Dr. Koch is assistant professor of family and community medicine, Medical College of Wisconsin, Milwaukee, Wisconsin. Dr. Simpson is adjunct professor of family and community medicine, Medical College of Wisconsin, and medical education program director, Aurora Health Care, Milwaukee, Wisconsin. Dr. Toth is associate professor of medicine and pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin. Dr. Marcdante is professor of pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin. Dr. Densmore is assistant professor of pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin. Dr. Young is assistant professor of family and community medicine, Medical College of Wisconsin, Milwaukee, Wisconsin. Dr. Weisgerber is associate professor of pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin. Dr. Morzinski is associate professor of family and community medicine, Medical College of Wisconsin, Milwaukee, Wisconsin. Dr. Havas is associate professor of family and community medicine, Medical College of Wisconsin, Milwaukee, Wisconsin.
Acad Med. 2014 Mar;89(3):477-81. doi: 10.1097/ACM.0000000000000153.
As calls for training and accreditation standards around improved patient care transitions have recently increased, more publications describing medical student education programs on care transitions have appeared. However, descriptions of students' experience with care transitions and the sender/receiver communication that supports or inhibits them are limited. To fill this gap, the authors developed this project to understand students' experiences with and perceptions of care transitions.
At the start of a patient safety intersession at the Medical College of Wisconsin (2010), 193 third-year medical students anonymously wrote descriptions of critical incidents related to care transitions they had witnessed that evoked a strong emotional reaction. Descriptions included the emotion evoked, clinical context, and types of information exchanged. The authors analyzed the incident descriptions using a constant comparative qualitative methodology.
Analysis revealed that 111 of the 121 medical students (92%) who disclosed emotional responses had strong negative reactions to unsuccessful transitions, experiencing frustration, irritation, fear, and anger. All of these negative emotions were associated with lack of or poor communication between the sender and receiver: ambiguous roles and responsibilities, insufficient detailing of the patient's medical course, inadequate identification of the people involved in the transition, incomplete delineation of what the patient needed, and unclear reasons for the transition.
Third-year medical students' descriptions of care-transition incidents reveal high rates of strong negative emotions and of communication gaps that may adversely affect patient care. Results support curricular innovations that align students' needs and experiences with safe patient care transitions.
随着呼吁提高患者护理过渡培训和认证标准的呼声越来越高，描述医学生在护理过渡方面教育计划的出版物也越来越多。然而，关于学生对护理过渡的体验以及支持或阻碍他们的发送者/接收者沟通的描述有限。为了填补这一空白，作者开展了这项研究，以了解学生在护理过渡方面的体验和看法。
在威斯康星医学院（2010 年）的患者安全专题讨论会上开始时，193 名三年级医学生匿名写下了他们所目睹的与护理过渡相关的关键事件的描述，这些事件引起了强烈的情绪反应。描述包括引起的情绪、临床背景和交换的信息类型。作者使用恒定性比较定性方法分析事件描述。
分析显示，121 名披露情绪反应的医学生中有 111 名（92%）对不成功的过渡有强烈的负面反应，感到沮丧、恼怒、恐惧和愤怒。所有这些负面情绪都与发送者和接收者之间缺乏或沟通不良有关：角色和责任不明确，对患者的医疗过程描述不充分，参与过渡的人员识别不足，对患者需要的描述不完整，以及过渡的原因不明确。
三年级医学生对护理过渡事件的描述显示，强烈的负面情绪和沟通差距的发生率很高，这可能会对患者护理产生不利影响。结果支持课程创新，使学生的需求和经验与安全的患者护理过渡保持一致。
