Lone Ranger or Pit Crew? Evaluating the Impact of a Team-Based Care Curriculum for Pediatric Residents
Introduction: Efforts to improve health care in the US are focusing on the Quadruple Aim which targets enhanced patient experiences, population health management, control of costs and improved provider satisfaction. Traditional academic centers have fallen behind in preparing pediatricians to practice in this new milieu; pediatric residents consistently report feeling least competent in systems-based practice. To better prepare residents to enter the work force, we introduced a team based care curriculum for pediatric residents in the 2016-2017 academic year. Methods: Participants in the new curriculum included all 21 residents in our academic based residency program. An inter-professional team developed a curriculum consisting of six core modules: team care, team communication, quality improvement, health care roles, champion teams and advanced communications. Prior to participation, residents completed a pre-test of knowledge and the validated Attitudes Toward Health Care Teams scale. The same instruments were administered after completion of the modules. Results: All 21 pediatric residents completed the pre and post-tests. Resident knowledge significantly improved from a pre-test score of 63% to a post test score of 70% (p< 0.05). The Quality Improvement and Team Roles subtests showed significant improvement (p<0.05). On the Attitudes Towards Health Care Teams scale, the residents had a favorable attitude toward team value and team efficiency; these did not significantly change from pre to post-test. Pediatric residents’ attitudes toward physicians shared role in the team improved significantly (p<0.01). They reported enhanced attitudes regarding two key constructs: 1) shared team leadership and responsibility and 2) limits on physician control of team function. Conclusions: While pediatric residents in general had a favorable view of team-based care, participation in a team-based care curriculum positively affected their views of the physician’s role on a team. Understanding shared labor within a team, may help residents to achieve the fourth Quadruple Aim of satisfaction in healthcare by all providers.
Tuell, Dawn Simmons; Jaishankar, Gayatri; Click, Ivy A.; Fox, Beth Anne; and Polaha, Jodi. 2018. Lone Ranger or Pit Crew? Evaluating the Impact of a Team-Based Care Curriculum for Pediatric Residents. Association of Pediatric Program Directors, Atlanta, GA. https://www.appd.org/meetings/pdf/APPDFinalProgram2018.pdf