Factors Associated With Resident Continuity in Ambulatory Training Practices

Fortuna, Robert J.; Garfunkel, Lynn C.; Mendoza, Michael; Ditty, Megan; West, Julia C.; Nead, Karen; Robbins, Brett

doi:10.4300/jgme-d-15-00755.1

Cited by 20 publications

(24 citation statements)

References 23 publications

(22 reference statements)

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“…Availability of sick visits with ambulatory providers decreases ED use, suggesting that improving the availability of these slots may reduce costs overall by reducing highcost encounters. 43,44 The creation of accountable care organizations under the PPACA can link the costs of strengthening continuity with savings from fewer high-cost urgent encounters. Furthermore, scheduling protocols with protected sick appointments can improve continuity.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, scheduling protocols with protected sick appointments can improve continuity. 44 Also, a continuity index may be a useful quality measure to provide timely and meaningful feedback. The results from our data reveal that continuity with a small group may be as effective as or more effective than continuity with a single provider, which has been demonstrated in adults and ED use.…”

Section: Discussionmentioning

confidence: 99%

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Continuity of Care in Infancy and Early Childhood Health Outcomes

2017

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Continuity of Care in Infancy and Early Childhood Health Outcomes

2017

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“…One study reported resident continuity in ambulatory clinics ranging from 33.1% to 83.8%. 33 While there is no agreed upon level of continuity that is considered appropriate in the primary care setting, previous studies have arbitrarily chosen goals between 0.50 and 0.70 using the UPC index based on panel size and number of clinics. 32 , 34 Each of our residents had UPC rates below those reported in the literature and below suggested goals for resident continuity.…”

Section: Discussionmentioning

confidence: 99%

Perceptions, practice, and “ownership:” experiences in continuity of the patient-doctor relationship in a family medicine residency

Lee

Kennett²,

Khera³

et al. 2017

Can. Med. Ed. J

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Background: The objective of this mixed-methods study was to determine interpersonal continuity (the ongoing therapeutic relationship between patient and health care provider) experiences of family medicine residents and preceptors, and explore their perceptions of interpersonal continuity.Methods: Quantitative data on resident and preceptor encounters were extracted from the electronic medical record (EMR). Opportunities for developing interpersonal continuity were determined using the Usual Provider Continuity (UPC) Index. A qualitative descriptive research method was used for the qualitative portion. Semi-structured interviews were conducted and constant comparative analysis was used to determine emerging themes.Results: Residents were found to have low UPC rates; preceptor rates were higher. Qualitative findings showed variable experiences with interpersonal continuity not apparent from UPC rates. Both preceptors and residents expressed perception of “ownership” of patients as a significant barrier to interpersonal continuity. Conclusion: This study suggests that a perceived lack of individual “ownership” of a patient panel was a significant barrier to developing interpersonal continuity. This might conflict with current changes towards team-based health care delivery. Understanding perceptions and changing them through a multi-faceted approach including resident teaching and faculty development might help improve interpersonal continuity which are core to both family medicine curricula and current models of health care delivery.

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“…2016;8:532-534. 16 The purpose of this study was to compare continuity and quality measures in teaching versus nonteaching primary care clinics.…”

Section: Topic 6: Graduate Medical Education Management Strategiesmentioning

confidence: 99%

Top Medical Education Studies of 2016: A Narrative Review

Fromme

Ryan

Darden

et al. 2018

Academic Pediatrics

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Education, like clinical medicine, should be based on the most current evidence in the field. Unfortunately, medical educators can be overwhelmed by the sheer volume and range of resources for this literature. This article provides an overview of 15 articles from 2016 that the authors consider the top articles in the field of pediatric medical education. The 7 authors, all medical educators with combined leadership and expertise across the continuum of pediatric medical education, used an iterative 3-stage process to review more than 6339 abstracts published in 2016. This process was designed to identify a small subset of articles that were most relevant to educational practices and most applicable to pediatric medical education. In the first 2 stages, pairs of authors independently reviewed and scored abstracts in 13 medical education-related journals and reached consensus to identify the articles that best met these criteria. In the final stage, all articles were discussed using a group consensus model to select the final articles included in this review. This article presents summaries of the 15 articles that were selected. The results revealed a cluster of studies related to observed standardized clinical encounters, self-assessment, professionalism, clinical teaching, competencies/milestones, and graduate medical education management strategies. We provide suggestions on how medical educators can apply the findings to their own practice and educational settings. This narrative review offers a useful tool for educators interested in keeping informed about the most relevant and valuable information in the field.

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Factors Associated With Resident Continuity in Ambulatory Training Practices

Abstract: Background Continuity of care is a critical element of residents' educational experience in primary care programs.

Cited by 20 publications

References 23 publications

Continuity of Care in Infancy and Early Childhood Health Outcomes

Continuity of Care in Infancy and Early Childhood Health Outcomes

Perceptions, practice, and “ownership:” experiences in continuity of the patient-doctor relationship in a family medicine residency

Top Medical Education Studies of 2016: A Narrative Review

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