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Dr. Smith, MS RN, W. Hill, Chris EdD, J. McMullin, Leo Chavez, C. Rhoads (2004)
Cultural consensus analysis as a tool for clinic improvementsJournal of General Internal Medicine, 19
C.S. Smith, M. Morris, W. Hill, C. Francovich, J. McMullin, L. Chavez, C Rhoads (2004a)
A qualitative study of resident learning in ambulatory clinic. The importance of exposure to ‘breakdown’ in settings that support effective responseAdvances in Health Sciences Education, 4
D. Westen, R. Rosenthal (2003)
Quantifying construct validity: two simple measures.Journal of personality and social psychology, 84 3
C. Smith, M. Morris, C. Francovich, W. Hill, J. Gieselman (2004)
A Qualitative Study of Resident Learning in Ambulatory ClinicAdvances in Health Sciences Education, 9
Recurrent problems in medical teaching clinic are common and difficult to address because of complex interpersonal dynamics. To minimize this difficulty, we developed a conceptual model that simplifies problems and identifies the root cause of tension between groups in clinic. We used recursive analysis and modeling of the data from a larger multi-site, multi-method study of problems in teaching clinic. The first dataset from this study consisted of problem lists generated and prioritized by knowledgeable insiders from each site. The second dataset was a cultural consensus analysis independently performed at each site. The final model was checked for face validity and construct validity (using model predictions versus prior data and convergent/discriminant analysis). The study was performed in five Veterans Affairs teaching clinics in the U.S. Our final model, the Perception of Care Map, is a pentagram with five critical perspectives of the clinic visit. These five perspectives are structured care, educational care, relationship-based care, algorithmic care and efficient care. Each group emphasizes one or more of these perspectives, and group locations on the conceptual map explain the observed tensions between groups. Validity of the model is high. The Perception of Care Map may be a useful adjunct for understanding and addressing recurrent problems in teaching clinic.
Advances in Health Sciences Education – Springer Journals
Published: Aug 19, 2005
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