PACER is a program that draws from foundational work of a prior training redesign initiatives and the primary care boards’ in-depth expertise in implementing innovations in clinical training. The initial stage in this foundational work included three “contained” single discipline initiatives [Preparing the Personal Physician for Practice (P4) project in family medicine, the Education Innovations Projects (EIP) in internal medicine and the Initiative for Innovation in Pediatric Education (IIPE)]. Using best practices from these initiatives, input from a national stakeholders’ meeting and studies on the changes needed in GME, the next model evolved – a trans-disciplinary effort, the Primary Care Faculty Development Initiative (PCFDI) pilot project.
The PCFDI was intentionally focused on development of residency faculty from family medicine, internal medicine and pediatrics to equip residents for their future practice as a starting point in the work needed to better prepare the primary care workforce. Results from this pilot (Carney PA et al. 2015 and Eiff MP et al. 2016) demonstrated that faculty in the primary care disciplines in medicine, who prior to PCFDI had little contact with each other, could come together successfully around PCMH transformation and trans-disciplinary training. However, this type of faculty development is insufficient because developing effective interprofessional teams and redesigned systems are critical to the success of transformed primary care practices. Optimal preparation of primary care physicians to practice in a PCMH must include meaningful IPE experiences that prepare them as well as other health professionals to work in an interprofessional environment with team-based care at the center. All health professions need to understand the roles of each profession and develop the mutual respect that enables all health professionals to overcome status barriers to become high functioning teams.
This “history” has led to the next frontier of faculty development, namely interprofessional training that builds upon on past lessons but also undertakes further transformation of faculty development in primary care. PACER seeks to accelerate this critically needed transformation in faculty development models by building high functioning interprofessional faculty teams. The relationship building and mutual respect that develops as these teams break through the typical entrenched siloes in training programs and the separate cultures in the health professions in their work together in PACER forms the foundation for them to test and adopt new models of interprofessional training in primary care practices using collaborative synergies.