Gillen Jacob R, Ramirez Adriana G, Farineau Diane W, Hoke Tracey R, Schirmer Bruce D, Williams Michael D, Lau Christine L
Department of Surgery, University of Virginia Health System, Charlottesville, Virginia.
Department of Surgery, University of Virginia Health System, Charlottesville, Virginia.
J Surg Educ. 2016 Nov-Dec;73(6):1052-1059. doi: 10.1016/j.jsurg.2016.05.017. Epub 2016 Jun 29.
Meaningful education of residents in systems-based practice is notoriously challenging, despite its recognition as 1 of the 6 Accreditation Council for Graduate Medical Education core competencies. To address this challenge, surgery residents and other members of the health care team were organized into interdisciplinary workgroups that were tasked with developing solutions to "systems issues" confronted on a daily basis. The project's goals included providing more meaningful, hands-on educational experience for residents in system-based practice, while also generating practical solutions to workflow issues through interprofessional collaboration.
Project participants included all surgery residents at the University of Virginia in Charlottesville, VA, as well as surgical health care professionals across all disciplines. Participants were organized into workgroups. Over the course of 3 sessions, each of 1-hour, each workgroup identified commonly encountered systems issues, chose 1 issue to address, and determined an implementable solution for this issue. In total, 140 participants were divided among 13 workgroups.
Workgroup topics ranged from improving paging etiquette to standardizing interdisciplinary communication. In total, 9 of the 13 proposals have been piloted or fully implemented as standard practice at our institution, either within a single unit or over the entire health system.
This project demonstrates an innovative approach toward resident education in system-based practice, providing residents with a hands-on experience in problem solving from a systems perspective. These interdisciplinary workgroups generated effective solutions to issues that were meaningful to frontline health care providers. Interdisciplinary collaboration within the workgroups served as a valuable team-building exercise to improve relations between the disciplines. This project can serve as a model for other institutions desiring meaningful education in the Accreditation Council for Graduate Medical Education competency of systems-based practice.
尽管基于系统的实践被公认为毕业后医学教育认证委员会的六大核心能力之一，但对住院医师进行有意义的此类教育极具挑战性。为应对这一挑战，外科住院医师和医疗团队的其他成员被组织成跨学科工作组，负责为日常面临的“系统问题”制定解决方案。该项目的目标包括为住院医师提供更有意义的、亲身体验的基于系统的实践教育，同时通过跨专业协作生成解决工作流程问题的实际方案。
项目参与者包括弗吉尼亚大学夏洛茨维尔分校的所有外科住院医师以及所有学科的外科医疗专业人员。参与者被组织成工作组。在3次每次1小时的会议过程中，每个工作组确定常见的系统问题，选择1个问题加以解决，并为该问题确定一个可实施的解决方案。总共140名参与者被分配到13个工作组中。
工作组的主题从改善传呼礼仪到规范跨学科沟通不等。在我们机构，13项提案中有9项已在单个科室或整个医疗系统内作为标准做法进行了试点或全面实施。
该项目展示了一种针对基于系统的实践中住院医师教育的创新方法，为住院医师提供了从系统角度解决问题的亲身体验。这些跨学科工作组针对对一线医疗服务提供者有意义的问题生成了有效的解决方案。工作组内的跨专业协作是一次宝贵的团队建设活动，有助于改善各学科之间的关系。该项目可为其他希望在毕业后医学教育认证委员会基于系统的实践能力方面开展有意义教育的机构提供一个范例。
