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Item 2023 Indiana Family Medicine Residencies Exit Survey Report(2023-11) Kochhar, Komal; Ho, Monling; Khan, MariamIn order to plan effective healthcare workforce development initiatives, it is important to understand the reasons why Indiana family medicine residents choose to practice in specific locations. Thus, having a better understanding of the factors that influence how residents choose a practice location will help improve efforts to recruit and retain family medicine physicians in areas of need within the state. The 2023 Indiana Family Medicine Residencies Exit Survey© marks the 12th consecutive year of determining what these physicians plan to do after graduation; and, for those planning to primarily provide clinical care, to determine where they plan to practice. In addition, the survey also obtained overall feedback on the residents’ training and their program’s curricula, as well as ideas and suggestions for improvement.Item Enhancing resident scholarship with a library partnership.(2022-04-28) Stumpff, Julia C.; Delbridge, Emilee J.; Vetter, Cecelia J.Introduction: The ACGME requires that residents understand and participate in scholarly activities in order to meet graduation requirements. Although library support had historically been available to residents, there was no evidence that this resource was utilized in the past. The Family Medicine residency utilizes the library partnership in order to educate residents about the most effective methods to search for relevant literature and provide residents with an overview of pertinent library resources, including how to access full-text articles. A couple of years ago, the presenters developed a curriculum to provide residents with education on library resources, so that residents could effectively complete their scholarly activities by utilizing evidence-based literature. Study Objective: The study objective was to gather data from residents who have received education on IUSM library resources in order to describe what residents learned and what they identify are future educational needs. Methods: During 2 academic years, 23 second-year residents attended a one-hour library instruction session while on their scholarship rotation. Thirteen residents attended a session during October – February of the first academic year, and 10 residents attended a session during August – November of the second academic year. The goals for the session were that residents would: learn the basics of searching for literature on a topic, become familiar with library resources, and begin searching for literature related to their individual scholarly projects. This cross-sectional study used an 8-question survey given to all second and third-year residents at the end of the second year that the library instruction sessions were implemented. Results: Thirteen of the 23 residents responded to the survey (57%). Five of the respondents (38%) were second-year residents, and 8 of the respondents (62%) were third-year residents. All 13 residents responded that they learned about library resources during the session, and 11 residents said they learned the basics of searching for literature on a topic. Eight residents responded that they learned how to get access to full-text articles. Seven residents also responded that having a second session after the project is further along would be useful to them, and 6 residents responded that citation information would be useful for the librarians to cover. Conclusions: Results of the cross-sectional survey indicated that the goal of increasing residents' knowledge about library resources was met. As a result of the library instruction, residents used what they learned when searching for articles and when accessing the full-text of articles. Feedback from the survey suggested that an additional session and more instruction on citation information would be helpful. Future scholarship sessions will be modified to include an introduction to citation management software, and an additional session will be scheduled during the third core to focus more in-depth on citation management software, keyword searching, and any other questions residents may have. Pre-& post-tests to evaluate residents' change in confidence when literature searching and managing citations during their scholarly project will be implemented.Item Integration in a residency scholarship curriculum: Successes and challenges in a family medicine program(Medical Library Association, 2024-05-20) Stumpff, Julia C.; Vetter, Cecelia J.; Delbridge, Emilee J.In early 2020, a Family Medicine (FM) faculty member reached out to request library instruction for second-year residents (PGY2) working on scholarly projects. Tailored library sessions were integrated into the second-year residency curriculum. Two years after implementing this program, 23 residents were surveyed to understand what residents learned and what training they still needed to assist them with their scholarly projects. Librarians and the FM faculty member then added citation management content to the curriculum. A research study to measure the impact of the library interventions on resident’s library research skills was piloted. Pre-test data showed that the FM residents lacked knowledge in locating library resources and were not comfortable with citation management tools. Post-test data showed that most residents were clearer about where to search for sources for their research, were more comfortable using citation managers, and better understood how to use Boolean terms.Item Staying Put or Moving Out? Analyzing Post-Residency Decisions of Family Medicine Physicians in Indiana: A 12-Year Survey Study(2024-04-26) Ho, Monling; Potter, Maddie; Kochhar, Komal; Wallach, PaulBackground: Understanding the factors influencing the practice location decisions of family medicine residents is critical for healthcare workforce planning. This is particularly pertinent given the persistent challenge of attracting medical school graduates to primary care and ensuring the distribution of primary care physicians to underserved areas. Study objective: This study aims to investigate the factors determining the practice choices of Indiana family medicine residents upon completing their residency, with the purpose of informing state initiatives to effectively recruit and retain physicians in areas of need. Methods: Since 2012, an annual cross-sectional survey has been administered to all final-year family medicine residents in Indiana (including both IUSM and non-IUSM programs), to gather information on their post-graduation plans and the reasons behind their practice location choices. Geographical Information Systems software was used to display the family medicine residents’ intended practice locations. The study has received exempt approval from the Indiana University Institutional Review Board and has analyzed data spanning twelve years. Results: The survey revealed a near-even gender split among respondents (55% male, 45% female), with 11% belonging to underrepresented groups in medicine. One-half reported Indiana as their hometown. 31% graduated from a medical school in Indiana, with 22% from IUSM and 9% from Marian University College of Osteopathic Medicine. The majority were MDs (63%), while 37% were DOs. One-half had educational debt exceeding $250,000. Most respondents felt “fully competent” in ACGME competency areas (91%), were trained to serve rural and underserved populations (86%), felt “fully competent” to serve rural and underserved populations (78%), and had the opportunity to participate in quality improvement/patient safety projects as well as to serve on committees during their training (91%). A majority “strongly agreed” or “agreed” that the quality of their program (87%), their faculty (83%), and their peers (88%) had exceeded expectations. Wellness was rated highly, with 76% indicating “excellent” or “very good” overall wellness, although 44% reported burnout. Most “strongly agreed” or “agreed” that their personal and professional lives were well-balanced (70%) and that they had resources available to maintain their wellness (81%). For practice location, 67% planned to stay in Indiana, 31% intended to leave the state, and 2% were undecided. Proximity to family (49%) and reasonable cost of practice in the state (49%) were the top reasons for choosing Indiana, while proximity to their family (50%) or their spouse’s family (43%) were cited as reasons to practice elsewhere. Conclusion: This study demonstrates the success of Indiana’s family medicine residency programs in maintaining a strong family physician workforce within the state over the past 12 years.Item Supporting the GME scholarship requirement: A pilot study of two library interventions(2023-04-28) Stumpff, Julia C.; Vetter, Cecelia J.; Delbridge, Emilee J.Introduction ACGME continues to require Family Medicine (FM) residents to complete two Scholarly Projects.1 To increase residents’ library skills in searching for and identifying high-quality literature, a pilot study was created to determine the training needs of FM residents and the effectiveness of the targeted training. In the first year, residents were provided with training on efficiently locating targeted and relevant articles and were introduced to the myriad of library resources available. Based on feedback from the 2021-2022 intervention, librarian liaisons developed an asynchronous educational intervention focused on citation management software (e.g., EndNote, Mendeley). The intervention addressed EndNote skills and the utility of using EndNote to create a library of citations and to easily cite that literature in their scholarly presentations. This pilot study assessed differences in residents' knowledge, usage of resources, and confidence before and after library interventions. [Fig. 1] Hypothesis Family Medicine residents' knowledge and utilization of library resources and citation management tools will increase after the library interventions. Methods To capture Family Medicine (FM) residents' knowledge and confidence about their scholarship projects, library liaisons created a pretest and a posttest, each with nine questions. Both tests were based on the Research Readiness-Focused Assessment Instrument developed by Rui Wang and outlined in the article “Assessment for One-Shot Library Instruction: A Conceptual Approach”2 Wang’s single-session assessment instrument was adapted to fit the multiple-session library intervention and questions specifically about citation management were added. Pre and posttests asked residents about their comfort using a citation manager and their level of confidence in completing the scholarship project. It also assessed database searching skills. Residents completed the pretest at the beginning of the first library intervention and the posttest directly after the second library intervention. The first library intervention was in-person in a library classroom where database searching skills were taught, and library resources were highlighted. The second library intervention was a 15-minute video about citation management and how to use EndNote software. QR codes were included in both library interventions which allowed residents to access the pretest and posttest on their phone. Data was collected and analyzed. Results Ten of 13 Family Medicine residents completed the pretest in 2022 before attending the first library session. Eleven of 12 remaining Family Medicine residents completed the posttest in 2023 after watching a 15-minute video on citation management tools and on EndNote, specifically. Pretest data confirmed: *residents lack knowledge in locating library resources. [Fig. 2] *residents are not comfortable with citation management tools. *some residents understood how to use Boolean terms to narrow and expand search results in PubMed. [Fig. 3] Posttest data showed: *residents were clearer about where to search for sources for their research. [Fig 2] *all residents understood how to use Boolean terms to narrow and expand search results in PubMed. [Fig. 3] *residents were more comfortable using citation managers. [Fig. 4] *residents identified more precise and suitable resources for scholarly research (ex. PubMed mentioned by 3 residents in the pretest and mentioned by 7 residents in the posttest) [Table 1] Conclusions These educational interventions provided residents with tools to meet the ACGME scholarship requirements. The majority of PGY-2 residents found the addition of a citation management session to provide useful information. Next Steps Seek IRB approval to conduct further research on this topic. Modify pre and posttests to only measure library resource knowledge and skills. Adjust timing of the 2nd library intervention to better fit into residents’ schedules. References Accreditation Council on Graduate Medical Education. ACGME Program Requirements for Graduate Medical Education in Family Medicine. June 12, 2022. Wang R. Assessment for one-shot library instruction: A conceptual approach. portal: Libraries and the Academy. 2016;16(3):619-48.Item Use of Artificial Intelligence Program to Increase Resident Confidence and POCUS Use at the Bedside(2024-04-26) Wilcox, James; Lobo, Daniela; Hernandez, Reuben; Holley, Matthew; Renshaw, ScottIntroduction: Point of Care Ultrasound (POCUS) education continues to increase in undergraduate and graduate medical education, mostly fueled by clinical usefulness and increasing graduate medical education requirements. Many schools are now teaching POCUS as a core part of the curriculum. However, with the sudden rush of POCUS education, one barrier often identified in the literature is a lack of trained faculty to educate residents and medical students. Study Objective: Our team at the Family Medicine Department recruited an artificial intelligence program developed by Global Ultrasound Institute to assist POCUS instructors with resident ultrasound education. The research project would use AI programming and learning to allow residents to access timely answers to questions at the bedside while on rounds, when a trained POCUS instructor might not always be present. Since POCUS instructors cannot be available for every bedside patient examination in the hospital or residency clinic, this AI program would provide answers to needed bedside questions to give residents more confidence with performing more POCUS evaluations. Methods: We would deploy the AI program for interns who have completed at least 6 months of POCUS training and residents who had completed prior intern POCUS training. This program would be available on smart phone devices for when rounding in adult medicine, pediatrics, OBGYN, and in the outpatient residency clinic. Residents will have 24/7 access to a smart AI who will answer questions about POCUS technique, indications for use, interpretation questions, and many more. The program will give residents a quick and focused answer, as well as access to resources for further study if needed. Resident POCUS use will be tracked with the Butterfly IQ academy, as well as with resident procedure logging. Results: Since this is a very new program and relationship with Global Ultrasound Institute, no results are currently available. We anticipate preliminary results will be available by the presentation date in April. Conclusions: Artificial Intelligence is changing the way medical education is approached in the United States and the world. This particular program will allow residents to have access to timely answers to their POCUS practice questions at the bedside, while on rounds. We anticipate this will allow residents the opportunity to use the ultrasound devices for more cases and scenarios, as well as have improved confidence in their ultrasound acquisition abilities, with the support of the AI Education Assistant.