Does the P4 Project Influence Match Results?—Q & A With Patricia Carney, PhD, Principal Investigator for P4
Patricia Carney, PhD will speak on Saturday, January 30, at the Predoctoral Education Conference in Jacksonville, Florida. She will highlight trends in health care reform that are likely to affect our educational programs and will address how partnerships must be formed to allow flexibility in program credentialing that will rapidly advance educational quality and improved health outcomes.
Q: Tell us about the impact of health care reform on your research. With the constant changes and unknowns, how in the world do you manage this study (any study)? It would seem challenging to measure the effects of residency redesign when nothing seems constant.
A: Yes, health care reforms are a dynamic process. We are using a case series design in P4, where each program is its own control group, and we are collecting historical cohort data, which will help us understand how features of all programs change over time. In addition, sites collect specific measures for the hypotheses they are testing that are unique to their programs. We conducted site visits to all 14 programs and reviewed/revised their hypotheses, identified data collection instruments and time periods, and we assisted them in connecting with other programs that are conducting similar studies. I like to think of our approach as health care and educational epidemiology—where we collect as much relevant data as is feasible and then conduct complex multivariate analyses designed to take into account the covariates that could be influencing outcomes.
Q: What do you believe is the most valuable lesson to date that family medicine educators can take from the P4 project?
A: Family medicine residents are very excited about the possibility of “intentional diversification;” that is, they want more flexibility in designing a residency program that will best prepare them for the type of medical practice they want to work in. Several programs are testing this innovation, and Match results (which we are analyzing now) appear to have improved for P4 sites.
Q: What, if anything, do your findings tell us about the future of family medicine education and our learners?
A: Preliminary data from the P4 project recently examined whether the innovations being tested at sites were influencing the residency Match. More specifically, we examined how programs fared in the Match, according to whether their innovations included a customized curriculum at the level of the resident. Our results show a 20% increase in LCME US graduates matching to these programs after implementation of this innovation compared to before.
Patricia Carney, PhD, is professor of family medicine and of public health and preventive medicine and associate director for Population Studies at the Oregon Health and Science University. She has contributed to the development of several clinical research grants in breast, cervical, and colorectal cancer screening, detection, and diagnosis.
Plan to attend the STFM Predoctoral Education Conference and hear more about the P4 Initiative, the initial findings, and the lessons Dr Carney believes family medicine can learn (and benefit) from.
posted by Traci @ STFM at
10:49 AM
2 Comments:
In viewing the surveys of our residents out several years, we have found that what they actually do in practice is very dissimilar to what they thought they would be doing when matching for a residency. Therefore, restricting training within the family medicine residency may gain a higher match goal and higher satisfaction on the intern side, but may lead to greater dissatisfaction with career options later in their professional life.
The big tension in education has always been between those who worry about standards and rules and those who felt that individuals or local educational programs were in the best position to determine educational needs. Everyone needed to learn how to read, for example, but what you do with your reading skills depends on if you are learning engineering or comparative literature. Adult learning requires that learners take responsibility for finding ways to learn and medicine as a profession has never distinguished itself as an adult learning environment. Family medicine education has spent most of its existence reorganizing the widgits of education, but not the basic premises on which those widgits are founded. If we have to experiment to find new ways of doing anything, let as many educational experiments happen as possible, with the requirement that each one has to be studied, analyzed and reported so we can all learn what works in what type of environment.
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