in English, German Die kardiorespiratorische Fitness gilt als unabhängiger Prognosefaktor für Morbidität und Mortalität unterschiedlicher Genese. Patientenrelevante Symptome wie latente Belastungsdyspnoe, körperliche Leistungsdefizite und Erschöpfung korrelieren oft schlecht mit der kardiopulmonalen und bildgebenden „Ruhediagnostik“. Die Spiroergometrie als Goldstandard der Belastungsanalyse dient der Früherkennung, Differenzialdiagnostik, Verlaufs- und Therapiekontrolle von kardiopulmonalen Erkrankungen und deren Prognose. Als integrative Untersuchungsmethode des Lungen-Herz-Kreislauf-Muskel-Systems ist sie bei geringem zeitlichem Mehraufwand deutlich aussagekräftiger und informativer als alternative Messmethoden und ermöglicht auch Aussagen im submaximalen Belastungsbereich. Trotz dieser enormen Bedeutung wird die Spiroergometrie aus verschiedenen Gründen (z. B. Aufwand, Budget, Expertise) auch hierzulande zu selten durchgeführt. Die Methode ist komplex, aber nicht unbedingt kompliziert. Ziel dieser Übersicht ist es daher, allen Interessierten diesen häufig wegweisenden Globaltest leichter zugänglich zu machen. Inhaltlich werden sowohl die physiologischen Grundlagen, die Indikationen und praktischen Aspekte der Messung als auch die strukturierte Auswertung spiroergometrischer Befunde übersichtlich vorgestellt. Damit soll auch das Interesse und der eigene Anspruch geweckt werden, diese fachspezifische Referenzuntersuchung in indizierten Fällen selbst häufiger durchzuführen.BACKGROUND AND OBJECTIVES Time spent in the electronic health record (EHR), away from direct patient care, is associated with physician burnout. Yet there is a lack of evidence quantifying EHR use among family physicians. The purpose of the study was to describe a method for quantifying habits and duration of use within the electronic health record in family medicine residents and faculty with particular attention paid to time spent after hours.  https://www.selleckchem.com/products/ITF2357(Givinostat).html  METHODS We audited EHR time for family medicine residents and faculty using an EHR vendor-provided, web-based tracking system. We collected and analyzed the number of patient encounters, total time in the EHR per patient, total time in the EHR after hours by physicians for a 6-month time period. RESULTS Over the 6-month period reviewed, family medicine trainees and faculty saw between one and 164 patients monthly, spent between 17 and 217 minutes in the EHR per patient, and spent between 0 and 33 hours in the EHR after hours per month. CONCLUSIONS Family medicine residents spend a significant amount of time completing EHR tasks after hours. Objective EHR data can be used by family medicine residency programs to devise interventions to decrease inefficient use of the EHR, decrease after-hours EHR use, and improve well-being.BACKGROUND AND OBJECTIVES Most family medicine residency training takes place in hospitals, which is not reflective of the outpatient care practiced by most primary care clinicians. This pilot study is an initial exploration of family medicine residency directors' opinions regarding this outpatient training gap. METHODS The authors surveyed 11 California family medicine residency program directors in 2017-2018 about factors that influence decisions regarding allocation of residents' inpatient and outpatient time. Nine of the 11 program directors agreed to be interviewed. We analyzed the interviews for common themes. RESULTS The participating program directors were generally satisfied with inpatient and outpatient balance in their residents' schedules. Factors identified as promoting inpatient training included the need for resident staffing of hospital services, the educational value of inpatient rotations, and a lack of capacity in continuity clinics. From the program directors' perspective, residency funding played no direct role in curriculum planning. Program directors also felt that the ACGME requirements prescribing 1,650 continuity clinic visits throughout residency inhibited the development of creative outpatient training opportunities. CONCLUSIONS Family medicine residency program directors participating in this exploratory study did not feel that their programs overly emphasized inpatient care and training.BACKGROUND AND OBJECTIVES Online journal clubs have recently become popular, but their effectiveness in promoting meaningful discussion of the evidence is unknown. We aimed to understand the learner experience of a hybrid online-traditional family medicine journal club. METHODS We used a qualitative descriptive study to understand the experience of medical students and residents at the University of Toronto with the hybrid online-traditional family medicine journal club, including perceived useful and challenging aspects related to participant engagement and fostering discussion. The program, informed by the literature and needs assessment, comprised five sessions over a 6-month period. Learners led the discussion between the distributed sites via videoconferencing and Twitter. Six of 12 medical students and 33 of 57 residents participated in one of four focus groups. Thematic data analysis was performed using the constant comparison method. RESULTS While participants could appreciate the potential of an online component to journal club to connect distributed learners, overall, they preferred the small group, face-to-face format that they felt produced richer and more meaningful discussion, higher levels of engagement, and a better learning opportunity. Videoconferencing and Twitter were seen as diminishing rather than enhancing their learning experience and they challenged the assumption that millennials would favor the use of social media for learning. CONCLUSIONS Our study demonstrates that for discussion-based teaching activities such as journal club, learners prefer a small-group, face-to-face format. Our findings have implications for the design of curricular programs for distributed medical learners.BACKGROUND AND OBJECTIVES With younger generations of learners and readily available technology, medical educators are challenged to include active learning methods that may be better for student learning than traditional lecture. Some of these methods, like online modules, can also reduce the demands on clerkship faculty time. We examined how content delivered via interactive, online module compared to traditional lecture for student learning and satisfaction. METHODS Third-year family medicine clerkship students completed questionnaires following either an online module or lecture on orofacial pain. We conducted the study over four consecutive rotations, alternating who received the content via classroom lecture or interactive online module. Students completed a questionnaire comprised of six multiple-choice knowledge questions, five questions with a clinical vignette format to assess application of knowledge, and six questions to assess satisfaction with elements of the course. The Centers of Excellence in Pain Education developed the online module and questionnaire.