The Johns Hopkins Aliki Initiative: A Patient-Centered Curriculum for Internal Medicine Residents

Abstract Patient-centered care is an important aspect of medicine. The Johns Hopkins Initiative Curriculum aims to teach residents to view patients as individuals and to consider the context of their lives outside the hospital in order to provide patient-centered, and safe, care across transitions. Specifically, this curriculum was developed to reform graduate medical education by teaching residents to: (1) provide more patient-centered care by understanding the psychosocial context of each patient's illness, and knowing patients as individuals; (2) optimize care across transitions from the hospital to postdischarge setting; and, (3) educate and empower patients in shared decision-making about treatments. This curriculum is meant to be administered over a 4-week period with residents receiving both didactic instruction and observation by attending physicians during resident-patient interactions. Instruction is provided across seven content areas consisting of: (1) medication adherence, (2) pharmacy curriculum, (3) call to next provider of care, (4) patient-centered discharge, (5) telephone contact with patients after discharge, (6) follow-up visits with patients after discharge (home and sub-acute visits), and (7) the challenging provider-patient relationship. Each area is accompanied by detailed administration directions in an accompanying Instructor's Guide. We are currently engaged in studies of the impact of this curriculum on learners and patients. In addition to providing more patient-centered care, we hope to demonstrate benefits in other educational outcomes, including medical knowledge, self-awareness, systems-based practice, and communication skills. We plan to assess whether patients report better relationships with their physicians and an improved understanding of their medical conditions and care. We also hope to demonstrate improved clinical outcomes such as reduced 30-day readmission rates and increased follow-through with recommended treatments and studies after discharge.