Four-Year Educational and Patient Care Outcomes of a Team-Based Primary Care Longitudinal Clerkship

Henschen, Bruce L.; Bierman, Jennifer A.; Wayne, Diane B.; Ryan, Elizabeth R.; Thomas, Jane deLima; Curry, Raymond H.; Evans, Daniel B.

doi:10.1097/acm.0000000000000897

Cited by 34 publications

(32 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…These findings corroborate and extend upon a previous study [3] that showed that an ECMH-modeled longitudinal clerkship is associated with quantitative benefits to patient care. Our study further advances that work by demonstrating significantly increased screening rates for several measures in the ECMH model compared with standard clinical SVFCs, including those that were not specifically targeted for intervention.…”

Section: Resultssupporting

confidence: 91%

“…In 2015, Henschen et al demonstrated improvements in cancer screening rates after implementation of a longitudinal clerkship called the education-centered medical home (ECMH) [3]. An ECMH is based on principles of the patient-centered medical home, including ‘continuity with a personal physician; team-based care; care coordination and integration; quality and safety; and enhanced access to care’ [11].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Impact of an education-centered medical home on quality at a student-volunteer free clinic

Russi

Bhaumik

Herzog

et al. 2018

Medical Education Online

View full text Add to dashboard Cite

Background: The continuity provided by longitudinal clerkships has documented benefits to medical student education. Yet, little quantitative data exist on the association between longitudinal clerkships and patient outcomes.Objective: This study compares screening metrics of a longitudinal clerkship called the education-centered medical home (ECMH) with the standard clinical model at a student-volunteer free clinic (SVFC). In the ECMH model, the same attending physician staffs one half-day of clinic with same group of students weekly for 4 years. Standard clinical models are staffed with students and physicians who come to the SVFC based on availability.Design: ECMH students aimed to increase human immunodeficiency virus (HIV) screening rates in their patient panel as part of a quality improvement project. Students prepared individualized care plans prior to patient visits that included whether screening had been performed. They were also reminded to confirm completion of testing. Percentages of patients screened for HIV before and after establishment of the ECMH were compared with four standard clinical models. Screening rates for breast, colon, and cervical cancer, as well as hepatitis C, served as secondary endpoints.Results: While screening rates were initially similar between models (43.2% and 34.8% for the ECMH and standard clinical panels, respectively, p = 0.32), HIV screening rates increased from 43.2% to 95.0% in the ECMH compared with a significantly smaller increase from 35.0% to 50.0% in the standard clinical panel (p < 0.0001). Additionally, the ECMH resulted in statistically significantly increased screening rates for cervical cancer (p < 0.001) and hepatitis C (p < 0.0001).Conclusions: This study demonstrates an association between a longitudinal ECMH clerkship and improved quality metrics at an SVFC. Even measures not targeted for intervention, such as colorectal cancer and hepatitis C, showed significant improvement in screening rates when compared with the standard clinical model.

show abstract

Section: Resultssupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

Impact of an education-centered medical home on quality at a student-volunteer free clinic

Russi

Bhaumik

Herzog

et al. 2018

Medical Education Online

View full text Add to dashboard Cite

show abstract

“…LICs and primary care are a natural fit, both emphasizing patient-centered care and continuity relationships among students, faculty, and patients, which can also have positive effects on students' primary care career selection. [12][13][14] Students in LICs experience continuity across multiple dimensions-Bcontinuity of patient contact and care, continuity of assessment and supervision, and continuity of clinical and cultural learning through patients, peers, health providers, and community health and social resources^. 15 Continuity with preceptors is especially important as they play a key role in shaping students' perceptions of primary care careers.…”

Section: Introductionmentioning

confidence: 99%

Longitudinal Continuity Learning Experiences and Primary Care Career Interest: Outcomes from an Innovative Medical School Curriculum

et al. 2018

View full text Add to dashboard Cite

show abstract

“…8 The reviews by Thistlethwaite and by Walters, and a later article by Henschen, showed that both longitudinal attachments in the community and LICs have a positive, though modest, effect on students' patient-centeredness. 6,9,10 As the decline in patient-centeredness takes place during the clinical years, it seems preferable to implement longitudinal student-patient relationships in this period. Up to now, LICs typically have been implemented in small cohorts of, on average, 20 students (range ¼2-85).…”

Section: Introductionmentioning

confidence: 99%

The Feasibility of Longitudinal Patient Contacts in a Large Medical School

Mol

Chen

Steerneman

et al. 2018

Teaching and Learning in Medicine

View full text Add to dashboard Cite

Problem: Longitudinal patient contacts are being implemented worldwide as a way to enhance a patient-centered orientation among medical students. In large medical schools, longitudinal integrated clerkships may not be feasible, so other ways must be sought to expose students to prolonged contact with patients. Intervention: Medical students were attached to a family practice and assigned a panel of 4 patients to follow over the 3 years of their clinical training. Their role was that of companion on the patient's medical journey. The program consisted of several encounters, joining the patient in the medical setting for significant events, and written assignments. This intervention was piloted with 35 students. We describe our experiences from the 1st pilot year of this program. Context: The intervention was performed with 3rd-year students-of a 6-year curriculum-at a large medical school in the Netherlands. Outcome: Finding enough patients per practice was feasible. On the whole, students fulfilled the program's expectations regarding frequency of patient encounters and assignments. The most frequent problems encountered by the students were uncertainty about their role and setting boundaries in their contact with the patients. They needed more preceptor supervision and coaching than they received. Lessons Learned: For junior students, close and structured supervision led by the faculty is necessary to help them navigate and learn from a panel of patients. Students need guidance about what role they should take on and on how to manage both their own and their patient's expectations. Guided reflection is necessary to help students give meaning to their experiences with patients.

show abstract

Four-Year Educational and Patient Care Outcomes of a Team-Based Primary Care Longitudinal Clerkship

Cited by 34 publications

References 32 publications

Impact of an education-centered medical home on quality at a student-volunteer free clinic

Impact of an education-centered medical home on quality at a student-volunteer free clinic

Longitudinal Continuity Learning Experiences and Primary Care Career Interest: Outcomes from an Innovative Medical School Curriculum

The Feasibility of Longitudinal Patient Contacts in a Large Medical School

Contact Info

Product

Resources

About