Literature Collection

9101

Teaching in a Family-Centered Care Model: The Exam Room as the Classroom

Type: Journal Article

Authors: S. Nagappan, A. Hartsell, N. Chandler

Year: 2013

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9102

Teaching integrated behavioral health in a primary care clerkship

Type: Journal Article

Authors: K. Zoberi, R. M. Niemiec, R. B. Margolis

Year: 2008

Publication Place: England

Abstract: BACKGROUND: Most behavioral health care is actually delivered by primary care physicians. Primary care clerkship students have a unique opportunity to learn about behavioral health and the integrated care model. Integrated care is an effective multidisciplinary model for delivering high quality care. PURPOSE: Evaluate the efficacy of a brief curriculum in increasing students' knowledge regarding common behavioral health issues. METHODS: We designed an interactive, 90-minute curriculum to introduce students to the unique model of integrated care, and to build skills in addressing a number of common behavioral health issues. Each problem is presented from both the medical and behavioral perspective. We evaluated this intervention with a pre- and post-clerkship test assessing knowledge regarding behavioral health care. RESULTS: There was significant improvement on the overall score and on seven of eight individual questions. CONCLUSIONS: This curriculum is an effective intervention for introducing integrated care and increasing knowledge of several common behavioral problems.

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9103

Teaching interprofessional teamwork in medical and nursing education in Norway: A content analysis

Type: Journal Article

Authors: I. Aase, K. Aase, P. Dieckmann

Year: 2013

Abstract: The notions of interprofessional education and interprofessional teamwork have attained widespread acceptance, partly because lack of teamwork has been tentatively linked to adverse incidents in healthcare. By analyzing data from 32 educational institutions, this study identifies the status of interprofessional teamwork in all nursing and medical education in Norway. The study programs issued by the 32 educational institutions were subject to content analysis, distilling the ambitions and goals for teaching interprofessional teamwork. Study program coordinators were approached and asked to what degree interprofessional teamwork was actually introduced in lecturing and clinical training. Results indicate that the medical and nursing schools clearly aspire to teach interprofessional teamwork and that this has largely been achieved when it comes to theoretical teaching. Although three of the four medical programs have integrated interprofessional teamwork into their clinical training, there is a gap in the nursing programs where introduction of interprofessional teamwork in clinical training has been limited. Current challenges are related to organizational issues (e.g. lack of institutional collaboration), practical difficulties (e.g. finding time to bring students of various professions together) and possibly managerial issues (e.g. lack of strategic perspective and change management).

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9104

Teaching junior doctors to manage patients who somatise: Is it possible in an afternoon?

Type: Journal Article

Authors: Paul Walters, Andre Tylee, James Fisher, David Goldberg

Year: 2007

Publication Place: United Kingdom: Wiley-Blackwell Publishing Ltd.

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9105

Teaching personal awareness

Type: Journal Article

Authors: Robert C. Smith, Francesca C. Dwamena, Auguste H. Fortin

Year: 2005

Publication Place: United Kingdom: Blackwell Publishing

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9106

Teaching primary care in community health centers: Addressing the workforce crisis for the underserved

Type: Journal Article

Authors: R. E. Rieselbach, B. J. Crouse, J. G. Frohna

Year: 2010

Publication Place: United States

Abstract: Universal coverage and multiple initiatives to improve health care delivery are crucial components of health care reform. However, the missing link has been a plan to rapidly address the primary care workforce crisis for the underserved. The authors propose a link between primary care graduate medical education and care for the underserved in community health centers, where expansion will be necessary for the anticipated increase in Medicaid and insured patients. This can be achieved by establishing primary care teaching health centers in expanded community health centers, which have established a patient-centered medical home practice environment. Residents would receive their final year of training in these centers, and then have the incentive of National Health Service Corps debt repayment if they subsequently practice in an underserved area. Primary care residents being trained in this setting would immediately increase the clinical capacity of community health centers and ultimately expand the primary care physician workforce. This proposal addresses the primary care physician workforce crisis and the associated key problems of limited access for the underserved and suboptimal primary care graduate medical education.

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9107

Teaching psychiatry in primary care residencies: Do training directors of primary care and psychiatry see eye to eye?

Type: Journal Article

Authors: H. Leigh, R. Mallios, D. Stewart

Year: 2008

Publication Place: United States

Abstract: OBJECTIVE: This study compares the views of psychiatry residency training directors about psychiatry and mental health training in the primary care programs in their institutions with those of the primary care residency training directors. METHODS: A 16-item questionnaire surveying specific areas of training and perceived adequacy of current teaching was distributed to 1,544 U.S. primary care and psychiatry program directors. RESULTS: The response rate was 53%. Among psychiatry training directors, 85% responded that psychiatry training in their primary care programs was minimal to suboptimal, while 68% of family practice training directors responded that their psychiatry training was optimal to extensive. Among psychiatry training directors, 89% were dissatisfied with the psychiatry training in their primary care programs, and only 8% were satisfied. In contrast, almost half of primary care training directors were satisfied. However, within the primary care programs, there was a marked difference between family practice (majority satisfied) and the rest (internal medicine, obstetrics and gynecology, pediatrics, mostly unsatisfied). All primary care and psychiatry training directors agreed that most basic psychiatric skills and diagnoses were taught in the primary care programs. For all skills and syndromes examined, psychiatry training directors consistently and significantly rated the training to be less adequate than did primary care training directors. There was general agreement that primary care physicians should be able to treat most uncomplicated cases in patients with psychiatric disorders, and some but not other psychiatric conditions. CONCLUSION: Psychiatry and primary care training directors, except in family practice, generally agree that psychiatry training in primary care programs is inadequate and should be significantly enhanced. There should be more communication between psychiatry and primary care training programs for optimal curriculum development.

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9108

Teaching Psychiatry Residents to Work at the Interface of Mental Health and Primary Care

Type: Journal Article

Authors: D. Cowley, K. Dunaway, M. Forstein, E. Frosch, J. Han, R. Joseph, R. M. McCarron, A. Ratzliff, B. Solomon, J. Unutzer

Year: 2014

Abstract: The authors present examples of programs educating psychiatry residents to work in integrated healthcare settings.

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9109

Teaching residents mental health care

Type: Journal Article

Authors: R. C. Smith, H. Laird-Fick, F. C. Dwamena, L. Freilich, B. Mavis, K. Grayson-Sneed, D. D'Mello, M. Spoolstra, D. Solomon

Year: 2018

Publication Place: Ireland

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9110

Teaching residents to prescribe buprenorphine for opioid use disorder: Insights from a community-based residency program

Type: Journal Article

Authors: Layla Cavitt, Joshua St. Louis, Wendy B. Barr, Ryan Dono, Nicholas Weida, Mia Sorcinelli

Year: 2021

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9111

Teaching the psychosocial aspects of care in the clinical setting: practical recommendations

Type: Journal Article

Authors: David E. Kern, William T. Branch, Jeffrey L. Jackson, Donald W. Brady, Mitchell D. Feldman, Wendy Levinson, Mack Lipkin

Year: 2005

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9112

Teaching undergraduate psychiatry in primary care: The impact on student learning and attitudes

Type: Journal Article

Authors: Kate Walters, Peter Raven, Joe Rosenthal, Jill Russell, Charlotte Humphrey, Marta Buszewicz

Year: 2007

Publication Place: United Kingdom: Blackwell Publishing

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9113

Team communication within integrated primary care in the context of suicide prevention: A mixed methods preliminary examination

Type: Journal Article

Authors: J. S. Funderburk, B. A. Levandowski, M. N. Wittink, W. R. Pigeon

Year: 2018

Publication Place: United States

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9114

Team communication within integrated primary care in the context of suicide prevention: A mixed methods preliminary examination

Type: Journal Article

Authors: J. S. Funderburk, B. A. Levandowski, M. N. Wittink, W. R. Pigeon

Year: 2020

Publication Place: United States

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9115

Team functioning as a predictor of patient outcomes in early medical home implementation

Type: Journal Article

Authors: F. M. Wu, L. V. Rubenstein, J. Yoon

Year: 2018

Publication Place: United States

Abstract: BACKGROUND: New models of patient-centered primary care such as the patient-centered medical home (PCMH) depend on high levels of interdisciplinary primary care team functioning to achieve improved outcomes. A few studies have qualitatively assessed barriers and facilitators to optimal team functioning; however, we know of no prior study that assesses PCMH team functioning in relationship to patient health outcomes. PURPOSE: The aim of the study was to assess the relationships between primary care team functioning, patients' use of acute care, and mortality. METHODOLOGY/APPROACH: Retrospective longitudinal cohort analysis of patient outcomes measured at two time points (2012 and 2013) after PCMH implementation began in Veterans Health Administration practices. Multilevel models examined practice-level measures of team functioning in relationship to patient outcomes (all-cause and ambulatory care-sensitive condition-related hospitalizations, emergency department visits, and mortality). We controlled for practice-level factors likely to affect team functioning, including leadership support, provider and staff burnout, and staffing sufficiency, as well as for individual patient characteristics. We also tested the model among a subgroup of vulnerable patients (homeless, mentally ill, or with dementia). RESULTS: In adjusted analyses, higher team functioning was associated with lower mortality (OR = 0.92, p = .04) among all patients and with fewer all-cause admissions (incidence rate ratio [IRR] = 0.90, p < 0.01), ambulatory care-sensitive condition-related admissions (IRR = 0.91, p = .04), and emergency department visits (IRR = 0.91, p = .03) in the vulnerable patient subgroup. CONCLUSION: These early findings give support for the importance of team functioning within PCMH models for achieving improved patient outcomes. PRACTICE IMPLICATIONS: A focus on team functioning is important especially in the early implementation of team-based primary care models.

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9116

Team functioning as a predictor of patient outcomes in early medical home implementation

Type: Journal Article

Authors: F. M. Wu, L. V. Rubenstein, J. Yoon

Year: 2018

Publication Place: United States

Abstract: BACKGROUND: New models of patient-centered primary care such as the patient-centered medical home (PCMH) depend on high levels of interdisciplinary primary care team functioning to achieve improved outcomes. A few studies have qualitatively assessed barriers and facilitators to optimal team functioning; however, we know of no prior study that assesses PCMH team functioning in relationship to patient health outcomes. PURPOSE: The aim of the study was to assess the relationships between primary care team functioning, patients' use of acute care, and mortality. METHODOLOGY/APPROACH: Retrospective longitudinal cohort analysis of patient outcomes measured at two time points (2012 and 2013) after PCMH implementation began in Veterans Health Administration practices. Multilevel models examined practice-level measures of team functioning in relationship to patient outcomes (all-cause and ambulatory care-sensitive condition-related hospitalizations, emergency department visits, and mortality). We controlled for practice-level factors likely to affect team functioning, including leadership support, provider and staff burnout, and staffing sufficiency, as well as for individual patient characteristics. We also tested the model among a subgroup of vulnerable patients (homeless, mentally ill, or with dementia). RESULTS: In adjusted analyses, higher team functioning was associated with lower mortality (OR = 0.92, p = .04) among all patients and with fewer all-cause admissions (incidence rate ratio [IRR] = 0.90, p < 0.01), ambulatory care-sensitive condition-related admissions (IRR = 0.91, p = .04), and emergency department visits (IRR = 0.91, p = .03) in the vulnerable patient subgroup. CONCLUSION: These early findings give support for the importance of team functioning within PCMH models for achieving improved patient outcomes. PRACTICE IMPLICATIONS: A focus on team functioning is important especially in the early implementation of team-based primary care models.

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9117

Team-Based Care: A Step in the Right Direction for Hypertension Control

Type: Journal Article

Authors: S. Sidney

Year: 2015

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9118

Team-based primary care with integrated mental health is associated with higher quality of care, lower usage and lower payments received by the delivery system

Type: Journal Article

Authors: A. F. English

Year: 2017

Publication Place: England

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9119

Team-based suicide prevention: lessons learned from early adopters of collaborative care

Type: Journal Article

Authors: Marsha N. Wittink, Brooke A. Levandowski, Jennifer S. Funderburk, Melanie Chelenza, Jane R. Wood, Wilfred R. Pigeon

Year: 2020

Publication Place: Philadelphia, Pennsylvania

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9120

Team-based suicide prevention: lessons learned from early adopters of collaborative care

Type: Journal Article

Authors: M. N. Wittink, B. A. Levandowski, J. S. Funderburk, M. Chelenza, J. R. Wood, W. R. Pigeon

Year: 2019

Publication Place: England

Abstract:

Suicide prevention in clinical settings requires coordination among multiple clinicians with expertise in different disciplines. We aimed to understand the benefits and challenges of a team approach to suicide prevention in primary care, with a particular focus on Veterans. The Veterans Health Administration has both a vested interest in preventing suicide and it has rapidly and systematically adopted team-based approaches for primary care interventions, including suicide prevention. We conducted eight focus groups and eight in-depth interviews with primary care providers (PCPs), behavioral health providers and nurses located in six regions within one Veterans Administration Catchment Area in the northeast of the US. Transcripts were analyzed using simultaneous deductive and inductive content analysis. Findings revealed that different clinicians were thought to have particular expertise and roles. Nurses were recognized as being well positioned to identify subtle changes in patient behavior that could put patients at risk for suicide; behavioral health providers were recognized for their skill in suicide risk assessment; and PCPs were felt to be an integral conduit between needed services and treatment. Our findings suggest that clinician role-differentiation may be an important by-product of team-based suicide prevention efforts in VHA settings. We contextualize our findings within both a processual and relational interprofessional framework and discuss implications for the implementation of team-based suicide prevention.

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