Continuity With Patients, Preceptors, and Peers Improves Primary Care Training : A Randomized Medical Education Trial
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.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2020 |
|---|---|
| Erschienen: |
2020 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:95 |
|---|---|
| Enthalten in: |
Academic medicine : journal of the Association of American Medical Colleges - 95(2020), 3 vom: 01. März, Seite 425-434 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Henschen, Bruce L [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
|---|
| Anmerkungen: |
Date Completed 11.05.2020 Date Revised 11.05.2020 published: Print Citation Status MEDLINE |
|---|
| doi: |
10.1097/ACM.0000000000003045 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM302323376 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM302323376 | ||
| 003 | DE-627 | ||
| 005 | 20231225110459.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231225s2020 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1097/ACM.0000000000003045 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1007.xml |
| 035 | |a (DE-627)NLM302323376 | ||
| 035 | |a (NLM)31626000 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Henschen, Bruce L |e verfasserin |0 (orcid)http://orcid.org/0000-0003-0994-9725. D.T. Liss is research assistant professor, Division of General Internal Medicine and Geriatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois; ORCID: https://orcid.org/0000-0001-5505-2922. B.P. Golden is instructor, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois; ORCID: https://orcid.org/0000-0003-0576-3894. K.A. Cameron is research professor, Division of General Internal Medicine and Geriatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois; ORCID: http://orcid.org/0000-0002-3535-6459. J.A. Bierman is associate professor, Division of General Internal Medicine and Geriatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois; ORCID: http://orcid.org/0000-0001-7534-8499. E.R |4 aut | |
| 245 | 1 | 0 | |a Continuity With Patients, Preceptors, and Peers Improves Primary Care Training |b A Randomized Medical Education Trial |
| 264 | 1 | |c 2020 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 11.05.2020 | ||
| 500 | |a Date Revised 11.05.2020 | ||
| 500 | |a published: Print | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a 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 | ||
| 520 | |a 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 | ||
| 520 | |a 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) | ||
| 520 | |a 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 | ||
| 650 | 4 | |a Journal Article | |
| 700 | 1 | |a Liss, David T |e verfasserin |4 aut | |
| 700 | 1 | |a Golden, Blair P |e verfasserin |4 aut | |
| 700 | 1 | |a Cameron, Kenzie A |e verfasserin |4 aut | |
| 700 | 1 | |a Bierman, Jennifer A |e verfasserin |4 aut | |
| 700 | 1 | |a Ryan, Elizabeth R |e verfasserin |4 aut | |
| 700 | 1 | |a Gard, Lauren A |e verfasserin |4 aut | |
| 700 | 1 | |a Neilson, Eric G |e verfasserin |4 aut | |
| 700 | 1 | |a Wayne, Diane B |e verfasserin |4 aut | |
| 700 | 1 | |a Evans, Daniel B |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Academic medicine : journal of the Association of American Medical Colleges |d 1989 |g 95(2020), 3 vom: 01. März, Seite 425-434 |w (DE-627)NLM012947180 |x 1938-808X |7 nnns |
| 773 | 1 | 8 | |g volume:95 |g year:2020 |g number:3 |g day:01 |g month:03 |g pages:425-434 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1097/ACM.0000000000003045 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 95 |j 2020 |e 3 |b 01 |c 03 |h 425-434 | ||