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Journal of General Internal Medicine

, Volume 22, Issue 12, pp 1704–1710 | Cite as

Continuity Clinic Satisfaction and Valuation in Residency Training

  • Stephen D. Sisson
  • Romsai Boonyasai
  • Kimberly Baker-Genaw
  • Julie Silverstein
Original Article

Abstract

Background

Internal Medicine residency training in ambulatory care has been judged inadequate, yet how trainees value continuity clinic and which aspects of clinic affect attitudes are unknown.

Objectives

To determine the value that Internal Medicine residents place on continuity clinic and how clinic precepting, operations, and patient panels affect its valuation.

Design and measurements

A survey on ambulatory care was developed, including questions on career choice and the value of clinical training experiences. Independent variables were Likert-scale ratings (1 = disagree strongly/no value; 3 = neutral; 5 = agree strongly/high value) on preceptors, patients, operations, and resident characteristics. Odds ratios and stepwise multivariate logistic regression with clustering were used to evaluate associations between clinic valuation and independent variables.

Subjects

Internal medicine residents at 3 residency programs.

Results

218 of 260 residents (83.8%) completed the survey. Resident ratings were highest on diversity of illness seen (4.1), medical record systems used (4.1), and contact with preceptors who were receptive to questions (4.8). Resident ratings were lowest on economic diversity of patients (2.7), interruptions from inpatient wards (3.1), and contact with preceptors who taught history and physical exam skills (3.5). High ratings on all precepting issues and nearly all operational issues were associated with valuing clinic. With multivariate analysis, high ratings of preceptors as role models were most strongly associated with valuing clinic (corrected relative risk 3.44). A planned career in general Internal Medicine was not associated with valuing clinic.

Conclusions

Satisfaction with preceptors, particularly as role models, and clinic operations correlate with the value residents place on continuity clinic.

KEY WORDS

ambulatory education clinic precepting residency training 

Notes

Conflict of Interest

Dr. Sisson receives an annual stipend for editing the curriculum contained on the web site described herein.

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Copyright information

© Society of General Internal Medicine 2007

Authors and Affiliations

  • Stephen D. Sisson
    • 1
  • Romsai Boonyasai
    • 1
  • Kimberly Baker-Genaw
    • 2
  • Julie Silverstein
    • 3
  1. 1.Division of General Internal Medicine, Department of MedicineJohns Hopkins School of MedicineBaltimoreUSA
  2. 2.Division of General Internal Medicine, Department of MedicineHenry Ford HospitalDetroitUSA
  3. 3.Division of General Medicine, Department of MedicineChristiana Care Health SystemWilmingtonUSA

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