title: Transforming primary care training--patient-centered medical home entrustable professional activities for internal medicine residents.
abstract: BACKGROUND
  The U.S. faces a critical gap between residency training and clinical practice that affects the recruitment and preparation of internal medicine residents for primary care careers. The patient-centered medical home (PCMH) represents a new clinical microsystem that is being widely promoted and implemented to improve access, quality, and sustainability in primary care practice.
  
  
  OBJECTIVE
  We address two key questions regarding the training of internal medicine residents for practice in PCMHs. First, what are the educational implications of practice transformations to primary care home models? Second, what must we do differently to prepare internal medicine residents for their futures in PCMHs?
  
  
  METHODS
  The 2011 Society of General Internal Medicine (SGIM) PCMH Education Summit established seven work groups to address the following topics: resident workplace competencies, teamwork, continuity of care, assessment, faculty development, 'medical home builder' tools, and policy. The output from the competency work group was foundational for the work of other groups. The work group considered several educational frameworks, including developmental milestones, competencies, and entrustable professional activities (EPAs).
  
  
  RESULTS
  The competency work group defined 25 internal medicine resident PCMH EPAs. The 2011 National Committee for Quality Assurance (NCQA) PCMH standards served as an organizing framework for EPAs.
  
  
  CONCLUSIONS
  The list of PCMH EPAs has the potential to begin to transform the education of internal medicine residents for practice and leadership in the PCMH. It will guide curriculum development, learner assessment, and clinical practice redesign for academic health centers.
authors.affiliation: University of California San Francisco, San Francisco Veterans Affairs Medical Center, 3333 California Street, Suite 380, San Francisco, CA 94118, USA. anna.chang@ucsf.edu
authors.forename: Anna
authors.initials: A
authors.lastname: Chang
authors.forename: Judith L
authors.initials: JL
authors.lastname: Bowen
authors.forename: Raquel A
authors.initials: RA
authors.lastname: Buranosky
authors.forename: Richard M
authors.initials: RM
authors.lastname: Frankel
authors.forename: Nivedita
authors.initials: N
authors.lastname: Ghosh
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Rosenblum
authors.forename: Sara
authors.initials: S
authors.lastname: Thompson
authors.forename: Michael L
authors.initials: ML
authors.lastname: Green
mesh_terms: D002983:Clinical Competence; D003479:Curriculum; D004503:Education, Medical, Graduate / Q000458:organization & administration; D004521:Educational Measurement / Q000379:methods; D006801:Humans; D007388:Internal Medicine / Q000193:education*; D007396:Internship and Residency / Q000458:organization & administration*; D018802:Patient-Centered Care / Q000458:organization & administration / Q000592:standards*; D011320:Primary Health Care / Q000458:organization & administration / Q000592:standards*; D011364:Professional Practice / Q000458:organization & administration / Q000592:standards; D016730:Program Development / Q000379:methods; D014481:United States