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Conditions Influencing Collaboration Among the Primary Care Disciplines as They Prepare the Future Primary Care Physician Workforce

机译:影响初级保健学科之间合作的条件,因为他们准备未来的初级保健医生劳动力

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Background and Objectives: Much can be gained by the three primary care disciplines collaborating on efforts to transform residency training toward interprofessional collaborative practice. We describe findings from a study designed to align primary care disciplines toward implementing interprofessional education. Methods: In this mixed methods study, we included faculty, residents and other interprofessional learners in family medicine, internal medicine, and pediatrics from nine institutions across the United States. We administered a web-based survey in April/May of 2018 and used qualitative analyses of field notes to study resident exposure to team-based care during training, estimates of career choice in programs that are innovating, and supportive and challenging conditions that influence collaboration among the three disciplines. Complete data capture was attained for 96.3% of participants. Results: Among family medicine resident graduates, an estimated 87.1% chose to go into primary care compared to 12.4% of internal medicine, and 36.5% of pediatric resident graduates. Qualitative themes found to positively influence cross-disciplinary collaboration included relationship development, communication of shared goals, alignment with health system/other institutional initiatives, and professional identity as primary care physicians. Challenges included expressed concerns by participants that by working together, the disciplines would experience a loss of identity and would be indistinguishable from one another. Another qualitative finding was that overwhelming stressors plague primary care training programs in the current health care climate—a great concern. These include competing demands, disruptive transitions, and lack of resources. Conclusions: Uniting the primary care disciplines toward educational and clinical transformation toward interprofessional collaborative practice is challenging to accomplish.
机译:背景和目标:三个初级保健学科可以获得很多初级保健学科,努力将居住培训转变为侦探协作实践的努力。我们描述了一项旨在将初级保健学科对准实施侦探忏悔教育的研究。方法:在这种混合方法研究中,我们包括来自美国九个机构的家庭医学,内科和儿科的教师,居民和其他专业学习者。我们在2018年4月/ 2018年5月进行了基于网络的调查,并使用了在培训期间研究居民的居民的居民护理,估计正在创新的计划中的职业选择,以及影响合作的支持性和具有挑战性的条件在三个学科中。达到了96.3%的参与者的完整数据捕获。结果:在家庭医学居民毕业生中,估计的87.1%选择初级保健,而初级保健为12.4%,36.5%的儿科居民毕业生。定性主题发现积极影响跨学科合作包括关系发展,共享目标的沟通,与卫生系统的一致性/其他机构举措,以及作为初级保健医生的专业认同。挑战包括参与者的担忧,通过共同努力,学科将丧失身份,并将彼此无法区分。另一个定性发现是,压倒性压力探伤了当前医疗保健气候的初级保健培训计划 - 这是一个很好的关注。这些包括竞争要求,破坏性过渡和缺乏资源。结论:将初级保健学科与侦探合作实践的初步保健学科联合起来挑战。

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