Veteran Affairs Centers of Excellence in Primary Care Education: Transforming nurse practitioner education

Rugen, Kathryn Wirtz; Watts, Sharon A.; Janson, Susan; Angelo, Laura A.; Nash, Melanie; Zapatka, Susan; Brienza, Rebecca; Gilman, Stuart C.; Bowen, Judith L.; Saxe, Jo Anne M.

doi:10.1016/j.outlook.2013.11.004

Cited by 34 publications

(32 citation statements)

References 6 publications

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“…Increased interprofessional education could assist PCPs in appropriately delegating tasks between staff members with different levels of training. 26 For most tasks, clerical staff reported not being relied upon with the exception of receiving and responding to messages, following up on referrals, and responding to prescription refill requests. This suggests that MAs have well defined, but limited roles in primary care teams, and that there may be capacity to take on additional tasks.…”

Section: Discussionmentioning

confidence: 99%

Who is responsible for what tasks within primary care: Perceived task allocation among primary care providers and interdisciplinary team members

et al. 2015

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Section: Discussionmentioning

confidence: 99%

Who is responsible for what tasks within primary care: Perceived task allocation among primary care providers and interdisciplinary team members

et al. 2015

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“…The formal educational curriculum included a full-day, team-building retreat for all staff and 2 hours per week of IP learning activities related to teambased care (e.g., communication skills and panel management) for trainees. 19 The university and safety net clinics developed team-based care models to improve patient care, continuity and trainee oversight. Both sites provided a brief orientation to the teambased care model for all staff, but did not have formal curricula or additional funding.…”

Section: Settingsmentioning

confidence: 99%

Internal Medicine Residents’ Perceptions of Team-Based Care and its Educational Value in the Continuity Clinic: A Qualitative Study

2015

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BACKGROUND :In order to teach residents how to work in interprofessional teams, educators in graduate medical education are implementing team-based care models in resident continuity clinics. However, little is known about the impact of interprofessional teams on residents' education in the ambulatory setting. OBJECTIVE: To identify factors affecting residents' experience of team-based care within continuity clinics and the impact of these teams on residents' education. DESIGN: This was a qualitative study of focus groups with internal medicine residents. PARTICIPANTS: Seventy-seven internal medicine residents at the University of California San Francisco at three continuity clinic sites participated in the study. APPROACH: Qualitative interviews were audiotaped and transcribed. The authors used a general inductive approach with sensitizing concepts in four frames (structural, human resources, political and symbolic) to develop codes and identify themes. KEY RESULTS: Residents believed that team-based care improves continuity and quality of care. Factors in four frames affected their ability to achieve these goals. Structural factors included communication through the electronic medical record, consistent schedules and regular team meetings. Human resources factors included the presence of stable teams and clear roles. Political and symbolic factors negatively impacted team-based care, and included low staffing ratios and a culture of ultimate resident responsibility, respectively. Regardless of the presence of these factors or resident perceptions of their teams, residents did not see the practice of interprofessional team-based care as intrinsically educational. CONCLUSIONS: Residents' experiences practicing teambased care are influenced by many principles described in the interprofessional teamwork literature, including understanding team members' roles, good communication and sufficient staffing. However, these attributes are not correlated with residents' perceptions of the educational value of team-based care. Including residents in interprofessional teams in their clinic may not be sufficient to teach residents how team-based care can enhance their overall learning and future practice.

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“…111‐148) (2010), the Department of Veterans Affairs redesign of graduate medical education in primary and specialty care settings that specifically emphasize team‐based, patient‐centered care (Rugen et al. ), and the recently released Institute of Medicine () report on the impact of IPE on collaborative practice and patient outcomes.…”

Section: Discussionmentioning

confidence: 99%

“…Since 2011, the Department of Veterans Affairs (VA) has funded Centers of Excellence in Primary Care to offer IPE to trainees to work alongside VA's patient aligned care teams, or PACT, as the model of care for veterans (Rugen et al. ).…”

Section: Background: Motivation For Ipementioning

confidence: 99%

“…By 2010, 92 percent of all U.S. academic health centers offered IPE courses and 89 percent offered IPE clinical training experiences (Greer et al 2014). However, IPE curricula vary by requirement (mandatory or elective), setting (classroom or practice based), clinical conditions (specific illnesses or primary care), duration (1-to 2-hour sessions, 1 month, to a full academic year), and scope (specific interprofessional relationships or entire models of care) (Meyer, Potter, and Gary 1997;Reeves et al 2012;Gilman et al 2014;Rugen et al 2014).…”

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confidence: 99%

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Has Interprofessional Education Changed Learning Preferences? A National Perspective

Kashner

Hettler

Zeiss³

et al. 2016

Health Services Research

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Veteran Affairs Centers of Excellence in Primary Care Education: Transforming nurse practitioner education

Cited by 34 publications

References 6 publications

Who is responsible for what tasks within primary care: Perceived task allocation among primary care providers and interdisciplinary team members

Who is responsible for what tasks within primary care: Perceived task allocation among primary care providers and interdisciplinary team members

Internal Medicine Residents’ Perceptions of Team-Based Care and its Educational Value in the Continuity Clinic: A Qualitative Study

Has Interprofessional Education Changed Learning Preferences? A National Perspective

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