Study shows residents may benefit most from time in the clinic

Jul 24, 2008

A new approach to internal medicine residency training could improve patient care and physician-patient relationships, according to a University of Cincinnati study.

Eric Warm, MD, associate professor of medicine and lead investigator of the study, says research showed residents who spent increased time in outpatient settings as opposed to the hospital delivered a higher quality of care and had more satisfaction in their duties.

Results of this study are published in the July edition of the Journal of General Internal Medicine.

"We essentially redesigned how the internal medicine residency runs," says Warm. "With this new system, residents complete one year in an outpatient clinic actually doing the things patients expect from their primary care doctors. In the past, residents were based mainly in the hospital, and their delivery of care to outpatients suffered."

Warm says in restructuring the program, he and colleagues hoped to reduce conflict between inpatient and outpatient care, provide enough time for hands-on learning and enhance the feeling of reward for residents, in addition to raising patient satisfaction and improving physician continuity.

He says there are two overall problems with current residency programs that are primarily focused on inpatient care: not enough time spent in the clinics and no tool to assess the quality of work in the clinic or ways to make it better.

"By placing our residents in the clinic, it allows them to focus on patient care," he says. "Within the first year, both the patients' and the residents' satisfaction had increased.

"We utilized the chronic care model—a tool that helps improve patient care—as our central operating force."

Instead of allowing residents to engage in "sporadic" interactions with patients for three years, this new model placed them face-to-face with the same patients for one year. During this time, they developed more intimate relationships with patients and learned how to assess and improve the quality of care they delivered.

Overall, residents reported an improvement in their ability to focus in the clinic without being distracted, an increase in personal reward and a greater sense of relationship with their patients.

Patients were also more satisfied with their care, according to Press-Ganey survey data.

Warm says there are several other legs of this study to be completed in the future, including research on the long-term impact on chronic disease.

"We hope research such as this will lead to the most optimal training for our doctors, which will benefit patients in the future," he says.

Source: University of Cincinnati

Explore further: Possible risk of folic acid overexposure

add to favorites email to friend print save as pdf

Related Stories

Pets and their therapeutic effects

Mar 24, 2014

A prestigious Veterinary Record journal has published a feature in which Professor Daniel Mills and Dr Sophie Hall discuss the therapeutic effects of companion animals.

Medicine goes mobile with smartphone apps, devices

Feb 19, 2014

Thanks to smartphones, email, video games and photo sharing are available at the touch of a finger. But attach a special case and that same phone can produce an electrocardiogram (EKG) from the electrical ...

Recommended for you

Possible risk of folic acid overexposure

22 minutes ago

A new study has shown that synthetic folic acid, the form taken in folic acid supplements we can buy over the counter, is not processed by the body in the same way as natural folates, the form found in green vegetables.

Is coffee aggravating your hot flashes?

3 hours ago

(HealthDay)—Drinking caffeine may worsen the hot flashes and night sweats that affect roughly two-thirds of women as they go through menopause, new survey data suggests.

AAFP: family docs report potential misuse of MGMA data

4 hours ago

(HealthDay)—Reports from family physicians have been received that employers may be misusing survey data to set higher compensation rates for general internal physicians than for family physicians, according ...

User comments : 0