Bruckel Jeffrey, Carballo Victoria, Kalibatas Orinta, Soule Michael, Wynne Kathryn E, Ryan Megan P, Shaw Tim, Co John Patrick T
Edward Lawrence Center for Quality and Safety, Massachusetts General Hospital, Boston, Massachusetts, USA.
Quality, Safety, and Value Division, Partners HealthCare, Boston, Massachusetts, USA.
Postgrad Med J. 2016 Mar;92(1085):137-44. doi: 10.1136/postgradmedj-2015-133446. Epub 2016 Jan 6.
Quality, patient safety and value are important topics for graduate medical education (GME). Spaced education delivers case-based content in a structured longitudinal experience. Use of spaced education to deliver quality and safety education in GME at an institutional level has not been previously evaluated.
To implement a spaced education course in quality, safety and value; to assess learner satisfaction; and to describe trainee knowledge in these areas.
We developed a case-based spaced education course addressing learning objectives related to quality, safety and value. This course was offered to residents and fellows about two-thirds into the academic year (March 2014) and new trainees during orientation (June 2014). We assessed learner satisfaction by reviewing the course completion rate and a postcourse survey, and trainee knowledge by the per cent of correct responses.
The course was offered to 1950 trainees. A total of 305 (15.6%) enrolled in the course; 265/305 (86.9%) answered at least one question, and 106/305 (34.8%) completed the course. Fewer participants completed the March programme compared with the orientation programme (42/177 (23.7%) vs 64/128 (50.0%), p<0.001). Completion rates differed by specialty, 80/199 (40.2%) in non-surgical specialties compared with 16/106 (24.5%) in surgical specialties (p=0.008). The proportion of questions answered correctly on the first attempt was 53.2% (95% CI 49.4% to 56.9%). Satisfaction among those completing the programme was high.
Spaced education can help deliver and assess learners' understanding of quality, safety and value principles. Offering a voluntary course may result in low completion. Learners were satisfied with their experience and were introduced to new concepts.
质量、患者安全和价值是毕业后医学教育（GME）的重要主题。间隔式教育在结构化的纵向体验中提供基于案例的内容。此前尚未对在机构层面使用间隔式教育在GME中开展质量和安全教育进行评估。
实施一门关于质量、安全和价值的间隔式教育课程；评估学习者满意度；并描述学员在这些领域的知识。
我们开发了一门基于案例的间隔式教育课程，涉及与质量、安全和价值相关的学习目标。该课程在学年约三分之二时间（2014年3月）提供给住院医师和研究员，在迎新培训期间（2014年6月）提供给新学员。我们通过审查课程完成率和课程后调查来评估学习者满意度，并通过正确回答的百分比来评估学员知识。
该课程面向1950名学员。共有305人（15.6%）报名参加该课程；265/305人（86.9%）至少回答了一个问题，106/305人（34.8%）完成了课程。与迎新培训课程相比，参加3月课程的完成人数较少（42/177人（23.7%）对64/128人（50.0%），p<0.001）。完成率因专业而异，非外科专业为80/199人（40.2%），而外科专业为16/106人（24.5%）（p=0.008）。首次尝试时正确回答问题的比例为53.2%（95%可信区间49.4%至56.9%）。完成该课程的学员满意度较高。
间隔式教育有助于传授和评估学习者对质量、安全和价值原则的理解。提供一门自愿参加的课程可能导致完成率较低。学习者对他们的体验感到满意，并接触到了新的概念。
