title: Nurturing 21st century physician knowledge, skills and attitudes with medical home innovations: the Wright Center for Graduate Medical Education teaching health center curriculum experience.
abstract: Purpose. The effect of patient centered medical home (PCMH) curriculum interventions on residents' self-reported and demonstrated knowledge, skills and attitudes in PCMH competency arenas (KSA) is lacking in the literature. This study aimed to assess the impact of PCMH curricular innovations on the KSA of Internal Medicine residents. Methods. Twenty four (24) Internal Medicine residents-12 Traditional (TR) track residents and 12 Teaching Health Center (THC) track residents-began training in Academic Year (AY) 2011 at the Wright Center for Graduate Medical Education (WCGME). They were followed through AY2013, covering three years of training. PCMH curricular innovations were focally applied July 2011 until May 2012 to THC residents. These curricular innovations were spread program-wide in May 2012. Semi-annual, validated PCMH Clinician Assessments assessing KSA were started in AY2011 and were completed by all residents. Results. Mean KSA scores of TR residents were similar to those of THC residents at baseline for all PCMH competencies. In May 2012, mean scores of THC residents were significantly higher than TR residents for most KSA. After program-wide implementation of PCMH innovations, mean scores of TR residents for all KSA improved and most became equalized to those of THC residents. Globally improved KSA scores of THC and TR residents were maintained through May 2014, with the majority of improvements above baseline and reaching statistical significance. Conclusions. PCMH curricular innovations inspired by Health Resources and Services Administration (HRSA's) Teaching Health Center funded residency program expansion quickly and consistently improved the KSA of Internal Medicine residents.
authors.affiliation: The Wright Center for Graduate Medical Education, Internal Medicine , Scranton, PA , USA.
authors.forename: Linda
authors.initials: L
authors.lastname: Thomas-Hemak
authors.affiliation: The Wright Center for Graduate Medical Education, Internal Medicine , Scranton, PA , USA.
authors.forename: Ghanshyam
authors.initials: G
authors.lastname: Palamaner Subash Shantha
authors.affiliation: The Wright Center for Graduate Medical Education, Internal Medicine , Scranton, PA , USA.
authors.forename: Lakshmi Rani
authors.initials: LR
authors.lastname: Gollamudi
authors.affiliation: The Wright Center for Graduate Medical Education, Internal Medicine , Scranton, PA , USA.
authors.forename: Jignesh
authors.initials: J
authors.lastname: Sheth
authors.affiliation: The Wright Center for Graduate Medical Education, Internal Medicine , Scranton, PA , USA.
authors.forename: Brian
authors.initials: B
authors.lastname: Ebersole
authors.affiliation: The Wright Center for Graduate Medical Education, Internal Medicine , Scranton, PA , USA.
authors.forename: Katlyn J
authors.initials: KJ
authors.lastname: Gardner
authors.affiliation: The Wright Center for Graduate Medical Education, Internal Medicine , Scranton, PA , USA.
authors.forename: Julie
authors.initials: J
authors.lastname: Nardella
authors.affiliation: The Wright Center for Graduate Medical Education, Internal Medicine , Scranton, PA , USA.
authors.forename: Meaghan P
authors.initials: MP
authors.lastname: Ruddy
authors.affiliation: The Wright Center for Graduate Medical Education, Internal Medicine , Scranton, PA , USA ; Tufts Medical School, Baystate Health , Springfield, MA , USA.
authors.forename: Lauren
authors.initials: L
authors.lastname: Meade
keywords: Affordable Care Act; Internal Medicine residency training; Patient centered medical home; Physician work force; Self reflection; Teaching health centers