Learning From Patients: Why Continuity Matters

Asgarova, Sevinj; MacKenzie, Mark; Bates, Joanna

doi:10.1097/acm.0000000000001911

Cited by 17 publications

(17 citation statements)

References 22 publications

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“…During the study year, we adopted an LCP based on the tenets of PCMHs, which provided patients: (1) continuity-a relationship with a single student provider for 12 months, (2) coordination of care across the healthcare network, and (3) quarterly check-ups with coaching related to medication and lifestyle management. 14,[16][17][18] Patients with chronic conditions who declined LCP participation received care under the previous episodic model.…”

Section: Program Settingmentioning

confidence: 99%

Continuity of Care in a Student-Run Free Clinic: Impact on Atherosclerotic Cardiovascular Disease Risk

Roth

Cooper

Way

2021

Fam Med

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Background and Objectives: Medical student-run free clinics (SRFC) provide underserved patients access to health care. Few studies have examined the effects of specific care models implemented by these clinics. We looked at the impact of a continuity of care delivery model on chronic care outcomes at an SRFC sponsored by Ohio State University College of Medicine. Methods: Using the SRFC electronic medical records, we abstracted health records of patients at risk for atherosclerotic cardiovascular disease (ASCVD). We formed three study groups matched on age and gender. Group 1 were the patients enrolled in a continuity of care program, Group 2 were patients who visit the SRFC at 3-month intervals, and Group 3 were sporadic visitors. Authors compared groups’ ASCVD risk score change over 12 months using a Group x Time Analysis of Variance. Results: We identified 81 subjects that met the qualifications for this study and assigned them to one of the three study groups. A Group x Time interaction showed that mean ASCVD risk scores improved significantly for continuity of care patients and regular visitor controls, but not for sporadic controls (F=3.82; df=2/1.72; P=.035; es=1.28). Conclusions: This SRFCs continuity of care delivery had no appreciable impact on lowering ASCVD Risk scores over and above frequent regular visits to the clinic. This finding suggests that SRFCs should focus on getting their chronic patient population to maintain a schedule of frequent check-ups, without investing in continuity of care. Longer-term studies are needed to detect a continuity of care delivery model effect.

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Section: Program Settingmentioning

confidence: 99%

Continuity of Care in a Student-Run Free Clinic: Impact on Atherosclerotic Cardiovascular Disease Risk

Roth

Cooper

Way

2021

Fam Med

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“…Training of students in the health professions involves undertaking clinical placements. During these placements students develop clinical skill proficiency and learn how to confidently and professionally interact with patients (1,2). However, placements come with the unique challenge of providing students with a valuable educational experience, while promoting optimal patient care, without adversely impacting the clinical setting in which the placement is being held (3,4).…”

Section: Introductionmentioning

confidence: 99%

“…In Australia, clinical training of nursing, allied health and medical students has traditionally occurred in metropolitan locations in university-led teaching facilities or public hospitals. As such providers of placements seek diversity in placement experiences (1)(2)(3)5). For instance, the opportunity to experience practice in rural localities (1).…”

Section: Introductionmentioning

confidence: 99%

“…Data from studies of medical placements suggest that a greater continuity occurs in longer placements as they enable students to integrate into practice life and subsequently students are able to reciprocate benefit to the practice (1,2,8). Extended clinical placements are thought to foster the ideal conditions in which social and spatial connectedness to a rural community can develop (10)(11)(12).…”

Section: Introductionmentioning

confidence: 99%

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Supervisor experiences of extended clinical placements in optometry: a mixed methods study

et al. 2022

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Background In Australia, optometry students have traditionally undertaken their clinical training in short-block rotations at University-led teaching clinics in metropolitan locations. Demand for clinical placements is growing as the number of optometry students steadily increases. As such, universities and clinical education providers must look for more diverse methods of student placement. Extended clinical placements in community-based settings are one alternative: a model similar to the longitudinal clerkships in medicine. This study aimed to explore the experience of extended clinical placements from the perspective of the optometrists who supervised students. It also sought to determine whether there were differences in views between metropolitan and rural practitioners. Methods This mixed methods study included a survey and interviews with optometrists who had previously supervised Deakin University optometry students on an extended 26-week (2 x 13-weeks) clinical placement. Lines of enquiry focused on; the benefits and challenges associated with extended placements; areas for improvement; duration of the placement; and willingness to supervise further students. Interviews were transcribed verbatim and analysed using Braun and Clarke’s 6 step method of thematic analysis with a qualitative descriptive approach. Results Supervisors felt that hosting a student prompted greater reflective practice and critical appraisal of clinical decisions. The extended nature of the placement was thought to foster greater immersion in the clinical setting and community for the students and establish a stronger relationship between supervisor and student. Supervisors recognised the importance of role-modelling and mentoring the next generation of optometrists however noted that taking on a student was a sizeable commitment. Willingness to host a student was not dependent on the supervisor’s location (rural vs metropolitan) p = 0.57. However, interviews uncovered motivations that were unique to supervisors residing in rural locations, such as succession planning. Conclusion Overall, supervisors were positive about the value of student extended clinical placement in optometry and felt that it was a fulfilling and professionally beneficial experience. Lack of time and financial remuneration were the key downsides highlighted. Schools of optometry might carefully consider engaging in discussion about the duration of such placements, but 26 weeks was considered appropriate by supervisors.

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“…Specifically, it is interpersonal continuity that is associated with a more complete educational experience for medical students and residents for the development of skills in interacting with patients over time and in managing chronic conditions. 11 , 12 When a program evaluation project specifies continuity of care as the target, such elements as opportunities for developing relationships with patients over time and throughout an illness experience become the focus for evaluation and improvement.…”

Section: Introductionmentioning

confidence: 99%

Five ways to get a grip on evaluating and improving educational continuity in health professions education programs

Lee

Ross

2020

Can. Med. Ed. J

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Presence of educational continuity is essential for progressive development of competence. Educational continuity appears to be a simple concept, but in practice, it is challenging to implement and evaluate because of its multifaceted nature. In this Black Ice article, we present some practical tips to help avoid misunderstandings and irregularities in implementation for those involved in evaluating and improving educational continuity in health professions education programs.

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Learning From Patients: Why Continuity Matters

Cited by 17 publications

References 22 publications

Continuity of Care in a Student-Run Free Clinic: Impact on Atherosclerotic Cardiovascular Disease Risk

Continuity of Care in a Student-Run Free Clinic: Impact on Atherosclerotic Cardiovascular Disease Risk

Supervisor experiences of extended clinical placements in optometry: a mixed methods study

Five ways to get a grip on evaluating and improving educational continuity in health professions education programs

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