title: The EFECT framework for interprofessional education in the patient centered medical home.
abstract: The very nature of the Patient-Centered Medical Home (PCMH) necessitates new instructional models that prepare learners for the roles they will have to assume in these transformed primary care practices. In this manuscript we describe a new instructional framework that seeks to blend the goals of patient-centered care and inter-professional education, and can be implemented in existing training environments while practice transformation continues to proceed. We propose a 5-step process, the EFECT framework, which is simultaneously a sequence of tasks for effective patient care and a guide for the learners and faculty in teaching and evaluating that care delivery. These steps include: (1) Eliciting a patient-centered narrative, (2) Facilitating an inter-professional team discussion, (3) Evaluating clinical evidence, (4) Creating a shared care plan, and (5) Tracking outcomes. We then report preliminary descriptive outcomes from the first EFECT pilot. Our proposed framework supports learners' abilities to construct a patient-centered narrative from multiple professional perspectives as the basis for developing an evidence-based, integrated care plan between the patient and the inter-professional care team and deliberately following up on outcomes. We present this framework to stimulate a process for creating new curricula and evaluative tools to measure and promote learner functioning in medical home environments.
authors.affiliation: Division of General Medicine, Brigham and Women's Hospital, Boston, MA, USA; Center for Primary Care, and Department of Health Care Policy, Harvard Medical School, Boston, MA, USA. Electronic address: abitton@partners.org.
authors.forename: Asaf
authors.initials: A
authors.lastname: Bitton
authors.affiliation: Internal Medicine Residency Program, Hennepin County Medical Center, Minneapolis, MN, USA; Department of Medicine, University of Minnesota, Minneapolis, MN, USA.
authors.forename: Anne G
authors.initials: AG
authors.lastname: Pereira
authors.affiliation: NW Regional Faculty Development Center, VAMC, Boise, ID, USA; Department of Medicine, University of Washington, Seattle, WA, USA; Department of Medical Education & Biomedical Informatics, University of Washington, Seattle, WA, USA.
authors.forename: C Scott
authors.initials: CS
authors.lastname: Smith
authors.affiliation: Division of General and Geriatric Medicine, University of Kansas, Kansas City, KS, USA.
authors.forename: Stewart F
authors.initials: SF
authors.lastname: Babbott
authors.affiliation: Department of Medicine, Oregon Health and Science University, Portland, OR, USA; Office of Academic Affiliations, Veterans Health Administration, Washington, DC, USA.
authors.forename: Judith L
authors.initials: JL
authors.lastname: Bowen
keywords: Inter-professional; Medical education; Patient-centered medical home; Primary care