Implementation of a direct observation and feedback tool using an interprofessional approach: a pilot study

ABSTRACT

Primary care trainees must learn how to communicate effectively with patients during brief outpatient encounters, and direct observation and feedback is necessary to improve these skills. At the same time, programs are seeking more interprofessional learning opportunities for skills that transcend professions. We sought to assess the feasibility of implementing a direct observation tool, the Patient Centered Observation Form (PCOF), for communication training across three professions at the graduate level. The PCOF was introduced to trainees at an interprofessional workshop, while faculty completed PCOF training online or in person. Following use of the PCOF, we surveyed participants to determine if using the PCOF increased a) trainee-reported confidence in providing patient-centered communication, and b) faculty-reported confidence in giving feedback about patient-centered communication. The PCOF appears to be a useful adjunct to standard precepting for teaching patient-centered communication skills, extending beyond medical residents to pharmacy residents and less so, to advanced practice nursing students. In addition, PCOF training and implementation can successfully occur simultaneously across disciplines, leveraging resources and encouraging interprofessional learning.

KEYWORDS:

• Interprofessional education
• communication
• patient centered practice
• surveys
• interprofessional collaboration

Conflict of Interest

The authors have no conflicts of interest to report.

Previous presentations

Innovations in Medical Education Poster Presentation, “Preparing a Patient Centered Primary Care Workforce through Direct Observation and Feedback: An Interprofessional Approach” Society for General Internal Medicine Annual Meeting, Washington DC, April 2017.

Additional information

Funding

Primary Care Faculty Development Initiative, awarded February 2013. PI: Taj Mustapha. Collaborators: Emily Borman-Shoap, Keri Hager, Mary Dierich, Patricia Adam, Heather Thompson Buum. This national grant program supported by HRSA and the Macy Foundation, conducted by Oregon Health & Science University, funded the initial faculty development and train-the-trainer sessions.University of Minnesota Division of General Internal Medicine Pilot Grant, awarded January 2016. PI: Heather Thompson Buum. Collaborators: Taj Mustapha, Emily Borman-Shoap, Keri Hager, Mary Dierich, Patricia Adam. This local grant program funded the Patient Centered Observation Form (PCOF) Implementation including materials and a project coordinator.University of Minnesota Herz Faculty Development Grant, awarded October 2015. PI: Patricia Adam. Collaborators: Heather Thompson Buum, Emily Borman-Shoap, Keri Hager, Mary Dierich. This local grant program allowed us to bring in the creator of the Patient Centered Observation Form (PCOF), Dr. Larry Mauksch, for on-site training in the use of the tool.

Notes on contributors

Heather Thompson Buum

Heather Thompson Buum MD, is an Assistant Professor of Medicine and practices both inpatient and outpatient general medicine at the University of Minnesota. She devotes half her time to primary care, and half to teaching and administrative roles. She is a course director and small group facilitator in the second year of medical school. Dr. Thompson is also the Internal Medicine lead for the Interprofessional Minnesota Primary Care Team (IMPACT) whose aim is the improve the teaching and training of primary care skills at the graduate level and using an interprofessional approach. She has published in the medical educaiton literature and recently authored two books on the experience of doctor as patient.

Mary Dierich

Mary Dierich PhD, RN, C-GNP, MSPH is a Clinical Associate Professor, School of Nursing, and Coordinator, Adult/Gerontological Nurse Practitioner Specialty Area, Adult and Gerontological Health Cooperative. Her research interests include the effect of medication management of readmission to the hospital; Models of care for older adults; Health care policy and the provision of care for older adults; Faculty Practice: HealthPartners GNP, Geriatrics Department.

Patricia Adam

Patricia Adam MD, MSPH, is the Department of Family Medicine and Community Health's Vice Chair for Clinical Affairs. She teaches in the University of Minnesota Medical Center Family Medicine Residency and is also one of the family medicine team members on the Minnesota Primary Care Transformation Collaborative. Dr. Adam's goal is to improve the care we deliver to our patients and the experience of our providers and staff as they serve our patients. She also partners with our community practices as the “Academic Footprint” within our Primary Care Service Line.

Keri D. Hager

Keri D. Hager Pharm. D., BCACP is an Associate Professor at the University of Minnesota (UMN) where she focuses on preparing the future workforce for collaborative team-based patient-centered primary care. Dr. Hager facilitates several UMN core interprofessional activities and leads the Interprofessional Minnesota PrimAry Care Team (IMPACT). Her current focus is on team collaboration in the clinical learning environment, and she has recently published on pharmacist, physician, and behavioral health collaboration. Dr. Hager is currently pursuing an interprofessional practice opportunity connecting patients with opioid use disorder with comprehensive medication management.