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农村家庭医学住院医师培训新项目和新方案的相关建议

Insights for New and Developing Rural Family Medicine Residency Programs.

机构信息

Frank H. Netter MD School of Medicine, Quinnipiac University, North Haven, CT.

Department of Medical Sciences Frank H. Netter MD School of Medicine, Quinnipiac University, Hamden, CT.

出版信息

Fam Med. 2023 Feb;55(2):81-88. doi: 10.22454/FamMed.2022.810495. Epub 2023 Jan 7.

Abstract

PURPOSE

Rural family medicine residency programs (RFMRPs) encounter unique hardships that threaten their sustainability and efficacy despite their recent success at addressing the rural physician shortage. The aim of this study was to explore strategies employed by RFMRP program directors from across the United States to strengthen their programs in the context of evolving paradigms in graduate medical education (GME).

METHODS

The authors conducted a qualitative semistructured telephone interview with 19 program directors of RFMRPs in June and July of 2020. Interviews were audio-recorded, transcribed verbatim, and analyzed using thematic content analysis.

FINDINGS

Two major themes emerged: (1) community enrichment and (2) the ability to evolve to meet demands. Community enrichment had five subthemes: evaluate local resources, prioritize community buy-in, design a robust continuity clinic, identify or cultivate a local physician champion, and support faculty and physician preceptors. Programs evolving to meet demands had four subthemes: frequently revisit program mission to align with scope of family medicine, redefine expectations in medical education, integrate longitudinal experiences, and implement innovation in curriculum design.

CONCLUSIONS

Community enrichment and programs' ability to evolve to meet demands are important attributes of a successful RFMRP. Our findings highlight strategies utilized by RFMRPs to help meet the needs of the changing landscape of rural family medicine GME and help identify best practices for developing RFMRPs.

摘要

目的

尽管农村家庭医学住院医师培训计划(RFMRP)最近在解决农村医生短缺问题方面取得了成功,但仍面临着一些独特的困难,这些困难威胁着它们的可持续性和效果。本研究旨在探讨美国各地 RFMRP 项目主任在研究生医学教育(GME)不断变化的模式背景下,为加强其项目而采用的策略。

方法

作者于 2020 年 6 月至 7 月对 19 名 RFMRP 项目主任进行了定性半结构式电话访谈。访谈进行了录音,并逐字转录,然后使用主题内容分析法进行分析。

结果

出现了两个主要主题:(1)社区充实和(2)能够适应需求而发展。社区充实有五个子主题:评估当地资源、优先考虑社区参与、设计强大的连续性诊所、确定或培养当地医生拥护者以及支持教师和医生导师。为适应需求而发展的计划有四个子主题:经常重新审视计划使命以适应家庭医学的范围、重新定义医学教育中的期望、整合纵向体验以及在课程设计中实施创新。

结论

社区充实和计划适应需求的能力是成功的 RFMRP 的重要特征。我们的研究结果强调了 RFMRP 用来帮助满足农村家庭医学 GME 不断变化的需求的策略,并有助于确定开发 RFMRP 的最佳实践。

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