Experiences of Patient-Centered Medical Home Staff Team Members Working in Interprofessional Training Environments
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enter to Improve Veteran Involvement in Care (CIVIC), VA Portland Healthcare System Portland, OR, USA; 2VA San Francisco Healthcare System San Francisco, CA, USA; 3University of California, San Francisco School of Medicine San Francisco, CA, USA; 4VA Connecticut Healthcare System West Haven, CT, USA; 5Yale School of Medicine New Haven, CT, USA; 6University of California, San Francisco School of Nursing San Francisco, CA, USA; 7Department of Community Health Systems, University of California, San Francisco San Francisco, CA, USA; 8Department of Psychiatry, University of California San Francisco, CA, USA; 9Division of General Internal Medicine, Oregon Health & Science University Portland, OR, USA.
BACKGROUND: Evidence is growing that interprofessional team-based models benefit providers, trainees, and patients, but less is understood about the experiences of staff who work beside trainees learning these models. OBJECTIVE: To understand the experiences of staff in five VA training clinics participating in an interprofessional team-based learning initiative. DESIGN: Individual semi-structured interviews with staff were conducted during site visits, qualitatively coded, and analyzed for themes across sites and participant groups. PARTICIPANTS: Patient-centered medical home (PCMH) staff members (n = 32; RNs, Clinical and Clerical Associates) in non-primary care provider (PCP) roles working on teams with trainees from medicine, nursing, pharmacy, and psychology. APPROACH: Benefits and challenges of working in an interprofessional, academic clinic were coded by the primary author using a hybrid inductive/directed thematic analytic approach, with review and iterative theme development by the interprofessional author team. KEY RESULTS: Efforts to improve interprofessional collaboration among trainees and providers, such as increased shared leadership, have positive spillover effects for PCMH staff members. These staff members perceive themselves playing an educational role for trainees that is not always acknowledged. Playing this role, learning from the “fresh” knowledge imparted by trainees, and contributing to the future of health care all bring satisfaction to staff members. Some constraints exist for full participation in the educational efforts of the clinic. CONCLUSIONS: Increased recognition of and expanded support for PCMH staff members to participate in educational endeavors is essential as interprofessional training clinics grow. KEY WORDS: health care workforce; interprofessional education; interprofessional practice; patient-centered medical home; academic clinic; qualitative methods.
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s11606-020-06055-y) contains supplementary material, which is available to authorized users. Received December 7, 2019 Accepted July 13, 2020
J Gen Intern Med DOI: 10.1007/s11606-020-06055-y © Society of General Internal Medicine (This is a U.S. government work and not under copyright protection in the U.S.; foreign copyright protection m
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