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Transforming Primary Care Training—Patient-Centered Medical Home Entrustable Professional Activities for Internal Medicine Residents

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ABSTRACT

INTRODUCTION

The U.S. faces a critical gap between residency training and clinical practice that affects the recruitment and preparation of internal medicine residents for primary care careers. The patient-centered medical home (PCMH) represents a new clinical microsystem that is being widely promoted and implemented to improve access, quality, and sustainability in primary care practice.

AIM

We address two key questions regarding the training of internal medicine residents for practice in PCMHs. First, what are the educational implications of practice transformations to primary care home models? Second, what must we do differently to prepare internal medicine residents for their futures in PCMHs?

PROGRAM DESCRIPTION

The 2011 Society of General Internal Medicine (SGIM) PCMH Education Summit established seven work groups to address the following topics: resident workplace competencies, teamwork, continuity of care, assessment, faculty development, ‘medical home builder’ tools, and policy. The output from the competency work group was foundational for the work of other groups. The work group considered several educational frameworks, including developmental milestones, competencies, and entrustable professional activities (EPAs).

RESULTS

The competency work group defined 25 internal medicine resident PCMH EPAs. The 2011 National Committee for Quality Assurance (NCQA) PCMH standards served as an organizing framework for EPAs.

DISCUSSION

The list of PCMH EPAs has the potential to begin to transform the education of internal medicine residents for practice and leadership in the PCMH. It will guide curriculum development, learner assessment, and clinical practice redesign for academic health centers.

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Acknowledgements

Contributors

We thank Karen Hauer, H. Carrie Chen, Patricia O’Sullivan, and C. Seth Landefeld for their thoughtful reviews of the manuscript.

Funders

Josiah Macy Jr. Foundation supported the Education Summit. Additional financial support for the Summit was provided by the United Health Foundation. The American College of Physicians, Primary Care Progress, and the Veterans Health Administration office of Academic Affiliations provided in-kind support.

Prior Presentations

The paper has not been presented. The list of EPAs from this Education Summit was presented at a workshop during the 2011 Annual Meeting of the Society of General Internal Medicine

Conflict of Interest

The authors declare that they do not have a conflict of interest.

Author information

Authors and Affiliations

  1. University of California San Francisco, San Francisco Veterans Affairs Medical Center, 3333 California Street, Suite 380, San Francisco, CA, 94118, USA

    Anna Chang MD

  2. Oregon Health and Science University, Portland, OR, USA

    Judith L. Bowen MD

  3. Veterans Health Administration Office of Academic Affiliations, Washington, DC, USA

    Judith L. Bowen MD

  4. University of Pittsburgh Medical Center, Pittsburgh, PA, USA

    Raquel A. Buranosky MD, MPH

  5. Richard L. Roudebush Veterans Affairs Medical Center, Indiana University School of Medicine, Indianapolis, IN, USA

    Richard M. Frankel PhD

  6. Brigham and Women’s Advanced Primary Care Associates, Harvard Medical School, Boston, MA, USA

    Nivedita Ghosh MD

  7. Baystate Medical Center, Tufts University School of Medicine, Springfield, MA, USA

    Michael J. Rosenblum MD

  8. Group Health Family Medicine Residency, University of Washington School of Medicine, Seattle, WA, USA

    Sara Thompson MD

  9. Yale University School of Medicine, New Haven, CT, USA

    Michael L. Green MD MSc

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  1. Anna Chang MD
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Correspondence to Anna Chang MD.

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Chang, A., Bowen, J.L., Buranosky, R.A. et al. Transforming Primary Care Training—Patient-Centered Medical Home Entrustable Professional Activities for Internal Medicine Residents. J GEN INTERN MED 28, 801–809 (2013). https://doi.org/10.1007/s11606-012-2193-3

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  • DOI: https://doi.org/10.1007/s11606-012-2193-3

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