Abstract
Purpose. The effect of patient centered medical home (PCMH) curriculum interventions on residents’ self-reported and demonstrated knowledge, skills and attitudes in PCMH competency arenas (KSA) is lacking in the literature. This study aimed to assess the impact of PCMH curricular innovations on the KSA of Internal Medicine residents.Methods. Twenty four (24) Internal Medicine residents—12 Traditional (TR) track residents and 12 Teaching Health Center (THC) track residents—began training in Academic Year (AY) 2011 at the Wright Center for Graduate Medical Education (WCGME). They were followed through AY2013, covering three years of training. PCMH curricular innovations were focally applied July 2011 until May 2012 to THC residents. These curricular innovations were spread program-wide in May 2012. Semi-annual, validated PCMH Clinician Assessments assessing KSA were started in AY2011 and were completed by all residents.Results. Mean KSA scores of TR residents were similar to those of THC residents at baseline for all PCMH competencies. In May 2012, mean scores of THC residents were significantly higher than TR residents for most KSA. After program-wide implementation of PCMH innovations, mean scores of TR residents for all KSA improved and most became equalized to those of THC residents. Globally improved KSA scores of THC and TR residents were maintained through May 2014, with the majority of improvements above baseline and reaching statistical significance.Conclusions. PCMH curricular innovations inspired by Health Resources and Services Administration (HRSA’s) Teaching Health Center funded residency program expansion quickly and consistently improved the KSA of Internal Medicine residents.
Highlights
The 21st century marks a period of dramatic shifts in health care paradigms in the United States
One legislative example is the Teaching Health Center Graduate Medical Education (THCGME) Program implemented by the Health Resources and Services Administration (HRSA)
Innovations applied to THC residents from the start of training included increased block continuity clinic exposure split between a Wright Center for Primary Care (WCPC) and a proximal FQHC, with an intentional ratio of 50% ambulatory and 50% hospital-based rotations
Summary
The 21st century marks a period of dramatic shifts in health care paradigms in the United States. Health care costs in the United States have grown exponentially (Martin et al, 2011), but are not paralleled by improvements in health care delivery efficiencies, public health outcomes, physician skill development or patient satisfaction with health care experiences (McGlynn et al, 2003; Wilensky & Berwick, 2014). The patient-centered medical home (PCMH) shows promise as a quality, team-based and population-health focused model of innovative primary care delivery that may potentiate valuable enhancement in health care delivery with a reduction in costs and improved health outcomes (Agency for Healthcare Research and Quality, 2011; Scholle et al, 2010; Stange et al, 2010). Ongoing systems of measurement and process changes in support of the implementation of high PCMH standards can enhance quality, cost-effectiveness and outcomes-focused care (Bitton, Martin & Landon, 2010; Agency for Healthcare Research and Quality, 2014). The Wright Center for Graduate Medical Education (WCGME) is the sponsoring institution for the ACGME-accredited Internal Medicine residency in the initial cohort of THCGME programs
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
