This prospective cohort study compared women participating in CenteringPregnancy® group prenatal care (N = 120) with those in standard individual care (N = 221) to determine if participation in Centering was associated with improvements in perceived social support and quality of life, with concomitant decreases in screens of postpartum depression and improvements in breastfeeding rates. Participants completed surveys at the onset of prenatal care, in the late third trimester and in the postpartum period. Centering participants had higher scores of perceived social support from friends after participating in group care (p < 0.05) with associated improvements in quality of life in the psychological and relational domains (p < 0.05) compared to standard care participants who showed higher scores of perceived support from family (p < 0.05) but did not show concomitant improvements in quality of life. This did not translate to any significant difference in scores on postpartum depression screens but was associated with improvements in breastfeeding continuation rates among Centering participants in the postpartum period. This study indicates that Centering care is associated with improved perceptions of peer social support with associated improvements in quality of life and higher rates of continued breastfeeding.
Background:The government is encouraging the adoption of electronic medical records (EMRs). There is little information about using EMRs in the obstetric literature and none about using them in family medicine residencies. Our purpose was to assess if using an EMR was associated with improvement in the ordering and availability of prenatal tests.Methods: A retrospective chart review comparing the rate at which prenatal laboratory values were present on the chart, ordered on time, and recorded on a prenatal flow sheet.Results
Introduction: 2011 Accreditation Council for Graduate Medical Education (ACGME) work hour rules prompted concerns regarding potential negative impacts on patient care and resident education. We were interested in resident reaction to call restructuring and night Toat (NF) in a family medicine residency over 3 years following implementation of the 2011 rules.
These findings suggest that family practice residencies do not add to the direct inpatient costs of teaching hospitals, and in certain instances may even reduce hospital patient care costs. In times of increasing cost consciousness in health care and medical education, this provides a further rationale for institutions to sponsor graduate training in family practice.
No one knows for sure how long it takes to train a competent family physician. Family medicine, internal medicine, and pediatrics all require a 3-year residency before board certification in the United States. In Canada, only 2 years are required for family medicine board certification. Before 1969, general practice training in the United States was also only a 2-year curriculum before it was extended to 3 years as it evolved into family medicine. Health care has changed dramatically since 1969, with an explosion of medical knowledge and new technology that challenges us to once again question the proper length of a family medicine residency education. Marguerite Duane, Larry Green, Susan Dovey, and their coauthors try to answer this question in 2 articles on the length and content of family medicine residency training. 1,2The first, published in 2002, was based on a simultaneous survey of family medicine residency directors, first-year residents in the programs of the sampled residency directors, and family physicians due for their first board recertification examination. The survey solicited their opinions about the length and content of family medicine residencies. The majority of respondents in each group favored the current 3-year model. However, 27% of residency directors, 32% of first-year residents, and 28% of recertifying family physicians supported adding a fourth year to residency training. All 3 groups agreed that the breadth and depth of the residency experience would have to be expanded to justify adding another year, but the only topics that they agreed warranted more training were officebased procedures and sports medicine. The most significant barriers they identified to adding a fourth year to residency education included the lack of agreement that it is necessary, financing the expansion, and lost opportunity costs for residents during the fourth year. For the follow-up study, Duane et al chose to resurvey only the resident group from their 2002 article. As first-year residents, this group had the largest percentage of respondents interested in a 4-year residency (32%), and they wanted to determine whether their opinions had changed as thirdyear residents. One of the weaknesses of the follow-up study is that it includes responses from only 280 of the original 533 respondents from the 2002 study. The responders in the current study have similar demographics compared with those lost to follow-up and the nonresponders. However, the current study's findings represent only 52.3% of the 2002 study's first-year resident responders, and only 28% of the 997 first-year residents initially surveyed for the 2002 study. Apart from this limitation, the follow-up study found remarkable consistency from first to third year in the residents' opinions concerning the length of their training. 2As third-year residents, 37% of the respondents favored 4-year family medicine residency programs compared with 32% as first-year residents. The third-year residents supported a fourth year of training because of the broad...
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