Gillian Spiegle1, Penny Yin1, Sarah Wright2, Stella Ng3, Tara O'Brien1, Farah Friesen4, Michael Friesen1,2,3,4, Rupal Shah1. 1. Department of Medicine, University of Toronto, Ontario, Canada. 2. The Wilson Centre, University of Toronto, Ontario, Canada. 3. Centre for Faculty Development, Unity Health Toronto, Ontario, Canada. 4. Centre for Faculty Development, Faculty of Medicine, University of Toronto, Ontario, Canada.
Abstract
BACKGROUND: The Canadian healthcare system faces increasing patient volumes and complexity amidst funding constraints. Ambulatory care offers a potential solution to some of these challenges. Despite growing emphasis on the provision of ambulatory care, there has been a relative paucity of ambulatory care training curricula within Canadian internal medicine residency programs. We conducted a narrative review to understand the current state of knowledge on postgraduate ambulatory care education (ACE), in order to frame a research agenda for Canadian Internal Medicine ACE. METHODS: We searched OVID Medline, Embase, and PsycINFO for articles that included the concepts of ambulatory care and medical or health professions education from 2005-2015. After sorting for inclusion/exclusion, we analyzed 30 articles, looking for dominant claims about ACE in Internal Medicine literature. RESULTS: We found three claims. First, ACE is considered to be a necessary component of medical training because of its distinction from inpatient learning environments. Second, current models of ambulatory care clinics do not meet residency education needs. Third, ACE presents opportunities to develop non-medical expert roles. CONCLUSIONS: The findings of our narrative review highlight a need for additional research regarding ACE in Canada to inform optimal ambulatory internal medicine training structures and alignment of educational and societal needs.
BACKGROUND: The Canadian healthcare system faces increasing patient volumes and complexity amidst funding constraints. Ambulatory care offers a potential solution to some of these challenges. Despite growing emphasis on the provision of ambulatory care, there has been a relative paucity of ambulatory care training curricula within Canadian internal medicine residency programs. We conducted a narrative review to understand the current state of knowledge on postgraduate ambulatory care education (ACE), in order to frame a research agenda for Canadian Internal Medicine ACE. METHODS: We searched OVID Medline, Embase, and PsycINFO for articles that included the concepts of ambulatory care and medical or health professions education from 2005-2015. After sorting for inclusion/exclusion, we analyzed 30 articles, looking for dominant claims about ACE in Internal Medicine literature. RESULTS: We found three claims. First, ACE is considered to be a necessary component of medical training because of its distinction from inpatient learning environments. Second, current models of ambulatory care clinics do not meet residency education needs. Third, ACE presents opportunities to develop non-medical expert roles. CONCLUSIONS: The findings of our narrative review highlight a need for additional research regarding ACE in Canada to inform optimal ambulatory internal medicine training structures and alignment of educational and societal needs.
Authors: Catherine F Gracey; Paul Haidet; William T Branch; Peter Weissmann; David E Kern; Gary Mitchell; Richard Frankel; Thomas Inui Journal: Acad Med Date: 2005-01 Impact factor: 6.893
Authors: Eric J Warm; Daniel P Schauer; Tiffiny Diers; Bradley R Mathis; Yvette Neirouz; James R Boex; Gregory W Rouan Journal: J Gen Intern Med Date: 2008-07 Impact factor: 5.128