Integrating Scholarship and Research into Clinical Practice

Background

Clinical medicine saves lives only by advancing new knowledge and its implementation. Family Medicine is a clinical discipline. Ergo, family medicine must evolve based on new knowledge and its implementation into practice. So, why are so few medical students, family medicine residents, fellows, and physicians engaged in this evolution called scholarship and research?

As professionals committed to the health and well-being of patients and communities, physicians must master a large and complex body of knowledge and skills.¹ Engaging in patient-centered care requires health care teams to work with patients and communities to answer their health care questions while adopting a critical and evidence-informed approach to treatment and management.¹ To tailor health care strategies to meet the needs of patients, families, and/or a community, all members of the health care team, including family physicians, must be engaging in adapting and expanding the complex body of knowledge and skills they possess at that moment in time.

In Canada, it is within CanMEDS-2015, CanMEDS-FM (Family Medicine), and the CanMEDS-FM Indigenous Health Supplement that the role of Scholar highlights the fact that “physicians demonstrate a lifelong commitment to reflective learning; as well as the creation, dissemination, application, and translation of medical knowledge”.^1-3

An essential component of the patient-centered clinical method is a commitment to asking and systematically answering questions.⁴ These changes would not have been possible without applying research into practice. As all health care teams focus on providing patient-centered clinical care, it is essential to always consider whether specific study results/findings and current clinical practice guidelines were designed for the individual to whom care is being provided. Asking questions and systematically answering them (research) is relevant to all forms of clinical practice. It is the responsibility of all health care team members, including family physicians, as they strive to provide optimal care to the individual, family, and/or community.

In Canada, Standards for Accreditation for Residency Programs in Family Medicine⁵ highlight resident involvement in practice improvement as a key component of maintaining satisfactory levels of scholarly activity within Departments of Family Medicine and the importance of having faculty members facilitate and coach residents’ involvement in such activities.

Ensuring that practice improvement is a fundamental part of everyone’s job, every day, in all parts of the health system will be required to build a culture where everyone recognizes that in health care, “everyone has two jobs when they come to work every day: to do their work and to improve it.”^6,7 As a result, it will require reflective practice and curiosity about one’s own practice, focusing on improving care, outcomes, and experiences.⁸

NAPCRG members have created an Introduction/Orientation for medical students and Family Medicine Residents/Fellows showing how the career of a physician can include research at various levels of saturation. There are practice-based research networks and electronic health information networks for those who are comfortable contributing their actions and patient-consented data to research. For those who want to understand more about study design and interpretation of analyses, there are other career opportunities, including Fellowships, data skills training and acquisition, and NIH training grants. There are options available for every level of research engagement. NAPCRG members introduce and mentor different groups of interested trainees as they change career pathways to include some or more research.

Annals of Family Medicine has also created its own video championing primary care research (https://www.youtube.com/channel/UCATLpuu7PmghzsDAeoPmKcA), with highlights on the publication and dissemination of the work we do as primary care researchers.

To further integrate family medicine/primary care research into clinical practice, NAPCRG and ADFM (Association of Departments of Family Medicine in the USA) will be hosting a Research Summit on October 30, 2023 just before the 51st Annual Meeting of NAPCRG. This Research Summit is being supported through the ABFM (American Board of Family Medicine) Foundation’s Family Medicine NEXT Initiative. Stay tuned…