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优化值班放射科住院医师学习障碍——端到端基于 Web 的住院医师反馈系统。

Minimizing Barriers in Learning for On-Call Radiology Residents-End-to-End Web-Based Resident Feedback System.

机构信息

Department of Radiology, MedStar Georgetown University Hospital, Washington, DC, USA.

Georgetown University School of Medicine, Washington, DC, USA.

出版信息

J Digit Imaging. 2018 Feb;31(1):117-123. doi: 10.1007/s10278-017-0015-1.

Abstract

Feedback is an essential part of medical training, where trainees are provided with information regarding their performance and further directions for improvement. In diagnostic radiology, feedback entails a detailed review of the differences between the residents' preliminary interpretation and the attendings' final interpretation of imaging studies. While the on-call experience of independently interpreting complex cases is important to resident education, the more traditional synchronous "read-out" or joint review is impossible due to multiple constraints. Without an efficient method to compare reports, grade discrepancies, convey salient teaching points, and view images, valuable lessons in image interpretation and report construction are lost. We developed a streamlined web-based system, including report comparison and image viewing, to minimize barriers in asynchronous communication between attending radiologists and on-call residents. Our system provides real-time, end-to-end delivery of case-specific and user-specific feedback in a streamlined, easy-to-view format. We assessed quality improvement subjectively through surveys and objectively through participation metrics. Our web-based feedback system improved user satisfaction for both attending and resident radiologists, and increased attending participation, particularly with regards to cases where substantive discrepancies were identified.

摘要

反馈是医学培训的重要组成部分,在培训过程中,受训者会收到关于其表现的信息以及进一步改进的方向。在诊断放射学中,反馈需要详细审查住院医师初步解释与主治医生最终解释影像研究之间的差异。虽然独立解释复杂病例的随叫随到经验对住院医师教育很重要,但由于多种限制,更传统的同步“读出”或联合审查是不可能的。如果没有一种有效的方法来比较报告、评分差异、传达重要的教学要点和查看图像,那么在图像解释和报告构建方面就会失去宝贵的经验。我们开发了一个简化的基于网络的系统,包括报告比较和图像查看,以最大限度地减少主治放射科医生和随叫随到的住院医师之间异步通信的障碍。我们的系统以简化、易于查看的格式实时、端到端地提供特定于病例和特定于用户的反馈。我们通过调查和参与度指标从主观和客观两方面评估质量改进。我们的基于网络的反馈系统提高了主治放射科医生和住院医师的用户满意度,并增加了主治医生的参与度,尤其是在发现实质性差异的情况下。

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