Electronic Thesis and Dissertation Repository

Thesis Format

Integrated Article

Degree

Master of Clinical Science

Program

Family Medicine

Supervisor

Reichert, Sonja M

2nd Supervisor

Osmun, William E

Co-Supervisor

Abstract

Aim: This thesis explored the experiences of family medicine preceptors and family medicine residents regarding multimorbidity care and education.

Methods: Two qualitative descriptive studies were conducted using semi structured interviews with family medicine preceptors and focus groups with family medicine residents. Interviews and focus groups were audio-taped and transcribed verbatim. Data analysis was iterative and interpretive in nature and done both independently and as a team.

Findings: Multimorbidity care is predominantly provided by family physicians yet there is little focus on multimorbidity education in the medical education curriculum. Multimorbidity education is informal and experiential in nature. There are both facilitators and challenges to multimorbidity care and it is important that family medicine residents receive education in this area. Suggestions to aid multimorbidity care and multimorbidity education are described.

Conclusions: Multimorbidity care is challenging for family physicians and residents and further education and research in this area are both worthwhile and required.

Summary for Lay Audience

This thesis includes two studies exploring experiences with multimorbidity in academic family medicine. Multimorbidity refers to patients who have multiple chronic conditions concurrently. In the first study, family medicine preceptors (family physicians who have an academic practice where they teach medical students and/or residents) were interviewed about their experiences caring for patients with multimorbidity. They were also asked about their experiences regarding multimorbidity management in the medical education curriculum. They described facilitators which help in providing care for patients with multimorbidity as well as challenges in providing care for patients with multimorbidity. They provided insights into their own experiences of multimorbidity education during their own medical training as well as their knowledge about multimorbidity education currently being taught in the medical curriculum. The second study explored the experiences of family medicine residents caring for patients with multimorbidity during their residency training as well the education they are taught regarding multimorbidity.

Both studies found multimorbidity care is predominantly provided by family physicians in our health care system, yet there is little focus on multimorbidity education in the medical education curriculum. Both studies highlighted important facilitators and challenges in caring for patients with multimorbidity. It is important that family medicine residents receive education in this area to prepare them for their future careers in family practice. Unfortunately, multimorbidity education currently is mostly informal and experiential in nature. Suggestions to aid multimorbidity care and education are described in both studies.

In summary, multimorbidity care is challenging for both family physicians and family medicine residents and further education and research are required given the increasing prevalence of multimorbidity in our society.

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