Brooks Joanna Veazey, Chien Alyna T, Singer Sara J, Peters Antoinette S
Department of Population Health, University of Kansas School of Medicine, 3901 Rainbow Blvd, Mail Stop 3044, Kansas City, KS 66160 USA.
Division of General Pediatrics, Department of Medicine, Boston Children's Hospital and Harvard Medical School, Boston, USA.
Med Sci Educ. 2019 Jul 26;29(4):969-975. doi: 10.1007/s40670-019-00784-4. eCollection 2019 Dec.
Primary care teamwork has been shown to increase satisfaction and decrease stress for physicians but the impact of outpatient teamwork for primary care residents' learning has not been described. This study aimed to understand the role of teamwork in residents' learning during and after the establishment of teams.
Interviews with 37 primary care residents addressed their experiences at outpatient clinic, including their perceptions about whether team-based care affected their educational experience. Using qualitative thematic analysis, transcripts were coded to identify themes about teamwork and learning, both positive and negative.
Residents described learning both about and through teamwork at continuity clinic, despite variation in the speed and extent of initial integration into teams. As residents learned how to work on a team, they realized the importance of face-to-face time together and trusting one another. Team members also taught residents about the clinical system and social aspects of patient care, as well as some procedural skills, which led them to understand how teamwork can improve patient care and efficiency. Finally, residents learned, through both optimal and suboptimal first-hand team experiences, to see team-based care as a model for future primary care practice.
While integrating residents into primary care teams, educators should consider the potential value of teamwork as an intentional learning method. Team members, beyond the preceptor, can offer valuable instruction, and team-based workplace learning prepares residents to use teamwork to optimize care for patients.
初级保健团队合作已被证明可提高医生的满意度并减轻其压力,但门诊团队合作对初级保健住院医师学习的影响尚未得到描述。本研究旨在了解团队合作在团队建立期间及之后对住院医师学习的作用。
对37名初级保健住院医师进行访谈,了解他们在门诊诊所的经历,包括他们对基于团队的护理是否影响其教育经历的看法。采用定性主题分析法,对访谈记录进行编码,以确定关于团队合作与学习的积极和消极主题。
住院医师描述了在连续性诊所通过团队合作进行学习的情况,尽管最初融入团队的速度和程度存在差异。随着住院医师学会如何在团队中工作,他们意识到面对面交流时间和相互信任的重要性。团队成员还向住院医师传授了临床系统、患者护理的社会方面以及一些操作技能,这使他们理解了团队合作如何能改善患者护理和提高效率。最后,住院医师通过最佳和次优的第一手团队经验,学会将基于团队的护理视为未来初级保健实践的模式。
在将住院医师融入初级保健团队时,教育工作者应考虑团队合作作为一种有意学习方法的潜在价值。除了带教老师外,团队成员也能提供有价值的指导,基于团队的职场学习使住院医师为利用团队合作优化患者护理做好准备。