influencing Collaboration Among the Primary Care Disciplines as They Prepare the Future Primary Care Physician Workforce.

Background And Objectives: Much can be gained by the three primary care disciplines collaborating on efforts to transform residency training toward interprofessional collaborative practice. We describe findings from a study designed to align primary care disciplines toward implementing interprofessional education.

Methods: In this mixed methods study, we included faculty, residents and other interprofessional learners in family medicine, internal medicine, and pediatrics from nine institutions across the United States.

A Comparison of Residency Applications and Match Performance in 3-Year vs 4-Year Family Medicine Training Programs.

Background And Objectives: The optimal length of residency training in family medicine is under debate. This study compared applicant type, number of applicants, match positions filled, matched applicant type, and ranks to fill between 3-year (3YR) and 4-year (4YR) residencies.

Methods: The Length of Training Pilot (LOTP) is a case-control study comparing 3YR (seven residencies) and 4YR (six residencies) training models.

Concerning trends in allopathic medical school faculty rank for Indigenous people: 2014-2016.

Background: Trends in faculty rank according to racial and ethnic composition have not been reviewed in over a decade.

Objective:  To study trends in faculty rank according to racial and ethnicity with a specific focus on Indigenous faculty, which has been understudied.

Methods: Data from the Association of American Medical Colleges' Faculty Administrative Management Online User System was used to study trends in race/ethnicity faculty composition and rank between 2014 and 2016, which included information on 481,753 faculty members from 141 US allopathic medical schools.

Redesigning Residency Training: Summary Findings From the Preparing the Personal Physician for Practice (P4) Project.

Background And Objectives: The Preparing the Personal Physician for Practice (P4) project (2007 to 2014) involved a comparative case study of experiments conducted by 14 selected family medicine programs designed to evaluate new models of residency education that aligned with the patient-centered medical home (PCMH). Changes in length, structure, content, and location of training were studied.

Methods: We conducted both a critical review of P4 published Evaluation Center and site-specific papers and a qualitative narrative analysis of process reports compiled throughout the project.

Impact of Residency Training Redesign on Residents' Clinical Knowledge.

Background And Objectives: The In-training Examination (ITE) is a frequently used method to evaluate family medicine residents' clinical knowledge. We compared family medicine ITE scores among residents who trained in the 14 programs that participated in the Preparing the Personal Physician for Practice (P4) Project to national averages over time, and according to educational innovations.

Methods: The ITE scores of 802 consenting P4 residents who trained in 2007 through 2011 were obtained from the American Board of Family Medicine.

Scope of Practice Among Recent Family Medicine Residency Graduates.

Background And Objectives: The scope of practice among primary care providers varies, and studies have shown that family physicians' scope may be shrinking. We studied the scope of practice among graduates of residencies associated with Preparing the Personal Physician for Practice (P4) and how length of training and individualized education innovations may influence scope.

Methods: We surveyed graduates 18 months after residency between 2008 and 2014.

Rural Curricular Guidelines Based on Practice Scope of Recent Residency Graduates Practicing in Small Communities.

Background And Objectives: The optimal curriculum for training family physicians for rural practice within a traditional urban-based residency is not defined. We used the scope of practice among recent family medicine graduates of residencies associated with Preparing the Personal Physician for Practice (P4), practicing in small communities, to identify rural curriculum components.

Methods: We surveyed graduates 18 months after residency between 2007 and 2014.

Team Training in Family Medicine Residency Programs and Its Impact on Team-Based Practice Post-Graduation.

Objective: Our objective was to examine perceptions of adequacy in team-based care training during residency and whether this influences practice choice post- residency training.

Methods: We analyzed self-administered survey data from recent residency graduates collected as part of the Preparing Personal Physicians for Practice (P4) Project to characterize residents' perceptions of adequacy of training they received on team-based care. Multivariable logistic regression was used to assess the association between adequacy of team-based care training and joining practices that use team-based care after residency graduation, adjusting for differences in demographics.

Factors Associated With Interest in Pursuing a Fourth Year of Family Medicine Residency Training.

Background And Objectives: The optimal length of residency training in family medicine, as with emergency medicine, is an ongoing debate due to several factors, but perceptions of graduating residents are missing from this debate.

Methods: We used data from 3,054 family medicine residents who registered for the American Board of Family Medicine certification examination in 2014. A practice demographic questionnaire was a mandatory component of registration.

Varied Rates of Implementation of Patient-Centered Medical Home Features and Residents' Perceptions of Their Importance Based on Practice Experience.

Background And Objectives: Little is known about how the patient-centered medical home (PCMH) is being implemented in residency practices. We describe both the trends in implementation of PCMH features and the influence that working with PCMH features has on resident attitudes toward their importance in 14 family medicine residencies associated with the P4 Project.

Methods: We assessed 24 residency continuity clinics annually between 2007-2011 on presence or absence of PCMH features.

Association Between Patient- Centered Medical Home Features and Satisfaction With Family Medicine Residency Training in the US.

Background And Objectives: Primary care residencies are undergoing dramatic changes because of changing health care systems and evolving demands for updated training models. We examined the relationships between residents' exposures to patient-centered medical home (PCMH) features in their assigned continuity clinics and their satisfaction with training.

Methods: Longitudinal surveys were collected annually from residents evaluating satisfaction with training using a 5-point Likert-type scale (1=very unsatisfied to 5=very satisfied) from 2007 through 2011, and the presence or absence of PCMH features were collected from 24 continuity clinics during the same time period.

The Importance of and the Complexities Associated With Measuring Continuity of Care During Resident Training: Possible Solutions Do Exist.

Background And Objectives: Evolutions in care delivery toward the patient-centered medical home have influenced important aspects of care continuity. Primary responsibility for a panel of continuity patients is a foundational requirement in family medicine residencies. In this paper we characterize challenges in measuring continuity of care in residency training in this new era of primary care.

A Model for Catalyzing Educational and Clinical Transformation in Primary Care: Outcomes From a Partnership Among Family Medicine, Internal Medicine, and Pediatrics.

Purpose: To report findings from a national effort initiated by three primary care certifying boards to catalyze change in primary care training.

Method: In this mixed-method pilot study (2012-2014), 36 faculty in 12 primary care residencies (family medicine, internal medicine, pediatrics) from four institutions participated in a professional development program designed to prepare faculty to accelerate change in primary care residency training by uniting them in a common mission to create effective ambulatory clinical learning environments. Surveys administered at baseline and 12 months after initial training measured changes in faculty members' confidence and skills, continuity clinics, and residency training programs.

Five Key Leadership Actions Needed to Redesign Family Medicine Residencies.

Background: New skills are needed to properly prepare the next generation of physicians and health professionals to practice in medical homes. Transforming residency training to address these new skills requires strong leadership.

Objective: We sought to increase the understanding of leadership skills useful in residency programs that plan to undertake meaningful change.

Financing Residency Training Redesign.

Background: Redesign in the health care delivery system creates a need to reorganize resident education. How residency programs fund these redesign efforts is not known.

Methods: Family medicine residency program directors participating in the Preparing Personal Physicians for Practice (P(4)) project were surveyed between 2006 and 2011 on revenues and expenses associated with training redesign.

Transforming primary care residency training: a collaborative faculty development initiative among family medicine, internal medicine, and pediatric residencies.

Problem: The scope and scale of developments in health care redesign have not been sufficiently adopted in primary care residency programs.

Approach: The interdisciplinary Primary Care Faculty Development Initiative was created to teach faculty how to accelerate revisions in primary care residency training. The program focused on skill development in teamwork, change management, leadership, population management, clinical microsystems, and competency assessment.

Innovating within the ACGME regulatory environment is not an oxymoron.

Background And Objectives: The aim of this study was to describe the analysis of program citations and cycle length for reaccreditation in the 14 family medicine residencies participating in the P4 project.

Methods: An exploratory narrative analysis was conducted on all actions taken by the Review Committee for Family Medicine (RC-FM) between 2003 and 2012. The analysis included cycle length and types of citations associated with accreditation actions.