Advancing Educational Continuity in Primary Care Residencies: An Opportunity for Patient-Centered Medical Homes

Judith Bowen, David Hirsh, Eva Aagaard, Catherine P. Kaminetzky, Marie Smith, Joseph Hardman, Shobhina G. Chheda

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Continuity of care is a core value of patients and primary care physicians, yet in graduate medical education (GME), creating effective clinical teaching environments that emphasize continuity poses challenges. In this Perspective, the authors review three dimensions of continuity for patient care - informational, longitudinal, and interpersonal - and propose analogous dimensions describing continuity for learning that address both residents learning from patient care and supervisors and interprofessional team members supporting residents' competency development. The authors review primary care GME reform efforts through the lens of continuity, including the growing body of evidence that highlights the importance of longitudinal continuity between learners and supervisors for making competency judgments. The authors consider the challenges that primary care residency programs face in the wake of practice transformation to patient-centered medical home models and make recommendations to maximize the opportunity that these practice models provide. First, educators, researchers, and policy makers must be more precise with terms describing various dimensions of continuity. Second, research should prioritize developing assessments that enable the study of the impact of interpersonal continuity on clinical outcomes for patients and learning outcomes for residents. Third, residency programs should establish program structures that provide informational and longitudinal continuity to enable the development of interpersonal continuity for care and learning. Fourth, these educational models and continuity assessments should extend to the level of the interprofessional team. Fifth, policy leaders should develop a meaningful recognition process that rewards academic practices for training the primary care workforce.

Original languageEnglish (US)
Pages (from-to)587-593
Number of pages7
JournalAcademic Medicine
Volume90
Issue number5
DOIs
StatePublished - 2015

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Patient-Centered Care
Internship and Residency
Continuity of Patient Care
Primary Health Care
continuity
Learning
Graduate Medical Education
Patient Care
Teaching
Educational Models
Primary Care Physicians
Administrative Personnel
Reward
Lenses
resident
Research Personnel
patient care
learning
Third Program
graduate

ASJC Scopus subject areas

  • Medicine(all)
  • Education

Cite this

Advancing Educational Continuity in Primary Care Residencies : An Opportunity for Patient-Centered Medical Homes. / Bowen, Judith; Hirsh, David; Aagaard, Eva; Kaminetzky, Catherine P.; Smith, Marie; Hardman, Joseph; Chheda, Shobhina G.

In: Academic Medicine, Vol. 90, No. 5, 2015, p. 587-593.

Research output: Contribution to journalArticle

Bowen, Judith ; Hirsh, David ; Aagaard, Eva ; Kaminetzky, Catherine P. ; Smith, Marie ; Hardman, Joseph ; Chheda, Shobhina G. / Advancing Educational Continuity in Primary Care Residencies : An Opportunity for Patient-Centered Medical Homes. In: Academic Medicine. 2015 ; Vol. 90, No. 5. pp. 587-593.
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