FPIN-Family Physicians Inquiries Network

1. FPIN-Family Physicians Inquiries Network 409 West Vandiver Drive Building 4 Suite 202 Columbia, MO 65202 (573) 256-2066 www.fpin.org

2. The 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.”

3. FPIN’s Origin and Leadership • Funded by a grant from the American Academy of Family Physicians in 1999 • Directed by a Board of Directors with 7 Founding Members: • The University of Chicago • University of Colorado • University of Missouri-Columbia • University of Washington • University of Wisconsin • Oregon Health Sciences University • University of North Carolina • Led by an Executive Director – LuShawna Romeo • Founded by Bernard Ewigman, MD, MSPH

4. FPIN Today FPIN is committed to staying abreast of the changes happening in primary care so that we can serve the discipline of family medicine. Here are some of the trends that we are observing and the initiatives we are exploring for the future.

5. Trend: More and more programs are requesting the ability to publish in a MEDLINE indexed journal. FPIN has increased the rigor of our editorial processes for our journal Evidence-Based Practice (EBP)to meet the Medline requirements to apply for acceptance.

6. Trend: Residency programs are reporting that it is becoming more challenging to meet scholarship requirements. FPIN is co-leading an initiative with the other family medicine organizations (STFM, AFMRD, ADFM, MedEdNet, and CERA, etc.) to explore the possibility of creating a National Scholarship Resource Center to give programs across the country a comprehensive directory for finding the resources, education, and services they need to build a culture of research.

7. Trend: Residency programs are becoming more interested in how they can improve the effectiveness of residency education. FPIN is looking to partner with MedEdNet (an organization committed to conducting educational research) to offer a graduate survey package to residency programs.

8. Trend: Residency QI projects are becoming a scholarly activity requirement. The Membership & Education Committee of FPIN’s Board of Directors has agreed to explore the possibility of FPIN developing a structured approach to implementing QI projects in the future.

9. Trend: Scholarship requirements are increasing in other primary care disciplines. FPIN is beginning to explore expanding our offerings in other primary care disciplines starting with osteopathic residency programs and potentially physician assistant programs in the future.

10. FPIN Member Spotlight “I like FPIN because FPIN is crucial to the future of Family Medicine. First, we need the answers FPIN writers produce. The quality of our clinical care must be based on accurate, trustworthy evidence, and these answers are accurate, trustworthy, and usable at the point of care. Second, we need a Family Medicine workforce that knows how to critically appraise the literature and extract from it actionable data—and FPIN is producing just such a workforce. So FPIN uplifts the quality of data we operate from, and it upgrades the quality of the clinicians who render care. What’s not to like about that?” - Dr. Frank deGruy, University of Colorado

11. FPIN is a Membership Organization

12. Who are FPIN Members? • FPIN Membership has grown from seven founding members in 2001 to 141 university and community based residency programs in 2014. • There are currently 5,900 individuals that comprise the academic consortium from member residency programs. These include department chairs, program directors, faculty, fellows, residents, students and residency/department staff. • We have a primarily volunteer based editorial staff of 30 physicians. • At any given time, at least 1,000 of our members are contributing to manuscript projects as authors, co-authors, or medical librarians. • We have worked with over 50% of US ACGME residency programs.

13. Why FPIN? University departments, university residency programs and community-based residency programs are working together to implement the FPIN mission by: • Developing a culture of research and scholarly publication. • Promoting mentoring programs among faculty and trainees. • Creating a supportive training environment for clinical scholarship training and translational research. • Ultimately, raising the level of scholarship and therefore the quality of patient care throughout family medicine and primary care.

14. FPIN Member Spotlight “Family physicians need to be able to understand and critically review the evidence that guides our clinical decisions. When I began doing faculty development, I realized we needed a more active way to ensure faculty had the skills they needed to teach residents. FPIN has offered us many professional development opportunities for faculty and residents. My goal is that no resident should graduate from one of our 22 residencies without having authored at least one manuscript answering a clinical question with a review of the best available evidence.  We are not there yet, but through FPIN writing we have an ever growing group of faculty now ready to assist them.  FPIN provides scholarship opportunities for clinical teachers that match their skills and interests.” - Dr. Nancy Stevens, University of Washington

15. FPIN Writing Projects Seven series designed to meet the needs of primary care clinicians everywhere

16. * PLUS: Diving for PURLs, EBP Features, and GEMs

17. FPIN's Publication Series • Clinical Inquiries - 716+ published • HelpDesk Answers - 821+ published • Evidence-Based Practice Features - 550+ published • eMedRef - 740+ published • PURLs - 100+ published • Diving for PURLs - 130+ published

18. Provides quick and comprehensive overviews of topics at physicians’ fingertips • Each author receives a PEPID subscription ($299.99 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 • Can be finalized in 6-9 months

19. Where is eMedRef Published?

20. 450-600 word manuscript • Brief, structured evidence-based answers to clinical questions • Work with Local Editor and Editor-in-Chief • Peer reviewed at another FPIN program • Ideal for faculty and resident/faculty pairs • Published in Evidence-Based Practice and PEPID • Can be finalized within an academic year

21. Where are HDAs Published?

22. Based on the best evidence resulting from a formal systematic literature search • Author qualifications: • have experience writing FPIN publications • demonstrate skills in analyzing and interpreting medical evidence • Proposed questions go through two types of editorial preview • Typically published in one of two indexed journals, the Journal of Family Practice or American Family Physician.

23. Where are CIs Published?

24. 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

25. Where are PURLs Published?

26. So why a PURLs spinoff series? Diving for PURLs will provide you with a synopsis of important studies that may not meet all of our PURL criteria. They may still change your individual practice, or they may be research studies that you hear about from your patients or the media. We find that about 1 in 5 studies that we select for intensive review meet all criteria for a PURL. Our Diving for PURLs group scours sources that cover 500 journals daily for useful research evidence, and we meet weekly to critically appraise and discuss studies that may meet our criteria to become a PURL. During these weekly meetings, we learn a lot about the articles we review. Some of the articles that do not quite meet all of the PURL criteria are still useful to our individual practices or helpful to support dialogue with our patients. Diving for PURLs is our attempt to share with you what we learn through this rigorous, continuous process.

27. EBP Features: • Musculoskeletal Health • EBM on the Wards • Maternity Care • Behavioral Health Matters • EBPediatrics • Geriatrics • Spotlight on Pharmacy • Integrated Medicine

28. NEW-GEMs (Good Evidence Matters) • GEMs will become the 7th FPIN publication series. • GEMs has the power to transform residency curriculum by offering a comprehensive learning path in critical appraisal.

29. GEMs as an Introductory Scholarly Activity • Critical appraisal of the validity/relevance of a single study incorporating user friendly statistics teaching • 6-9 months to complete • Modeled after our successful PURLs project • A long term and comprehensive training program in all aspects of critical appraisal • Institute mini-modules

30. Publication What will a published GEM consist of? • Completed critical appraisal form and a brief written summary of a single research study that meets validity criteria for Step 1 or Step 2 evidence according to the Center for Evidence Based Medicine (CEBM) as well as; • Meet FPIN criteria for meaningfulness to patients • Meet FPIN criteria for usefulness in answering clinical questions relevant to family medicine and primary care • Peer-reviewed and editorially approved for publication • Electronically linked to the original study reviewed • Published electronically in Evidence-Based Practice

31. GEMs Journal Club GEMs Journal Clubs = Training to write GEMs • GEMs I – RCTs addressing questions of treatment benefit • GEMs II – Systematic reviews/meta-analyses of RCTs addressing questions of treatment benefit • GEMs III – All other study designs that qualify as Step 1 or Step 2 evidence for answering clinical questions on rates, diagnosis, prognosis, screening and questions of treatment, treatment harms and rare harms due to treatment

32. FPIN Member Spotlight “I initially got involved in FPIN (Family Physicians Inquiries Network) because I like to write, and because I really like to ask questions. I got very interested in how family doctors learn about new studies, and that’s how I got involved with PURLs. I’ve been writing and editing PURLs since the first ones were published in 2007. FPIN supports family medicine scholarship at its most fundamental levels: looking at a patient and asking a question, disseminating evidence-based answers and new evidence, and providing publication opportunities. FPIN is a great community of staff and fellow family doctors looking to advance our field.” - Dr. Kate Rowland, The University of Chicago and Advocate Illinois Masonic

33. Our Journal: Evidence-Based Practice

34. Evidence-Based Practice • Deeply committed to providing accurate, unbiased, and evidence-based information that will help physicians provide better care to their patients – without the influence of industry support. • Articles are written by FPIN Members • Residents and faculty • Answer questions you experience on a daily basis • Paid subscription includes 48 AMA PRA Category 1 Credits TM

35. FPIN Member Spotlight “For the past seven years, I've been mentoring our PGY-2 residents through FPIN writing projects. It has become a crucial component of our curriculum giving experience in medical information searching, appraisal, publication, and application. By giving our residents real world experience in producing medical information they have become more informed consumers of medical information.” - Dr. Tom Satre, University of Minnesota

36. Education FPIN has expanded its core service offerings to include a variety of educational offerings

37. FPIN Institute • Included with your FPIN Membership • Access to the Online Learning Catalog • Online 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 • PURLs Journal Club Toolkits • Live webcast series: EBM Physician Numeracy Curriculum • Ongoing development of new offerings

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

39. Onsite Workshops • FPIN travels across the country delivering live workshops to residency programs. We offer a variety of educational programming. Our most popular offerings walk faculty and residents through the process of conducting a literature search, synthesizing evidence, and co-authoring manuscripts in small writing groups.

40. FPIN Member Spotlight “At the University of Missouri, we have believed in FPIN from the start.  We promote FPIN writing projects as an exercise in scholarly writing and critical thinking for students, residents and faculty.  Learners at all of these different stages work together to learn how to ask and answer questions using the best available evidence—essential skills for the practice of modern medicine.  No one else in Family Medicine is doing the work that FPIN does to link clinical knowledge and scholarship in a way that is feasible for family doctors.” - Dr. Laura Morris University of Missouri - Columbia