Abstract
Background
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.
Aim
To test the feasibility of a longitudinal clerkship based on PCMH principles and anchored by PCMH educational objectives.
Setting
Two community-based family medicine clinics, one academic internal medicine clinic, and one pediatric clinic affiliated with an urban medical school.
Participants
56 medical student volunteers.
Program Description
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.
Program Evaluation
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.
Discussion
An Education-Centered Medical Home (ECMH) is feasible and is highly rated by students and faculty. Expansion of this model is underway.
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Acknowledgments
Contributors
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.
Funders
Intramural funding was obtained from the Feinberg Academy of Medical Educators, Northwestern University Feinberg School of Medicine.
Prior presentations
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.
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Henschen, B.L., Garcia, P., Jacobson, B. et al. The Patient Centered Medical Home as Curricular Model: Perceived Impact of the “Education-Centered Medical Home”. J GEN INTERN MED 28, 1105–1109 (2013). https://doi.org/10.1007/s11606-013-2389-1
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DOI: https://doi.org/10.1007/s11606-013-2389-1