What is HOME? Exploring learning themes in a home-visit educational program for postgraduate residents in Taiwan

Physician home visits are essential for delivering care to frail, homebound older adults with limited access to routine healthcare. This study examined the experiential learning themes of a home-visit course within a postgraduate year training program in Taiwan.

A descriptive, exploratory qualitative study was conducted to examine the learning experiences of second-year postgraduate residents who participated in 10 half-days home-visit program as part of their mandatory geriatric medicine training at a university hospital between August 1, 2020, and July 31, 2021. Reflective essays from 47 residents were analyzed using qualitative content analysis to identify key themes.

Three major themes emerged: learning process, learning content, and challenges. The learning process comprised four stages: adaptation, observation, awareness, and reflection. Learning content included a deeper understanding of patients as individuals within the community (holistic care), improved skills in coordinating interdisciplinary teams and integrating patient care information (organizational thinking), greater awareness and empathy through relational practices (mindful engagement), and a stronger appreciation for empowering patients and families through education, goal setting, and community support (empowerment)-conceptualized as the HOME model. Residents also identified challenges in negotiating family dynamics, navigating structural constraints, and reconciling gaps between policy ideals and the realities of home-based care.

These findings support the integration of structured home-visit experiences into postgraduate training to promote competency development, person-centered care, and reflective learning in real-world settings.