"That's why they call it practice".

The authors discuss how, as their residency family medicine practices are transforming into Patient-Centered Medical Homes, they are witnessing shifting expectations for everyone: medical assistant, faculty and resident physician, licensed practical nurse, behavioral health clinician. At all levels of experience and expertise, they are called on to change. In the health care context, "practice" has multiple meanings. Practice, in the sense of "the clinical scope of work we do every day" corresponds to Merriam Webster's first definition of the word, "to be professionally engaged in" or "to do or perform often, customarily, or habitually." In this editorial, the authors call upon their colleagues to recognize the second definition of "practice" and build in opportunities to "train by repeated exercises" within day to day clinical activity. By this they mean, build in mechanisms to prompt reflection on your work, every day, seeking and incorporating feedback from others on your team. Effective primary care systems protect time for practice and learning. These organizations demonstrate "adaptive reserve," consisting of action and reflection cycles, facilitative leadership, a learning culture, the ability to improvise, and effective relationships and communication. (PsycINFO Database Record (c) 2014 APA, all rights reserved).