Document Detail

Teaching residents about patient and practice termination in community-based continuity settings.
MedLine Citation:
PMID:  7489076     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The pediatric residency program at the University of Massachusetts Medical Center, Worcester, has based its continuity experience in community practices since 1988. Residents develop a relationship not only with their patients but also with the preceptors, with whom they are paired one-on-one, and with office staff. OBJECTIVE: To describe the structure and results of an educational program that was developed to address the termination issues that arise at the end of residency. The educational program consists of four components: (1) a seminar, (2) a "mini-block" rotation, (3) office staff involvement, and (4) a resident-preceptor dinner. RESULTS: The following issues and themes have been recurrent in the discussions during the past 4 years: (1) the importance, for patient and resident, of identifying who will be the subsequent health care provider for the patient; (2) the inability to identify which patients had strongest attachment to residents; (3) parental surprise about the resident's departure, even though all parents had been told that the resident was going to be in the practice for only a limited period; (4) the desire of residents to have follow-up on patients after termination; (5) critical aspects of the process of informing patients about the resident's departure; (6) the importance of identifying and addressing the attachment of the resident to the preceptor and office staff, as well as to patients; and (7) the affirming experience that the termination sessions with the patients can be for the residents. CONCLUSION: Although the termination process is potentially emotionally difficult, it can be a personally and educationally valuable experience for residents.
T G DeWitt; K B Roberts
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Archives of pediatrics & adolescent medicine     Volume:  149     ISSN:  1072-4710     ISO Abbreviation:  Arch Pediatr Adolesc Med     Publication Date:  1995 Dec 
Date Detail:
Created Date:  1996-01-04     Completed Date:  1996-01-04     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  9422751     Medline TA:  Arch Pediatr Adolesc Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1367-70     Citation Subset:  AIM; IM    
Department of Pediatrics, University of Massachusetts Medical School, Worcester, USA.
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MeSH Terms
Continuity of Patient Care*
Internship and Residency* / organization & administration
Interprofessional Relations
Medical Staff, Hospital / psychology
Parents / psychology
Pediatrics / education*
Physician-Patient Relations*
Professional-Family Relations
Program Development
Program Evaluation
Grant Support

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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