Abstract
Background
Residents serve as access points to the health care system for the most vulnerable
patients in the United States. Two large academic medical centers have identified
performance gaps between resident and faculty physicians. Our intent in this study
was to measure the scope of resident-faculty performance gaps in a nationwide sample
and identify potential targets for intervention.
Methods
This is a qualitative study of 12 residency programs representing 4 out of 5 US regions.
Main measures include perceptions of population health performance in resident versus
faculty populations, description of precepting model employed, perceptions of differences
between resident and faculty patients, and handoff processes at the time of graduation.
Results
Of the 8 programs that routinely compare resident and faculty performance, half had
confirmed the presence of outcome disparities on routine population health metrics.
Seven out of 12 programs employ a 1:1 preceptor:resident comanagement structure. Ten
of the 12 programs perceived that resident panels were more psychosocially complex;
2 had a formal process to measure this. Four of the 12 programs had a process to monitor
patient loss to follow-up after resident transition.
Conclusions
Resident-faculty performance disparities may be a widespread problem nationally. Potential
targets for intervention include increased preceptor engagement, improving access
for empanelment in the faculty practice for vulnerable patient populations, and employing
more robust handoff practices. Integrating a culture of quality improvement to continuously
monitor important educational metrics such as outcome disparities, panel demographics,
educational continuity, and patient loss in the resident panel should be a routine
practice for academic health centers.
Keywords
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Article Info
Publication History
Published online: March 04, 2022
Footnotes
Funding: None.
Conflicts of Interest: None.
Authorship: All authors had access to the data and a role in writing this manuscript.
Identification
Copyright
© 2022 Elsevier Inc. All rights reserved.
