Ortiz Michael, Ottolini Mary, Agrawal Dewesh
Pediatric Hematology/Oncology Fellow, Memorial Sloan-Kettering Cancer Center.
Pediatric Hematology/Oncology Fellow, New York Presbyterian-Weill Cornell Medical Center.
MedEdPORTAL. 2016 Jul 8;12:10424. doi: 10.15766/mep_2374-8265.10424.
Residents at most institutions change rotations every 2 to 4 weeks. It often takes significant time for residents to become acclimated to the different protocols, expectations, and environments of each unique rotation. As a result, residents often spend time searching for answers, time that could be spent in outside learning and direct patient care. The goal of this resource is to provide a novel guidebook that improves residents' efficiency and knowledge of best patient care practices.
The guidebook begins with an introductory chapter with key contact information that can be filled in for the user's institution, which is followed by 16 rotation-specific chapters. A rotation-based approach was chosen as it focuses the content on the most pertinent information. Thus, trainees can quickly read a chapter to cover the most pertinent content for their current rotation. As a surrogate marker for efficiency, noon-conference attendance logs were queried to assess improvement in on-time attendance after introduction of the guidebook.
After introduction of the learning resources, on-time arrival to noon conference improved for all residents and interns. Guidebook survey results were universally favorable; however, around half of respondents stated that they used the guidebook once or less per rotation.
Underutilization of these resources potentially contributed to the lack of a statistically significant improvement overall. Future directions should focus on augmenting the quality and utilization of the guidebook and then reevaluating if, once well adopted, there is a sustained benefit.
大多数机构的住院医师每2至4周更换一次轮转科室。住院医师通常需要花费大量时间来适应每个独特轮转科室的不同方案、期望和环境。因此,住院医师常常把时间花在寻找答案上,而这些时间本可以用于课外学习和直接的患者护理。本资源的目标是提供一本新颖的指南手册,以提高住院医师的效率,并增进他们对最佳患者护理实践的了解。
该指南手册开篇是一个介绍性章节,其中包含可填写用户所在机构关键联系信息的内容,随后是16个针对各轮转科室的章节。之所以选择基于轮转科室的方法,是因为它将内容聚焦于最相关的信息。这样,学员们可以快速阅读一个章节,以涵盖其当前轮转科室最相关的内容。作为效率的替代指标,查询了午间会议出勤记录,以评估指南手册推出后准时出勤情况的改善。
在引入学习资源后,所有住院医师和实习生午间会议的准时到达率都有所提高。指南手册的调查结果普遍良好;然而,约一半的受访者表示,他们每轮转科室使用指南手册的次数为一次或更少。
这些资源利用不足可能是总体上缺乏统计学显著改善的原因。未来的方向应侧重于提高指南手册的质量和利用率,然后在其被充分采用后重新评估是否有持续的益处。