Children living in households with 1 or more male adults that are not related to them are at increased risk for maltreatment injury death. This risk is not elevated for children living with a single parent, as long as no other adults live in the home.

Frequent clinic attenders consume a large portion of health care resources while feeling underserved. At the same time, physicians are frustrated trying to adequately care for these patients. Previous trials of team care in primary care have rarely included control groups. Adults with eight or more clinic visits in the past year were nonrandomly assigned to usual care or team care. For the latter group, a Care Team met to review each case and create a care plan. Changes in patient health care use, well-being, and satisfaction from baseline to 6 months were compared between team care and usual care patients. In addition, Care Team members' perceptions of team care were assessed by quantitative and qualitative methods. Study patients were medically complex. Self-reported overall well-being and overall care satisfaction improved in the 12-patient team care group, but remained unchanged in the 8 patient usual care group. Median 6-month visits fell by 3 visits among team care patients and increased by 1.5 among usual care patients. Most Care Team members rated team care as positive and as improving quality of care. Members were divided on its effect on care efficiency and workload. Team care is feasible within a family medicine residency practice and may improve care.

Introduction: Team-based, interprofessional approaches to outpatient care are critical to high-quality patient care. However, few specific educational interventions promoting these skills in graduate level health care trainees have been described to date. Methods: University of Minnesota faculty from the Schools of Medicine, Pharmacy, and Nursing created an interprofessional workshop experience exploring core concepts in outpatient care for graduate level trainees in pediatrics, family medicine, medicinepediatrics, internal medicine, graduate-level nursing, and pharmacy. We focused on four key content areas: teamwork, systems thinking, the patient-centered health care home, and patient-centered communication. The workshop included brief didactics, role-plays, team-based experiences, and interactive skill practice. Participants completed an end-of-day survey reflecting on knowledge and attitude. Results: From 2014-2017, nine workshops reached 305 trainees. Survey results from the 2015-2016 academic year are representative of our overall results and revealed that learners found the content high yield, and that they valued the opportunity to learn with their interprofessional colleagues. Improvements in perceived knowledge were noted in all domains. Trainees also reported increased skills, with 81% reporting both increased confidence in working within the interprofessional team, and change in attitude, and 90% reporting increased interest in working with their interprofessional colleagues after the workshop. Discussion: Creating an opportunity for postgraduate level trainees from a variety of disciplines and professions to convene and focus on interprofessional team-based skills can fill a gap in interprofessional learning as they enter practice. Trainees were able to draw on their everyday experiences and find common ground with their interprofessional colleagues.

Background and Objectives: For years, family medicine has taught patient-centered communication through observations and observation checklists. We explored the utility of one checklist, the Patient-Centered Observation Form (PCOF), to teach and evaluate patient-centered communication in our family medicine residencies. Methods: We conducted a mixed-method study of five University of Minnesota Family Medicine Residencies’ seven years of experience teaching and evaluating residents’ patient-centered communication skills. All programs have a behavioral health (BH) faculty-led observation curriculum that uses the PCOF to assess resident skills and give feedback. We conducted a BH faculty focus group and interviews, generated themes from the BH responses, and then queried family medicine (FM) faculty regarding these themes through an online survey. Results: Ten BH faculty participated in the focus group/interviews, and 71% (25/35) of FM faculty completed the survey about themes derived from the BH interviews. The residencies complete between 1 to 11 observations per resident per year. Since implementation, four programs have continuously used the PCOF due to its versatility, design as a formative rather than summative feedback tool, and relative ease of use. BH faculty believe longitudinal observations with the PCOF resulted in improved resident patient-centered communication. Most importantly, all faculty described a shift in family medicine culture toward patient-centered communication. Time for observations and feedback is the primary curricular barrier. Conclusions: Our findings support the utility of the PCOF for teaching and evaluating patient-centered communication in family medicine training.

Bullying behavior among school students known as school bullying is rapidly increasing. Generally, children who are victims of bullying will feel unhappiness, especially when they are in an environment where they are being bullied. This study aims to obtain factual data about the bullying behavior at elementary school children located in East Bandung area. This is a descriptive research with quantitative approach. The number of sample used in this study was 494 children aged between 10-12 years who attend elementary school in East Bandung area. The instruments used in this study are a modified questionnaire from The Children's Happiness Scale and the Illinois Bully Scale. The data obtained then presented in the form of tables and graphs. The results showed that students had been victims of bullying and/or had done bullying in various types and levels. In general, verbal psychological bullying forms are ranked top for both boys and girls, followed by non-verbal psychological bullying and the last is physical bullying.

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ProblemFamily medicine faculty and residents have observed that continuity clinic is often unsatisfying, attributed to a lack of patient and team continuity and erratic clinic schedules pieced together after the prioritization of hospital service and rotation schedules.

Background and Objectives: Continuity of care between patients and their primary care providers is associated with improved patient outcomes and experience, decreased health care costs, and improved provider well-being. Strategies to enhance continuity of care in residency programs involve electronic health record, scheduling, and panel management methods. Our study compared physician-patient continuity rates (pre and post) for one family medicine residency’s implementation of a set-day clinic (SDC) scheduling model. Methods: In July 2019, Bethesda Clinic switched from a rotation-driven scheduling (RDS) model to SDC. Physicians were divided into two scheduling groups: Monday, Thursday, or Friday; or Tuesday, Wednesday, or Friday. We used visit data from two 6-month periods, October 2018 to March 2019 (RDS) and October 2021 to March 2022 (SDC), to calculate continuity using the continuity for physician formula. We used t tests to compare mean continuity rates between the RDS and SDC periods. In June 2022, faculty and residents were emailed a nine-question survey about SDC. Results: Adherence to the SDC model ranged from 65% to 76%. Postgraduate year (PGY) 3 residents’ continuity increased significantly (P<.001) from 44% (RDS) to 56% (SDC), while PGY2 residents’ continuity increased, nonsignificantly, from 38% to 43%. Among those that completed the survey, 94% of residents and 78% of faculty were in favor of SDC. Conclusions: We demonstrated that SDC is feasible and well received by residents and faculty alike. Continuity was highest for PGY2 and PGY3 residents during the SDC period. Predictable clinic schedules have the potential to improve continuity in family medicine residency clinics and may improve physician well-being.