Implementing teams in a patient-centered medical home residency practice: lessons learned.

Introduction: The "new model of care" calls for a new approach for primary care delivery that focuses on patient centeredness, quality, safety, effective and efficient care, and interdisciplinary teamwork. Medical education needs to parallel this health care reorganization. Implementing a team approach in a residency practice, especially in ambulatory settings, poses unique challenges.

Effects of implementation of a team model on physician and staff perceptions of a clinic's organizational and learning environments.

Background And Objectives: Although teamwork is widely promoted by the Institute of Medicine, the American Academy of Family Physicians, and the Future of Family Medicine project, the health care literature does not provide clear direction on how to create or maintain high-functioning teams in ambulatory residency education. In 2004, we reorganized the clinical operation of our family medicine residency clinic into teams, each consisting of faculty, residents, and nursing and administrative staff. We hypothesized that operating within teams would have a positive effect on employees' job satisfaction and perceptions of our clinic's organizational and learning environments.

Insights from practice-based researchers to develop family medicine faculty as scholars.

Background And Objectives: National mandates call for accelerating scholarly development of family medicine faculty. One strategy to address these mandates is training more faculty to participate in practice-based research (PBR). We need to determine competencies that enable faculty to conduct PBR, methods for training faculty in PBR, and strategies to streamline PBR operations in clinics.

Exploring physician and staff perceptions of the learning environment in ambulatory residency clinics.

Background And Objectives: Investigations of teaching quality in ambulatory clinics have generally focused on faculty and medical student perspectives. We investigated the association of learning and organizational environment variables with faculty, resident, and nursing staff perceptions of quality of teaching and with a measure of resident learning in ambulatory residency clinics.

Methods: Annually over 5 years (1998-2002), we distributed learning and organizational environment surveys to faculty, residents, and staff in three ambulatory clinics of the Wayne State University Department of Family Medicine.

Synchronous distance learning as an effective and feasible method for delivering residency didactics.

Background And Objectives: Providing effective multisite didactic teaching in residency programs remains a challenge. There is limited evidence regarding the educational equivalency of the traditional and distance learning methods for delivery of didactics. We introduced a synchronous two-way audio and video Internet-transmitted distance learning methodology in two sites.

Scholarly development of clinician faculty using evidence-based medicine as an organizing theme.

While scholarship is a critical component of the mission of all academic departments, little is known about how to approach the scholarly development of clinician faculty. The authors developed a thematically based faculty development curriculum with two primary components: evidence-based clinical practice and critical appraisal of current clinical research. They took a task management approach to reducing anticipated barriers to program success by instituting a regularly scheduled seminar series, providing evidence-based reading materials, recruiting clinician faculty as speakers for the clinical presentations, and providing continuing medical education credits for seminar attendance.

E-conferencing for delivery of residency didactics.

Objective: While didactic conferences are an important component of residency training, delivering them efficiently is a challenge for many programs, especially when residents are located in multiple sites, as they are at Wayne State University School of Medicine in the Department of Family Medicine. Our residents find it difficult to travel from our hospitals or rotation sites to a centralized location for conferences. In order to overcome this barrier, we implemented distance learning and electronically delivered the conferences to the residents.