Attributes Affecting the Medical School Primary Care Experience
ABSTRACT Favorable primary care (PC) experiences might encourage more medical students to pursue generalist careers, yet academicians know little about which attributes influence the medical school PC experience. The authors sought to identify such attributes and weight their importance.
Semistructured interviews with 16 academic generalist leaders of family medicine, general internal medicine, and general pediatrics led to the development of a Web-based survey, administered to a national sample of 126 generalist faculty. Survey respondents rated (on a nine-point Likert-like scale) the importance of each interview-generated PC medical school attribute and indicated (yes/no) whether outside experts' assessment of the attributes would be valid. The authors assessed interrater agreement.
Interview thematic analysis generated 58 institutional attributes in four categories: informal curriculum (23), institutional infrastructure (6), educational/curricular infrastructure (6), and specific educational experiences (23). Of these 58, 31 (53%) had median importance ratings of >7 (highly important). For 14 of these (45%), more than two-thirds of respondents indicated external expert surveys would provide a valid assessment. Of the 23 informal curriculum attributes, 20 (87%) received highly important ratings; however, more than two-thirds of respondents believed that external expert survey ratings would be valid for only 4 (20%) of them. Strong agreement occurred among respondents across the generalist fields.
Academic generalist educators identified several attributes as highly important in shaping the quality of the medical school PC experience. Informal curriculum attributes appeared particularly influential, but these attributes may not be validly assessed via expert surveys, suggesting the need for other measures.
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ABSTRACT: Student perceptions of day-to-day physician work life, and relationships between these perceptions and specialty choices, have not been quantitatively explored. The study's purposes were to measure student perceptions of primary care and specialist physician work life, including administrative burden, time pressures, autonomy, and relationships with patients, to determine whether senior students' perceptions vary from junior students' perceptions and to determine whether students with primary care career plans view primary care work life differently than their peers. A cross-sectional anonymous survey was offered to all students at three allopathic US medical schools between 2006 and 2008. Of 1,533 eligible students, 983 submitted usable surveys (response rate 64.1%). Students viewed the day-to-day work life of all physicians negatively but viewed primary care physician work life more negatively. Senior students viewed specialist work life more positively and primary care work life more negatively than junior students. Students planning primary care and specialist careers had similar views of primary care and specialist work life. Students have negative views of the work life of all physicians, especially primary care physicians. Students planning careers in primary care share this negative view of their future work life, suggesting that their career choices are not based on different work life perceptions.Family medicine 01/2012; 44(1):7-13.
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ABSTRACT: BackgroundThe students’ perception of working conditions in hospitals hasn’t been subject of research in Germany so far. However the perception plays an important role talking about the sustainability of working conditions. The iCept Study wants to examine the perception of medical students compared to the perception of practicing physicians.Methods/designThe perception will be investigated with a redesigned questionnaire based upon two established and validated questionnaires. The two samples built for this study (students and physician) will be chosen from members of the labor union Marburger Bund. The iCept-Study is designed as an anonymized online-survey.DiscussionThe iCept-Study is thought to be the basis of ongoing further investigations regarding the perception of working conditions in hospitals. The results shall serve the facilitation of improving working conditions.Journal of Occupational Medicine and Toxicology 02/2013; 8(1):3. DOI:10.1186/1745-6673-8-3
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ABSTRACT: The annual U.S. News & World Report (USN&WR) Primary Care Medical School (PCMS) ranking attracts considerable attention, but its measurement properties have not been published. The authors examined the short-term stability of the PCMS ranking and the PCMS score from which it derives, along with the short-term spread of schools' rankings. The authors employed published data and methods to reconstruct the 2009-2012 PCMS scores and rankings. They used mixed-effects models to assess the within-school, between-year reliability (short-term stability) of the PCMS score and ranking, yielding intraclass correlation coefficients (ICCs). They defined short-term spread as the median within-school range in ranking across the four-year study period. Reconstructed PCMS scores correlated highly with published scores all four years (Pearson correlations ≥ 98.9%). Most schools' mean annual PCMS scores were tightly clustered near the center of the score distribution. ICCs for the PCMS score and ranking were, respectively, 94% and 90%. The median difference between the best and worst ranking over the study period was 4 for the 18 schools with an average annual ranking of 1 to 20, and 17 for the other 89 schools (P < .001, Kruskal-Wallis test). The short-term stability of the USN&WR PCMS score and ranking were reasonably good. However, the short-term spread in PCMS rankings was large, particularly among schools with mean annual rankings below the top 20. The variability is greater than could be plausibly attributed to actual changes in training quality. These findings raise questions regarding the ranking's validity and usefulness.Academic medicine: journal of the Association of American Medical Colleges 06/2013; 88(8). DOI:10.1097/ACM.0b013e31829a249a