Teaching prenatal ultrasound to family medicine residents

Prenatal ultrasound is a powerful diagnostic tool, but there has been little research on how to teach ultrasound to family physicians. The available evidence supports teaching through didactics followed by supervised scanning. Didactic topics include physics and machine usage, indications, fetal biometry, anatomic survey, practice management, ethical issues, and resources. Supervised scanning reinforces the didactic components of training. A "hand-on-hand" supervised scanning technique is recommended for the transmission of psychomotor skills in these sessions. Curricula for teaching ultrasound should include information on which residents will be taught prenatal ultrasound, who will teach them, how to create time for learning ultrasound skills, and how to test for competency. The literature suggests that competency can be achieved within 25-50 supervised scans. Measures of competency include examination and qualitative analysis of scanning. Competency-based testing needs further development because no uniform standards have been established.     

The effect of a simple educational intervention on interest in early abortion training among family medicine residents

OBJECTIVES: We aimed to assess the effect of an educational intervention on the interest in and support for abortion training among family medicine residents. METHODS: We conducted a cross-sectional survey before and after an educational lecture on medical and surgical abortion in primary care among 89 residents in 10 New Jersey family medicine programs. RESULTS: Before the lecture, there was more interest in medical abortion training than surgical abortion. Resident interest in surgical abortion and overall support for abortion training increased after the educational intervention (p<.01). CONCLUSIONS: Efforts to develop educational programs on early abortion care may facilitate the integration of abortion training in family medicine.     

Improving presentation skills of family medicine residents: a randomized controlled study

A randomized controlled time series design was used to evaluate the influence of an educational intervention designed to improve the presentation skills of family medicine residents. Each resident gave three presentations, with the educational intervention occurring between the first and second presentations in the experimental group, and between the second and third presentations in the control group. The presentations were evaluated using a standardized format. The experimental group, in contrast to the control group, showed significant improvement in scores for all major criteria after receiving the educational intervention between presentations 1 and 2. This improvement continued with repetition between presentations 2 and 3. After receiving the educational intervention between presentations 2 and 3, the control group also demonstrated significant improvement in several key areas. We conclude that an educational intervention can improve the presentation skills of family medicine residents. Education coupled with repeated opportunities for presentation will produce a greater improvement in resident performance than repeated presentations alone.     

片医制社区医疗健康管理效果观察

目的观察片医制社区医疗健康管理效果。方法经八路社区糖尿病患者480例以片医片护一结合的形式进行社区医疗健康管理,问卷调查入组时及实施健康管理后6个月其自我管理状况。结果对社区糖尿病人群开展糖尿病健康管理后,其自我管理状况显著优于教育前,差异有统计学意义（P〈0．05）。结论通过片医片护一结合长期系统的糖尿病健康教育,可以提高患者掌握糖尿病知识的程度和治疗的依从性。     

Medical errors: Preliminary results of a study among Turkish family medicine residents

Abstract

Background: Regular use of evidence-based medicine (EBM) among general practitioners (GP) is insufficient.

Objective: To analyse whether knowledge and attitudes about EBM can be improved among mentors in general practice by involving sixth-year medical students as academic detailers.

Methods: An interventional non-randomized before-and-after study included 98 GPs (49 in the intervention group of mentors and 49 controls) and 174 medical students attending family medicine clinical rotations. A telephone survey on knowledge and attitudes towards EBM was conducted among participating physicians before, and six months after the rotation. During the rotation, each mentor chose two cases from real life, and the students’ task was to form an answerable clinical question, find the evidence-based answer and to write a brief report. The mentor reviewed the report and discussed it with the student.

Results: Students’ EBM detailing intervention led to significant improvement in knowledge and attitudes about EBM in the intervention group of mentors in general practice compared to control GPs (relative increase in knowledge was 20 ± 46.9% vs 6 ± 12.1%, respectively; P = 0.042). Among participants with Ph.D. or specialization in family medicine, the observed effects of the intervention were similar as in the total sample, and statistically significant, but not in the group of participants with neither scientific degree nor specialization in family medicine.

Conclusion: Knowledge and attitudes of GP mentors towards EBM can be improved by involving medical students as academic detailers. Further studies should explore the effectiveness of this method among GPs that are not mentors, and who do not have a specialization or research degree.     

Neonatal circumcision model and competency evaluation for family medicine residents

Neonatal circumcision is one of the most common procedures performed by family physicians and is a recommended procedure for resident training. Few models or simulators exist. A model of neonatal genitalia was constructed using a cocktail wiener covered by a surgical glove finger. A competency checklist was used to review the steps of the procedure. Posttest/pretest-posttest assessment found significant improvement in knowledge and comfort in three groups of learners. Ninety percent of participants were deemed competent in all 15 areas of the checklist. The easily replicable model was felt to reasonably model the neonatal genitalia for circumcision training.