Family Physicians Inquiries Network

The Buzz… “We wish to extend our most sincere appreciation to you and the FPIN team for the outstanding "FPIN educational experience" you provided the Family Medicine Residents and Faculty. Everyone is still buzzing about the event and the knowledge and skills they gained. In addition we are very clear as to our next steps.” Doug Reich, MD Bronx Hospital FMR “Oh, yeah!!!!!! So exciting!!!!!!!!!!!!! Thank you!!!! Thank you for your help on this article too. It really has motivated me to do more research on questions that I have.” Roxanna Mirza - Resident MO Research FMR

Agenda I. What is FPIN and What is the Mission? II. A Membership Organization III. Publications IV. Scholarly Activity V. FPIN Implementation VI. FPIN & MedEdNet

I. What is FPIN and What is the Mission? Family Physicians Inquiries Network

What is FPIN? FPIN is a membership organization offering medical scholarship education to students, residents, faculty, and fellows in family medicine. Publication projects are used as a means for teaching Evidence-Based Medicine (EBM) concepts.

FPIN Mission: FPIN supports a collaborative learning community for primary care clinicians, learners, and faculty to promote and disseminate evidence-based scholarship. We improve patient care by translating research into practice. Academic Departments with University & Community-based Residencies are working together to help each: – Develop a culture of research and scholarly publication – Promote mentoring programs among faculty and trainees – Create a supportive environment for translational research – Ultimately, raise the level of scholarship throughout the discipline

II. A Membership Organization

How does FPIN membership help? First, it will assist your program in defining your unique EBM curricular goals. Second, it will partner with your program to achieve those goals through implementation assistance, editorial mentorship, and writing project management.

Expand upon what you are doing now Utilize FPIN membership to build on your current curriculum Learning modules Journal clubs Structured writing projects Learn to apply skills at the next level- FPIN provides an avenue to put EBM skills to work Employ EBM skills that have been taught Learn all the ways that FPIN can help you meet your scholarly activity requirements Learn how to earn CME credit for your FPIN work

Member Benefits Peer-reviewed publication opportunity Electronic subscriptions to Evidence-Based Practice Full access to the FPIN Institute including online self-study modules, PURLs Journal Club Kits, and Physician Numeracy curriculum Peer-reviewing opportunities for AAFP Prescribed credit 1:1 author mentoring calls Ongoing scholarship reports for each manuscript in process Support through the FPIN Project Manager Team and Education Department Workshop and webinar opportunities to expedite project implementation (fee-based)

FPIN Institute Included with your FPIN Membership  Access to Online Learning Catalog  Institute training calls with FPIN Staff  Physician “experts” collaborate on FPIN Institute curriculum On-line self-study courses covering FPIN writing projects, EBM curriculum development, and more:  Accompanying handouts  Links to additional resources  Comprehension quizzes to assess learning  Ability to generate progress reports for additional accountability Live webcast series: EBM Physician Numeracy Curriculum Ongoing development of new offerings

Courses Available on the Institute eMedRef Institute Introduction to eMedRef Conducting a Smart Search Literature Search ‐ Demos Steps to Writing eMedRef Writing for eMedRef ‐ Demo eMedRef Editorial Process HelpDesk Answers Institute Introduction to HDAs Dissecting the Clinical Question HDA Literature Search ‐ Demo Evaluating the Evidence –Levels of Evidence (LOEs) Evaluating the Evidence – Strengths of Recommendation (SORs) Synthesizing the Evidence HDA Writing ‐ Demo Peer Review ‐ Critically Appraising What’s Before You Final Steps to the HDA Project Clinical Inquiries Institute Introduction to Clinical Inquiries Working with Librarian Co ‐ Authors Conducting a Smart Search with PICO Evidence Tables Summarizing Evidence Statistics for CIs Writing a Clinical Inquiry Submitting Your First CI Draft The CI Editorial Process Plus, rebroadcast videos of our 2012 conference presentations will be available! PURLs Institute Surveying & Utilizing the Literature Selecting PURLs PURL Journal Club PURL Jam ‐ Video

Courses Available on the Institute FPIN Implementation Institute FPIN Overview ‐ Video Importance of Structure ‐ FPIN Case Studies FPIN Implementation ‐ Video Fast ‐ track HDA Orientation ‐ Video LIVE Online Writing Workshop Webinar ‐ eMedRef (fee based) LIVE Online Writing Workshop Webinar – HDAs (fee based) General Scholarship Institute Paving the EMB Trail ‐ Video How to Use Track Changes ‐ Demo Defining Study Types Physician Numeracy Institute Introduction to EBM Physician Numeracy Diagnostic Reasoning I Diagnostic Reasoning II Diagnostic Reasoning III Biostatistics I Biostatistics II Biostatistics III Biostatistics IV Biostatistics V Survival I Survival II Etiology Design of Studies of Therapies I Design of Studies of Therapies II Analysis of Studies of Therapies Systematic Reviews I Systematic Reviews II

III. Publications FPIN has multiple writing projects and will work with you to find the right fit for your program

Provides quick and comprehensive overviews of topics at physicians’ fingertips Each author receives a PEPID subscription ($ value) Ideal for busy students, residents and faculty Published in PEPID and portions of selected topics are published in Evidence-Based Practice New initiatives include developing a peer review process and recruiting regional senior editors

word manuscript Brief, structured evidence-based answers to clinical questions Work with Local Editor and Editor-in-Chief Peer reviewed at another FPIN program Can be finalized in 6-7 months Ideal for faculty and resident/faculty pairs Published in Evidence-Based Practice and PEPID

Critical Components of an HDA Clinical Question Evidence Based Answer (35-75 words, with SORT grade) Evidence Summary ( words) References ( words, with LOEs) Continuing Medical Education Question (Multiple choice. Not included in word count) The ideal word count is 500, including references. HDAs should run no more than 600 words – a small table counts for approximately 100 words.

Published HelpDesk Answer

750 word manuscript Work with Librarian Co-author, Assistant Editor, and Editor in Chief Peer reviewed at another FPIN program Ideal for faculty promotion and tenure Fully indexed and published in The Journal of Family Practice, American Family Physician, Evidence-Based Practice and PEPID

Relevant, valid, practice-changing, and immediately-applicable recommendations Drawn from literature surveillance system Work with team to review literature or author manuscript Ideal for programs looking for a high level team activity Published in The Journal of Family Practice and PEPID

PURL Journal Club Plug and play comprehensive monthly toolkit available through FPIN Institute including: 1. Journal Club Instructions 2. Speaker Notes including teaching points 3. Journal Club participant worksheet 4. Completed review form for reference 5. Published PURL Ideal for programs looking for a structured approach to journal clubs with little faculty skill or time.

Evidence-Based Practice FPIN’s journal Articles are written by members of the consortium – they answer questions you experience on a daily basis Electronic subscription included with membership; discounted print rate: $59/year includes 48 AMA PRA Category 1 Credits TM Subscription print rate available for non-members: $119/year includes 48 AMA PRA Category 1 Credits TM

IV. Scholarly Activity

Current RRC Requirements for Faculty Scholarship  Must establish and maintain an environment of inquiry and scholarship with an active research component  Must regularly participate in clinical discussions, rounds, journal clubs, and conferences.  Some should also demonstrate scholarship  Peer-reviewed funding, publications, presentations, participation in national committees or organizations  Should encourage and support residents in scholarly activities

What’s new in Proposed Requirements for Faculty Core family medicine faculty members must participate in faculty development programs designed to enhance the effectiveness of their teaching, administration, leadership, scholarship, clinical and behavioral components of faculty performance

Current RRC Requirements for Resident Scholarship Curriculum must advance residents’ knowledge of the basic principles of research Residents must have a supervised experience in scholarly activity (big description follows….) Forum must be provided for analyzing scientific evidence Must have guided experience in application of emerging clinical knowledge to own panels

What’s new in Proposed Requirements Much more direct language:  Curriculum in basics of principles of research  Projects  “Residents should complete two scholarly projects at least one of which should be a quality improvement project.”

Other big change affecting scholarship Section IV.A on Didactics and Conferences  Gutted!  “The program must provide a regularly scheduled forum for residents to explore and analyze evidence pertinent to the practice of family medicine such as journal club.”

Are There Numbers Coming? Review Committee Update Slide Presentation from PDW  Residency Faculty  2 projects per faculty member on average over 5 years (regional or national dissemination)  Residents  2 projects per resident by end of residency (local or more wide- spread dissemination)

Your PIF (NAS?) and FPIN Residency Scholarly Activity (PR IV.B)  Does the program ensure that residents are provided supervised experiences in research or other scholarly activities? YES  Are residents introduced to the basic principles of study design, performance, analysis and reporting, and the relevance of research to patient care? YES  List the scholarly activities of the residents during the last three years. LIST FPIN Publications  List scholarly investigative projects currently in process by residents and other types of scholarly activities in which resident are engaged. LIST FPIN Publications

Your PIF and FPIN Faculty Research and Scholarly Activities & Faculty Development (PR II. B.9)  Faculty Development Opportunities:  Peer-review an FPIN publication, teach residents using the PURLs Journal Club, become an FPIN workshop presenter  List the academic achievements of the program director and family medicine faculty during the last three years.  Complete an FPIN publication, help lead FPIN presentations at National Conferences

Your PIF and FPIN Conferences (PR IV.A.3.c)  List required conferences, seminars, workshops and/or other planned group activities. Host an FPIN onsite workshop  In addition to structure didactic conferences what other methods of learning does your program use to foster continuous professional development of residents?  Self-directed learning modules FPIN Institute courses and comprehension quizzes  Small group discussions Participate in an FPIN webinar  Journal club Utilize the PURLs Journal Club  Workshops Host an FPIN onsite workshop

Your PIF and FPIN Practice-Based Learning and Improvement (PR IV.A.5.c))  Describe one example of a learning activity in which residents engage to develop the skills needed to use information technology to locate, appraise, and assimilate evidence from scientific studies and apply it to their patients’ health problems. The description should include: a) Locating information b) Using information c) Technology d) Appraising information e) Assimilating evidence information f) Applying information to patient care  All aspects of being an FPIN member and completing the step by step writing process along with using the FPIN Institute satisfy this requirement!

Self-Reported CME Credits for FPIN Work Publications  HelpDesk Answers, Clinical Inquiries  Earn 10 elective AAFP credits/paper; 30 credits during a 3 year cycle Peer Reviewing  HelpDesk Answers, Clinical Inquiries  Earn 3 AAFP Prescribed credits per manuscript; 30 credits during a 3 year cycle Evidence-Based Practice (EBP)  Earn 48 AAFP elective credits and AMA PRA Category 1 credits TM per year as an EBP subscriber Workshop/Webinar Faculty Presenter  Earn 5-10 AAFP Prescribed credits per workshop/webinar; 20 credits a year FPIN is continuing to evaluate additional avenues for CME credit!

V. Implementation

Common Scholarship Program Barriers Faculty barriers:  Protected time  Shortage of faculty, resources  Leaders don’t have enough experience to mentor Resident barriers:  Lack of structured expectations, experiences  Enthusiasm towards evidence-based medicine Shared barriers: Fear of statistics Difficulty with evidence synthesis Procrastination

Scholarship Success Plan Effectively assess the skills amongst your faculty and residents Identify faculty development project Schedule a hands-on group workshop Mandate faculty complete a project first Assign a leader/champion to create timetable checklists for accountability REQUIRE a scholarly project for your residents Protect time with structured expectations, completion dates

Steps to FPIN 1. Join FPIN 2. Set Goals and Create Strategy 3. Utilize FPIN Institute 4. Train Faculty 5. Resident & Student Introduction to FPIN 6. Consider a Webinar or Onsite Workshop* 7. Publish & Follow Through Additional Fee Involved

Webinars One writing group, max of 4 faculty participants Ideal for faculty new to FPIN seeking a quick start Sessions generally span over the period of 8 weeks and require homework, increasing the comprehension of key skills Participants will receive 1:1 feedback prior to manuscript submission Optimum “train the trainer” solution for faculty with a desire to co-mentor residents with their scholarly activity projects Note: there is an additional cost for the webinars.

Why does the FPIN approach work? Publication projects are built for residents and programs to be successful Writing projects are ACHIEVABLE for busy residency programs Time frames are achievable to ensure residents are published while in residency

VI. FPIN is Proud to Announce Our Strategic Partnership with MedEdNet

MedEdNet, a AHRQ-registered practice- based research network, is a collaboration of primary care residency programs dedicated to studying innovations in medical education. Mission: To improve the health of populations served by primary care practices by conducting research on educational effectiveness in residency training.

The P4 Project MedEdNet is the result of the P 4 project P4 is the 1 st comprehensive examination of the structure, length, and content of FMRs since they were defined in the 1960s P4 project was a 6 year national demonstration of innovations in Patient-Centered Medical Homes (PCMH) in FMR training

MedEdNet Graduate Survey Benefits Follow residents from their 1 st year of training into actual clinical practice Determine and understand the relationships between residency training and post graduate scope of practice Interactive Web page allows you to compare your program’s results to those in the entire network

Development of FPIN Institute Courses in Partnership with MedEdNet Coming in 2014 Including the following new courses: –Fitting manuscript development into your busy academic year –Essentials of collaborative academic writing –Developing strong educational research grants –Managing educational research projects after you are funded

Due to our shared commitment to translate research into practice in an effort to improve the quality of healthcare, FPIN & MedEdNet expect to be offering joint presentations and collaborations in the coming future!

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