ArticleJournal of general internal medicine2014
Impact of 4 + 1 block scheduling on patient care continuity in resident clinic.
Article in Journal of general internal medicine, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
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Who cites it
23 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Uses of Electronic Health Record Data to Measure the Clinical Learning Environment of Graduate Medical Education Trainees: A Systematic Review.Academic medicine : journal of the Association of American Medical Colleges · 2023Pooled it
- The Impact of Block Ambulatory Scheduling on Internal Medicine Residencies: a Systematic Review.Journal of general internal medicine · 2019Pooled it
- Resident Perceptions of Ambulatory Block Handoffs in the X + Y Block Scheduling Model.Journal of general internal medicine · 2025Article
- Impact of Ambulatory Blocks on Pulmonary Critical Care Fellow Outpatient Training Experience.ATS scholar · 2024Article
- The Impact of Changing From a 6+2 to a 3+1 Residency Block Schedule on Patient Access and Other Outcomes.Journal of graduate medical education · 2024Article
- Learning in Tension: A Case Study Examining What Internal Medicine Residents Learn in the Ambulatory Care Setting.Perspectives on medical education · 2023Article
- Education Research: The Effect of an X + Y Schedule Model on Neurology Residency Training.Neurology. Education · 2022Article
- X+Y Scheduling in Psychiatry Training.Academic psychiatry : the journal of the American Association of Directors of Psychiatric Residency Training and the Association for Academic Psychiatry · 2022Article
- Residency Practice Transformation: Implementation of Team-Based Care in an Academic Continuity Clinic.Journal of graduate medical education · 2020Article
- Multidisciplinary approach to maximise continuity in an academic internal medicine resident clinic.BMJ open quality · 2020Article
- A National Survey of Internal Medicine Primary Care Residency Program Directors.Journal of general internal medicine · 2019Article
- A Decade of Teaching and Learning in Internal Medicine Ambulatory Education: A Scoping Review.Journal of graduate medical education · 2019Article
- Making the Case for an X + Y Scheduling Model in Preliminary Internal Medicine Residency Training.Journal of graduate medical education · 2018Article
- Continuity of Care in Resident Outpatient Clinics: A Scoping Review of the Literature.Journal of graduate medical education · 2018Article
- Resident and Preceptor Perceptions of Preceptor Integration Into Resident Clinic Scheduling Templates.Journal of graduate medical education · 2017Article
- Factors Associated With Resident Continuity in Ambulatory Training Practices.Journal of graduate medical education · 2016Article
- For the General Internist: A Summary of Key Innovations in Medical Education.Journal of general internal medicine · 2016Review
- Fulfilling outpatient medicine responsibilities during internal medicine residency: a quantitative study of housestaff participation with between visit tasks.BMC medical education · 2016Article
- Continuity of Care as an Educational Goal but Failed Reality in Resident Training: Time to Innovate.Journal of graduate medical education · 2016Article
- The Selling of Primary Care 2015.Journal of general internal medicine · 2015Article
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundLeaders in medical education have called for redesign of internal medicine training to improve ambulatory care training. 4 + 1 block scheduling is one innovative approach to enhance ambulatory education.
aimTo determine the impact of 4 + 1 scheduling on resident clinic continuity.
settingResident continuity clinic in traditional scheduling in which clinics are scheduled intermittently one-half day per week, compared to 4 + 1 in which residents alternate 1 week of clinic with 4 weeks of an inpatient rotation or elective.
participantsFirst-year internal medicine residents. PROGRAM DESCRIPTION: We measured patient-provider visit continuity, phone triage encounter continuity, and lab follow-up continuity. PROGRAM EVALUATION: In traditional scheduling as opposed to 4 + 1 scheduling, patients saw their primary resident provider a greater percentage; 71.7% vs. 63.0% (p = 0.008). In the 4 + 1 model, residents saw their own patients a greater percentage; 52.1% vs. 37.1% (p = 0.0001). Residents addressed their own labs more often in 4 + 1 model; 90.7% vs. 75.6% (p = 0.001). There was no significant difference in handling of triage encounters; 42.3% vs. 35.8% (p = 0.12). DISCUSSION: 4 + 1 schedule improves visit continuity from a resident perspective, and may compromise visit continuity from the patient perspective, but allows for improved laboratory follow-up, which we pose should be part of an emerging modern definition of continuity.
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