Factors Affecting Resident Satisfaction in Continuity Clinic—a Systematic Review

Abstract

Clinic structures that limit inpatient and outpatient conflict and enhance continuity, along with a dedicated outpatient faculty, are associated with greater resident satisfaction. Implications for further research are discussed.

How preceptors develop trust in continuity clinic residents and how trust influences supervision: A qualitative study

“…Our study also highlighted that longitudinal relationships do not always yield trust development. These instances, while uncommon, can lead to dissatisfaction within the preceptorresident relationship and negatively impact resident engagement and career choice [35,36]. Faculty development, particularly around skills to address barriers to trust, provide constructive feedback, and facilitate relationship-building could promote productive and meaningful longitudinal relationships within the continuity clinic setting.…”

Creating a Satisfying Continuity Clinic Experience for Primary Care Trainees

“…Numerous studies have evaluated important elements to crafting a well-organized educational experience, such as optimizing the EHR, arranging schedules to ensure continuity and team-based care, supporting the clinic with appropriate resources, and encouraging a well-trained faculty. 6,7 However, most studies addressed specific challenges within a single institution and were of small scale and short duration. Generalizing such findings to other residency programs is difficult.…”

“…This increased requirement presupposes that greater exposure will inevitably lead to more primary care physicians, but some have argued it is increased exposure to high-quality, high-functioning primary care experiences that inspire trainees to contemplate a career in primary care. 5 In 2018, Stepczynski et al 6 conducted a systematic review of all English-language articles published prior to December 2016 about physician trainee satisfaction with ambulatory training. In that review, only 2 factors were reliably associated with trainee satisfaction: minimizing outpatient/inpatient conflict and recruiting faculty dedicated to outpatient teaching.…”

A National Survey of Internal Medicine Primary Care Residency Program Directors

“…23 Not surprisingly, scheduling models that limit inpatient and outpatient conflict for residents may translate into greater resident satisfaction with their training. 24 X + Y scheduling, a model that schedules residents' inpatient or non-ambulatory rotations (BX^blocks) in discrete periods with alternating ambulatory or BY^blocks, is instituted specifically to decrease the conflict between inpatient and outpatient patient care responsibilities. 25,26 Several studies of X + Y scheduling have found this model to be associated with less care fragmentation, increased perception of clinic continuity among residents, and higher resident satisfaction.…”