Continuity With Patients, Preceptors, and Peers Improves Primary Care Training
| Autor: | Bruce L. Henschen, Blair P. Golden, Lauren A. Gard, Daniel B. Evans, Kenzie A. Cameron, David T. Liss, Jennifer A. Bierman, Eric G. Neilson, Diane B. Wayne, Elizabeth R. Ryan |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Male
Medical home Program evaluation Models Educational Students Medical Medical psychology 020205 medical informatics education 02 engineering and technology Burnout Peer Group Education 03 medical and health sciences 0302 clinical medicine Surveys and Questionnaires Health care 0202 electrical engineering electronic engineering information engineering Humans Medicine 030212 general & internal medicine Curriculum Randomized Controlled Trials as Topic Chicago Medical education Primary Health Care business.industry Professional development Clinical Clerkship Peer group General Medicine Continuity of Patient Care Preceptorship Female business Education Medical Undergraduate Program Evaluation |
| Zdroj: | Academic Medicine. 95:425-434 |
| ISSN: | 1040-2446 |
| DOI: | 10.1097/acm.0000000000003045 |
| Popis: | PURPOSE Infusing continuity of care into medical student clerkships may accelerate professional development, preserve patient-centered attitudes, and improve primary care training. However, prospective, randomized studies of longitudinal curricula are lacking. METHOD All entering Northwestern University Feinberg School of Medicine students in 2015 and 2016 were randomized to the Education Centered Medical Home (ECMH), a 4-year, team-based primary care clerkship; or a mentored individual preceptorship (IP) for 2 years followed by a traditional 4-week primary care clerkship. Students were surveyed 4 times (baseline, M1, M2, and M3 year [through 2018]); surveys included the Maslach Burnout Inventory (MBI); the Communication, Curriculum, and Culture (C3) survey assessing the hidden curriculum; and the Attitudes Toward Health Care Teams (ATHCT) scale. The authors analyzed results using an intent-to-treat approach. RESULTS Three hundred twenty-nine students were randomized; 316 (96%) participated in surveys. Seventy percent of all respondents would recommend the ECMH to incoming first-year students. ECMH students reported a more positive learning environment (overall quality, 4.4 ECMH vs 4.0 IP, P < .001), greater team-centered attitudes (ATHCT scale, 3.2 vs 3.0, P = .007), less exposure to negative aspects of the hidden curriculum (C3 scale, 4.6 vs 4.3, P < .001), and comparable medical knowledge acquisition. ECMH students established more continuity relationships with patients (2.2 vs 0.3, P < .001) and reported significantly higher professional efficacy (MBI-PE, 4.1 vs 3.9, P = .02). CONCLUSIONS In this randomized medical education trial, the ECMH provided superior primary care training across multiple outcomes compared with a traditional clerkship-based model, including improved professional efficacy. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|