Family-oriented patient care through the residency training cycle.

Objective: Because family oriented patient care improves patient outcome and reduces family burden, clinical family skills of communication, assessment, alliance, and support are part of core competencies required of all residents. Teaching residents to "think family" as part of core competencies and to reach out to families requires change in the teaching environment.

Methods: This article advocates teaching residents family skills throughout the training years as an integrated part of routine patient care rather than in isolated family clinics or a course in "family therapy." It reviews family skills required of residents in all treatment settings and family skills that are specific to inpatient, emergency room, outpatient, and consultation-liaison services.

Results: Families can be seen in multiple treatment settings throughout resident training using recent research to support appropriate interventions for patients and caregivers.

Conclusion: The process of establishing change in the training environment requires a commitment on the part of the training faculty to include families, but is possible within the current training framework.