Learning to Deliver Care in a Medical Home: A Qualitative Analysis of Residents' Reflections on Practice

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Abstract

Objective.

We used online structured reflection to improve residents' understanding of care delivery in the medical home.

Methods.

Third-year pediatric residents participated in an online curriculum on delivering effective, patient-centered primary care in the medical home to children with special health care needs. Residents were prompted to respond to questions designed to stimulate reflection. We qualitatively assessed their responses, graded their depth of reflection, and provided structured feedback.

Results.

Residents identified aspects of their practice consistent with medical home principles. Depth of reflection increased over time. Residents realized they needed to better understand families' financial, emotional, and social needs and increase families' involvement in care planning. Residents identified systems issues and practice changes to improve care delivery.

Conclusions.

Online reflective writing with feedback is a powerful strategy to improve residents' learning. Residents identified and began to make practice changes to provide patient-centered care in a medical home.

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