Internal Medicine Residents' Perceptions of Team-Based Care and its Educational Value in the Continuity Clinic: A Qualitative Study.
J Gen Intern Med
; 30(9): 1279-85, 2015 Sep.
Article
em En
| MEDLINE
| ID: mdl-26173512
ABSTRACT
BACKGROUND:
In order to teach residents how to work in interprofessional teams, educators in graduate medical education are implementing team-based care models in resident continuity clinics. However, little is known about the impact of interprofessional teams on residents' education in the ambulatory setting.OBJECTIVE:
To identify factors affecting residents' experience of team-based care within continuity clinics and the impact of these teams on residents' education.DESIGN:
This was a qualitative study of focus groups with internal medicine residents.PARTICIPANTS:
Seventy-seven internal medicine residents at the University of California San Francisco at three continuity clinic sites participated in the study.APPROACH:
Qualitative interviews were audiotaped and transcribed. The authors used a general inductive approach with sensitizing concepts in four frames (structural, human resources, political and symbolic) to develop codes and identify themes. KEYRESULTS:
Residents believed that team-based care improves continuity and quality of care. Factors in four frames affected their ability to achieve these goals. Structural factors included communication through the electronic medical record, consistent schedules and regular team meetings. Human resources factors included the presence of stable teams and clear roles. Political and symbolic factors negatively impacted team-based care, and included low staffing ratios and a culture of ultimate resident responsibility, respectively. Regardless of the presence of these factors or resident perceptions of their teams, residents did not see the practice of interprofessional team-based care as intrinsically educational.CONCLUSIONS:
Residents' experiences practicing team-based care are influenced by many principles described in the interprofessional teamwork literature, including understanding team members' roles, good communication and sufficient staffing. However, these attributes are not correlated with residents' perceptions of the educational value of team-based care. Including residents in interprofessional teams in their clinic may not be sufficient to teach residents how team-based care can enhance their overall learning and future practice.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Equipe de Assistência ao Paciente
/
Médicos
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Atenção Primária à Saúde
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Educação de Pós-Graduação em Medicina
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Instituições de Assistência Ambulatorial
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Medicina Interna
/
Internato e Residência
Tipo de estudo:
Clinical_trials
/
Prognostic_studies
/
Qualitative_research
Limite:
Adult
/
Female
/
Humans
/
Male
País/Região como assunto:
America do norte
Idioma:
En
Ano de publicação:
2015
Tipo de documento:
Article