The Patient Centered Medical Home as Curricular Model: Perceived Impact of the “Education-Centered Medical Home”
- 1.2k Downloads
The patient-centered medical home (PCMH) model aims to provide patient-centered care, lower costs, and improve health outcomes. Medical students have not been meaningfully integrated in this model.
To test the feasibility of a longitudinal clerkship based on PCMH principles and anchored by PCMH educational objectives.
Two community-based family medicine clinics, one academic internal medicine clinic, and one pediatric clinic affiliated with an urban medical school.
56 medical student volunteers.
We embedded student teams in existing faculty practices and recruited a high-risk patient panel for each team. Clinical education occurred through a traditional clinic preceptor model and was augmented by 3rd and 4th year students directly observing 1st and 2nd year students. Didactic content included monthly Grand Rounds conferences.
Students attended 699 clinics, recruited 273 continuity patients, and participated in 9 Grand Rounds conferences. Student confidence with PCMH principles increased and attitudes regarding continuity were highly positive. “Continuity,” “early clinical exposure,” and “peer teaching” were the most powerful themes expressed by students. Faculty response to the pilot was highly positive.
An Education-Centered Medical Home (ECMH) is feasible and is highly rated by students and faculty. Expansion of this model is underway.
KEY WORDSpatient-centered medical home medical education longitudinal integrated clerkship early clinical experience curriculum design continuity in education
The authors thank Ricardo Rosenkranz, MD, Mark Loafman, MD, Sharon Unti, MD, Jennifer Bierman, MD, John Butter, MD, Stephanie Kerns, and Emily Kern, MD, for their contributions to the ECMH pilot. We also thank Rebecca DeHoek, MD, Alisha Thomas, MD, and Mary Nevin, MD, for their willingness to participate as preceptors in the ECMH pilot and the PCC Community Wellness Center for their support in hosting pilot sites. Finally, we thank Raymond Curry, MD, and John X. Thomas, PhD, for their administrative support.
Intramural funding was obtained from the Feinberg Academy of Medical Educators, Northwestern University Feinberg School of Medicine.
We presented the ECMH pilot as a workshop at the Central Group on Educational Affairs Conference in St. Louis, MO, in 2012.
Conflict of Interest
The authors declare that they do not have a conflict of interest.
- 1.Patient-Centered Primary Care Collaborative. Joint principles of the Patient-Centered Medical Home. Available at: http://www.pcpcc.net/content/joint-principles-patient-centered-medical-home. Accessed January 19, 2013.
- 2.American College of Physicians (ACP). Patient-Centered Medical Home. Available at: http://www.acponline.org/running_practice/pcmh/. Accessed January 19, 2013.
- 3.Agency for Healthcare Research and Quality. Patient Centered Medical Home resource center. Available at: http://www.pcmh.ahrq.gov/portal/server.pt/community/pcmh__home/. Accessed January 19, 2013.
- 4.Grumbach K, Bodenheimer T, Grundy P. The outcomes of implementing Patient-Centered Medical Home interventions: A review of the evidence on quality, access and costs from recent prospective evaluation studies. Available at: http://www.pcpcc.net/files/pcmh_evidence_outcomes_2009.pdf. Accessed January 19, 2013.
- 5.Cooke M, Irby D, O’Brien B. Educating physicians: A call for reform of medical school and residency. San Francisco: Jossey-Bass; 2010.Google Scholar
- 6.Baxley E, Dearing J, Esquivel M, et al. Joint principles for the medical education of physicians as preparation for practice in the Patient-Centered Medical Home. Available at: http://www.acponline.org/running_practice/delivery_and_payment_models/pcmh/understanding/educ-joint-principles.pdf Accessed January 19, 2013.
- 12.Konkin J, Suddards C. Creating stories to live by: caring and professional identity formation in a longitudinal integrated clerkship. Adv Health Sci Educ. 2011 Nov 4.Google Scholar
- 19.Poncelet A, Bokser S, Calton B, et al. Development of a longitudinal integrated clerkship at an academic medical center. Med Educ Online. 2011;16:1–10.Google Scholar
- 26.Rosenthal MB, Abrams MK, Bitton A, and the Patient-Centered Medical Home Evaluators’ Collaborative. Recommended core measures for evaluating the Patient-Centered Medical Home: Cost, utilization, and clinical quality. Available at: http://www.commonwealthfund.org/∼/media/Files/Publications/Data%20Brief/2012/1601_Rosenthal_recommended_core_measures_PCMH_v2.pdf. Accessed January 19, 2013.