Authors: Saima I Chaudhry Sandy Balwan Karen A Friedman Suzanne Sunday Basit Chaudhry Deborah DiMisa Alice Fornari
Publish Date: 2013/04/18
Volume: 28, Issue: 8, Pages: 1100-1104
Abstract
Traditional ambulatory training models have limitations in important domains including opportunities for residents to learn fragmentation of care delivery experience and satisfaction with ambulatory experiences New models of ambulatory training are neededA mixedmethods analysis of survey and nominal group data measuring three primary outcomes 1 Perception of learning opportunities and quality of faculty teaching 2 Reported fragmentation of care delivery experience 3 Satisfaction with ambulatory experiences Selfreported empanelment was a secondary outcome Residents’ learning opportunities increased p = 0007 but quality of faculty teaching was unchanged Participants reported less fragmentation in the care residents provide patients in the inpatient and outpatient setting p 00001 Satisfaction with ambulatory training improved p 00001 Selfreported empanelment also increased p 00001 Results held true for residents faculty and staff at all three ambulatory training sites p 00001A 4 + 1 model increased resident time in ambulatory continuity clinic enhanced learning opportunities reduced fragmentation of care residents provide and improved satisfaction with ambulatory experiences More studies of similar models are needed to evaluate effects on additional trainee and patient outcomesThe authors wish to acknowledge the following people for their support in the creation of the 4 + 1 model and the use of survey questions Dr Jeffrey Weiss Program Director Internal Medicine Residency at Tulane University Dr Marc Shalaby Program Director Internal Medicine Residency at Lehigh Valley and Dr Linda Roth Department of Family Medicine Wayne State UniversityThe authors would also like to thank the residents chief residents and administrative staff of the Hofstra North Shore LIJ IM Residency Program for their flexibility in transitioning to a new model of residency training and Rinkal Sundhani for her editorial assistance with this manuscript
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