How reorganizing a general medicine clinic affected residentsʼ and patientsʼ satisfaction

Lofgren, Richard P.; Mladenovic, Jeanette

doi:10.1097/00001888-199009000-00013

Cited by 4 publications

(4 citation statements)

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“…Programmatic restructuring interventions described by Harrison et al, 12 Chaudhry et al, 13 Warm et al,, 17 and Lofgren and Mladenovic 15 all resulted in statistically significant increases in resident satisfaction. In contrast, the restructuring intervention described by Wieland et al 18 did not influence resident satisfaction.…”

Section: Interventional Studies On Scheduling and Reorganizationmentioning

confidence: 93%

“…1). While most studies evaluated a single residency program (Barnett et al, 11 Harrison et al, 12 Chaudhry et al, 13 Hochman et al, 14 Lofgren et al, 15 Roth et al, 16 Warm et al, 17 Wieland et al 18 ), two studies each evaluated three residency programs (Sisson et al 19 and Percoralo et al 1 ) and one study evaluated 36 internal medicine programs (Serwint et al 20 ). There was no uniform survey tool used to assess satisfaction among this group of studies.…”

Section: Description Of Studiesmentioning

confidence: 99%

“…The models proposed in the interventional studies varied significantly. In their 1990 paper, Lofgren and Mladenovic 15 describe creating what we would now call the Btraditionalĥ alf-day per week clinic model. In this model, PGY2 and PGY3 residents scheduled patients into one afternoon clinic session per week no matter the inpatient rotation.…”

Section: Interventional Studies On Scheduling and Reorganizationmentioning

confidence: 99%

“…During the long block, they had no inpatient responsibilities. Each of these interventions led to the increased perception of resident-patient continuity (Resident-Patient Continuity from Resident provider perspective, RPC-R) (Harrison et al, 12 Chaudhry et al, 13 Warm et al, 17 and Lofgren and Mladenovic 15 ). Apart from Lofgren and Mladenovic, they all demonstrated decreased tension between inpatient and outpatient responsibilities.…”

Section: Interventional Studies On Scheduling and Reorganizationmentioning

confidence: 99%

See 3 more Smart Citations

Factors Affecting Resident Satisfaction in Continuity Clinic—a Systematic Review

et al. 2018

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Section: Interventional Studies On Scheduling and Reorganizationmentioning

confidence: 93%

Section: Description Of Studiesmentioning

confidence: 99%

Section: Interventional Studies On Scheduling and Reorganizationmentioning

confidence: 99%

Section: Interventional Studies On Scheduling and Reorganizationmentioning

confidence: 99%

See 2 more Smart Citations

Factors Affecting Resident Satisfaction in Continuity Clinic—a Systematic Review

et al. 2018

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Improving Resident Education and Patient Safety: A Method to Balance Initial Caseloads at Academic Year-End Transfer

Young

Niehaus²,

Lieu³

et al. 2010

Academic Medicine

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Medical Students' and Residents' preferred site characteristics and preceptor behaviours for learning in the ambulatory setting: a cross-sectional survey

et al. 2004

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BackgroundMedical training is increasingly occurring in the ambulatory setting for final year medical students and residents. This study looks to identify if gender, school, level of training, or speciality affects learner's (final year medical students and residents) preferred site characteristics and preceptor behaviours for learning in the ambulatory setting.MethodsAll final year medical students and residents at the five medical schools in Ontario (N = 3471) were surveyed about the site characteristics and preceptor behaviours most enhancing their learning in the ambulatory setting. Preferred site characteristics and preceptor behaviours were rank ordered. Factor analysis grouped the site characteristics and preceptor behaviours into themes which were then correlated with gender, school, level of training, and speciality.ResultsHaving an adequate number and variety of patients while being supervised by enthusiastic preceptors who give feedback and are willing to discuss their reasoning processes and delegate responsibility are site characteristics and preceptor behaviours valued by almost all learners. Some teaching strategies recently suggested to improve efficiency in the ambulatory teaching setting, such as structuring the interview for the student and teaching and reviewing the case in front of the patient, were found not to be valued by learners. There was a striking degree of similarity in what was valued by all learners but there were also some educationally significant differences, particularly between learners at different levels and in different specialities. Key findings between the different levels include preceptor interaction being most important for medical students as opposed to residents who most value issues pertaining to patient logistics. Learning resources are less valued early and late in training. Teaching and having the case reviewed in front of the patient becomes increasingly less valued as learners advance in their training. As one approaches the end of ones' training office management instruction becomes increasingly valued. Differences between specialities pertain most to the type of practice residents will ultimately end up in (ie: office based specialties particularly valuing instruction in office management and health care system interaction).ConclusionsPreceptors need to be aware of, and make efforts to provide, teaching strategies such as feedback and discussing clinical reasoning, that learners have identified as being helpful for learning. If strategies identified as not being valued for learning, such as teaching in front of the patient, must continue it will be important to explore the barriers they present to learning. Although what all learners want from their preceptors and clinic settings to enhance their learning is remarkably similar, being aware of the educationally significant differences, particularly for learners at different levels and in different specialities, will enhance teaching in the ambulatory setting.

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How reorganizing a general medicine clinic affected residentsʼ and patientsʼ satisfaction

Cited by 4 publications

References 0 publications

Factors Affecting Resident Satisfaction in Continuity Clinic—a Systematic Review

Factors Affecting Resident Satisfaction in Continuity Clinic—a Systematic Review

Improving Resident Education and Patient Safety: A Method to Balance Initial Caseloads at Academic Year-End Transfer

Medical Students' and Residents' preferred site characteristics and preceptor behaviours for learning in the ambulatory setting: a cross-sectional survey

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