The methodology used in studies regarding dementia prevalence among centenarians is sufficiently varied that combination of existing studies into a meta-analysis is not possible. Suggestions for assuring quality in future centenarian research are presented.
Background and Objectives: General competencies developed in undergraduate and graduate medical education are sometimes promoted as applicable in any practice context. However, rural practice presents challenges and opportunities that may require unique training. The objectives of this national survey of both undergraduate and graduate medical educators and practicing physicians were to further develop a previously published list of competency domains for working in rural communities and to assess their relative importance in education and practice.
Methods: Using six rural competency domains first refined with a national group at the Society of Teachers of Family Medicine Annual Meeting in Baltimore in 2008, the authors employed a snowball strategy to survey medical educators and physicians regarding the importance and relevance of this list and to solicit additional domains and competencies.
Results: All six domains were considered important, with average responses for each domain ranging from 4.16 to 4.78 on a 5-point Likert scale (1-not important; 5-extremely important). Unique relevance to rural practice was more varied, with average responses for domains ranging from 2.36 to 3.6 (1-not at all unique; 5-extremely unique). Analysis of free text responses identified two important new domains—Comprehensiveness and Agency/Courage—and provided clarification of some competencies within existing domains.
Conclusions: This study validates and further elaborates dimensions of competence believed to be important in rural practice. The authors propose these domains as a common language and framework for addressing the unique challenges and opportunities that training and practicing in a rural setting present.
As family physicians, researchers, and educators who have been engaged in population health at the local, state, and national level for more than 3 decades, we would like to thank Drs Hollander-Rodriguez and DeVoe for their commentary on "Family Medicine's Task in Population Health: Defining It and Owning It" 1 and offer our perspectives for those who are either beginning the journey of working with their community, or like us, working to continually enhance those relationships. We believe that population health is owned by the population, beginning with those residing in the community, as well as public health departments, community-based organizations, businesses, schools, and faith-based organizations, to name a few. As family physicians, we have important roles within this larger community, but there are a few key points to bear in mind. One lesson we have learned is the need to begin by learning from and listening to the community. The US Department of Health and Human Services publication, Principles of Community Engagement, on which we worked, offers practical guidance, including:
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