Clinical and Cultural Issues in Caring for Deaf
People
Steven Barnett, MD
Background and Objectives: The
clinical practice of family medicine is increasingly cross-cultural.
Promoting culturally sensitive and competent health care is
one of the goals of medical educators in guiding medical students
and residents, as well as designing continuing education for
family physicians. Working with minority communities is essential
to meet that goal. The Deaf community is a linguistic and
cultural minority group that is often overlooked. Working
with the Deaf community to help develop cultural competency
and sensitivity has potential benefits. This article introduces
some of the sociocultural experiences of deafness and their
relevance in health care settings.
Special Series
(Fam Med 1999;31(1):17-22.)
Retention
of Family Medicine Faculty Development Fellows in Academic
Medicine
Francis P. Kohrs, MD, MSPH; Arch G. Mainous
III, PhD
Objective: This study measured the retention
of family medicine faculty development fellows in academic medicine.
Methods: Surveys were sent, in two stages, to 1) fellowship
program directors and 2) fellows. These surveys were about full-time
faculty development fellowships with new or continued Title
VII funding during the interval of 1993–1996. Retention as faculty
was the primary outcome. Likelihood of leaving academics and
service in a federally designated medically underserved area
were secondary outcomes.
Results: The fellowship program directors survey produced
an 88% response rate and identified 105 alumni. The survey of
fellows yielded a response rate of 73% (n=77). The retention
rate of these newly graduated family medicine fellows in academic
positions was 75% (n=58). A total of 37% (n=21) of alumni in
full- and part-time teaching positions reported being likely
to leave their current position within the next 2 years.
Conclusions: Retention rates of newly graduated family
medicine fellows in academic positions are similar to rates
reported in the 1980s. This group anticipates a high job turnover
within the next 2 years.
Educational Research and Methods
(Fam Med 1999;30(1):23-7.)
Variability
in the Learning Experiences of Family Practice Residents During
an Obstetrics Rotation
Alicia M. Weissman, MD; Jeffrey D. Dawson,
ScD; Dianna L. Fox
Background and Objectives:
Residency rotations do not necessarily provide the same clinical
experience to each resident. This study quantified and explained
the variability in participation in deliveries by family practice
residents during an obstetrics rotation at a community hospital.
Methods: We collected prospectively completed resident
experience logs from 17 residents and information from the
hospital Summary of Delivery forms for 1,166 deliveries. The
data were analyzed using methods to account for within-supervisor
correlation.
Results: Participation and delivery rates varied markedly.
In stepwise conditional regression analysis, resident participation
in deliveries was positively associated with prior resident
involvement during the labor and negatively associated with
occurrence of the delivery on the night shift and with male
gender of the resident. Resident performance of delivery was
positively associated with non-instrumented vaginal delivery,
prior resident involvement during the labor, and patient multiparity
and negatively associated with male resident gender.
Conclusions: We found substantial variability in resident
experience and identified several factors associated with
increased resident experience. Variability of experience among
residents in clinical rotations should be assessed to ensure
that all residents receive adequate training.
Educational Research and Methods
(Fam Med 1999;31(1):28-33.)
The
Role of the Chair’s Spouse in Academic Departments of Family
Medicine
Anita D. Taylor, MAEd
Background and Objectives: Family medicine
has the highest percentage of unfilled budgeted faculty positions
of all clinical and basic science departments. To successfully
recruit and retain academic leaders, personal and professional
issues need to be recognized and valued. This study reports
the results of a national survey of chairs and an important,
often overlooked factor in recruitment and retention—the spouse
of the department chair.
Methods: Questionnaires were sent to 107 chairs of
academic departments or divisions of family medicine and their
spouses.
Results: There was a usable response rate of 86%, and
data from 85 questionnaires (79%) were analyzed. The spouses’
highest role priority was family, perhaps reflecting their
relatively young mean age of 48.6 years. There was a statistically
significant correlation between those who were “oriented”
to the role of chair’s spouse and a higher level of participation
in departmental activities. Data are also reported on spouse
role satisfaction, expectations, and factors in deciding to
stay or leave their current location.
Conclusions: The results suggest that with the increased
competition for family physicians in a multitude of practice
settings, search committees for family medicine department
chairs need to be innovative and attentive to personal as
well as professional factors in recruiting and retaining future
and current department chairs. It would be prudent to acknowledge
the role of the spouse in decisions concerning job selection
and satisfaction.
Educational Research and Methods
(Fam Med 1998;31(1):34-8.)
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