Applying health information technology and team-based care to residency education.

BACKGROUND AND OBJECTIVES: Training physicians capable of practicing within the Patient-centered Medical Home (PCMH) is an emerging area of scholarly inquiry within residency education. This study describes an effort to integrate PCMH principles into teaching practices within a university-based residency setting and evaluates the effect on clinical performance. METHODS: Using participant feedback and clinical data extracted from an electronic clinical quality management system, we retrospectively examined performance outcomes at two family medicine residency clinics over a 7-year period. Instructional approaches were identified and clinical performance patterns analyzed. RESULTS: Alumni ratings of the practice-based curriculum increased following institution of the PCMH model. Clinical performance outcomes indicated improvements in the delivery of clinical care to patients. Implementation of instructional methodologies posed some challenges to residency faculty, particularly in development of consistent scheduling of individualized feedback sessions. Residents required the greatest support and guidance in managing point-of-care clinical reminders during patient encounters. CONCLUSIONS: Teaching practices that take into consideration the integration of team-based care and use of electronic health technologies can successfully be used to deliver residency education in the context of the PCMH model. Ongoing assessment provides important information to residency directors and faculty in support of improving the quality of clinical instruction.

Developing online learning modules in a family medicine residency.

BACKGROUND AND OBJECTIVES: Online modules offer an opportunity to overcome barriers to educational delivery. Such approaches can require significant investment dependent on the development model used. There is little in the literature on the formative assessment of design and development. Better understanding is needed to determine effective methods of training and supporting faculty authors. METHODS: The purpose of this study was to examine the effectiveness of Web-based modules developed by a Department of Family Medicine in delivering instruction to resident learners and to examine perceptions of the design and development process. Participants included 49 resident learners and 28 faculty and staff members as the development team. Data collection involved use of Web-based surveys, participant observation focus groups, and pretesting/posttesting. Frequency distributions and mean comparisons were used to analyze quantitative data. Participant comments were thematically analyzed. RESULTS: Residents felt that modules met their educational goals and contributed to understanding of core content. Pretest/posttest data showed statistical improvement for a majority of modules. The use of Web authoring software for Web-based learning and scheduling time to work on the modules posed the greatest challenges to module authors. CONCLUSIONS: Formative assessment methods can provide important information to module developers and support staff to shape training, content development, and improve module ease of use, navigation, and content for resident learners.