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Continuity in Community Medicine Training: Is It Time to Rethink the Block Rotation?

Rebecca Bernstein1, Leslie Ruffalo1, Jeffrey Morzinski1

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Continuity in family medicine residency programs significantly enhances community partnerships and resident competency. Program-level continuity, not resident-level, was linked to better outcomes in community medicine training.

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Area of Science:

  • Family Medicine Education
  • Community Health
  • Medical Training Curricula

Background:

  • Family medicine residency training prioritizes community medicine.
  • Scholarship highlights bidirectionality and continuity in community partnerships.
  • Continuity is crucial for both family medicine and community engagement.

Purpose of the Study:

  • To investigate the link between continuity in community medicine curricula, partnership quality, and resident competency.
  • To determine if program-level or resident-level continuity impacts community medicine outcomes.

Main Methods:

  • Survey data from the 2015-2016 Council of Academic Family Medicine Educational Research Alliance (CERA) Family Medicine Program Director survey.
  • Assessed community medicine curricular structures, partnership quality, and resident competency.
  • Multivariate logistic regression analyzed the impact of continuity on partnership quality and resident competency.

Main Results:

  • 227 of 461 programs (49%) responded.
  • Block rotation was the most common curriculum structure (66%).
  • Program-level continuity correlated significantly with high-quality partnerships (OR 3.51) and educational outcomes (OR 2.85), while resident-level continuity did not.

Conclusions:

  • Continuity at the program level is vital for high-quality family medicine residency community partnerships.
  • Program-level continuity positively impacts resident education in community medicine.
  • Further research should differentiate the effects of program-level versus resident-level continuity.