Educational outcomes from a novel house call curriculum for internal medicine residents: Report of a 3-year experience

Physician house calls are an important mode of healthcare delivery to frail homebound older adults and positively affect patient outcomes and learner education, but most physicians receive scant training in home care medicine. A novel longitudinal curriculum in house call medicine for internal medicine residents was implemented in July 2006, and educational outcomes were evaluated over the following 3 years. The 2-year curriculum included didactic and experiential components. Residents made house calls with preceptors and alone and completed a series of computer modules outlining knowledge essential to providing home-based care. They discussed the important features of the modules in regularly scheduled small groups throughout the 2-year experience, and each taught a "house call morning report" in their senior resident year. Evaluation methods included surveys before, during, and at the end of the 2-year curriculum (knowledge and attitudes); direct observation by preceptors during house calls (skills); and an online, anonymous survey at the end of each year (attitudes). Results show statistically significant increases in residents' knowledge, skills, and attitudes relevant to home care medicine. Residents describe educationally significant and positive effects from their house call experiences. This novel curriculum improved medical residents' knowledge, attitudes, and skills in performing house calls for frail elderly individuals. The longer-term outcomes of this intervention will continue to be studied, with the hope that it may be used to help provide educational opportunities to prepare the physician workforce to meet the service needs of a growing segment of the population.