Cronholm Peter F, Klusaritz Heather, Nguyen Giang T, Kellom Katherine, Kearney Matthew, Miller-Day Michelle, Gabbay Robert
Mixed Methods Research Lab.
Fam Med. 2016 Sep;48(8):603-12.
This study's objectives were to assess resident understanding and engagement with the patient-centered medical home (PCMH) model and to assess the impact of participation in a PCMH transformation collaborative on residents' experiences and perceptions related to their training environment.
Residents from practices participating in the largest state-wide PCMH learning collaborative were asked to complete surveys describing their experiences with the collaborative and the PCMH transformation process. Residents from four representative participating residencies were recruited to participate in focus groups designed to provide qualitative data to augment our understanding of the quantitative survey results.
We had a reasonable average response rate (39%) with a total of 100 completed resident surveys. Quantitative data illustrated high levels of residents' endorsement of PCMH awareness, engagement, and PCMH-related skills acquisition. The analyses suggested higher levels of PCMH engagement, understanding, and sense of adequacy of preparation among residents who attended learning collaborative sessions compared to those who did not. While qualitative data validated many of the quantitative findings, they also illustrated a somewhat detached and peripheral description of resident experiences with the transformation process.
The presented data describe the complexities of preparing the next generation of providers for practice. Our mixed-methods study illustrated the strengths of participating in the learning collaborative but also areas of focus necessary for improving the experience and educational benefits of PCMH-related curricula involving residents.
本研究的目的是评估住院医师对以患者为中心的医疗之家(PCMH)模式的理解和参与程度,并评估参与PCMH转型协作对住院医师与培训环境相关的经历和认知的影响。
来自参与全州最大规模PCMH学习协作的医疗机构的住院医师被要求完成调查问卷,描述他们在协作和PCMH转型过程中的经历。从四个有代表性的参与培训项目中招募住院医师参加焦点小组,旨在提供定性数据,以加深我们对定量调查结果的理解。
我们的平均回复率合理(39%),共有100份住院医师调查问卷完成。定量数据表明住院医师对PCMH认知、参与度和与PCMH相关技能获取的认可度较高。分析表明,参加学习协作会议的住院医师与未参加的相比,在PCMH参与度、理解度和准备充分感方面水平更高。虽然定性数据证实了许多定量研究结果,但它们也显示出住院医师对转型过程经历的描述有些脱节和边缘化。
所呈现的数据描述了为下一代医疗服务提供者做好实践准备的复杂性。我们的混合方法研究表明了参与学习协作的优势,同时也指出了改善涉及住院医师的PCMH相关课程的体验和教育效益所需关注的领域。