Faculty Development Needs in Residency Redesign for Practice in Patient-centered Medical Homes: A P4 Report

OBJECTIVES: The study's objective was to describe faculty development skills needed for residency redesign in 14 family medicine residencies associated with the Preparing the Personal Physician for Practice (P4) project. METHODS: We used self-administered surveys to assess ratings of existing faculty development efforts and resident attitudes about faculty teaching between 2007 and 2011. Telephone interviews were conducted to assess faculty development activities and needs at baseline. Early project faculty development needs were addressed using tailored sessions delivered during site visits. We conducted a detailed content analysis of 14 site-specific comprehensive reports to characterize ongoing faculty development needs and faculty themes related to residency redesign. RESULTS: Early in the P4 project, faculty needs included skills in using the electronic health record (EHR) in teaching, change management, curriculum design, evaluation, learning portfolios and individualized learning plans, career coaching, qualitative research, competency-based assessment, and leadership. As the project progressed, the need for a "learning together" approach when training residents in transformed practices emerged. Using the EHR more effectively, evaluation and competency-based assessment skills, individualized curriculum design, better career coaching skills, shared leadership, and team-based care skills were consistent faculty development needs. Redesign strategies included having a committed core faculty group, faculty retreats, curricular change process management, intra-residency collaboration, and providing adequate support for key individuals. CONCLUSIONS: Faculty attempting to redesign residencies to train residents in patient-centered medical homes need new skills, and understanding these needs can inform faculty development programs nationally to achieve the crucial mission of training the workforce to accomplish this transformation.