LAUSR

It is estimated that 1.9 million older adults are completely homebound with many more requiring the assistance of others to leave their home. Many of these patients are best served with home-based medical care, and yet medical trainees receive limited training to provide care in the home environment. Incorporating house calls into residency training is integral to teaching resident physicians about the care of homebound older adults. Although the COVID-19 pandemic has shifted medical education online, it remains important that we provide opportunities for trainees to build longitudinal primary care relationships, learn geriatric care in the home environment, and receive feedback from attending preceptors directly observing their clinical care. The Johns Hopkins Home-based Medicine (JHOME) program provides home-based primary care to older adults in Baltimore, Maryland, and is a unique opportunity for longitudinal training in this setting. Internal medicine residents in the general internal medicine (GIM) track of the Johns Hopkins Bayview (JHB) Internal Medicine Residency Program follow a panel of 4–5 homebound older adult patients during their second and third years of residency and see them at home every 3 months during their community-based practice rotation. Typically, attending preceptors and residents see patients in the home together, allowing preceptors to directly observe the visit and provide feedback. In response to the COVID-19 pandemic, the JHOME team adapted house call education to limit the number of visitors in the home while still preserving opportunities for practice-based learning. Following 9 months of piloting several visit approaches, we surveyed residents to gather their perspectives and plan for future education.