Skip to main content
Top
Published in: Journal of General Internal Medicine 4/2012

01-04-2012 | Innovations in Medical Education

Effects of a Focused Patient-Centered Care Curriculum on the Experiences of Internal Medicine Residents and their Patients

Authors: Neda Ratanawongsa, MD, MPH, Molly A. Federowicz, MA, Colleen Christmas, MD, Laura A. Hanyok, MD, Janet D. Record, MD, David B. Hellmann, MD, Roy C. Ziegelstein, MD, Cynthia S. Rand, PhD

Published in: Journal of General Internal Medicine | Issue 4/2012

Login to get access

Abstract

BACKGROUND

Traditional residency training may not promote competencies in patient-centered care.

AIM

To improve residents’ competencies in delivering patient-centered care.

SETTING/PARTICIPANTS

Internal medicine residents at a university-based teaching hospital in Baltimore, Maryland.

PROGRAM DESCRIPTION

One inpatient team admitted half the usual census and was exposed to a multi-modal patient-centered care curriculum to promote knowledge of patients as individuals, improve patient transitions of care, and reduce barriers to medication adherence.

PROGRAM EVALUATION

Annual resident surveys (N = 40) revealed that the intervention was judged as professionally valuable (90%) and important to their training (90%) and offered experiences not available during other rotations (88%). Compared to standard inpatient rotation evaluations (n = 163), intervention rotation evaluations (n = 51) showed no differences in ratings for traditional medical learning, but higher ratings for improving how housestaff address patient medication adherence, communicate with patients about post-hospital transition of care, and know their patients as people (all p < 0.01). On post-discharge surveys, patients from the intervention team (N = 177, score 90.4, percentile ranking 97%) reported greater satisfaction with physicians than patients on standard teams (N = 924, score 86.1, percentile ranking 47%) p < 0.01).

DISCUSSION

A patient-centered inpatient curriculum was associated with higher satisfaction ratings in patient-centered domains by internal medicine residents and with higher satisfaction ratings of their physicians by patients. Future research will explore the intervention’s impact on clinical outcomes.
Appendix
Available only for authorised users
Literature
1.
go back to reference Institute of Medicine. Committee on Quality of Health Care in America. Crossing the quality chasm: a new health system for the 21st century. Washington DC: National Academy Press; 2001:337. Institute of Medicine. Committee on Quality of Health Care in America. Crossing the quality chasm: a new health system for the 21st century. Washington DC: National Academy Press; 2001:337.
3.
go back to reference Ratanawongsa N, Rand CS, Magill CF, et al. Teaching residents to know their patients as individuals. The Aliki initiative at Johns Hopkins Bayview Medical Center. Pharos Alpha Omega Alpha Honor Med Soc. 2009;72(3):4–11.PubMed Ratanawongsa N, Rand CS, Magill CF, et al. Teaching residents to know their patients as individuals. The Aliki initiative at Johns Hopkins Bayview Medical Center. Pharos Alpha Omega Alpha Honor Med Soc. 2009;72(3):4–11.PubMed
4.
go back to reference Record JD, Rand C, Christmas C, et al. Reducing heart failure readmissions by teaching patient-centered care to internal medicine residents. Arch Intern Med. 2011;171(9):858–9.PubMedCrossRef Record JD, Rand C, Christmas C, et al. Reducing heart failure readmissions by teaching patient-centered care to internal medicine residents. Arch Intern Med. 2011;171(9):858–9.PubMedCrossRef
5.
go back to reference Ludmerer KM. Redesigning residency education-moving beyond work hours. N Engl J Med. 2010;362(14):1337–8.PubMedCrossRef Ludmerer KM. Redesigning residency education-moving beyond work hours. N Engl J Med. 2010;362(14):1337–8.PubMedCrossRef
6.
7.
go back to reference Reed DA, Fletcher KE, Arora VM. Systematic review: association of shift length, protected sleep time, and night float with patient care, residents' health, and education. Ann Intern Med. 2010;153(12):829–42.PubMed Reed DA, Fletcher KE, Arora VM. Systematic review: association of shift length, protected sleep time, and night float with patient care, residents' health, and education. Ann Intern Med. 2010;153(12):829–42.PubMed
8.
go back to reference Arora VM, Georgitis E, Siddique J, et al. Association of workload of on-call medical interns with on-call sleep duration, shift duration, and participation in educational activities. JAMA. 2008;300(10):1146–53.PubMedCrossRef Arora VM, Georgitis E, Siddique J, et al. Association of workload of on-call medical interns with on-call sleep duration, shift duration, and participation in educational activities. JAMA. 2008;300(10):1146–53.PubMedCrossRef
9.
go back to reference McMahon GT, Katz JT, Thorndike ME, Levy BD, Loscalzo J. Evaluation of a redesign initiative in an internal-medicine residency. N Engl J Med. 2010;362(14):1304–11.PubMedCrossRef McMahon GT, Katz JT, Thorndike ME, Levy BD, Loscalzo J. Evaluation of a redesign initiative in an internal-medicine residency. N Engl J Med. 2010;362(14):1304–11.PubMedCrossRef
10.
go back to reference Suchman AL, Matthews DA. What makes the patient-doctor relationship therapeutic? Exploring the connexional dimension of medical care. Ann Intern Med. 1988;108(1):125–30.PubMed Suchman AL, Matthews DA. What makes the patient-doctor relationship therapeutic? Exploring the connexional dimension of medical care. Ann Intern Med. 1988;108(1):125–30.PubMed
11.
go back to reference Bray-Hall S, Schmidt K, Aagaard E. Toward safe hospital discharge: a transitions in care curriculum for medical students. J Gen Intern Med. 2010;25(8):878–81.PubMedCrossRef Bray-Hall S, Schmidt K, Aagaard E. Toward safe hospital discharge: a transitions in care curriculum for medical students. J Gen Intern Med. 2010;25(8):878–81.PubMedCrossRef
12.
go back to reference Wiecha JM, Markuns JF. Promoting medical humanism: design and evaluation of an online curriculum. Fam Med. 2008;40(9):617–9.PubMed Wiecha JM, Markuns JF. Promoting medical humanism: design and evaluation of an online curriculum. Fam Med. 2008;40(9):617–9.PubMed
13.
go back to reference Matter CA, Speice JA, McCann R, et al. Hospital to home: improving internal medicine residents' understanding of the needs of older persons after a hospital stay. Acad Med. 2003;78(8):793–7.PubMedCrossRef Matter CA, Speice JA, McCann R, et al. Hospital to home: improving internal medicine residents' understanding of the needs of older persons after a hospital stay. Acad Med. 2003;78(8):793–7.PubMedCrossRef
14.
go back to reference Lown BA, Sasson JP, Hinrichs P. Patients as partners in radiology education: an innovative approach to teaching and assessing patient-centered communication. Acad Radiol. 2008;15(4):425–32.PubMedCrossRef Lown BA, Sasson JP, Hinrichs P. Patients as partners in radiology education: an innovative approach to teaching and assessing patient-centered communication. Acad Radiol. 2008;15(4):425–32.PubMedCrossRef
15.
16.
go back to reference Glickman SW, Boulding W, Manary M, et al. Patient satisfaction and its relationship with clinical quality and inpatient mortality in acute myocardial infarction. Circ Cardiovasc Qual Outcome. 2010;3(2):188–95.CrossRef Glickman SW, Boulding W, Manary M, et al. Patient satisfaction and its relationship with clinical quality and inpatient mortality in acute myocardial infarction. Circ Cardiovasc Qual Outcome. 2010;3(2):188–95.CrossRef
17.
go back to reference Boulding W, Glickman SW, Manary MP, Schulman KA, Staelin R. Relationship between patient satisfaction with inpatient care and hospital readmission within 30 days. Am J Manag Care. 2011;17(1):41–8.PubMed Boulding W, Glickman SW, Manary MP, Schulman KA, Staelin R. Relationship between patient satisfaction with inpatient care and hospital readmission within 30 days. Am J Manag Care. 2011;17(1):41–8.PubMed
18.
go back to reference Roy CL, Liang CL, Lund M, et al. Implementation of a physician assistant/hospitalist service in an academic medical center: impact on efficiency and patient outcomes. J Hosp Med. 2008;3(5):361–8.PubMedCrossRef Roy CL, Liang CL, Lund M, et al. Implementation of a physician assistant/hospitalist service in an academic medical center: impact on efficiency and patient outcomes. J Hosp Med. 2008;3(5):361–8.PubMedCrossRef
19.
go back to reference Meltzer D, Manning WG, Morrison J, et al. Effects of physician experience on costs and outcomes on an academic general medicine service: results of a trial of hospitalists. Ann Intern Med. 2002;137(11):866–74.PubMed Meltzer D, Manning WG, Morrison J, et al. Effects of physician experience on costs and outcomes on an academic general medicine service: results of a trial of hospitalists. Ann Intern Med. 2002;137(11):866–74.PubMed
20.
go back to reference Ziegelstein RC, Rand CS, Hellmann DB. Redesign of internal-medicine teaching. N Engl J Med. 2010;363(6):594. author reply 594.PubMed Ziegelstein RC, Rand CS, Hellmann DB. Redesign of internal-medicine teaching. N Engl J Med. 2010;363(6):594. author reply 594.PubMed
21.
go back to reference Garman AN, Garcia J, Hargreaves M. Patient satisfaction as a predictor of return-to-provider behavior: analysis and assessment of financial implications. Qual Manag Health Care. 2004;13(1):75–80.PubMed Garman AN, Garcia J, Hargreaves M. Patient satisfaction as a predictor of return-to-provider behavior: analysis and assessment of financial implications. Qual Manag Health Care. 2004;13(1):75–80.PubMed
22.
go back to reference Charmel PA, Frampton SB. Building the business case for patient-centered care. Healthc Financ Manag. 2008;62(3):80–5. Charmel PA, Frampton SB. Building the business case for patient-centered care. Healthc Financ Manag. 2008;62(3):80–5.
23.
go back to reference Cooke M, Irby DM, Sullivan W, Ludmerer KM. American medical education 100 years after the Flexner report. N Engl J Med. 2006;355(13):1339–44.PubMedCrossRef Cooke M, Irby DM, Sullivan W, Ludmerer KM. American medical education 100 years after the Flexner report. N Engl J Med. 2006;355(13):1339–44.PubMedCrossRef
24.
go back to reference Irby DM, Cooke M, O'Brien BC. Calls for reform of medical education by the Carnegie Foundation for the Advancement of Teaching: 1910 and 2010. Acad Med. 2010;85(2):220–7.PubMedCrossRef Irby DM, Cooke M, O'Brien BC. Calls for reform of medical education by the Carnegie Foundation for the Advancement of Teaching: 1910 and 2010. Acad Med. 2010;85(2):220–7.PubMedCrossRef
Metadata
Title
Effects of a Focused Patient-Centered Care Curriculum on the Experiences of Internal Medicine Residents and their Patients
Authors
Neda Ratanawongsa, MD, MPH
Molly A. Federowicz, MA
Colleen Christmas, MD
Laura A. Hanyok, MD
Janet D. Record, MD
David B. Hellmann, MD
Roy C. Ziegelstein, MD
Cynthia S. Rand, PhD
Publication date
01-04-2012
Publisher
Springer-Verlag
Published in
Journal of General Internal Medicine / Issue 4/2012
Print ISSN: 0884-8734
Electronic ISSN: 1525-1497
DOI
https://doi.org/10.1007/s11606-011-1881-8

Other articles of this Issue 4/2012

Journal of General Internal Medicine 4/2012 Go to the issue

Clinical Practice: Clinical Images

ST-Segment Elevation and Minimally Reactive Pupils

Healing Arts: Materia Medica

A Prescription for Song

Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine