Teaching the Patient Centered Medical Home (PCMH): Taking a Medical Model and Making it a Curriculum Niladri Das, MD Faculty, UPMC St. Margaret Family Medicine Residency Program Stephen A Wilson, MD, MPH Director, Faculty Development Fellowship UPMC St. Margaret Family Medicine Residency Program Linda Hogan, PhD Director, Faculty Development UPMC St. Margaret Family Medicine Teaching Fellowship

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Objectives On completion of this session, the participants should be able to: 1.Describe the key principles of a PCMH 2.Apply the Kemp Model of Curriculum Design and the Dreyfus Model of Skill Acquisition to the development of a PCMH Curriculum 3.Formulate teaching strategies to establish a medical home curriculum in their own practice environment

Instructional Design, 2 nd Edition, by J. E. Kemp Kemp Model of Instructional Design

Teachers/Developers Family Medicine Faculty Development Fellows (3) Pharmacy Residents (8) Faculty (3)

Instructional Design, 2 nd Edition, by J. E. Kemp Kemp Model of Instructional Design

Who were our stakeholders? 3 Family Health Centers in 3 separate neighborhoods Residents Faculty Nurses/MAs Staff Nurse Managers Pharmacists Nutrition Social Workers Learner Characteristics

Dreyfus Model of Skill Acquisition Expert Proficient Competent Advanced Beginner Novice

StageLearner CharacteristicsTeaching Styles Novice Follows rules Context free Responsible only for following rules Instructor directed – break skill into discrete tasks, concepts, rules Advanced Beginner Can apply rules Still does not feel responsible Provide practice, teach rules and reason techniques for action Competent Organizes rules into principles Responsible for own decision Facilitator- learner’s needs guide instruction Proficient Intuitive diagnosis Conscious care planning High commitment Mentor - Be available, model, teach advanced or “new” skills Expert Pattern recognition High commitment Co-Mentor – available for synergistic interdependent work

Survey Says! 1. Do you understand what a PCMH is?  (27/45) 63% of Respondents Reported Understood PCMH concept 2. What would like to learn in a PCMH Curriculum?  Roles  Practice Improvement  How the model works  Billing Pre- Assessment Topics

Goals Define the PCMH Concept Understand PCMH in their present practice and consider implementation in future practice environments Identify FHC PCMH needs and develop a plan to address those needs Define the PCMH Model Identify a current practice need Develop an Action Plan to address that need utilizing resources available in the PCMH model Objectives Goals & Objectives

How do you define PCMH? A model for delivering primary health care

Joint Principles of Medical Home Personal physician Physician directed medical practice Whole person orientation Care is coordinated Quality and safety Enhanced Access Payment Joint Principles of the Patient-Centered Medical Home, Published on Patient Centered Primary Care Collaborative (

1.Personal physician (NCQA) 2.Physician directed medical practice (NCQA) 3.Whole person orientation/ Comprehensive Care 4.Patient-Centered (AHRQ) 5.Care is coordinated and/or Integrated/Coordinated Care 6.Quality and safety 7.Enhanced access to care/Accessible Services 8.Payment (NCQA) Joint Principles of the Patient-Centered Medical Home, Published on Patient Centered Primary Care Collaborative (

Key Principles of a PCMH Comprehensive Healthcare Care Coordination Improved Accessibility Safety and Quality Patient Centeredness Content

Teaching and Learning Activities Video T&L Activities Support Services

T&L Activities

Teachers/Developers Family Medicine Faculty Development Fellows (3) Pharmacy Residents (8) Faculty (3) LEARNERS LEARNERS

Diabetic Patient panel data (registry) PCMH Handout 5 WHYs Worksheet PDSA Cycle T&L Activities Identify a FHC Need and develop an action plan to address it

Evaluation Post Curriculum Feedback Positives: Activation, Use of Technology Negatives: Continuity of Learners Variable Should have been more rigorous with Evaluation Evaluation Revise

Small Groups Develop a PMCH Curriculum utilizing the Kemp Model in Your Own Practice Setting You have 20 minutes

Discussion & Close Please forward any comments or questions to: Thank You