scholarly journals The system, the resident, and the preceptor: a curricular approach to continuity of care training

2021 ◽  
Author(s):  
Allyson Merbaum ◽  
Kulamakan Kulasegaram ◽  
Rebecca Stoller ◽  
Oshan Fernando ◽  
Risa Freeman
Keyword(s):  
Primary Care ◽  
Continuity Of Care ◽  
Training Programs ◽  
Phenomenological Approach ◽  
Critical Education ◽  
Residency Programs ◽  
Distributed Training ◽  
Care Training ◽  
Unique Framework ◽  
Qualitative Phenomenological

Abstract Background Continuity of care (CoC) is integral to the practice of comprehensive primary care, yet research in the area of CoC training in residency programs is limited. In light of distributed medical education and evolving accreditation standards, a rigorous understanding of the context and enablers contributing to CoC education must be considered in the design and delivery of residency training programs. Approach At our preceptor-based community academic site, we developed a system—resident—preceptor (SRP) framework to explore factors that influence a resident’s perception regarding CoC, and established variables in each area to enhance learning. We then implemented a two-year educational SRP intervention (SRPI) to one cohort of residents and their preceptors to integrate critical education factors and align teaching of continuity of care within curricular goals. Evaluation Evaluation of the intervention was based on resident interviews and faculty focus groups, and a qualitative phenomenological approach was used to analyze the data. While some factors identified are inherent to family medicine, the opportunity for reflection is a unique component to inculcate CoC learning. Reflection The SRP innovation provides a unique framework to facilitate residents’ understanding and development of CoC competency. Our model can be applied to all residency programs, including traditional academic sites as well as distributed training sites, to enhance CoC education.

scholarly journals Transforming the Primary Care Training Clinic: New York State’s Hospital Medical Home Demonstration Pilot

2015 ◽  
Vol 7 (2) ◽  
pp. 247-252 ◽  
Author(s):  
Marietta Angelotti ◽  
Kathryn Bliss ◽  
Dana Schiffman ◽  
Erin Weaver ◽  
Laura Graham ◽  
...  
Keyword(s):  
Primary Care ◽  
New York ◽  
Quality Of Care ◽  
Medical Home ◽  
New York State ◽  
Residency Programs ◽  
Hospital Medical ◽  
Primary Care Training ◽  
Care Training

Abstract Background Training in patient-centered medical home (PCMH) settings may prepare new physicians to measure quality of care, manage the health of populations, work in teams, and include cost information in decision making. Transforming resident clinics to PCMHs requires funding for additional staff, electronic health records, training, and other resources not typically available to residency programs. Objective Describe how a 1115 Medicaid waiver was used to transform the majority of primary care training sites in New York State to the PCMH model and improve the quality of care provided. Methods The 2013–2014 Hospital Medical Home Program provided awards to 60 hospitals and 118 affiliated residency programs (training more than 5000 residents) to transform outpatient sites into PCMHs and provide high-quality, coordinated care. Site visits, coaching calls, resident surveys, data reporting, and feedback were used to promote and monitor change in resident continuity and quality of care. Descriptive analyses measured improvements in these areas. Results A total of 156 participating outpatient sites (100%) received PCMH recognition. All sites enhanced resident education using PCMH principles through patient empanelment, development of quality dashboards, and transforming resident scheduling and training. Clinical quality outcomes showed improvement across the demonstration, including better performance on colorectal and breast cancer screening rates (rate increases of 13%, P ≤ .001, and 11%, P = .011, respectively). Conclusions A 1115 Medicaid waiver is a viable mechanism for states to transform residency clinics to reflect new primary care models. The PCMH transformation of 156 sites led to improvements in resident continuity and clinical outcomes.

Incorporating integrative healthcare into interprofessional education: What do primary care training programs need?

2019 ◽  
Vol 14 ◽  
pp. 6-12 ◽  
Author(s):  
Audrey J. Brooks ◽  
Mary S. Koithan ◽  
Ana Marie Lopez ◽  
Maryanna Klatt ◽  
Jeannie K. Lee ◽  
...  
Keyword(s):  
Primary Care ◽  
Interprofessional Education ◽  
Training Programs ◽  
Primary Care Training ◽  
Integrative Healthcare ◽  
Care Training

Influence of an office‐based internal medicine clerkship on selection of primary care training programs: A 5‐year experience

1996 ◽  
Vol 8 (4) ◽  
pp. 200-207
Author(s):  
Mary T. Ramsbottom‐Lucier ◽  
Diane P. Martin ◽  
Jan D. Carline ◽  
N. Fred Shannon ◽  
Paul G. Ramsey
Keyword(s):  
Internal Medicine ◽  
Primary Care ◽  
Training Programs ◽  
Medicine Clerkship ◽  
Primary Care Training ◽  
Internal Medicine Clerkship ◽  
Care Training ◽  
Selection Of

Senior Medical Students’ Attitudes toward Choosing Residency Programs in Primary Care

1985 ◽  
Vol 1 (4) ◽  
pp. 38-43 ◽  
Author(s):  
Robert R. Franklin ◽  
Pamela A. Samaha ◽  
Janet C. Rice ◽  
Susan M. Igras
Keyword(s):  
Primary Care ◽  
Medical Students ◽  
Residency Programs ◽  
Students Attitudes

5. A needs assessment for a CanMEDS-based curriculum in ambulatory care for internal medicine residents in Canada

2007 ◽  
Vol 30 (4) ◽  
pp. 29
Author(s):  
R. Wong ◽  
S. Roff
Keyword(s):  
Internal Medicine ◽  
Ambulatory Care ◽  
Learning Outcomes ◽  
Delphi Technique ◽  
Training Programs ◽  
Internal Medicine Training ◽  
Modified Delphi ◽  
Ambulatory Training ◽  
Ambulatory Medicine ◽  
Care Training

In Canada, graduates of internal medicine training programs should be proficient in ambulatory medicine and practice. Before determining how to improve education in ambulatory care, a list of desired learning outcomes must be identified and used as the foundation for the design, implementation and evaluation of instructional events. The Delphi technique is a qualitative-research method that uses a series of questionnaires sent to a group of experts with controlled feedback provided by the researchers after each round of questions. A modified Delphi technique was used to determine the competencies required for an ambulatory care curriculum based on the CanMEDS roles. Four groups deemed to be critical stakeholders in residency education were invited to take part in this study: 1. Medical educators and planners, 2. Members of the Canadian Society of Internal Medicine (CSIM), 3. Recent Royal College certificants in internal medicine, 4. Residents currently in core internal medicine residency programs. Panelists were sent questionnaires asking them to rate learning outcomes based on their importance to residency training in ambulatory care. Four hundred and nineteen participants completed the round 1 questionnaire that was comprised of 75 topics identified through a literature search. Using predefined criteria for degree of importance and consensus, 19 items were included in the compendium and 9 were excluded after one round. Forty-two items for which the panel that did not reach consensus, as well as 3 new items suggested by the panel were included in the questionnaire for round 2. Two hundred and forty participants completed the round 2 questionnaire; consensus was reached for each of the 45 items. After two rounds, 21 items were included in the final compendium as very high priority topics (“must be able to”). An additional 26 items were identified as high priority topics (“should be able to”). The overall ratings by each of the four groups were similar and there were no differences between groups that affected the selection of items for the final compendium. To our knowledge this is the first time a Delphi-process has been used to determine the content of an ambulatory care curriculum in internal medicine in Canada. The compendium could potentially be used as the basis to structure training programs in ambulatory care. Barker LR. Curriculum for Ambulatory Care Training in Medical residency: rationale, attitudes and generic proficiencies. J Gen Intern Med 1990; 5(supp.):S3-S14. Levinsky NG. A survey of changes in the proportions of ambulatory training in internal medicine clerkships and residencies from 1986-87 to 1996-97. Acad Med 1998; 73:1114-1115. Linn LS, Brook RH, Clarke VA, Fink A, Kosecoff J. Evaluation of ambulatory care training by graduates of internal medicine residencies. J Med Educ 1986; 61:293-302.

scholarly journals ‘Somebody stuck me in a bag of sand’: Lived experiences of the altered and uncomfortable body after stroke

2021 ◽  
pp. 026921552110007
Author(s):  
Hannah Stott ◽  
Mary Cramp ◽  
Stuart McClean ◽  
Ailie Turton
Keyword(s):  
Support Groups ◽  
Phenomenological Study ◽  
Community Support ◽  
Phenomenological Approach ◽  
The Body ◽  
Stroke Survivors ◽  
Post Stroke ◽  
Personal Perceptions ◽  
Psychological Sense ◽  
Qualitative Phenomenological

Objective: This study explored stroke survivors’ experiences of altered body perception, whether these perceptions cause discomfort, and the need for clinical interventions to improve comfort. Design: A qualitative phenomenological study. Setting: Participants’ homes. Participants: A purposive sample of 16 stroke survivors were recruited from community support groups. Participants (median: age 59; time post stroke >2 years), were at least six-months post-stroke, experiencing motor or sensory impairments and able to communicate verbally. Interventions: Semi-structured, face-to-face interviews were analysed using an interpretive phenomenological approach and presented thematically. Results: Four themes or experiences were identified: Participants described (1) a body that did not exist; (2) a body hindered by strange sensations and distorted perceptions; (3) an uncontrollable body; and (4) a body isolated from social and clinical support. Discomfort was apparent in a physical and psychological sense and body experiences were difficult to comprehend and communicate to healthcare staff. Participants wished for interventions to improve their comfort but were doubtful that such treatments existed. Conclusion: Indications are that altered body perceptions cause multifaceted physical and psychosocial discomfort for stroke survivors. Discussions with patients about their personal perceptions and experiences of the body may facilitate better understanding and management to improve comfort after stroke.

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