Soaring costs of health care, patients living longer with chronic illnesses, and continued attrition of interest in primary care contribute to the urgency of developing an improved model of health care delivery. Out of this need, the concept of the team-based, patient-centered medical home (PCMH) has developed. Amidst implementation in academic settings, clinical teachers face complex challenges not previously encountered: teaching while simultaneously learning about the PCMH model, redesigning clinical delivery systems while simultaneously delivering care within them, and working more closely in expanded interprofessional teams.
To address these challenges, the authors reviewed three existing faculty development models and recommended four important adaptations for preparing clinical teachers for their roles as system change agents and facilitators of learning in these new settings. First, many faculty find themselves in the awkward position of teaching concepts they have yet to master themselves. Professional development programs must recognize that, at least initially, health professions learners and faculty will be learning system redesign content and skills together while practicing in the evolving workplace. Second, all care delivery team members influence learning in the workplace. Thus, the definition of faculty must expand to include nurses, pharmacists, social workers, medical assistants, patients, and others. These team members will need to accept their roles as educators. Third, learning to deliver health care in teams will require support of both interprofessional collaboration and intraprofessional identity development. Fourth, learning to manage change and uncertainty should be part of the core content of any faculty development program within the PCMH.
Dr. Clay is staff physician, VA Ann Arbor Healthcare System, and clinical assistant professor, Department of Medicine, University of Michigan Medical School, both in Ann Arbor, Michigan.
Dr. Sikon is chair, Department of Internal Medicine and Geriatrics, Cleveland Clinic, and associate professor of medicine, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, both in Cleveland, Ohio.
Dr. Lypson is assistant dean for graduate medical education and professor of internal medicine and medical education, University of Michigan Medical School, and staff physician, VA Ann Arbor Health Care System, both in Ann Arbor, Michigan.
Dr. Gomez is professor of clinical medicine, David Geffen School of Medicine at UCLA, Los Angeles, California.
Dr. Kennedy-Malone is professor of nursing, School of Nursing at the University of North Carolina, Greensboro, North Carolina.
Dr. Bussey-Jones is associate professor of medicine and staff member, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia.
Dr. Bowen is professor of medicine, Oregon Health & Sciences University School of Medicine, Portland, Oregon, and education consultant, Veterans Health Administration Office of Academic Affiliations, Washington, DC.
Other disclosures: None.
Ethical approval: Not applicable.
The authors have informed the journal that they agree that both Dr. Clay and Dr. Sikon completed the intellectual and other work typical of the first author.Correspondence should be addressed to Dr. Sikon, 9500 Euclid Ave. G10, Cleveland Clinic, Cleveland, OH; telephone: (216) 444-9896; fax: (216) 636-2334; e-mail: firstname.lastname@example.org.