Triple Aim for Clinical Teachers (TACT): Faculty Physician Perceptions on Their Ability to Balance Clinical Quality, Trainee Learning, and Teaching Efficiency

Background: A common challenge facing teaching physicians is balancing high-quality student and resident teaching with efficient, high-quality care and patient service. Publicly accessible clinic performance reports increasingly affect where patients seek care and demand that teaching clinics rise to consumer expectations while training future physicians to function in the modern health care workplace. Limited information is available to guide physicians to achieve the triple aim for clinical teachers (TACT): clinical quality/patient experience, trainee learning, and teaching efficiency. Purpose: To understand clinical teachers’ TACT-related experiences, perceptions and preferences for how to learn TACT-associated skill sets to improve their competence as teachers. Methods: A 7-question needs assessment survey was distributed to teaching faculty members in family medicine, internal medicine and ob/gyn in a health care system. Ranking, rating and free-response item formats were used to determine teachers’ prioritization of care management and patient satisfaction metrics within medical education and their perceived skills and limitations in incorporating these factors into medical education. Data was analyzed using descriptive statistics and narrative comments using qualitative thematic analysis. This project was deemed “not human subjects research” by Aurora Health Care. Results: A 78% response rate was obtained (32/41). Respondents’ top 3 teaching priorities were “Meeting specific clerkship objectives/residency milestones,” “Impact on your time/teaching efficiency” and “Service quality priorities for the clinic.” Respondents ranked learner’s evaluation of teaching among their lowest priorities. 63% of respondents reported that they involve learners in improvement efforts (quality, safety, patient experience). Respondents identified a variety of strategies for involving learners in improvement efforts (medical students initiate patient callback, follow up on lab tests, check/address health maintenance items; residents identify a care management target), although time was consistently identified as a barrier to learner involvement. Conclusion: Survey results confirmed that clinical teachers place value on integrating efforts to enhance clinical quality/patient experience as they teach yet face challenges to TACT goal attainment. Findings will inform description of successful TACT strategies, assessment of their effectiveness and faculty development initiati