Background and Objectives: The transition to clerkships is one of the most challenging times during medical school. To help students better cope, many schools have established transition-to-clerkship curricula. Such curricula may optimally prepare students through increasing their self-efficacy and response efficacy. We hypothesized that a small-group, near-peer-led format would be ideally suited to help students achieve these outcomes. Methods: During process improvement for a transition-to-clerkship curriculum, we conducted an informal focus group and subsequent survey of postclerkship students to guide curricular innovation, including incorporation of third- and fourth-year students as near-peer instructors in a seminar format. Seminars included three sequential small-group discussions focused on discrete topic areas and concluded with a large-group session highlighting salient discussion points. To evaluate the impact of this educational strategy, near-peer learners were surveyed before and after the seminars. Results: Junior student participants reported feeling more prepared to integrate into the health care team, develop a clerkship study plan, and access applicable, valuable study materials, both immediately following the seminars and 6 months later, demonstrating increased self-efficacy. These students placed equal or greater value on these topics as compared to students in previous year groups, demonstrating similar response efficacy. Conclusions: This study demonstrated an increase in student self-efficacy that persisted 6 months postintervention, in addition to similar response efficacy. Future research could be directed toward: (1) investigating whether improvements in self-efficacy among students transitioning to clerkships are associated with improved clerkship performance and (2) studying outcomes for near-peer teachers.
Background and Objectives: Emerging evidence suggests that running gait retraining plays an important role in the treatment and prevention of running-related injury, yet it remains unclear how gait retraining is being utilized by family physicians with their patients. By surveying family physicians and residents, this study is the first to investigate the frequency of gait retraining discussions with patients with running-related injuries, barriers to these discussions, and physician confidence and perceived value in engaging in these discussions, so as to better inform family physician training on this subject. Methods: This study investigated family physician attitudes toward gait retraining though a cross-sectional survey administered to 532 military family physicians and residents at the 2019 Uniformed Services Academy of Family Physicians Annual Meeting. Main outcome measures included frequency of, confidence in, and value of discussions of running gait retraining with patients with running-related injuries. Obstacles to discussing gait retraining, knowledge on the topic, and previous training on the topic were also assessed. Results: With a 72.2% response rate, the majority of respondents (82%) felt discussions on the topic are at least somewhat valuable. However, 63% of respondents infrequently discuss the topic with patients, while 71% lack confidence in engaging in these discussions. The most frequently reported obstacles were lack of knowledge (55%) and time (24%). Conclusions: Family physicians find value in discussions of running gait retraining with their patients, but discussion frequency and physician confidence are low. Educational interventions increasing physician knowledge and the development of non-time-intensive approaches would be best suited for improving confidence and discussion frequency for this valued skill.
Introduction: Given that primary care has been found to be the most likely point of entry into the health care system for concussion patients, diagnosis and management of concussions are vital to the education of family medicine physicians. Studies of primary care residencies reveal a self-perceived deficiency in sports medicine education. This project was designed to determine the effect of a concussion management clinic on family medicine residents’ confidence in and personal value placed on diagnosing and managing concussions. Methods: This project was completed in a family medicine residency as a retrospective evaluation of an educational improvement project during the 2016-2017 academic year. The intervention involved implementation of a structured clinical experience focused on management of concussions. Residents were surveyed preintervention, as well as 5 and 11 months postintervention, measuring resident exposure to and confidence in diagnosing and managing concussions. Results: Residents demonstrated significantly increased confidence in diagnosing concussions and managing complicated concussions following the intervention (both F [2, 84]=3.56, P=0.03). Post hoc analysis indicated the statistical difference was found between preintervention measures and 1 academic year later. The number of concussions seen positively correlated with resident confidence in both diagnosing and managing concussions while personal value remained high. Conclusions: This project is the first to evaluate the impact of a concussion clinic on resident education, demonstrating significant improvement in multiple areas of concussion education. Replicating the project in other family medicine residencies could be beneficial in determining if this clinic education model improves resident outcomes in other residencies.
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