HMO development for primary care team teaching of medical and nursing students

This article describes a three-year effort to facilitate the development of a university health maintenance organization (HMO) into an effective clinical teaching site for the team practice of primary care. Project staff initiated several activities to promote team development in the HMO. These included review and development of algorithms to guide physician/nurse teams in the care of patients with common problems, workshops on communication and role negotiating skills, and preceptor training. A variety of objective and subjective methods were employed to assess HMO team development and the effectiveness of the HMO as a primary care teaching site. Initial resistance to both team practice and teaching have been overcome. Students who were trained in the project not only acquired good clinical skills but also, perhaps more importantly, developed skills in professional role negotiation and communication as well.