There's No Place Like Home: Evaluating Family Medicine Residents' Training in Home Care

Laditka, Sarah B.; Fischer, Mary; Mathews, Kevin B.; Sadlik, Janine M; Warfel, Mark E.

doi:10.1300/j027v21n02_01

Cited by 16 publications

(9 citation statements)

References 5 publications

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“…Home visits have been qualitatively reported to be a valuable aspect of geriatric, primary care, and other ambulatory‐based rotations of medical students 17, 19, 32. Postdischarge visits in graduate medical education have been shown to improve residents' awareness of and skills with transitions in care 28, 33, 34…”

Section: Discussionmentioning

confidence: 99%

Postdischarge follow‐up visits for medical and pharmacy students on an inpatient medicine clerkship

Lai

Nye

Bookwalter

et al. 2008

Journal of Hospital Medicine

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BACKGROUND Teaching medical and pharmacy students to collaborate on discharge planning for chronically ill patients may facilitate their ability to provide quality care. OBJECTIVE To determine whether a discharge curriculum would improve students' attitudes and self‐assessed skills in interdisciplinary collaboration and transitional care for chronically ill patients. DESIGN The discharge curriculum of an inpatient medicine clerkship focused on safe patient transitions after hospitalization. Curricular components included an interdisciplinary workshop, follow‐up visits with discharged patients, a final group debriefing, and letters to patients' primary care providers. Preassigned medical and pharmacy student partners coordinated discharges and conducted postdischarge visits. The change in students' attitudes and skills in interdisciplinary collaboration and discharge planning was assessed using a 5‐point Likert‐scaled survey given before and after the curriculum, and students reported their satisfaction using additional Likert‐scaled and open‐ended questions. RESULTS The program was completed by 97% of students (37 of 39 medical, 22 of 22 pharmacy). The postcurriculum survey response rates were 92% and 86%, respectively; matched response rates were 58% and 59%. The attitudes and self‐assessed skills of both medical and pharmacy students significantly improved for most survey items after the curriculum. Students also reported that the curriculum had a favorable impact on their learning about interdisciplinary care (4.3, SD 0.72), humanism (4.3, SD 0.63), and discharge planning (4.4, SD 0.70). Ninety‐three percent reported that the curriculum was valuable to their education. CONCLUSIONS A clinically oriented curriculum with postdischarge visits improved students' attitudes and self‐assessed skills in interdisciplinary collaboration and transitional care and fostered a patient‐centered approach to care. Journal of Hospital Medicine 2008;3:20–27. © 2008 Society of Hospital Medicine.

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Section: Discussionmentioning

confidence: 99%

Postdischarge follow‐up visits for medical and pharmacy students on an inpatient medicine clerkship

Lai

Nye

Bookwalter

et al. 2008

Journal of Hospital Medicine

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“…17 Family medicine residency programs provide specific training for geriatric assessment, including home-based primary care, but with variable emphasis on assessing vulnerability. 1,18 Primary care physicians continue to endorse the importance of home-based assessments of vulnerability as part of their scope of practice. 19 To address this gap, primary care physicians sometimes rely on the services of other clinical and social services professionals.…”

mentioning

confidence: 99%

Assessing Safe and Independent Living in Vulnerable Older Adults: Perspectives of Professionals Who Conduct Home Assessments

Naik

Kunik²,

Cassidy³

et al. 2010

The Journal of the American Board of Family Medicine

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Objectives: The objectives of this study were to describe social services and health professionals' perceptions of vulnerability among older adults living in the community and to elicit how these professionals screen vulnerability in community and in-home settings.Methods: Focus group sessions were conducted and analyzed using standardized methods of qualitative analysis. Participants included social services and health professionals (n ‫؍‬ 45) who routinely encounter vulnerable older adults.Results: Four themes characterized vulnerability: the inability to perform activities of daily living, lack of social support, sociodemographic factors, and neuropsychiatric conditions. When screening older adults, participants reported evaluating basic cognitive abilities, decision-making processes, and the capacity to adequately plan and safely perform everyday tasks. Participants stated that screening is best performed by an interdisciplinary team in the home setting and preferably on more than one occasion.Conclusions: Social services and health professionals in this study described routinely screening for vulnerability in community-living older adults using a multidomain approach. These professionals endorse the use of assessments that screen an older adult's cognitive and functional capacities for safe and independent living. Further research is needed that integrates routine screening for vulnerability by community social services professionals with the assessments and interventions conducted by primary care physicians. (J Am Board Fam Med 2010;23:614 -621.)

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“…26 Published transitional care curricula in internal medicine and family medicine rarely describe use of experiential learning (eg, direct patient contact, real-life experience with different care systems and disciplines) in diverse care systems, 10,[28][29][30][31][32] whereas residency curricula in home or nursing home settings or interdisciplinary teams do not focus on transitional care. [11][12][13][14][15][16][17][18][19][20][21][22][23][24][25] For example, nursing home curricula do not focus on how the complex care structure of postacute care affects transitions, or how transitional care to and from the nursing home can be optimized at an individual patient and system level. 20,21,24 Our curriculum addresses this gap by providing exposure to the continuum of care that patients experience.…”

Section: Discussionmentioning

confidence: 99%

“…10 Other curricula involve different care settings or interdisciplinary teams but do not focus on transitional care. [11][12][13][14][15][16][17][18][19][20][21][22][23][24][25] We describe a curriculum to teach internal medicine residents to provide better transitional care at hospital discharge through experiential learning in different care settings outside of the acute hospital with a focus on other health care disciplines involved in care transitions.…”

Section: Introductionmentioning

confidence: 99%

Getting Out of Silos: An Innovative Transitional Care Curriculum for Internal Medicine Residents Through Experiential Interdisciplinary Learning

Schoenborn¹,

Christmas²

2013

Journal of Graduate Medical Education

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Background Care transitions are common and highly vulnerable times during illness. Physicians need better training to improve care transitions. Existing transitional care curricula infrequently involve settings outside of the hospital or other health care disciplines. Intervention We created a curriculum to teach internal medicine residents how to provide better transitional care at hospital discharge through experiential, interdisciplinary learning in different care settings outside of the acute hospital, and we engaged other health care disciplines frequently involved in care transitions. Setting/Participants Nineteen postgraduate year-1 internal medicine trainees at an academic medical center in an urban location completed experiences in a postacute care facility, home health care, and outpatient clinics. Program Description The 2-week required curriculum involved teachers from geriatric medicine; physical, occupational, and speech therapy; and home health care, with both didactic and experiential components and self-reflective exercises. Program Evaluation The curriculum was highly rated (6.86 on a 9-point scale) and was associated with a significant increase in the rating of the overall quality of transitional care education (from 4.09 on a 5-point scale in 2011 to 4.53 in 2012) on the annual residency program survey. Learners reported improved knowledge in key curricular areas and that they would change practice as a result of the curriculum. Conclusions Our transitional care curriculum for internal medicine residents provides exposure to care settings and health care disciplines that patients frequently encounter. The curriculum has shown positive, short-term effects on learners' perceived knowledge and behavior.

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There's No Place Like Home: Evaluating Family Medicine Residents' Training in Home Care

Cited by 16 publications

References 5 publications

Postdischarge follow‐up visits for medical and pharmacy students on an inpatient medicine clerkship

Postdischarge follow‐up visits for medical and pharmacy students on an inpatient medicine clerkship

Assessing Safe and Independent Living in Vulnerable Older Adults: Perspectives of Professionals Who Conduct Home Assessments

Getting Out of Silos: An Innovative Transitional Care Curriculum for Internal Medicine Residents Through Experiential Interdisciplinary Learning

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