Promoting Patient-Centered Care During Residency Training:
an Inpatient Tale of Two Programs
Raquel G. Hernandez
Janet D. Record
Laura A. Hanyok
Cynthia S. Rand
Robert A. Dudas
Roy C. Ziegelstein
Published online: 23 April 2018
International Association of Medical Science Educators 2018
Background Teaching residents to provide patient-centered care (PCC) is a challenge within traditional residency programs. We
describe strategies developed to adapt a PCC curriculum from an existing program to a new one, highlighting components that
were duplicated as well as those that were adapted to local needs.
Activity The authors compared their PCC curricula against known barriers to PCC teaching, identified strategies as shared or
tailored in each domain, and described outcomes.
Results Sixteen shared curricular strategies were identified. One hundred percent of pediatric residents (n = 20) Bagreed or
strongly agreed^ that the newly adopted PCC strategies promote an understanding of patient-centered care.
Discussion Success related to shared and tailored strategies may inform how PCC training models in other specialties may be
Keywords Patient-centered care
Patient-centered care (PCC) is widely recognized as an essen-
tial element in high-quality healthcare and is cited as a central
priority towards Bcrossing the quality chasm^ by the Institute
of Medicine . Service demands often cause trainees to
spend more time Bchecking boxes^ rather than considering
the needs of their patients [2, 3] such that the tension between
service and education has led educators to carefully examine
the way residents are trained  within high-acuity, inpatient
settings where service demands often undermine patient cen-
teredness. The Accreditation Council for Graduate Medical
Education (ACGME) has previously identified barriers to pro-
viding PCC in six categories: culture, physical environment,
people, skills/capabilities, time, and teaching/assessment .
Programmatic strategies to address these PCC barriers have
not previously been described but might be of high value to
medical educators. In pediatrics, the Bpatient^ is usually in-
deed the Bfamily,^ but for the purposed of clarity in this paper,
we will utilize BPCC^ to refer to both patient-centered care
and family-centered care.
In 2007, leaders of the internal medicine residency program at
the Johns Hopkins Bayview Medical Center (JHBMC) intro-
duced a PCC-focused inpatient curriculum called the BAliki^
curriculum . When this PCC curriculum demonstrated pos-
itive educational  and clinical outcomes , national
leaders in education began to highlight the curriculum as an
important training advance in PCC . The JHBMC PCC
curriculum provided a model to inform the development of a
parallel curriculum at a newly established pediatric residency
program at Johns Hopkins All Children’sHospital(JHACH),
known as the BBlue Team,^ and program leadership at
This project has not previously been presented or published in any other
journal or venue.
* Raquel G. Hernandez
Johns Hopkins University School of Medicine, Baltimore, MD, USA
Johns Hopkins All Children’s Hospital, 601 5th Street South, St.
Petersburg, FL 33701, USA
Johns Hopkins Bayview Medical Center, Baltimore, MD, USA
Medical Science Educator (2018) 28:289–294