Dulay Maya, Laponis Ryan, O'Brien Bridget C, Gupta Reena, Ramanan Radhika A, Julian Katherine
J Grad Med Educ. 2017 Oct;9(5):622-626. doi: 10.4300/JGME-D-16-00696.1.
Providing a robust continuity clinic experience is difficult due to uneven distribution of resident time. Immersion experiences early in training may improve residents' learning experiences.
We designed and implemented a continuity immersion experience to improve internal medicine interns' satisfaction and confidence with their outpatient skills, and we evaluated the timing of the experience and its benefits for learners.
Two cohorts of interns at 1 academic institution participated in a 3-week immersion block (during the first or second quarter of the intern year). Interns were surveyed twice about satisfaction and confidence. Analysis included independent and paired sample tests to compare interns' responses pre- and postimmersion, and to evaluate effects over time.
A total of 124 interns completed the immersion, with a survey response rate of 61%. Interns' self-rated confidence on a 5-point Likert scale improved significantly compared with preimmersion in the areas of medical knowledge and confidence with their electronic health record and communication skills ( ≤ .010 for all assessments). Interns reported high satisfaction with continuity clinic following immersion (cohort 1: 4.5 ± 0.54; cohort 2: 4.3 ± 0.68; on a 5-point scale with 5 = very satisfied). Improvements in knowledge, skills, and satisfaction in cohort 1 were sustained over 3 months.
A 3-week immersion experience in the first 6 months of residency improved interns' confidence in ambulatory content areas and satisfaction with clinic.
由于住院医师时间分配不均,提供丰富的连续性门诊体验较为困难。培训早期的沉浸式体验可能会改善住院医师的学习体验。
我们设计并实施了一项连续性沉浸式体验,以提高内科实习生对门诊技能的满意度和自信心,并评估该体验的时机及其对学习者的益处。
一所学术机构的两批实习生参加了为期3周的沉浸式培训(在实习年的第一季度或第二季度)。实习生就满意度和自信心接受了两次调查。分析包括独立样本和配对样本检验,以比较实习生在沉浸式培训前后的反应,并评估随时间的影响。
共有124名实习生完成了沉浸式培训,调查回复率为61%。与沉浸式培训前相比,实习生在医学知识、电子健康记录和沟通技能方面的自信心在5分制李克特量表上有显著提高(所有评估的P值均≤0.010)。实习生报告称,在沉浸式培训后对连续性门诊的满意度很高(第1组:4.5±0.54;第2组:4.3±0.68;5分制,5表示非常满意)。第1组在知识、技能和满意度方面的改善持续了3个月。
住院医师培训前6个月为期3周的沉浸式体验提高了实习生对门诊内容领域的信心和对门诊的满意度。