背景:美国的初级保健在临床医生招募方面面临挑战,保留,和倦怠,预计未来十年劳动力将进一步短缺。基于团队的护理可以防止临床医生职业倦怠,职业发展和领导力方面的跨专业教育(IPE)的机会可以鼓励初级保健转型。尽管在初级保健劳动力中发挥着越来越重要的作用,与医生一起培训医生助理(PA)的IPE计划很少见。我们描述了设计,课程,以及基于社区的初级保健医生和PA的跨专业初级保健转变研究金的结果。
方法:社区初级保健冠军(CPCC)奖学金为期一年,兼职奖学金培训了九名博士,十四名医生,以及在六个内容支柱中具有至少两年研究生临床经验的行为主义者:质量改进(QI),健康和倦怠,心理健康,健康的社会决定因素,医学教育,和物质使用障碍。研究金包括每月自学活动的经常性时间表,讲座,指导,和社区专家晚上讨论。对研究金的评估包括,post,和一年的后续知识自我评估,态度,和对六个内容领域的信心,健康前和健康后调查,讲座和讨论评估,以及中点和退出焦点小组。
结果:研究员在奖学金后的所有内容领域中,28项自我评估项目中有24项显着改善,在18个项目中的16个项目中,为期一年的研究金。他们证明了在研究金之后的情绪疲惫和人格解体的减少,并增加了在研究金之后的跨专业团队中工作的信心,这种信心持续了一年的后续评估。所有研究员都完成了QI项目,四个研究员在全国会议上介绍了他们的工作。焦点小组的数据显示,研究员经历了合作,与他们的临床工作相关的有意义的专业发展。他们赞赏在晚上的讨论中灵活的形式和跨专业社区专家的参与。
结论:CPCC研究金培养了一个跨专业的实践社区,为医生和PA提供了有效的IPE经验。学习活动,特别是社区专家的讨论,允许灵活的,相关经验,导致个人和专业成长,并增加了在跨专业团队中工作的信心。
BACKGROUND: Primary care in the US faces challenges with clinician recruitment, retention, and burnout, with further workforce shortages predicted in the next decade. Team-based care can be protective against clinician burnout, and opportunities for interprofessional education (IPE) on professional development and leadership could encourage primary care transformation. Despite an increasingly important role in the primary care workforce, IPE initiatives training physician assistants (PAs) alongside physicians are rare. We describe the design, curriculum, and outcomes from an interprofessional primary care transformation fellowship for community-based primary care physicians and PAs.
METHODS: The Community Primary Care Champions (CPCC) Fellowship was a one-year, part-time fellowship which trained nine PAs, fourteen physicians, and a behavioralist with at least two years of post-graduate clinical experience in six content pillars: quality improvement (QI), wellness and burnout, mental health, social determinants of health, medical education, and substance use disorders. The fellowship included a recurring schedule of monthly activities in self-study, lectures, mentoring, and community expert evening discussions. Evaluation of the fellowship included pre, post, and one-year follow-up self-assessments of knowledge, attitudes, and confidence in the six content areas, pre- and post- wellness surveys, lecture and discussion evaluations, and midpoint and exit focus groups.
RESULTS: Fellows showed significant improvement in 24 of 28 self-assessment items across all content areas post-fellowship, and in 16 of 18 items one-year post-fellowship. They demonstrated reductions in emotional exhaustion and depersonalization post-fellowship and increased confidence in working in interprofessional teams post-fellowship which persisted on one-year follow-up assessments. All fellows completed QI projects and four presented their work at national conferences. Focus group data showed that fellows experienced collaborative, meaningful professional development that was relevant to their clinical work. They appreciated the flexible format and inclusion of interprofessional community experts in evening discussions.
CONCLUSIONS: The CPCC fellowship fostered an interprofessional community of practice that provided an effective IPE experience for physicians and PAs. The learning activities, and particularly the community expert discussions, allowed for a flexible, relevant experience, resulting in personal and professional growth along with increased confidence working within interprofessional teams.