Linda M. Roth

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. Methods: We introduced interdisciplinary teams in a family medicine residency site, integrating clinical and educational objectives. Results: We report our challenges and successes in the transformational journey to a patient-centered medical home, for which a team approach is critical to achieving high quality care. Conclusion: Establishing high-functioning interdisciplinary teams takes leadership commitment; the engagement of everyone in the practice; investment in staff, resident, and faculty development; and clear communication of vision and goals. Integration of clinical and educational objectives can be powerfully synergistic. Clinical, organizational, and educational outcomes are needed to evaluate impact.

Action Research: A Dynamic Discipline for Advancing Professional Goals

Action research methodology, a cyclical problem-solving process including the steps of planning, acting and reflecting, was used to facilitate organisational and scholarly development of academic staff in a clinically focused mid-western university occupational therapy department in the USA. An experienced staff development consultant worked with the professor and chair to create a 3-year developmental programme of several half-day and full-day workshops, graduate seminars and courses, team projects and individual career development consultations. Staff members created individual vision and mission statements and professional career plans and integrated these with departmental vision and mission statements and a strategic plan. Developmental efforts resulted in identifiable achievements of department members in improving teaching, clarifying community/professional service goals and involvement, and becoming more knowledgeable about, skilful at and actively engaged in academic scholarship.

Developing clinical teachers and their organizations for the future of medical education

In the October 2000 issue of Medical Education, Prideaux et al. addressed the current and future challenges of maintaining excellence in clinical teaching in the evolving health care environment, in which ®nancial pressures demand more attention to service at the potential expense of teaching and research. In addition to ®nancial pressures, growing numbers and types of learners are being integrated into clinical settings, further increasing the complexity of the environment in which clinicians teach and deliver patient care. While these challenges are substantial, the authors postulate that fundamentally, the basis of good teaching is rooted in good clinical practice. They then outline a clear framework for conceptualizing the roles of clinicians who are engaged in teaching as well as in patient care.

Essentials for great teams: trust, diversity, communication ... and joy.

In clinics and hospitals, in conference rooms and classrooms, in hallways and lunchrooms, we demonstrate daily our effectiveness or ineffectiveness as team members. We interact with patients, coworkers, and learners in ways that result in smooth, well-functioning, patient-centered processes, or we

Teaching portfolios: reflecting upon and improving teaching.

A number of benefits can be seen for academic medical faculty and their learners as a result of using the teaching portfolio to focus on facultys work as educators. While the portfolios initial purpose may be to document the extent and quality of teaching, thoughtful reflection on and documentation of the process and outcomes of teaching can lead faculty to advance in their teaching skills as medical practitioners who are charged with inducting new learners into the profession.