Effectiveness of the family medicine curriculum in the improvement of skills and knowledge of family medicine residents in Sudan 2024: A quantitative and qualitative survey

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Ahmed, and 3 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6476665/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 12 You are reading this latest preprint version Abstract Family medicine was established in Sudan in 2006 after the first family medicine master's degree program was established. The objective of this study was to evaluate the effectiveness of the family medicine curriculum in the Sudan Medical Specialization Board (SMSB) and provide baseline and updated data on the strengths and weaknesses of the family medicine training program. A cross-sectional quantitative and qualitative descriptive survey was conducted from February to October 2024. Data was collected through a pretested, pre-coded online questionnaire. Semi-structured in-depth interviews were conducted with the family medicine specialists and trainers in the SMSB. All data were summarized numerically (mean, standard deviation, median) and graphically (frequency tables). The Chi square test was used to determine association among categorized variables. P value < 0.05 is considered statistically significant. Qualitative data was recorded, transcribed, coded, and analyzed using a content analysis approach. A total of 100 family medicine doctors participated in the study. Most of the participants (82%) were females. Regarding the job title (76%) of the participants were residents and the rest (24%) were specialists. More than half of the participants (66%) were from Khartoum state. Most of the participants (87%) reported satisfaction with the family medicine training curriculum in the SMSB and its effectiveness in improving knowledge and practices. Furthermore, (81%) of the participants reported that the lectures and workshops arranged for the residents were sufficient to improve their knowledge. Some of the residents interviewed (30%) complained of dissatisfaction with the research methodology course, and about half of them reported that the course was ineffective and did not improve their knowledge and skills in research. Furthermore, residents reported the family medicine research committee in the SMSB had unclear requirements which was reflected in a high rejection rate of the research proposals submitted by residents. The SMSB family medicine curriculum is a comprehensive training-based curriculum that increases residents’ satisfaction, knowledge, skills, and patients’ respect. Significant concerns arise regarding the need for standardized curriculum details, trainer availability, and research support, all of which are crucial for the ongoing development and effectiveness of the program. Health sciences/Health care Health sciences/Medical research Family medicine Curriculum effectiveness knowledge training Sudan Figures Figure 1 Introduction Family medicine is globally considered a new specialty, that was identified in 1969 [ 1 ]. In Sudan, family medicine was acknowledged in 2006 with a master’s degree [ 2 , 3 ]. Since then, family medicine practice in Sudan has improved due to the improvement of educational programs. Five educational institutions in Khartoum and Gezira states currently offer postgraduate training programs for family medicine residents in Sudan [ 2 , 4 ]. However, there is still some lack of awareness of the family physician’s role and a lack of knowledge that family physicians must uphold [ 2 , 5 ]. Lack of awareness of the family medicine specialty affects the continuity of care and the referral system at the primary care level, which may create a professional practical gap [ 2 , 6 , 7 ]. The most significant barrier hindering family physicians from fully utilizing their skills and role in primary healthcare is the gap between diagnostic testing and referral processes [ 8 ]. Therefore, a strong training-based curriculum that contains continuous medical education (CME), and continuous professional development (CPD) programs, anticipated to improve the diagnostic knowledge and referral skills of family medicine doctors and improve their adherence and implementation of the clinical guidelines [ 9 , 10 ]. High-quality CME and CPD programs have a positive impact on the practice and clinical experience of family medicine doctors [ 11 ]. The Curriculum defines the recommended training strategies for the residents’ training. Knowledge, attitudes, skills, and topic competencies for family medicine residents should be attained through a longitudinal well-established training program [ 12 ]. The curriculum for family medicine residency can structure experience in several specified areas. A well-written program and course learning outcomes and structured didactic lectures, workshops, journal clubs, and conferences are important in the family medicine curriculum. Similarly, a focus on evidence-based and outcome-oriented studies of common and chronic diseases is essential for family medicine physicians [ 13 ]. Furthermore, suitable referral patterns and providing cost-effective care are important parts of the family medicine curriculum [ 13 ]. The family medicine training program should include the integration of knowledge and skills. Family physicians must be trained to be patient-centered and to gain good knowledge and skills in the management of chronic diseases [ 14 , 15 ]. There are few published studies about family medicine in Sudan in general. There is no recent study that evaluated the efficacy of the family medicine curriculum and satisfaction of the family medicine residents in the Sudan Medical Specialization Board (SMSB). This study aimed to evaluate the effectiveness of the family medicine curriculum in the SMSB to provide baseline and updated data on the strengths and weaknesses of the family medicine training program in the SMSB. Methods Study design and population A descriptive cross-sectional quantitative and qualitative study was conducted during the period from February to October 2024. SMSB was established in 1995 by Presidential Decree under the Sudan Medical Specialization Act. SMSB is the sole professional training body in the Republic of Sudan mandated to manage and deliver medical and health specialty programs in the country [ 16 ]. The driving foundation of SMSB is its specialty councils, which are responsible for the implementation of all activities concerning the training of medical doctors including the development and review of curricula. There are more than 61 specialty councils in the SMSB that offer master’s degrees (M.Sc.) and Medical Decoration (MD) [ 17 ]. The study population was composed of the third and fourth-year family medicine residents at SMSB and the family medicine specialists/ consultants who have achieved the SMSB clinical MD, as they are more aware of the curriculum and the training program in SMSB. Family medicine trainers in the SMSB were also included in the in-depth interviews. Data Collection The study adopted a mixed design approach (quantitative and qualitative). Quantitative data was collected with the use of a pre-coded and pre-tested structured questionnaire ( Annex 1 ) that was designed by the first author for this study to collect the required information about the effectiveness of the family medicine curriculum. Pilot study was done, and the questionnaire was modified accordingly. The data was collected by the first author. The questionnaire was posted online using a Google form and was distributed in the WhatsApp groups of family medicine residents in the SMSB and the family medicine specialists. Data was collected online due to the war and the consequent displacement of the targeted family medicine doctors. Lack of internet in most of the cities in Sudan affected the data collection and number of the participants. A convenience sampling technique was used. A total of 100 family medicine doctors were surveyed during the four-months period of data collection. For the qualitative part of this research: Twelve semi-structured in-depth online interviews were done with the family medicine residents, specialists/ consultants, and trainers in the SMSB. The interviews aimed to extract in-depth information about the strengths and weaknesses of the family medicine curriculum in the SMSB. The interviews were audio-recorded and took about 15 minutes. Notes were taken during and after each interview to supplement the information. The recordings were transcribed verbatim, and the copies were anonymous. Qualitative data was collected and analyzed by the first author. Statistical analysis The statistical package for social sciences (SPSS 23) was used to summarize the data numerically (mean, standard deviation, median) and graphically (frequency tables). Chi square test was used to determine association among categorized variables. P value < 0.05 is considered statistically significant. Qualitative data were recorded, transcribed, coded, and then analyzed using a content analysis approach. Ethical approval and consent to participate Written ethical clearance and approval for conducting this research were obtained from the Alneelain University Institutional Review Board (IRB). Written informed consent was taken from all participants with assurance of confidentiality and all rights. All methods were performed in accordance with the relevant guidelines and regulations. Participation was voluntary; any participant had the right to withdraw at any time. The collected information was used for research purposes only, with the consecration of all privacy issues. Results Quantitative results A total of 100 family medicine doctors participated in the study. Most of the participants (82%) were females. Regarding the job title (76%) of the participants were residents and the others (24%) were specialists/ consultants. More than half of the participants (66%) were from Khartoum state as shown in Table (1). Results of the study revealed that (43%) of the participants completed a training program in family medicine before joining the SMSB. Of them (67.4%) obtained a master’s degree in family medicine before joining the SMSB training program, and the rest (32.6%) obtained a family medicine diploma before joining the SMSB training program, as shown in Table (1) . Table (1): Demographic characteristics of the participants, (n = 100). Variables Frequency Percent (%) Gender: Female 82 82.0 Male 18 18.0 Job title : Resident 76 76.0 Specialist 24 24.0 Residence : Khartoum state 66 66.0 Gezira state 20 20.0 Other state 14 14.0 Did you received family medicine training program before joining the training in the SMSB Yes 43 43.0 No 57 57.0 If yes, which type of training? (n = 43) Diploma in family medicine 14 32.6 M.Sc. family medicine 29 67.4 Most of the participants (87%) reported satisfaction with the SMSB family medicine training curriculum, and they believed it to be effective in improving knowledge and practice. In addition, (81%) of the participants reported that the lectures and workshops arranged for the residents were sufficient to improve their knowledge, Table (2) . The satisfaction rate with the arranged courses and workshops and the clinical-based training program in SMSB was high, amounting to (86%) and (81%), respectively. Most of the participants (93%) reported that the introduction of online learning was useful to the residents. Regarding the research methodology course, (70%) of the respondents reported that the course was sufficient in improving their knowledge, and the rest (30%) believed the research methodology course was not adequate as shown in Table (2). Table (2): Respondents’ opinion regarding the effectiveness of the family medicine curriculum, (n = 100). Variables Frequency Percent (%) Satisfaction with the family medicine training curriculum in the SMSB: Yes 87 87.0 No 13 13.0 The family medicine training curriculum in the SMSB is effective in improving knowledge and practice : Yes 87 87.0 No 13 13.0 Lectures and workshops that were arranged for the residents were sufficient in improving their knowledge : Yes 81 81.0 No 19 19.0 Satisfaction with the arranged courses and workshops in the SMSB : Yes 86 86.0 No 14 14.0 Satisfaction with the clinical-based training program in SMSB : Yes 81 81.0 No 19 19.0 Introduction of the online learning was useful to the residents : Yes 93 93.0 No 7 7.0 The research methodology course in SMSB was sufficient in improving the knowledge : Yes 70 70.0 No 30 30.0 Half of the respondents (15/30, 50%) who reported inadequacy of the research methodology course in the SMSB reported that the course was not effective in improving their knowledge and skills. (14/30, 46.7%) of them reported the course duration was short, and only (1/30, 3.3%) reported that the course materials were not simple, as shown in Figure (1) . Satisfaction with the family medicine curriculum revealed significant association when tested in cross tabulation with residence (p value = 0.000), respondents’ opinion regarding the effectiveness of the family medicine curriculum (p value = 0.000), respondents’ opinion regarding the effectiveness of the research methodology course (p value = 0.000) and the satisfaction with the clinical-based training program in SMSB (p value = 0.000), as displayed in table (3). Table (3): Cross tabulation between satisfaction with the family medicine curriculum and respondents job title, residence and opinion regarding the effectiveness of the family medicine curriculum, (n = 100). Variables Satisfaction with the family medicine curriculum P value No Yes Job title: Resident 10 66 0.620 Specialist 3 21 Residence : Khartoum state 5 61 0.000 Gezira state 1 19 Other state 7 7 Did you received family medicine training program before joining the training in the SMSB? No 7 50 0.517 Yes 6 37 Do you think the family medicine training curriculum in the SMSB is effective in improving your knowledge and practice? No 13 0 0.000 Yes 0 87 Do you think the research methodology course in SMSB is quite enough in improving the knowledge? No 12 18 0.000 Yes 1 69 Are you satisfied with the clinical-based training program in SMSB? No 12 7 0.000 Yes 1 80 Qualitative results: The in-depth interviews results highlighted the respondents' perceptions of positive and negative aspects of the family medicine curriculum at the SMSB. Positive perception of training quality About 75% of the surveyed doctors reported a well-prepared family medicine training program. Family medicine training focuses on clinical-based training, including CME and CPD programs. Residents feel that the duration of the clinical rotation, especially the final nine months, is sufficient for improving clinical knowledge. Comprehensive curriculum The curriculum covers all disciplines and is patient centered. Regular updates to the curriculum help maintain its relevance and effectiveness compared to other specialties. Curriculum details and structure need improvement Some specialists called for a more detailed curriculum to standardize training across different training centers in Sudan. There is a requirement for clearly defined topics for tutorials and case discussions, alongside activating weekly reports summarizing completed activities. Lack of family medicine trainers The centralization of family medicine trainers in Khartoum and Gezira states poses a significant challenge. Many newly graduated specialists seek better opportunities abroad, further exacerbating the shortage of trainers in Sudan. Suggested improvements Recommendations for organizing "Training of Trainers" (TOT) workshops to improve the skills of the trainers. Research challenges Residents expressed difficulties with unclear requirements from the research committee, resulting in a high rejection rate of proposals without justification. Suggestions from residents include a review or reform of the research committee's processes to improve clarity and support their work. Summary The interviews reveal a largely positive view of the family medicine curriculum's design and execution at SMSB, highlighting its comprehensive and clinically focused nature. However, significant concerns arise regarding the need for standardized curriculum details, trainer availability, and research support, all of which are crucial for the ongoing development and effectiveness of the program. Discussion The study's purpose was to evaluate the effectiveness of the family medicine curriculum in SMSB. Qualitative and quantitative surveys were used to collect the data for the study. Our findings from both the qualitative and quantitative surveys were consistent with the adequacy of the family medicine training program at the SMSB. The satisfaction rate of residents for the family medicine curriculum in the SMSB was high, concerning the training with a well-arranged four-year clinical rotation, courses, and workshops. These results are consistent with Pensa et al . findings [ 18 ]. The qualitative survey revealed that the SMSB four-year family medicine training program is effective in improving skills and knowledge. Peck et al . concluded in their study that the family skill curriculum used in their school improved the residents’ knowledge and attitudes [ 19 ]. The CME and CPD programs in the family medicine specialty in SMSB improve the knowledge and experience of the residents. In 2015, similar results were reported by May et al . [ 11 ]. Findings showed that clinical rotation in SMSB is patient-centered training and covers all disciplines in family medicine. This results in improving the residents’ knowledge, attitude, and patient respect. Our findings are consistent with Schiefer et al . who aimed to assess the skills and empathy of the family medicine curriculum [ 20 ]. Some interviewed residents indicated dissatisfaction with the research methodology course in SMSB. The course was not effective in improving the knowledge and skills of half of them. Furthermore, residents reported that the family medicine research committee at the SMSB had unclear requirements which were reflected in a high rejection rate of the research proposals submitted by residents. Family medicine in Sudan is one of the specialties preferred by female doctors. Most of the study participants were females. Furthermore, more than half of the participants were from Khartoum state. These results were consistent with Abdelgadir et al . study on feminization in family medicine in Sudan. Also, they reported that most family medicine doctors from Khartoum and Gezira states due to the presence of training programs and job offers in these states [ 21 ]. The qualitative survey identified some problems facing family residents in Sudan. The training programs are mainly concentrated in Khartoum and Gezira states, and residents of other states complained that the arrangements and organization of training lectures and workshops in their states are different from those in Khartoum and Gezira states. These differences in the curriculum may be due to the lack of family medicine trainers in the other states in Sudan. Moreover, the availability of enough referral primary health care (PHC) centers and family medicine doctors in Khartoum and Gezira states could explain these differences. The same issue was discussed by Abdelgadir et al . as they reported the economic situation and the government plan play an important role in the localization of the jobs and training programs in Khartoum and Gezira states [ 21 ]. The inequalities in the distribution of the workforce are thought to be one of the major threats challenging the Sudanese health sector [ 22 ]. Rural and remote areas lack enough qualified health workers which affects the delivery of health care services and health education [ 21 , 23 ]. Conclusion The family medicine curriculum in SMSB is a comprehensive training curriculum that effectively increases knowledge, skills, and patient respect among residents. The CME and CPD programs improve the skills and experience of family doctors. Residents in the SMSB are satisfied during their four years of clinical rotation. The organized lectures and workshops are sufficient to improve residents’ knowledge. The research methodology course is challenging for some residents. Family medicine training programs were mainly localized in Khartoum and Gezira states in Sudan. This resulted in the improvement of primary care and centralization of family medicine jobs in these states, which shows clear discrepancies between these states and the other states of the country. Recommendations Based on the results of this study, the following recommendations are offered as possible means to improve family medicine curriculum and training in Sudan. The SMSB in collaboration with the Ministry of Health (MOH) needs to expand the coverage and improve PHC facilities to include the rest of the states of Sudan. The MOH must encourage family medicine doctors to work in Sudan PHC centers and SMSB training programs by facilitating the recruitment and arranging job offers to cover all states of Sudan. The family medicine curriculum must be regularly reviewed, evaluated, and updated to improve the family medicine training in Sudan. The SMSB Family Medicine Council must re-evaluate the research methodology course to improve residents’ skills and knowledge. The family medicine research committee in the SMSB needs to reauthorize clear guidance to the family medicine residents to solve the problem of the high rejection rate of the research proposals. Further studies on family medicine training and practice in Sudan must be done to improve the settings of family medicine and engorgement of auditing. Study strengths and limitations The study adopted mixed qualitative and quantitative approaches for better results. However, some obstacles were faced in collecting data for the qualitative survey due to the war in Sudan and the consequent displacement and lack of internet. Relatively small sample size and might limit the validity of the results. Abbreviations CME Continuous medical education CPD Continuous professional development IRB Institutional review board MD Medical Decoration M.Sc. Master’s degree PHC Primary health care SMSB Sudan Medical Specialization Board TOT Training of trainers Declarations Availability of data and material The datasets used and/or analyzed during the current study are available from the corresponding author upon reasonable request. Competing interests The authors declared that they had no competing interests. Clinical trial number Not applicable Consent for publication Not applicable Funding This study was supported via funding from Deanship of Scientific Research, Prince Sattam bin Abdulaziz University [project number: PSAU/2025/R/1446]. Authors’ contributions Hiba Salah Abdelgadir: Conceptualization; Data curation; Formal analysis; Funding acquisition; Investigation; Methodology; Project administration; Resources; Software, original draft; Writing. Hind Salah Abdelgadir: Data curation; Resources; Software; Formal analysis, original draft; Writing - review & editing. Nasreldin M. Ahmed: Supervision, original draft; review & editing. Adel A. Nasser: Original draft; review & editing. Abed Saif Ahmed Alghawli: Original draft; review & editing, Funding acquisition. Amani A. K. Elsayed: Original draft; review & editing. All authors approved the final version of the manuscript before submission. Acknowledgments Thanks to Dr. Salah Abdelgadir Abdelmagid and Ms. Samia Mohamed Eltayb for their support and guidance. Special thanks to the family medicine colleagues and residents for their acceptance to participate in the study. References Bailey, Tom. "Is family medicine a specialty?: YES." 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Sudan Medical Specialization Board, web page, Available at: www.smsb.gov.sd/. (Accessed 21 October 2024). Pensa, Mellisa, Patty Frew, and Sherril B. Gelmon. "Integrating improvement learning into a family medicine residency curriculum." Fam Med 45.6 (2013): 409-416. Peck, Erin C., Florencia Lebensohn-Chialvo, and Colleen T. Fogarty. "Teaching family-oriented care to family medicine residents: Evaluation of a family skills curriculum." Families, Systems, & Health 40.1 (2022): 87. Schiefer, Rebekah, Sheldon Levy, and Rebecca Rdesinski. "A family systems curriculum: evaluating skills and empathy." Family medicine 53.1 (2021): 54-57. Abdelgadir, Hiba Salah, Sahar Bajouri, and Hind Salah Abdelgadir. "Implementation of the clinical practice guidelines among family medicine doctors at primary health care facilities in Khartoum and Gezira states of Sudan." BMC Primary Care 25.1 (2024): 277. Nurelhuda, Nazik, et al. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-6476665","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Article","associatedPublications":[],"authors":[{"id":454879669,"identity":"33a89ac7-6da6-4842-9f6a-0f6327e44fb6","order_by":0,"name":"Hiba Salah Abdelgadir","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA80lEQVRIiWNgGAWjYBACA2YeEGUBxIkNDB+AFBs7cVokwFoYZ4C0MBPSwgDXksAA0U5Iizk778GPP2ok7Prbk9s+2/zaJs/HzMD44WMObi2WzXzJ0jzHJJJnnHnYPDu377ZhGzMDs+TMbXgcdpjHQJqBTSKZ4UZiM3Nuz21GoBY2Zl78Wox//vgnkSwP0mLZc9ueGC1mErxtEnYGIC0MP24nEqGFL82at08iwRDoF8behtvJbcyMzfj9cv7s4Zs/vtnYyx1Pf8zw489t2/ntzQc/fMSjBQaAUQ8EjG1gsoGweiCwh1B/iFI8CkbBKBgFIwwAAPuCTyRwkzR8AAAAAElFTkSuQmCC","orcid":"","institution":"Alzaiem Alazhari University","correspondingAuthor":true,"prefix":"","firstName":"Hiba","middleName":"Salah","lastName":"Abdelgadir","suffix":""},{"id":454879670,"identity":"0a71bd88-5029-4860-b8a6-71202d93a238","order_by":1,"name":"Hind Salah Abdelgadir","email":"","orcid":"","institution":"Alzaiem Alazhari University","correspondingAuthor":false,"prefix":"","firstName":"Hind","middleName":"Salah","lastName":"Abdelgadir","suffix":""},{"id":454879671,"identity":"a4c5e9f8-9765-485b-8f6e-bc772b402771","order_by":2,"name":"Nasreldin M. 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K.","lastName":"Elsayed","suffix":""}],"badges":[],"createdAt":"2025-04-18 06:53:25","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-6476665/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-6476665/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":82603896,"identity":"15ade9bd-0518-4da0-a76d-6dd93ef66094","added_by":"auto","created_at":"2025-05-13 09:54:13","extension":"jpg","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":38443,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eDistribution of the participants according to their opinion of the negative points of the research methodology course, (n = 30).\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"1.jpg","url":"https://assets-eu.researchsquare.com/files/rs-6476665/v1/91298b05b57a3e0c603dc5fe.jpg"},{"id":82606989,"identity":"85c9a313-45ed-4223-91cf-8724e662e33a","added_by":"auto","created_at":"2025-05-13 10:10:14","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1491484,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6476665/v1/39886db5-3f66-463c-b6cc-b0d79432c689.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Effectiveness of the family medicine curriculum in the improvement of skills and knowledge of family medicine residents in Sudan 2024: A quantitative and qualitative survey","fulltext":[{"header":"Introduction","content":"\u003cp\u003eFamily medicine is globally considered a new specialty, that was identified in 1969 [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. In Sudan, family medicine was acknowledged in 2006 with a master\u0026rsquo;s degree [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. Since then, family medicine practice in Sudan has improved due to the improvement of educational programs. Five educational institutions in Khartoum and Gezira states currently offer postgraduate training programs for family medicine residents in Sudan [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. However, there is still some lack of awareness of the family physician\u0026rsquo;s role and a lack of knowledge that family physicians must uphold [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eLack of awareness of the family medicine specialty affects the continuity of care and the referral system at the primary care level, which may create a professional practical gap [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. The most significant barrier hindering family physicians from fully utilizing their skills and role in primary healthcare is the gap between diagnostic testing and referral processes [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. Therefore, a strong training-based curriculum that contains continuous medical education (CME), and continuous professional development (CPD) programs, anticipated to improve the diagnostic knowledge and referral skills of family medicine doctors and improve their adherence and implementation of the clinical guidelines [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. High-quality CME and CPD programs have a positive impact on the practice and clinical experience of family medicine doctors [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe Curriculum defines the recommended training strategies for the residents\u0026rsquo; training. Knowledge, attitudes, skills, and topic competencies for family medicine residents should be attained through a longitudinal well-established training program [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]. The curriculum for family medicine residency can structure experience in several specified areas.\u003c/p\u003e \u003cp\u003eA well-written program and course learning outcomes and structured didactic lectures, workshops, journal clubs, and conferences are important in the family medicine curriculum. Similarly, a focus on evidence-based and outcome-oriented studies of common and chronic diseases is essential for family medicine physicians [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]. Furthermore, suitable referral patterns and providing cost-effective care are important parts of the family medicine curriculum [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe family medicine training program should include the integration of knowledge and skills. Family physicians must be trained to be patient-centered and to gain good knowledge and skills in the management of chronic diseases [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e, \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThere are few published studies about family medicine in Sudan in general. There is no recent study that evaluated the efficacy of the family medicine curriculum and satisfaction of the family medicine residents in the Sudan Medical Specialization Board (SMSB). This study aimed to evaluate the effectiveness of the family medicine curriculum in the SMSB to provide baseline and updated data on the strengths and weaknesses of the family medicine training program in the SMSB.\u003c/p\u003e"},{"header":"Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eStudy design and population\u003c/h2\u003e \u003cp\u003eA descriptive cross-sectional quantitative and qualitative study was conducted during the period from February to October 2024. SMSB was established in 1995 by Presidential Decree under the Sudan Medical Specialization Act. SMSB is the sole professional training body in the Republic of Sudan mandated to manage and deliver medical and health specialty programs in the country [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]. The driving foundation of SMSB is its specialty councils, which are responsible for the implementation of all activities concerning the training of medical doctors including the development and review of curricula. There are more than 61 specialty councils in the SMSB that offer master\u0026rsquo;s degrees (M.Sc.) and Medical Decoration (MD) [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe study population was composed of the third and fourth-year family medicine residents at SMSB and the family medicine specialists/ consultants who have achieved the SMSB clinical MD, as they are more aware of the curriculum and the training program in SMSB. Family medicine trainers in the SMSB were also included in the in-depth interviews.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eData Collection\u003c/h3\u003e\n\u003cp\u003eThe study adopted a mixed design approach (quantitative and qualitative). Quantitative data was collected with the use of a pre-coded and pre-tested structured questionnaire (\u003cem\u003eAnnex 1\u003c/em\u003e) that was designed by the first author for this study to collect the required information about the effectiveness of the family medicine curriculum. Pilot study was done, and the questionnaire was modified accordingly. The data was collected by the first author. The questionnaire was posted online using a Google form and was distributed in the WhatsApp groups of family medicine residents in the SMSB and the family medicine specialists. Data was collected online due to the war and the consequent displacement of the targeted family medicine doctors. Lack of internet in most of the cities in Sudan affected the data collection and number of the participants. A convenience sampling technique was used. A total of 100 family medicine doctors were surveyed during the four-months period of data collection.\u003c/p\u003e \u003cp\u003eFor the qualitative part of this research: Twelve semi-structured in-depth online interviews were done with the family medicine residents, specialists/ consultants, and trainers in the SMSB. The interviews aimed to extract in-depth information about the strengths and weaknesses of the family medicine curriculum in the SMSB. The interviews were audio-recorded and took about 15 minutes. Notes were taken during and after each interview to supplement the information. The recordings were transcribed verbatim, and the copies were anonymous. Qualitative data was collected and analyzed by the first author.\u003c/p\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003eStatistical analysis\u003c/h2\u003e \u003cp\u003eThe statistical package for social sciences (SPSS 23) was used to summarize the data numerically (mean, standard deviation, median) and graphically (frequency tables). Chi square test was used to determine association among categorized variables. \u003cem\u003eP value\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05 is considered statistically significant. Qualitative data were recorded, transcribed, coded, and then analyzed using a content analysis approach.\u003c/p\u003e \u003cp\u003e \u003cstrong\u003eEthical approval and consent to participate\u003c/strong\u003e \u003cp\u003e Written ethical clearance and approval for conducting this research were obtained from the Alneelain University Institutional Review Board (IRB). Written informed consent was taken from all participants with assurance of confidentiality and all rights. All methods were performed in accordance with the relevant guidelines and regulations. Participation was voluntary; any participant had the right to withdraw at any time. The collected information was used for research purposes only, with the consecration of all privacy issues.\u003c/p\u003e \u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cdiv id=\"Sec7\" class=\"Section2\"\u003e \u003ch2\u003eQuantitative results\u003c/h2\u003e \u003cp\u003eA total of 100 family medicine doctors participated in the study. Most of the participants (82%) were females. Regarding the job title (76%) of the participants were residents and the others (24%) were specialists/ consultants. More than half of the participants (66%) were from Khartoum state as shown in \u003cb\u003eTable\u0026nbsp;(1).\u003c/b\u003e\u003c/p\u003e \u003cp\u003eResults of the study revealed that (43%) of the participants completed a training program in family medicine before joining the SMSB. Of them (67.4%) obtained a master\u0026rsquo;s degree in family medicine before joining the SMSB training program, and the rest (32.6%) obtained a family medicine diploma before joining the SMSB training program, as shown in \u003cb\u003eTable\u0026nbsp;(1)\u003c/b\u003e.\u003c/p\u003e \u003cp\u003e \u003cb\u003eTable\u0026nbsp;(1): Demographic characteristics of the participants, (n\u0026thinsp;=\u0026thinsp;100).\u003c/b\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"No\" id=\"Taba\" border=\"1\"\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFrequency\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003ePercent (%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003eGender:\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e82\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e82.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e18.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eJob title\u003c/b\u003e:\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eResident\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e76\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e76.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSpecialist\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e24.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eResidence\u003c/b\u003e:\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eKhartoum state\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e66\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e66.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGezira state\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e20.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOther state\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e14.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eDid you received family medicine training program before joining the training in the SMSB\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e43\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e43.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e57\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e57.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eIf yes, which type of training? (n\u0026thinsp;=\u0026thinsp;43)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDiploma in family medicine\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e32.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eM.Sc. family medicine\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e67.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eMost of the participants (87%) reported satisfaction with the SMSB family medicine training curriculum, and they believed it to be effective in improving knowledge and practice. In addition, (81%) of the participants reported that the lectures and workshops arranged for the residents were sufficient to improve their knowledge, \u003cb\u003eTable\u0026nbsp;(2)\u003c/b\u003e.\u003c/p\u003e \u003cp\u003eThe satisfaction rate with the arranged courses and workshops and the clinical-based training program in SMSB was high, amounting to (86%) and (81%), respectively. Most of the participants (93%) reported that the introduction of online learning was useful to the residents. Regarding the research methodology course, (70%) of the respondents reported that the course was sufficient in improving their knowledge, and the rest (30%) believed the research methodology course was not adequate as shown in Table\u0026nbsp;(2).\u003c/p\u003e \u003cp\u003e \u003cb\u003eTable\u0026nbsp;(2): Respondents\u0026rsquo; opinion regarding the effectiveness of the family medicine curriculum, (n\u0026thinsp;=\u0026thinsp;100).\u003c/b\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"No\" id=\"Tabb\" border=\"1\"\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFrequency\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003ePercent (%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003eSatisfaction with the family medicine training curriculum in the SMSB:\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e87\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e87.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e13.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eThe family medicine training curriculum in the SMSB is effective in improving knowledge and practice\u003c/b\u003e:\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e87\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e87.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e13.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eLectures and workshops that were arranged for the residents were sufficient in improving their knowledge\u003c/b\u003e:\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e81\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e81.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e19\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e19.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSatisfaction with the arranged courses and workshops in the SMSB\u003c/b\u003e:\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e86\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e86.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e14.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSatisfaction with the clinical-based training program in SMSB\u003c/b\u003e:\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e81\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e81.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e19\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e19.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eIntroduction of the online learning was useful to the residents\u003c/b\u003e:\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e93\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e93.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eThe research methodology course in SMSB was sufficient in improving the knowledge\u003c/b\u003e:\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e70\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e70.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e30.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eHalf of the respondents (15/30, 50%) who reported inadequacy of the research methodology course in the SMSB reported that the course was not effective in improving their knowledge and skills. (14/30, 46.7%) of them reported the course duration was short, and only (1/30, 3.3%) reported that the course materials were not simple, as shown in \u003cb\u003eFigure (1)\u003c/b\u003e.\u003c/p\u003e \u003cp\u003eSatisfaction with the family medicine curriculum revealed significant association when tested in cross tabulation with residence (p value\u0026thinsp;=\u0026thinsp;0.000), respondents\u0026rsquo; opinion regarding the effectiveness of the family medicine curriculum (p value\u0026thinsp;=\u0026thinsp;0.000), respondents\u0026rsquo; opinion regarding the effectiveness of the research methodology course (p value\u0026thinsp;=\u0026thinsp;0.000) and the satisfaction with the clinical-based training program in SMSB (p value\u0026thinsp;=\u0026thinsp;0.000), as displayed in table (3).\u003c/p\u003e \u003cp\u003e \u003cb\u003eTable\u0026nbsp;(3): Cross tabulation between satisfaction with the family medicine curriculum and respondents job title, residence and opinion regarding the effectiveness of the family medicine curriculum, (n\u0026thinsp;=\u0026thinsp;100).\u003c/b\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"No\" id=\"Tabc\" border=\"1\"\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003eSatisfaction with the family medicine curriculum\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cem\u003eP value\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e \u003cp\u003eJob title:\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eResident\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e66\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.620\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSpecialist\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e21\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eResidence\u003c/b\u003e:\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eKhartoum state\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e61\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e0.000\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGezira state\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e19\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOther state\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eDid you received family medicine training program before joining the training in the SMSB?\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.517\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e37\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eDo you think the family medicine training curriculum in the SMSB is effective in improving your knowledge and practice?\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.000\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e87\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eDo you think the research methodology course in SMSB is quite enough in improving the knowledge?\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.000\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e69\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAre you satisfied with the clinical-based training program in SMSB?\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.000\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e80\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003eQualitative results:\u003c/h2\u003e \u003cp\u003eThe in-depth interviews results highlighted the respondents' perceptions of positive and negative aspects of the family medicine curriculum at the SMSB.\u003c/p\u003e \u003cp\u003e \u003cstrong\u003ePositive perception of training quality\u003c/strong\u003e \u003cp\u003eAbout 75% of the surveyed doctors reported a well-prepared family medicine training program. Family medicine training focuses on clinical-based training, including CME and CPD programs. Residents feel that the duration of the clinical rotation, especially the final nine months, is sufficient for improving clinical knowledge.\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cstrong\u003eComprehensive curriculum\u003c/strong\u003e \u003cp\u003eThe curriculum covers all disciplines and is patient centered. Regular updates to the curriculum help maintain its relevance and effectiveness compared to other specialties.\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cstrong\u003eCurriculum details and structure need improvement\u003c/strong\u003e \u003cp\u003eSome specialists called for a more detailed curriculum to standardize training across different training centers in Sudan. There is a requirement for clearly defined topics for tutorials and case discussions, alongside activating weekly reports summarizing completed activities.\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cstrong\u003eLack of family medicine trainers\u003c/strong\u003e \u003cp\u003eThe centralization of family medicine trainers in Khartoum and Gezira states poses a significant challenge. Many newly graduated specialists seek better opportunities abroad, further exacerbating the shortage of trainers in Sudan.\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cstrong\u003eSuggested improvements\u003c/strong\u003e \u003cp\u003eRecommendations for organizing \"Training of Trainers\" (TOT) workshops to improve the skills of the trainers.\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cstrong\u003eResearch challenges\u003c/strong\u003e \u003cp\u003eResidents expressed difficulties with unclear requirements from the research committee, resulting in a high rejection rate of proposals without justification. Suggestions from residents include a review or reform of the research committee's processes to improve clarity and support their work.\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cstrong\u003eSummary\u003c/strong\u003e \u003cp\u003eThe interviews reveal a largely positive view of the family medicine curriculum's design and execution at SMSB, highlighting its comprehensive and clinically focused nature. However, significant concerns arise regarding the need for standardized curriculum details, trainer availability, and research support, all of which are crucial for the ongoing development and effectiveness of the program.\u003c/p\u003e \u003c/p\u003e \u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003eThe study's purpose was to evaluate the effectiveness of the family medicine curriculum in SMSB. Qualitative and quantitative surveys were used to collect the data for the study. Our findings from both the qualitative and quantitative surveys were consistent with the adequacy of the family medicine training program at the SMSB.\u003c/p\u003e \u003cp\u003eThe satisfaction rate of residents for the family medicine curriculum in the SMSB was high, concerning the training with a well-arranged four-year clinical rotation, courses, and workshops. These results are consistent with Pensa \u003cem\u003eet al\u003c/em\u003e. findings [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe qualitative survey revealed that the SMSB four-year family medicine training program is effective in improving skills and knowledge. Peck \u003cem\u003eet al\u003c/em\u003e. concluded in their study that the family skill curriculum used in their school improved the residents\u0026rsquo; knowledge and attitudes [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe CME and CPD programs in the family medicine specialty in SMSB improve the knowledge and experience of the residents. In 2015, similar results were reported by May \u003cem\u003eet al\u003c/em\u003e. [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eFindings showed that clinical rotation in SMSB is patient-centered training and covers all disciplines in family medicine. This results in improving the residents\u0026rsquo; knowledge, attitude, and patient respect. Our findings are consistent with Schiefer \u003cem\u003eet al\u003c/em\u003e. who aimed to assess the skills and empathy of the family medicine curriculum [\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eSome interviewed residents indicated dissatisfaction with the research methodology course in SMSB. The course was not effective in improving the knowledge and skills of half of them. Furthermore, residents reported that the family medicine research committee at the SMSB had unclear requirements which were reflected in a high rejection rate of the research proposals submitted by residents.\u003c/p\u003e \u003cp\u003eFamily medicine in Sudan is one of the specialties preferred by female doctors. Most of the study participants were females. Furthermore, more than half of the participants were from Khartoum state. These results were consistent with Abdelgadir \u003cem\u003eet al\u003c/em\u003e. study on feminization in family medicine in Sudan. Also, they reported that most family medicine doctors from Khartoum and Gezira states due to the presence of training programs and job offers in these states [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe qualitative survey identified some problems facing family residents in Sudan. The training programs are mainly concentrated in Khartoum and Gezira states, and residents of other states complained that the arrangements and organization of training lectures and workshops in their states are different from those in Khartoum and Gezira states. These differences in the curriculum may be due to the lack of family medicine trainers in the other states in Sudan. Moreover, the availability of enough referral primary health care (PHC) centers and family medicine doctors in Khartoum and Gezira states could explain these differences.\u003c/p\u003e \u003cp\u003eThe same issue was discussed by Abdelgadir \u003cem\u003eet al\u003c/em\u003e. as they reported the economic situation and the government plan play an important role in the localization of the jobs and training programs in Khartoum and Gezira states [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e]. The inequalities in the distribution of the workforce are thought to be one of the major threats challenging the Sudanese health sector [\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e]. Rural and remote areas lack enough qualified health workers which affects the delivery of health care services and health education [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e, \u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e].\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThe family medicine curriculum in SMSB is a comprehensive training curriculum that effectively increases knowledge, skills, and patient respect among residents. The CME and CPD programs improve the skills and experience of family doctors. Residents in the SMSB are satisfied during their four years of clinical rotation. The organized lectures and workshops are sufficient to improve residents\u0026rsquo; knowledge. The research methodology course is challenging for some residents. Family medicine training programs were mainly localized in Khartoum and Gezira states in Sudan. This resulted in the improvement of primary care and centralization of family medicine jobs in these states, which shows clear discrepancies between these states and the other states of the country.\u003c/p\u003e \u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003eRecommendations\u003c/h2\u003e \u003cp\u003eBased on the results of this study, the following recommendations are offered as possible means to improve family medicine curriculum and training in Sudan.\u003c/p\u003e \u003cp\u003eThe SMSB in collaboration with the Ministry of Health (MOH) needs to expand the coverage and improve PHC facilities to include the rest of the states of Sudan. The MOH must encourage family medicine doctors to work in Sudan PHC centers and SMSB training programs by facilitating the recruitment and arranging job offers to cover all states of Sudan.\u003c/p\u003e \u003cp\u003eThe family medicine curriculum must be regularly reviewed, evaluated, and updated to improve the family medicine training in Sudan.\u003c/p\u003e \u003cp\u003eThe SMSB Family Medicine Council must re-evaluate the research methodology course to improve residents\u0026rsquo; skills and knowledge.\u003c/p\u003e \u003cp\u003eThe family medicine research committee in the SMSB needs to reauthorize clear guidance to the family medicine residents to solve the problem of the high rejection rate of the research proposals.\u003c/p\u003e \u003cp\u003eFurther studies on family medicine training and practice in Sudan must be done to improve the settings of family medicine and engorgement of auditing.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec12\" class=\"Section2\"\u003e \u003ch2\u003eStudy strengths and limitations\u003c/h2\u003e \u003cp\u003eThe study adopted mixed qualitative and quantitative approaches for better results. However, some obstacles were faced in collecting data for the qualitative survey due to the war in Sudan and the consequent displacement and lack of internet. Relatively small sample size and might limit the validity of the results.\u003c/p\u003e \u003c/div\u003e"},{"header":"Abbreviations","content":"\u003cdiv class=\"DefinitionList\"\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eCME\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eContinuous medical education\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eCPD\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eContinuous professional development\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eIRB\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eInstitutional review board\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eMD\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eMedical Decoration\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eM.Sc.\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eMaster\u0026rsquo;s degree\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003ePHC\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003ePrimary health care\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eSMSB\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eSudan Medical Specialization Board\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eTOT\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eTraining of trainers\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003c/div\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAvailability of data and material\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets used and/or analyzed during the current study are available from the corresponding author upon reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declared that they had no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eClinical trial number\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was supported via funding from Deanship of Scientific Research, Prince Sattam bin Abdulaziz University [project number: PSAU/2025/R/1446].\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026rsquo; contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eHiba Salah Abdelgadir:\u0026nbsp;\u003c/strong\u003eConceptualization; Data curation; Formal analysis; Funding acquisition; Investigation; Methodology; Project administration; Resources; Software, original draft; Writing.\u0026nbsp;\u003cstrong\u003eHind Salah Abdelgadir:\u0026nbsp;\u003c/strong\u003eData curation; Resources; Software; Formal analysis, original draft; Writing - review \u0026amp; editing.\u0026nbsp;\u003cstrong\u003eNasreldin M. Ahmed:\u0026nbsp;\u003c/strong\u003eSupervision,\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003eoriginal draft; review \u0026amp; editing.\u0026nbsp;\u003cstrong\u003eAdel A. Nasser:\u0026nbsp;\u003c/strong\u003eOriginal draft; review \u0026amp; editing.\u0026nbsp;\u003cstrong\u003eAbed Saif Ahmed Alghawli:\u0026nbsp;\u003c/strong\u003eOriginal draft; review \u0026amp; editing, Funding acquisition.\u0026nbsp;\u003cstrong\u003eAmani A. K. Elsayed:\u0026nbsp;\u003c/strong\u003eOriginal draft; review \u0026amp; editing.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eAll authors approved the final version of the manuscript before submission.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgments\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThanks to Dr. Salah Abdelgadir Abdelmagid and Ms. Samia Mohamed Eltayb for their support and guidance. Special thanks to the family medicine colleagues and residents for their acceptance to participate in the study.\u0026nbsp;\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eBailey, Tom. \u0026quot;Is family medicine a specialty?: YES.\u0026quot; \u003cem\u003eCanadian Family Physician\u003c/em\u003e 53.2 (2007): 221-223.\u003c/li\u003e\n\u003cli\u003eMANSOUR, MUSA Basheer, et al. \u0026quot;Introducing a Structured Blended Medical Educational Program to Family Medicine Physicians in Sudan Medical Specialization Board (SMSB)-Sudan-2019.\u0026quot; \u003cem\u003ePrinciples and Practice of Clinical Research\u003c/em\u003e 6.3 (2020).\u003c/li\u003e\n\u003cli\u003eCharlton, Bruce G. \u0026quot;Lectures are such an effective teaching method because they exploit evolved human psychology to improve learning.\u0026quot; \u003cem\u003eMedical Hypotheses\u003c/em\u003e 67.6 (2006): 1261-1265.\u003c/li\u003e\n\u003cli\u003eMohamed, Khalid Gaffer, et al. \u0026quot;Impact on core values of family medicine from a 2-year Master\u0026rsquo;s programme in Gezira, Sudan: observational study.\u0026quot; \u003cem\u003eBMC Family Practice\u003c/em\u003e 20 (2019): 1-9.\u003c/li\u003e\n\u003cli\u003eMohamed, K. G., et al. \u0026quot;Confidence in Procedural Skills before and after a Two‐Year Master\u0026rsquo;s Programme in Family Medicine in Gezira State, Sudan.\u0026quot; \u003cem\u003eAdvances in Medicine\u003c/em\u003e 2017.1 (2017): 6267015.\u003c/li\u003e\n\u003cli\u003eMohamed, Khalid G., et al. \u0026quot;Scaling up family medicine training in Gezira, Sudan\u0026ndash;a 2-year in-service master programme using modern information and communication technology: a survey study.\u0026quot; \u003cem\u003eHuman Resources for Health\u003c/em\u003e 12 (2014): 1-9.\u003c/li\u003e\n\u003cli\u003eNeja\u0026scaron;mić, Danijel, et al. \u0026quot;Awareness, attitudes, barriers, and knowledge about evidence-based medicine among family physicians in Croatia: a cross-sectional study.\u0026quot; \u003cem\u003eBMC family practice\u003c/em\u003e 21 (2020): 1-12.\u003c/li\u003e\n\u003cli\u003eLindsay, Elizabeth, et al. \u0026quot;Family physicians\u0026rsquo; continuing professional development activities: current practices and potential for new options.\u0026quot; \u003cem\u003eCanadian medical education journal\u003c/em\u003e 7.1 (2016): e38.\u003c/li\u003e\n\u003cli\u003eGoulet, Fran\u0026ccedil;ois, et al. \u0026quot;Effects of continuing professional development on clinical performance: results of a study involving family practitioners in Quebec.\u0026quot; \u003cem\u003eCanadian Family Physician\u003c/em\u003e 59.5 (2013): 518-525.\u003c/li\u003e\n\u003cli\u003eAbdelgadir, Hiba Salah, et al. \u0026quot;Adherence of doctors to hypertension clinical guidelines in academy charity teaching hospital, Khartoum, Sudan.\u0026quot; \u003cem\u003eBMC health services research\u003c/em\u003e 19 (2019): 1-6.\u003c/li\u003e\n\u003cli\u003eMay-Miller, Hannah, et al. \u0026quot;Improving the quality of discharge summaries: implementing updated Academy of Medical Royal Colleges standards at a district general hospital.\u0026quot; \u003cem\u003eBMJ Open Quality\u003c/em\u003e 4.1 (2015): u207268-w2918.\u003c/li\u003e\n\u003cli\u003eHebert, Randy S., et al. \u0026quot;A systematic review of resident research curricula.\u0026quot; \u003cem\u003eAcademic Medicine\u003c/em\u003e 78.1 (2003): 61-68.\u003c/li\u003e\n\u003cli\u003eButler, Dennis J., Joseph Brocato, and Mark Yeazel. \u0026quot;Family Medicine Didactics Revisited.\u0026quot; \u003cem\u003eFamily medicine\u003c/em\u003e 49.10 (2017): 778-784.\u003c/li\u003e\n\u003cli\u003eWhite, Brett. \u0026quot;Developing A Longitudinal Curriculum In Information Mastery In A Family Medicine Residency.\u0026quot; (2013).\u003c/li\u003e\n\u003cli\u003eThom, David H., et al. \u0026quot;Description and evaluation of an EBM curriculum using a block rotation.\u0026quot; \u003cem\u003eBMC Medical Education\u003c/em\u003e 4 (2004): 1-6.\u003c/li\u003e\n\u003cli\u003eSudan Medical Specialization Board, Health care information for all, Available at: https://www.hifa.org/support/supporting-organisations/sudan-medical-specialization-board. (Accessed 21 October 2024). \u003c/li\u003e\n\u003cli\u003eSudan Medical Specialization Board, web page, Available at: www.smsb.gov.sd/. (Accessed 21 October 2024).\u003c/li\u003e\n\u003cli\u003ePensa, Mellisa, Patty Frew, and Sherril B. Gelmon. \u0026quot;Integrating improvement learning into a family medicine residency curriculum.\u0026quot; \u003cem\u003eFam Med\u003c/em\u003e 45.6 (2013): 409-416.\u003c/li\u003e\n\u003cli\u003ePeck, Erin C., Florencia Lebensohn-Chialvo, and Colleen T. Fogarty. \u0026quot;Teaching family-oriented care to family medicine residents: Evaluation of a family skills curriculum.\u0026quot; \u003cem\u003eFamilies, Systems, \u0026amp; Health\u003c/em\u003e 40.1 (2022): 87.\u003c/li\u003e\n\u003cli\u003eSchiefer, Rebekah, Sheldon Levy, and Rebecca Rdesinski. \u0026quot;A family systems curriculum: evaluating skills and empathy.\u0026quot; \u003cem\u003eFamily medicine\u003c/em\u003e 53.1 (2021): 54-57.\u003c/li\u003e\n\u003cli\u003eAbdelgadir, Hiba Salah, Sahar Bajouri, and Hind Salah Abdelgadir. \u0026quot;Implementation of the clinical practice guidelines among family medicine doctors at primary health care facilities in Khartoum and Gezira states of Sudan.\u0026quot; \u003cem\u003eBMC Primary Care\u003c/em\u003e 25.1 (2024): 277.\u003c/li\u003e\n\u003cli\u003eNurelhuda, Nazik, et al. \u0026quot;Encouraging junior doctors to work in rural Sudan: a discrete choice experiment.\u0026quot; \u003cem\u003eSpecial issue on scaling up health workforce in the Eastern Mediterranean Region\u003c/em\u003e 24.9-2018 (2018).\u003c/li\u003e\n\u003cli\u003eWorld Health Organization. \u003cem\u003eIncreasing access to health workers in remote and rural areas through improved retention: global policy recommendations\u003c/em\u003e. World Health Organization, 2010.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"scientific-reports","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"scirep","sideBox":"Learn more about [Scientific Reports](http://www.nature.com/srep/)","snPcode":"","submissionUrl":"","title":"Scientific Reports","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Scientific Reports","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Family medicine, Curriculum, effectiveness, knowledge, training, Sudan","lastPublishedDoi":"10.21203/rs.3.rs-6476665/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6476665/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eFamily medicine was established in Sudan in 2006 after the first family medicine master's degree program was established. The objective of this study was to evaluate the effectiveness of the family medicine curriculum in the Sudan Medical Specialization Board (SMSB) and provide baseline and updated data on the strengths and weaknesses of the family medicine training program. A cross-sectional quantitative and qualitative descriptive survey was conducted from February to October 2024. Data was collected through a pretested, pre-coded online questionnaire. Semi-structured in-depth interviews were conducted with the family medicine specialists and trainers in the SMSB. All data were summarized numerically (mean, standard deviation, median) and graphically (frequency tables). The Chi square test was used to determine association among categorized variables. \u003cem\u003eP value\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05 is considered statistically significant. Qualitative data was recorded, transcribed, coded, and analyzed using a content analysis approach. A total of 100 family medicine doctors participated in the study. Most of the participants (82%) were females. Regarding the job title (76%) of the participants were residents and the rest (24%) were specialists. More than half of the participants (66%) were from Khartoum state. Most of the participants (87%) reported satisfaction with the family medicine training curriculum in the SMSB and its effectiveness in improving knowledge and practices. Furthermore, (81%) of the participants reported that the lectures and workshops arranged for the residents were sufficient to improve their knowledge. Some of the residents interviewed (30%) complained of dissatisfaction with the research methodology course, and about half of them reported that the course was ineffective and did not improve their knowledge and skills in research. Furthermore, residents reported the family medicine research committee in the SMSB had unclear requirements which was reflected in a high rejection rate of the research proposals submitted by residents. The SMSB family medicine curriculum is a comprehensive training-based curriculum that increases residents\u0026rsquo; satisfaction, knowledge, skills, and patients\u0026rsquo; respect. Significant concerns arise regarding the need for standardized curriculum details, trainer availability, and research support, all of which are crucial for the ongoing development and effectiveness of the program.\u003c/p\u003e","manuscriptTitle":"Effectiveness of the family medicine curriculum in the improvement of skills and knowledge of family medicine residents in Sudan 2024: A quantitative and qualitative survey","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-05-13 09:54:09","doi":"10.21203/rs.3.rs-6476665/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2025-06-08T06:50:26+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-06-03T14:54:18+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-05-31T04:36:04+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"224202607344035818594869933906225577132","date":"2025-05-29T12:17:25+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"270394539798073122903397850320379052677","date":"2025-05-29T09:07:05+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-05-13T09:53:19+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"280496941008557077101619402381545678510","date":"2025-05-11T17:02:26+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-05-07T06:22:18+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-04-29T04:14:43+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2025-04-29T03:35:34+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-04-28T05:51:52+00:00","index":"","fulltext":""},{"type":"submitted","content":"Scientific Reports","date":"2025-04-18T06:50:49+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"scientific-reports","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"scirep","sideBox":"Learn more about [Scientific Reports](http://www.nature.com/srep/)","snPcode":"","submissionUrl":"","title":"Scientific Reports","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Scientific Reports","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"43199b9c-5c05-43fc-8903-1e86be71432f","owner":[],"postedDate":"May 13th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[{"id":48359703,"name":"Health sciences/Health care"},{"id":48359704,"name":"Health sciences/Medical research"}],"tags":[],"updatedAt":"2025-08-01T04:53:15+00:00","versionOfRecord":[],"versionCreatedAt":"2025-05-13 09:54:09","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-6476665","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6476665","identity":"rs-6476665","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}