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Physicians within the family medicine workforce are the most diverse compared to other medical specialties in both primarily clinical and academic settings. Family physicians also provide care to the most diverse patients and communities across the United States. As such, research and scholarly work from family physicians on diversity, equity, inclusion, and antiracism (DEIA) can be incredibly impactful. Yet many practicing and teaching physicians are unaware of their colleagues’ scholarly DEIA work, which aims to elucidate inequities and barriers to optimal care and, importantly, to educate on ways physicians and learners can recognize and address specific needs of patients and communities marginalized by health care policies and practices. In collaboration with editors from several family medicine journals, the authors move beyond the traditional editorial space to share recent practice-changing and innovative articles, adding voice and momentum to improve DEIA efforts in all spaces where the practice and teaching of family medicine exists.

Background and Objectives: The Association of American Medical Colleges identifies telemedicine competence as an important skill for graduating medical students, but which educational methods are effective in improving student performance is unclear. We aimed to assess the impact of two educational interventions on student performance in telemedicine standardized patient encounters. Methods: Sixty second-year medical students participated in the telemedicine curriculum during their required longitudinal ambulatory clerkship. Students first completed a preintervention telemedicine standardized patient (SP) encounter in October 2020. They subsequently were assigned to two intervention groups (ie, a role-play intervention, N=30; a faculty demonstration, N=30) and completed a teaching case. In December 2020, they completed a postintervention telemedicine SP encounter. Each case was a unique clinical scenario. SPs scored the encounters across six domains based on a standardized performance checklist. We compared the median scores for these domains and the median total score pre- and postintervention (using Wilcoxon signed rank and rank-sum tests) and the difference in median score by intervention type. Results: Students scored highly in history-taking and communication performance but had low physical exam (PE) and assessment/plan scores. Postintervention, median scores in PE (ie, median score difference 2, interquartile ranges [IQR] 1-3.5, P<.001), assessment/plan (ie, median score difference 0.5, IQR 0-2, P=.005), and overall performance improved significantly (ie, median score difference 3, IQR 0-5, P<.001). Conclusions: Early medical students had low performance at baseline in telemedicine PE and assessment/plan skills, but both a role-play intervention and faculty demonstration led to significant increases in student performance.

Background and Objectives: Our innovative, highly rated, interprofessional Primary Care Course (PCC) engaged learners in dentistry, medicine, nursing, physician assistants, pharmacy, public health, and social work. PCC used a low-resource, flexible classroom format, earned 99% high student ratings, and increased PC career plans in 56% of students. This study assessed changes in PC knowledge and attitudes and tracked PC career outcomes over 5 years. Methods: We conducted before-and-after surveys of PCC students at baseline, 1-year, and 5-year follow-up, using anonymous online surveys. An additional controlled study compared PCC students with similar students from the course waitlist. Results: Surveys yielded responses from 100% (84) at baseline, 81% (68) at 1 year, 57% (48) at 5 years, and 34% (28/83) among waitlist students at year 5. Before-and-after matched pairs analyses documented significant increases at year 1, sustained through year 5, in knowledge of PC training and referral patterns and attitudes toward PC value and role in future US health care. Precourse, 56% of students planned PC careers. At year 5, PCC graduates reported working in PC (74%, 29/39), delivering direct PC patient care (48%, 19/39), and working with underserved communities (74%, 29/39). The PC knowledge and attitudes of waitlist students at year 5 were similar to PCC student baseline scores and were significantly lower at year 5. Only 27% (7/26) of waitlist students reported working in PC at year 5. Conclusions: PCC was associated with sustained increases in PC knowledge, attitudes, and careers across health professions. This low-resource, flexible format can contribute to building PC knowledge, attitudes, and workforce.

The use of race remains common at all levels of medical science and practice, including education, research, and care delivery. There are ongoing vigorous debates about the validity of the manner in which race is used. Unfortunately, when one looks closely at the manner in which race is used, what one often finds is in fact racism. This article explores some of the ways in which the development of the concept of race as a biological construct, was used to justify racism, and shaped the early development of scientific thought. This historical perspective is used to elaborate the ways in which those seminal ideas continue to distort medical research, education, and care delivery, and perpetuate health disparities.

Background and Objectives: The College of Family of Physicians of Canada’s Certificates of Added Competence (CACs) denote enhanced-skill family physicians who function beyond the scope of family practice or in specialized areas fundamental to family medicine practice. The credential provides recognition for skill development in areas of need and is intended to augment comprehensive care; however, there are concerns that it increases focused practice and decreases commitment to generalist care. To inform credentialing policies, we elucidated physician and trainee motivations for pursuing the CAC credential. Methods: We conducted secondary analyses of interview data collected during a multiple case study of the impacts of the CACs in Canada. We collected data from six cases, sampled to reflect variability in geography, patient population, and practice arrangement. The 48 participants included CAC holders, enhanced-skill family physicians, generalist family physicians, residents, specialists, and administrative staff. We subjected data to qualitative descriptive analysis, beginning with inductive code generation, and concluding in unconstrained deduction. Results: Family physicians and trainees pursue the credential to meet community health care needs, limit or promote diversity in practice, secure perceived professional benefits, and/or validate their sense of expertise. Notably, family physicians face barriers to engaging in enhanced skill training once their practice is established. Conclusions: While the CACs can enhance community-adaptive comprehensive care, they can also incentivize migration away from generalist practice. Credentialing policies should support enhanced skill designations that respond directly to pervasive community needs.

Background and Objectives: Stay-at-home orders, social isolation recommendations, and fear of COVID-19 exposure have led to delays in children’s preventive health services during the pandemic. Delays can lead to missed opportunities for early screening and detection of health problems, and increased risks for outbreaks of vaccine-preventable diseases. Understanding prevalence of and reasons for missed, delayed, or skipped preventive health services is important for developing strategies to achieve rapid catch-up of essential health services. Methods: Using the Household Pulse Survey (n=37,064), a large, nationally-representative household survey fielded from April 14 to May 10, 2021, we examined prevalence of households with children who have missed, delayed, or skipped preventive health services, and factors associated with and reasons contributing to missed, delayed, or skipped preventive health services. Results: About one-quarter of parents had children who missed, delayed, or skipped preventive check-ups in the past year. Delays in children’s preventive health services were more common among respondents with higher education, households with greater numbers of children, and children who learned remotely or did not participate in formal education. Main reasons attributed to delayed preventive health services were limited appointments at health providers’ offices (42.9%), concern about COVID-19 exposure at health providers’ offices (42.2%), and closed health providers’ offices due to the pandemic (29.0%). Conclusions: Physician office closures and concern about COVID-19 exposure resulted in over one-quarter of parents delaying preventive services for their children since the pandemic began. Coordinated efforts are needed to achieve rapid catch-up of preventive services and routine vaccines.

Background and Objectives: Promotion has historically valued the scholarship of discovery over the scholarship of teaching. The clinician-educator promotion pathway is an attractive option for academic family physicians engaged in significant teaching. However, clinician-educators are less often promoted than peers on other tracks. Family medicine educators face unique challenges in promotion due to clinical requirements and often less guidance on how to meet promotion criteria. Promotion recognizes achievements of faculty and is often tied to higher base salary. We aimed to identify promotion preparation tips for academic family medicine educators. Methods: We surveyed members of the Society of Teachers of Family Medicine (STFM) Medical Student Education Collaborative electronically on promotion preparation lessons learned in (1) curriculum vitae preparation, (2) personal statement preparation, (3) selecting external reviewers, and (4) identifying measurable achievements. This qualitative study used grounded theory and constant comparison. Results: Fourteen individuals from 13 medical institutions responded with tips for success in promotion preparation. The tips identified actionable steps for promotion preparation of academic family medicine educators. Several main themes emerged, including the importance of timely and thorough documentation, detailed planning, and being knowledgeable about institutional-specific criteria early. Conclusions: The tips provided in this study support family medicine educators in preparing for promotion and can be used as a tool for mentors, chairs and faculty development.