Collaborative Inpatient Medicine Service, Johns Hopkins Bayview Medical Center, Johns Hopkins University School of Medicine, Baltimore, Maryland 21224, USA.
J Hosp Med. 2009 Oct;4(8):486-9. doi: 10.1002/jhm.532.
Medical consultation is an integral part of hospitalist physicians' practice, yet there is no uniform training to achieve competency in this area during residency.
To improve the quality of medical consultations performed by hospitalists in an academic medical center.
Single group pre-post study design comparing knowledge and behaviors after exposing physicians to an educational intervention.
Johns Hopkins Bayview Medical Center, 2006-2007.
Seven hospitalist faculty members, and 12 internal medicine house-staff members, who served on the medical consultation service during the study period.
Participants were exposed to an educational intervention consisting of a case-based module teaching the principles of medical consultation, as well as audit and feedback in which they critically reviewed their most recent written consultations.
Pretests and posttests were used to assess knowledge. Performance and physician behaviors were assessed following the intervention; consultations done by hospitalists in the months prior to the educational intervention were scored and compared to their postintervention consultations. Wilcoxon signed rank tests and paired t tests were used for the analyses.
Improvement in the median knowledge score (pretest vs. posttest) was significant only for house-staff and not for faculty (10/14 vs. 12/14, P = 0.03 and 11/14 vs. 12/14, P = 0.08, respectively). The quality of consults written by all hospitalists improved after the educational intervention; the mean scores increased from 2.7 to 3.3 (P = 0.0006).
This curricular intervention including audit and feedback was effective in improving the quality of medical consultations performed by hospitalist physicians.
医疗咨询是医院医师实践的一个组成部分，但在住院医师培训期间，没有统一的培训来实现这方面的能力。
提高学术医疗中心医院医师进行医疗咨询的质量。
在暴露于教育干预措施后，比较知识和行为的单组前后研究设计。
约翰霍普金斯湾景医疗中心，2006-2007 年。
7 名医院医师教员和 12 名内科住院医师，在研究期间担任医疗咨询服务的成员。
参与者接触到一个教育干预措施，该措施包括一个基于案例的模块，教授医疗咨询的原则，以及审核和反馈，在其中他们对最近的书面咨询进行了批判性审查。
使用前测和后测来评估知识。在干预后评估绩效和医生行为；在教育干预之前的几个月中，对医院医师进行的咨询进行评分，并将其与干预后的咨询进行比较。使用 Wilcoxon 符号秩检验和配对 t 检验进行分析。
只有住院医师的中位数知识得分（前测与后测）有所提高，而不是教员（10/14 与 12/14，P=0.03 和 11/14 与 12/14，P=0.08）。所有医院医师撰写的咨询质量在教育干预后都有所提高；平均分数从 2.7 提高到 3.3（P=0.0006）。
包括审核和反馈在内的这种课程干预措施有效地提高了医院医师进行医疗咨询的质量。
