Enhancing team development in an internal medicine resident continuity clinic.

Interprofessional teamwork is important for the provision of safe, high value patient care and is recognized as essential by the ACGME. We aimed to assess the impact of an interprofessional continuity clinic teamwork curriculum on perceptions of team development and patient safety. This project was conducted in an IM Resident Continuity Clinic where 96 residents, supported by 28 faculty and 48 interprofessional team members, attended continuity clinic two afternoons per week during alternating months of a 50/50 outpatient-inpatient training model.

Survivor Health Connection Project: Understanding Experiences of Accessing Health Care Among Those Affected by Intimate Partner Violence During the COVID-19 Pandemic.

Objectives: Intimate partner violence (IPV) has short- and long-term health effects, including physical injuries and traumatic brain injury, as well as sexual, reproductive, and mental health issues. However, accessing necessary health care is often challenging for IPV survivors and became even more difficult during the COVID-19 pandemic. We examined access to health care among those affected by IPV during the COVID-19 pandemic to better connect survivors to health and social support services.

Networking Matters: A Social Network Analysis of the Association of Program Directors of Internal Medicine.

: Networking has positive effects on career development; however, personal characteristics of group members such as gender or diversity may foster or hinder member connectedness. Social network analysis explores interrelationships between people in groups by measuring the strength of connection between all possible pairs in a given network. Social network analysis has rarely been used to examine network connections among members in an academic medical society.

Immunization education for internal medicine residents: A cluster-randomized controlled trial.

Purpose: The aims of this study are to evaluate the impact of a novel immunization curriculum based on the Preferred Cognitive Styles and Decision Making Model (PCSDM) on internal medicine (IM) resident continuity clinic patient panel immunization rates, as well as resident immunization knowledge, attitudes, and practices (KAP).

Methods: A cluster-randomized controlled trial was performed among 143 IM residents at Mayo Clinic to evaluate the PCSDM curriculum plus fact-based immunization curriculum (intervention) compared to fact-based immunization curriculum alone (control) on the outcomes of resident continuity clinic patient panel immunization rates for influenza, pneumococcal, tetanus, pertussis, and zoster vaccines. Pre-study and post-study immunization KAP surveys were administered to IM residents.

Continuity Clinic Model and Diabetic Outcomes in Internal Medicine Residencies: Findings of the Educational Innovations Project Ambulatory Collaborative.

Background: Efforts to improve diabetes care in residency programs are ongoing and in the midst of continuity clinic redesign at many institutions. While there appears to be a link between resident continuity and improvement in glycemic control for diabetic patients, it is uncertain whether clinic structure affects quality measures and patient outcomes.

Methods: This multi-institutional, cross-sectional study included 12 internal medicine programs.

Rating the Quality of Entrustable Professional Activities: Content Validation and Associations with the Clinical Context.

Background: Entrustable professional activities (EPAs) have been developed to assess resident physicians with respect to Accreditation Council for Graduate Medical Education (ACGME) competencies and milestones. Although the feasibility of using EPAs has been reported, we are unaware of previous validation studies on EPAs and potential associations between EPA quality scores and characteristics of educational programs.

Objectives: Our aim was to validate an instrument for assessing the quality of EPAs for assessment of internal medicine residents, and to examine associations between EPA quality scores and features of rotations.

Determinants of Patient Satisfaction in Internal Medicine Resident Continuity Clinics: Findings of the Educational Innovations Project Ambulatory Collaborative.

Background: Many internal medicine programs have reorganized their resident continuity clinics to improve the ambulatory care experience for residents. The effect of this redesign on patient satisfaction is largely unknown.

Methods: Our multi-institutional, cross-sectional study included 569 internal medicine residents from 11 programs participating in the Educational Innovations Project Ambulatory Collaborative.

Clinic Design and Continuity in Internal Medicine Resident Clinics: Findings of the Educational Innovations Project Ambulatory Collaborative.

Background: Many internal medicine (IM) programs have reorganized their resident continuity clinics to improve trainees' ambulatory experience. Downstream effects on continuity of care and other clinical and educational metrics are unclear.

Methods: This multi-institutional, cross-sectional study included 713 IM residents from 12 programs.

Enhancing motivation with the "virtual" supervisory role: a randomized trial.

Background: We aimed to explore the influence of a motivationally-enhanced instructional design on motivation to learn and knowledge, hypothesizing that outcomes would be higher for the enhanced instructional format.

Methods: Medicine residents completed four online learning modules on primary care topics. Using a crossover design, learners were randomized to receive two standard and two motivationally-enhanced learning modules.

Clinic design, key practice metrics, and resident satisfaction in internal medicine continuity clinics: findings of the educational innovations project ambulatory collaborative.

Background: Internal medicine programs are redesigning ambulatory training to improve the resident experience and answer the challenges of conflicting clinical responsibilities. However, little is known about the effect of clinic redesign on residents' satisfaction.

Objective: We assessed residents' satisfaction with different resident continuity clinic models in programs participating in the Educational Innovations Project Ambulatory Collaborative (EPAC).

Resident physician perspectives on outpatient continuity of care.

Background: The outpatient continuity clinic is an essential component of internal medicine residency programs, yet continuity of patient care in these clinics is suboptimal. Reasons for this discontinuity have been inadequately explored.

Objective: We sought to assess perceived factors contributing to discontinuity in trainee ambulatory clinics.

Update in internal medicine residency education: a review of the literature in 2010 and 2011.

Background: Evidence-based practice in education requires high-quality evidence, and many in the medical education community have called for an improvement in the methodological quality of education research.

Objective: Our aim was to use a valid measure of medical education research quality to highlight the methodological quality of research publications and provide an overview of the recent internal medicine (IM) residency literature.

Methods: We searched MEDLINE and PreMEDLINE to identify English-language articles published in the United States and Canada between January 1, 2010, and December 31, 2011, focusing on IM residency education.

Test-enhanced web-based learning: optimizing the number of questions (a randomized crossover trial).

Purpose: Questions enhance learning in Web-based courses, but preliminary evidence suggests that too many questions may interfere with learning. The authors sought to determine how varying the number of self-assessment questions affects knowledge outcomes in a Web-based course.

Method: The authors conducted a randomized crossover trial in one internal medicine and one family medicine residency program between January 2009 and July 2010.

Executive function changes before memory in preclinical Alzheimer's pathology: a prospective, cross-sectional, case control study.

Background: Early treatment of Alzheimer's disease may reduce its devastating effects. By focusing research on asymptomatic individuals with Alzheimer's disease pathology (the preclinical stage), earlier indicators of disease may be discovered. Decreasing cerebrospinal fluid beta-amyloid42 is the first indicator of preclinical disorder, but it is not known which pathology causes the first clinical effects.

An evaluation of internal medicine residency continuity clinic redesign to a 50/50 outpatient-inpatient model.

Background: There have been recent calls for improved internal medicine outpatient training, yet assessment of clinical and educational variables within existing models is lacking.

Objective: To assess the impact of clinic redesign from a traditional weekly clinic model to a 50/50 outpatient-inpatient model on clinical and educational outcomes.

Design: Pre-intervention and post-intervention study intervals, comparing the 2009-2010 and 2010-2011 academic years.

Improved resident physician confidence with advance care planning after an ambulatory clinic intervention.

Many primary care providers feel uncomfortable discussing end-of-life care. The aim of this intervention was to assess internal medicine residents' advance care planning (ACP) practices and improve residents' ACP confidence. Residents participated in a facilitated ACP quality improvement workshop, which included an interactive presentation and chart audit of their own patients.

There is no "i" in teamwork in the patient-centered medical home: defining teamwork competencies for academic practice.

Evidence suggests that teamwork is essential for safe, reliable practice. Creating health care teams able to function effectively in patient-centered medical homes (PCMHs), practices that organize care around the patient and demonstrate achievement of defined quality care standards, remains challenging. Preparing trainees for practice in interprofessional teams is particularly challenging in academic health centers where health professions curricula are largely siloed.

The Motivated Strategies for Learning Questionnaire: score validity among medicine residents.

Context: The Motivated Strategies for Learning Questionnaire (MSLQ) purports to measure motivation using the expectancy-value model. Although it is widely used in other fields, this instrument has received little study in health professions education.

Objectives: The purpose of this study was to evaluate the validity of MSLQ scores.

Residents' reflections on quality improvement: temporal stability and associations with preventability of adverse patient events.

Purpose: Residents' reflections on quality improvement (QI) opportunities are poorly understood. The authors used the Mayo Evaluation of Reflection on Improvement Tool (MERIT) to measure residents' reflection scores across three years and to determine associations between reflection scores and resident and adverse patient event characteristics.

Method: From 2006 to 2009, 48 Mayo Clinic internal medicine residents completed biannual reflections on adverse events and classified event severity and preventability.

Group assessments of resident physicians improve reliability and decrease halo error.

Background: Individual faculty assessments of resident competency are complicated by inconsistent application of standards, lack of reliability, and the "halo" effect.

Objective: We determined whether the addition of faculty group assessments of residents in an ambulatory clinic, compared with individual faculty-of-resident assessments alone, have better reliability and reduced halo effects.

Design: This prospective, longitudinal study was performed in the outpatient continuity clinics of a large internal medicine residency program.

Effect of visit length and a clinical decision support tool on abdominal aortic aneurysm screening rates in a primary care practice.

Rationale, Aims And Objectives: In 2005, the US Preventive Services Task Force issued recommendations for one-time abdominal aortic aneurysm (AAA) screening using abdominal ultrasonography in men aged 65 to 75 years with a history of smoking. However, despite a mortality rate of up to 80% for ruptured AAAs, providers order the screening for a minority of patients. We examined AAA screening rates among providers and investigated the role of visit duration and other factors in whether patients received screening.