Outcomes of the Education-Centered Medical Home
In response to calls for medical education leaders to improve continuity within medical education, Northwestern University has developed a novel, team-based primary care clerkship, “The Education-Centered Medical Home.” The purpose of this project is to further strengthen the existing evidence base for longitudinal primary care clerkships as “best practice” nationally.
Northwestern Feinberg School of Medicine has created the Education-Centered Medical Home (ECMH) program. The ECMH is a team-based, longitudinal primary care clerkship founded on the principle of continuity and focused on teaching the educational principles of the Patient-Centered Medical Home. 1 The ECMH embeds medical student teams into primary care clinics to care for an authentic panel of complex patients over time.
Foster a Culture of Accountability
A four-year structure with stable relationships among patients, preceptors and peers allows trainees to see the natural history of chronic illness and, therefore, appreciate the profound impacts of social determinants of health on patient outcomes over time. Gone are the “one-visit-and-done,” superficial encounters that tend to be the norm in traditional family medicine or primary care clerkships. Instead, students meet patients struggling with diabetes or asthma during their first year and are tasked to fulfill the role of health coach and patients advocate for the next four years.
The ECMH also fosters a culture of accountability and improvement by having clinics track their outcomes and design and implement annual quality improvement projects. Prior work shows that our ECMH model is feasible, highly rated by students, mitigates the negative effects of the hidden curriculum, improves perceptions of their primary care training experience and increases students’ measures of patient-centeredness compared with students in the traditional curriculum.2.3 Intriguingly, preliminary data show that patients in one ECMH clinic were more engaged and had better chronic disease management metrics after working with student coaches compared with historic controls.
Learn more about the program here: https://www.feinberg.northwestern.edu/md-education/curriculum/components/learning-strategies/education-centered-medical-home/index.html
- Evans DB. Acad Med 2011.Evans DB. The Patient-Centered Medical Home as a Curricular Model: Medical Students Need an “Educational Home.” Acad Med. 2011 Nov; 86(11):e2.
- Henschen BL, Garcia P, Jacobson B, et al. The patient centered medical home as curricular model: perceived impact of the “education-centered medical home”. Journal of general internal medicine. 2013;28(8):1105-1109.
- Henschen BL, Bierman JA, Wayne DB, et al. Four-Year Educational and Patient Care Outcomes of a Team-Based Primary Care Longitudinal Clerkship. Academic medicine : Journal of the Association of American Medical Colleges. 2015;90(11 Suppl):S43-49.