Effects of a focused patient-centered care curriculum on the experiences of internal medicine residents and their patients

BACKGROUND: Traditional residency training may not promote competencies in patient-centered care. AIM: To improve residents' competencies in delivering patient-centered care. SETTING/PARTICIPANTS: Internal medicine residents at a university-based teaching hospital in Baltimore, Maryland. PROGRAM DESCRIPTION: One inpatient team admitted half the usual census and was exposed to a multimodal patient-centered care curriculum to promote knowledge of patients as individuals, improve patient transitions of care, and reduce barriers to medication adherence. PROGRAM EVALUATION: Annual resident surveys (N= 40) revealed that the intervention was judged as professionally valuable (90%) and important to their training (90%) and offered experiences not available during other rotations (88%). Compared to standard inpatient rotation evaluations (n=163), intervention rotation evaluations (n=51) showed no differences in ratings for traditional medical learning, but higher ratings for improving how housestaff address patient medication adherence, communicate with patients about post-hospital transition of care, and know their patients as people (all p<0.01). On post-discharge surveys, patients from the intervention team (N=177, score 90.4, percentile ranking 97%) reported greater satisfaction with physicians than patients on standard teams (N=924, score 86.1, percentile ranking 47%) p<0.01). DISCUSSION: A patient-centered inpatient curriculum was associated with higher satisfaction ratings in patient-centered domains by internal medicine residents and with higher satisfaction ratings of their physicians by patients. Future research will explore the intervention's impact on clinical outcomes. KEY WORDS: residency education; patient-centered care.