Historic source document from the Coastal Research Group local archive.
Internet Based Annotated Bibliography on the Outcomes Studies of Family Practice Residency Graduates PUBLICATION INFORMATION Schneeweiss, Ronald; Ellsbury, Kathleen; Montano, Daniel; Gore, Ed; and Gordon, Katherine C. "Hospital privileges for family physicians: documentation of family practice residents experiences in training" J FAM PRACT 26: 178-184, Feb 88 TYPE OF STUDY Regional LOCATION Department of Family Practice, University of Washington, Seattle, Washington GRADUATE YEARS COVERED 1979 and 1983 graduates NUMBER OF GRADUATES SURVEYED 77 graduates sent forms, 44 returns for 56 percent response rate.
TYPES OF DATA ANALYZED PRACTICE SETTING TYPES No PATIENT ENCOUNTER TYPES No OFFICE RECORD SYSTEM TYPES No PRACTICE SELECTION CHARACTERISTICS No ADEQUACY OF TRAINING No COMMUNITY SIZE No SIZES OF PROGRAMS No STATE AND REGIONAL RETENTION – No 5.
ABSTRACT Of the 33 regional network graduates in 1979 and 44 graduates in 1983, 56 percent responded to a questionnaire regarding use and values of the AAFP log-card system to document privileges while in training.
This study tabulated how log-card system was used by graduates to obtain hospital privileges and what areas of documentation were most important to graduates.
Eight areas were identified as having the highest frequency level for documentation and were vaginal delivery, cesarean section, internal fetal monitor, pediatric ventilator, pudendal or paracervical block, gastrointestinal hemorrhage, external fetal monitor, fetal distress and toxemia.
Size of hospital where privileges requested indicated that hospitals between 50 and 199 beds were more likely to require documentation than other size hospitals.
Authors concluded that residents were more likely to document experiences in obstetrics, critical care, surgery and trauma but did not answer the question of what residents should document but did recommend that faculties advise residents on a limited number of problems/procedures for log-card documentations.
Overall, they felt the AAFP log-card system, and the procedures developed by the network, was an effective program, and was found useful by graduates.
An appendix listing procedures by frequency of resident documentation will be especially useful to programs defining what residents should or should not document.
Although the response rate was low, the authors did an excellent job of limiting their remarks.
The study is an excellent example of relating training systems to graduate outcome needs. [TCB89] PUBLICATION INFORMATION Hansel, Nancy K.; Nixon, Sam A.; Oser, George T.; AND Zenner, George O. "Choice of practice location by Texas family physicians" J MED EDUCA 63:191-193, Mar 1988 TYPE OF STUDY State LOCATION Department of Family and Community Medicine, University of Texas Health Science Center, Houston, Texas GRADUATE YEARS COVERED Not applicable NUMBER OF GRADUATES SURVEYED Not applicable TYPES OF DATA ANALYZED PRACTICE SETTING TYPES No PATIENT ENCOUNTER TYPES No OFFICE RECORD SYSTEM TYPES No PRACTICE SELECTION CHARACTERISTICS Yes ADEQUACY OF TRAINING No COMMUNITY SIZE No SIZES OF PROGRAMS No STATE AND REGIONAL RETENTION – No 5.
ABSTRACT 731 of the 1,946 members of the Texas Academy of Family Physicians were surveyed yielding a 38 percent response rate.
They were questioned regarding factors that influenced their practice location selection.
They were also grouped by SMSA or non-SMSA location.
The three most important personal variables affecting choice of location were acceptability to spouse, quality of education for children, and overall life-style of the area.
The three most important professional variables were adequate hospital facilities, availability of contact with physician colleagues, and availability of consultants.
When comparing rural versus urban family physicians, differences were found.
Two important differences were that urban physicians valued cultural advantages of location over rural physicians and rural physicians valued availability of consultants over urban physicians.
The study determined that rural-reared family physicians were more likely to practice in rural locations than were urban-reared family physicians.
The small return rate for this study is the major weakness as the general "rule of thumb" for survey rates is a 70 percent response if the information is to be valid.
However, due to the large population size, this criterion may not be as critical in terms of study design as for smaller populations.
Also, the authors related their findings to other studies with similar findings. [TCB89] PUBLICATION INFORMATION Dale, David C.; Belknap, Benjamin H.; Chase, John D.; and Haviland, James W. "The regional graduate medical program of the University of Washington" J MED EDUCA 63:347-355, May 88 TYPE OF STUDY Regional LOCATION Department of Family Practice, University of Washington, Seattle, Washington GRADUATE YEARS COVERED 1971 to 1986 NUMBER OF GRADUATES SURVEYED N/A TYPES OF DATA ANALYZED A.
PRACTICE SETTING TYPES No PATIENT ENCOUNTER TYPES No OFFICE RECORD SYSTEM TYPES No PRACTICE SELECTION CHARACTERISTICS No ADEQUACY OF TRAINING No COMMUNITY SIZE No SIZES OF PROGRAMS Minimal data STATE AND REGIONAL RETENTION Yes, but very general 5.
ABSTRACT The WAMI program of the University of Washington had 77 percent of the residency positions in the region and involved more than 30 hospitals and clinics.
The family practice residency network program of the University was a part of the regional approach.
58% of the residents completing training during this period were family physicians, general internists, and general pediatricians.
The article discusses the total effort with little specific information on family practice, except that the family practice residency network was funded separately from the other programs.
A comparison of the two financial systems shows that the family practice residency network program generated 50 percent of its income from patient care revenue while the other programs only generated 16 percent of its income from patient care revenue.
For family practice, the important contribution of this article is the paucity of University support for the family practice residency network when compared to other residency programs in the WAMI network.
Also, the authors complained about the high cost of family practice centers in the system.
This perspective, from a deans point-of-view, is valuable in grasping the mind-set of contemporary university concerns as opposed to family practice educational priorities.
However, the study sheds little light on graduate follow-up. [TCB89] PUBLICATION INFORMATION Strelnick, A.
H.; Bateman, William B.; Jones, Clara; Shepherd, Saundra D.; Massad, Robert J.; Townsend, Janet M.; Grossman, Richard; Korin, Eliana; and Schorow, Mitch. "Graduate primary care training: a collaborative alternative for family practice, internal medicine, and pediatrics." ANN INTERN MED, 109:324-334, Aug 88.
TYPE OF STUDY Regional LOCATION Residency Program in Social Medicine, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, New York GRADUATE YEARS COVERED 1970 to 1985 NUMBER OF GRADUATES SURVEYED 218 graduates surveyed but authors did not report return, although it appears data are based on 138 returns which would be a 63.3 percent return rate.
TYPES OF DATA ANALYZED PRACTICE SETTING TYPES No PATIENT ENCOUNTER TYPES No OFFICE RECORD SYSTEM TYPES No PRACTICE SELECTION CHARACTERISTICS No ADEQUACY OF TRAINING No COMMUNITY SIZE No SIZES OF PROGRAMS Yes STATE AND REGIONAL RETENTION – No 5.
ABSTRACT This interdisciplinary residency program is described well by the authors.
Organizational charts and public clinics and programs nationally illustrate the evolution of social health programs.
Data on graduates are limited to participation of underrepresented minorities and women among graduates, characteristics of graduate practices regarding those who remain as generalist, those serving primarily poor and working class patients, team practice, urban practice and board-certification.
Analysis by specialty, e.g., family medicine, internal medicine, and pediatrics is included.
Family practice is shown to be positive on the above characteristics when compared to pediatrics and about equal with internal medicine.
An extensive list of references is well worth the copy costs for a reprint.
Although the emphasis is not central to family practice dogma, the authors do an excellent job of presenting the social medicine point-of-view and the role of family practice residency training in their institution as part of that role.
Major policy positions are taken and defended based on the acitivities of their graduates in serving needy populations.
The article suffers from poor description of research design parameters, e.g., how data were collected, and response rates. [TCB89] PUBLICATION INFORMATION Rabinowitz, Howard K.; "Evaluation of a selective medical school admissions policy to increase the number of family physicians in rural and underserved areas" N ENG J MED 319:480-486, Aug 25, 88.
TYPE OF STUDY Medical School LOCATION Department of Family Medicine, Jefferson Medical College, Philadelphia, Pennsylvania GRADUATE YEARS COVERED 1982 to 1985 NUMBER OF GRADUATES SURVEYED 843 medical students who graduated between 1978 and 1981 were studied to determine practice characteristics.
The return rate was 843 of 890 for a 94.7 percent return rate.
TYPES OF DATA ANALYZED PRACTICE SETTING TYPES Yes PATIENT ENCOUNTER TYPES No OFFICE RECORD SYSTEM TYPES No PRACTICE SELECTION CHARACTERISTICS No ADEQUACY OF TRAINING No COMMUNITY SIZE Yes, by county as SMSA or non-SMSA SIZES OF PROGRAMS No STATE AND REGIONAL RETENTION – No 5.
ABSTRACT This longitudinal study investigated the impact of Physician Shortage Area Program [PSAP] instituted by Jefferson Medical College in 1974 on eventual practice locations of graduates comparing PSAP participants with non-participants. (PSAP participation was restricted to 24 students per class beginning in 1978 where the total class enrollment was 223 students.
PSAP graduates were almost five times as likely to practice in rural areas (37.8 to 42.2 percent vs.
10.0 to 11.8 percent), and two to four times as likely to practice in areas where there is a physician shortage (26.7 to 40.0 percent vs.
9.2 to 11.2 percent).
They were seven to ten times as likely as their peers to combine a career in family medicine with practice in a rural or underserved area (24.4 to 31.1 percent vs.
3.1 to 3.9 percent, thereby fulfilling the goals of the PSAP (All differences were statistically significant.) The study concludes that the medical school admission policy can have a major impact on specialty choice and practice locations of physicians, especially in providing physicians for family practice and who will serve in medically underserved areas.
A major problem of the study was that it did not count SMSA family physicians serving in urban, medically underserved areas.
The importance of this study is the positive role undergraduate family practice programs play in specialty selection and eventual practice patterns. [TCB89]
Source file: coastal/crgtemp/fpfus3.html. Historic from local Coastal Research Group archive files during the DEV archive reorganization.