Reimagining the 5Ms: A Novel Application of the 5Ms Framework to Teach Residents How to Manage Medical Complexity...

Introduction With advances in medicine, physicians care for an increasingly complex population. To prepare resident physicians to practice independently, they must receive formal instruction on managing medically complex patients. While the 5Ms framework of age-friendly care was developed to address the comprehensive and complicated needs of older adults, it can be adapted to optimize care for complex patients of any age. The 5Ms framework includes five domains: Mobility, Medications, Mentation, Multicomplexity, and Matters Most.  Methods The authors developed a workshop to teach internal medicine residents a novel approach to organizing the care of complex patients across the lifespan. Case-based learning was combined with literature review and clinical application of learned topics. Learners were encouraged to participate in anonymous pre- and post-workshop surveys, where they reported their comfort level with the 5Ms framework and their confidence in outpatient clinical scenarios of adult patients with varying medical complexity. Results Paired survey responses were analyzed (n=76). Before the workshop, approximately 50% of learners were aware of the 5Ms framework, and only two residents felt "very comfortable" or "extremely comfortable" with it. After the workshop, comfort level with the 5Ms framework improved, with 51% of respondents reporting their comfort level as "very comfortable" or "extremely comfortable." Residents also reported increased confidence in their ability to manage every case scenario. Approximately 97% of residents said they would use the 5Ms framework post-workshop. Discussion This innovative workshop demonstrated that the 5Ms framework can be applied to complex patients of all ages. It offers a useful tool for educating residents on how to organize their care of medically complex patients.