Teaching Team Membership to Family Medicine Residents: What Does It Take?

Department of Family Medicine, Concord Hospital, Concord, New Hampshire, USA.
Families Systems & Health (Impact Factor: 1.13). 03/2011; 29(1):29-43. DOI: 10.1037/a0022306
Source: PubMed


Primary care reform proponents advocate for patient-centered medical homes built on interdisciplinary teamwork. Recent efforts document the difficulty achieving reform, which requires personal transformation by doctors. Currently no widely accepted curriculum to teach team membership in Family Medicine residencies exists. Organizational Development (OD) has 40 years of experience assessing and teaching the skills underlying teamwork. We present a curriculum that adapts OD insights to articulate a framework describing effective teamwork; define and teach specific team membership skills; reframe residents' perception of medicine to make relationships relevant; and transform training experiences to provide practice in interdisciplinary teamwork. Curriculum details include a rotation to introduce the new framework, six workshops, experiential learning in the practice, and coaching as a teaching method. We review program evaluations. We discuss challenges, including institutional resources and support, incorporation of a new language and culture into residency training, recruitment "for fit," and faculty/staff development. We conclude that teaching the relationship skills of effective team membership is feasible, but hard. Succeeding has transformative implications for patient relationships, residency training and the practice of family medicine.

16 Reads
  • Source
    • "Experiential learning is an effective learning tool in diverse domains. It appears to be particularly effective in contexts in which complex information must be processed (e.g., Burke et al. 2011) and contexts in which deeply ingrained behavioral attitudes are challenged (e.g., Eubank et al. 2011). Thus an experiential learning-based activity is well suited for teaching about gender inequity. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Interventions aimed at raising awareness of gender inequity in the workplace provide information about sexism, which can elicit reactance or fail to promote self-efficacy. We examined the effectiveness of experiential learning using the Workshop Activity for Gender Equity Simulation – Academic version (WAGES-Academic) to deliver gender inequity information. To assess whether the way gender inequity information is presented matters, we compared WAGES-Academic to an Information Only condition (knowledge without experiential learning) and a Group Activity control condition. We predicted that only the information presented in an experiential learning format (i.e., WAGES-Academic) would be retained because this information does not provoke reactance and instills self-efficacy. Participants (n = 241; U.S. college students from a large mid-Atlantic state university) filled out a gender equity knowledge test at baseline, after the intervention, and then 7–11 days later (to assess knowledge retention). In addition, we measured feelings of reactance and self-efficacy after the intervention. Results revealed that participants in the WAGES condition retained more knowledge than the other conditions. Furthermore, the effect of WAGES vs. Information Only on knowledge was mediated by WAGES producing less reactance and greater feelings of self-efficacy. Results suggest that experiential learning is a powerful intervention to deliver knowledge about gender equity in a non-threatening, lasting way.
    Sex Roles 12/2012; 67(11-12). DOI:10.1007/s11199-012-0181-z · 1.47 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Expanded competencies in population health and systems-based medicine have been identified as a need for primary care physicians. Incorporating formal training in preventive medicine is one method of accomplishing this objective. We identified three family medicine residencies that have developed formal integrated pathways for residents to also complete preventive medicine residency requirements during their training period. Although there are differences, each pathway incorporates a structured approach to dual residency training and includes formal curriculum that expands resident competencies in population health and systems-based medicine. A total of 26 graduates have completed the formally combined family and preventive medicine residencies. All are board certified in family medicine, and 22 are board certified in preventive medicine. Graduates work in a variety of academic, quality improvement, community, and international settings utilizing their clinical skills as well as their population medicine competencies. Dual training has been beneficial in job acquisition and satisfaction. Incorporation of formal preventive medicine training into family medicine education is a viable way to use a structured format to expand competencies in population medicine for primary care physicians. This type of training, or modifications of it, should be part of the debate in primary care residency redesign.
    Family medicine 07/2011; 43(7):480-6. · 1.17 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Health care reform calls for patient-centered medical homes built around whole person care and healing relationships. Efforts to transform primary care practices and deliver these qualities have been challenging. This study describes one Family Medicine residency's efforts to develop an adaptive leadership curriculum and use coaching as a teaching method to address this challenge. We review literature that describes a parallel between the skills underlying such care and those required for adaptive leadership. We address two questions: What is leadership? Why focus on adaptive leadership? We then present a synthesis of leadership theories as a set of process skills that lead to organization learning through effective work relationships and adaptive leadership. Four models of the learning process needed to acquire such skills are explored. Coaching is proposed as a teaching method useful for going beyond information transfer to create the experiential learning necessary to acquire the process skills. Evaluations of our efforts to date are summarized. We discuss key challenges to implementing such a curriculum and propose that teaching adaptive leadership is feasible but difficult in the current medical education and practice contexts. (PsycINFO Database Record (c) 2012 APA, all rights reserved).
    Families Systems & Health 08/2012; 30(3):241-52. DOI:10.1037/a0029689 · 1.13 Impact Factor
Show more