The 50/50 Block Schedule: Impact on Residents' and Preceptors' Perceptions, Patient Outcomes, and Continuity of Care

References

• Accreditation Council for Graduate Medical Education. ACGME program requirements for graduate medical education in internal medicine. Chicago, IL: Author. Available from http://www.acgme.org/Specialties/Program-Requirements-and-FAQs-and-Applications/pfcatid/2/Internal%20Medicine.
   Google Scholar
• Shalaby M, Yaich S, Donnelly J, Chippendale R, DeOliveira MC, Noronha, C. X + Y scheduling models for internal medicine residency programs—A look back and a look forward. J Grad Med Educ. 2014;6:639–642. https://doi.org/10.4300/JGME-D-14-00034.1. PMID:26140111
   PubMedGoogle Scholar
• Thomas KG, West CP, Popkave C, et al. Alternative approaches to ambulatory training: Internal medicine residents' and program directors' perspectives. J Gen Intern Med. 2009;24:904–910. https://doi.org/10.1007/s11606-009-1015-8. PMID:19475458
   PubMed Web of Science ®Google Scholar
• Nadkarni M, Reddy S, Bates CK, Fosburgh B, Babbott S, Holmboe E. Ambulatory-based education in internal medicine: Current organization and implications for transformation. Results of a national survey of resident continuity clinic directors. J Gen Intern Med. 2011;26:16–20. https://doi.org/10.1007/s11606-010-1437-3. PMID:20628830
   PubMed Web of Science ®Google Scholar
• Salerno SM, Faestel PM, Mulligan T, Rosenblum MJ. Disruptions and satisfaction in internal medicine resident continuity clinic differ between inpatient and outpatient rotations. Teach Learn Med. 2007;19:30–34. https://doi.org/10.1080/10401330709336620. PMID:17330996
   PubMed Web of Science ®Google Scholar
• Schumacher DJ, Englander R, Carraccio C. Developing the master learner: Applying learning theory to the learner, the teacher, and the learning environment. Acad Med. 2013;88:1635–1645. https://doi.org/10.1097/ACM.0b013e3182a6e8f8. PMID:24072107
   PubMed Web of Science ®Google Scholar
• Sisson SD, Boonyasai R, Baker-Genaw K, Silverstein J. Continuity clinic satisfaction and valuation in residency training. J Gen Intern Med. 2007;22:1704–1710. https://doi.org/10.1007/s11606-007-0412-0. PMID:17932723
   PubMed Web of Science ®Google Scholar
• Sisson SD, Dalal D. Internal medicine residency training on topics in ambulatory care: A status report. Am J Med. 2011;124:87–90. https://doi.org/10.1016/j.amjmed.2010.09.007
   Web of Science ®Google Scholar
• Young JQ, Van Merrienboer J, Durning S, Cate OT. Cognitive load theory: Implications for medical education: AMEE Guide No. 86. Med Teach. 2014;36:371–384. https://doi.org/10.3109/0142159X.2014.889290. PMID:24593808
   PubMed Web of Science ®Google Scholar
• Feddock CA, Hoellein AR, Griffith CH, et al. Are continuity clinic patients less satisfied when residents have a heavy inpatient workload? Eval Health Prof. 2005;28:390–399. https://doi.org/10.1177/0163278705281070. PMID:16272421
   PubMed Web of Science ®Google Scholar
• Chaudhry SI, Balwan S, Friedman KA, et al. Moving forward in GME reform: A 4+1 model of resident ambulatory training. J Gen Intern Med. 2013;28:1100–1104. https://doi.org/10.1007/s11606-013-2387-3. PMID:23595929
   PubMed Web of Science ®Google Scholar
• Heist K, Guese M, Nickels M, Swigris R, Chacko K. Impact of 4+1 block scheduling on patient care continuity in resident clinic. J Gen Intern Med. 2013;29:1195–1199. https://doi.org/10.1007/s11606-013-2750-4
   Web of Science ®Google Scholar
• Mariotti JL, Shalaby M, Fitzgibbons JP. The 4+1 schedule: A novel template for internal medicine residencies. J Grad Med Educ. 2010;2:541–547. https://doi.org/10.4300/JGME-D-10-00044.1. PMID:22132275
   PubMedGoogle Scholar
• Hoskote S, Mehta B, Fried ED. The six-plus-two ambulatory care model: A necessity in today's internal medicine residency program. J Med Educ Perspectives. 2012;1:16–19.
   Google Scholar
• Warm EJ, Schauer DP, Diers T, et al. The ambulatory long block: An Accreditation Council for Graduate Medical Education (ACGME) Educational Innovations Project (EIP). J Gen Intern Med. 2008;23:921–926. https://doi.org/10.1007/s11606-008-0588-y. PMID:18612718
   PubMed Web of Science ®Google Scholar
• Bates CK, Yang J, Huang G, et al. Separating residents' inpatient and outpatient responsibilities: Improving patient safety, learning environments, and relationships with continuity patients. Acad Med. 2016;91:60–64. https://doi.org/10.1097/ACM.0000000000000849. PMID:26244257
   PubMed Web of Science ®Google Scholar
• Wieland ML, Halvorsen AJ, Chaudhry R, Reed DA, McDonald FS, Thomas KG. An evaluation of internal medicine residency continuity clinic redesign to a 50/50 outpatient-inpatient model. J Gen Intern Med. 2013;28:1014–1019. https://doi.org/10.1007/s11606-012-2312-1. PMID:23595923
   PubMed Web of Science ®Google Scholar
• Denton GD, Lo MC, Brandenburg S, et al. Solutions to common problems in training learners in general internal medicine ambulatory settings. Am J Med. 2015;128:1152–1157. https://doi.org/10.1016/j.amjmed.2015.05.023. PMID:26071822
   PubMed Web of Science ®Google Scholar
• Keitz SA, Holland JG, Melander EH, Bosworth HB, Pincus SH. The Veterans Affairs learners' perceptions survey: The foundation for educational quality improvement. Acad Med. 2003;78:910–917. https://doi.org/10.1097/00001888-200309000-00016. PMID:14507624
   PubMed Web of Science ®Google Scholar
• Breslau N, Reeb KG. Continuity of care in a university-based practice. J Med Educ. 1975;50:965–969. PMID:1159765
   PubMedGoogle Scholar
• Agency for Healthcare Research and Quality. United States Department of Health and Human Services measures inventory. Rockville, MD: Author. Available from http://www.qualitymeasures.ahrq.gov/hhs/index.aspx.
   Google Scholar
• Peccoralo LA, Tackett S, Ward L, et al. Resident satisfaction with continuity clinic and career choice in general internal medicine. J Gen Intern Med. 2013;28:1020–1027.
   PubMed Web of Science ®Google Scholar
• Laponis R, O'Sullivan PS, Hollander H, Cornett P, Julian K. Educating generalists: Factors of resident continuity clinic associated with perceived impact on choosing a generalist career. J Grad Med Educ. 2011;3:469–474. https://doi.org/10.4300/JGME-D-10-00227.1. PMID:23205193
   PubMedGoogle Scholar
• Francis MD, Thomas K, Langan M, et al. Clinic design, key practice metrics, and resident satisfaction in internal medicine continuity clinics: Findings of the educational innovations project ambulatory collaborative. J Grad Med Educ. 2014;6:249–255. https://doi.org/10.4300/JGME-D-13-00159.1. PMID:24949127
   PubMedGoogle Scholar
• Francis MD, Warm E, Julian KA, et al. Determinants of patient satisfaction in internal medicine resident continuity clinics: Findings of the Educational Innovations Project Ambulatory Collaborative. J Grad Med Educ. 2014;6:470–477. https://doi.org/10.4300/JGME-D-13-00398.1. PMID:26279771
   PubMedGoogle Scholar