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利用基于网络的工具在以家庭为中心的查房中增加体格检查教学。

Increasing Physical Exam Teaching on Family-Centered Rounds Utilizing a Web-Based Tool.

作者信息

Patel Aarti, Unaka Ndidi, Holland Deborah, Schuler Christine, Mangeot Colleen, Sucharew Heidi, Younts Angela, Maag Logan, Treasure Jennifer, Sobolewski Brad, Statile Angela

机构信息

Department of Pediatrics, Rady Children's Hospital, San Diego, Calif.; and Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.

出版信息

Pediatr Qual Saf. 2017 Jun 16;2(4):e032. doi: 10.1097/pq9.0000000000000032. eCollection 2017 Jul-Aug.

Abstract

INTRODUCTION

Millennial trainees prefer innovative, multimodal education on topics including the physical exam (PE). Attendings inconsistently meet these needs on family-centered rounds. To enhance PE teaching, a Web site (PEToolkit) was created, but its use was infrequent. We aimed to increase PEToolkit use from 2 to 5 page counts per week in 7 months.

METHODS

This quality improvement project took place at a large academic center in 1 Hospital Medicine team. Key drivers informed interventions, and an annotated run chart tracked progress. We tracked secondary measures, including changes in perception of teaching skill among attendings and resident-observed methods of PE teaching, through survey methodology.

RESULTS

Median page counts increased to 5 counts per week in 7 months. The most impactful interventions included training senior residents to teach with the PEToolkit Web site and team feedback on Web site usage midweek. Survey responses from 37 attendings showed that those with more exposure to PEToolkit had increased self-perceived skill of PE teaching ( = 0.02). Survey responses from 52 residents showed that those on the intervention team reported more use of video for PE teaching ( < 0.001) and higher frequency of PE teaching ( = 0.02), compared with those on the nonintervention team.

CONCLUSIONS

We increased PEToolkit Web site use during family-centered rounds, thereby emphasizing the importance of PE teaching in this setting in an innovative way. Engagement of learners, frequent feedback, and coaching should be considered when incorporating technology in teaching.

摘要

引言

千禧一代实习生更喜欢关于包括体格检查(PE)在内的主题的创新多模式教育。在以家庭为中心的查房中,主治医生不能始终满足这些需求。为加强体格检查教学,创建了一个网站(PEToolkit),但其使用频率不高。我们的目标是在7个月内将PEToolkit的使用量从每周2页面浏览量提高到5页面浏览量。

方法

这个质量改进项目在一家大型学术中心的1个医院医学团队中进行。关键驱动因素为干预措施提供依据,一份带注释的运行图跟踪进展情况。我们通过调查方法跟踪次要指标,包括主治医生对教学技能认知的变化以及住院医生观察到的体格检查教学方法。

结果

在7个月内,每周页面浏览量中位数增至5次。最具影响力的干预措施包括培训高年资住院医生使用PEToolkit网站进行教学以及团队在周中对网站使用情况的反馈。37名主治医生的调查回复显示,更多接触PEToolkit的人自我感知的体格检查教学技能有所提高(P = 0.02)。52名住院医生的调查回复显示,与非干预组相比,干预组的住院医生报告在体格检查教学中更多使用视频(P < 0.001)且体格检查教学频率更高(P = 0.02)。

结论

我们在以家庭为中心的查房期间增加了PEToolkit网站的使用,从而以创新方式强调了在这种环境下体格检查教学的重要性。在将技术融入教学时,应考虑学习者的参与度、频繁反馈和指导。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/06c9/6132483/51ad547879a1/pqs-2-e032-g001.jpg

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