a Department of Medicine, Division of Geriatrics, Duke University Medical Center , Durham , NC , USA.
b Department of Medicine, Division of General Internal Medicine, Hospital Medicine Programs, DUMC , Durham , NC , USA.
Med Educ Online. 2019 Dec;24(1):1648944. doi: 10.1080/10872981.2019.1648944.
: Physician assistants (PAs) are an integral part of inpatient care teams, but many PAs do not receive formal education on authoring discharge summaries. High-quality discharge summaries can mitigate patient risk during transitions of care by improving inter-provider communication. : To understand the current state of discharge summary education at our institution, and describe a novel curriculum to teach PA students to write effective discharge summaries. : Students completed a pre-survey to assess both knowledge and comfort levels regarding discharge summaries. They wrote a discharge summary and received feedback from two evaluators, an inpatient provider (IPP) familiar with the described patient and a simulated primary care provider (PCP). Students completed a post-survey reassessing knowledge and comfort. : Prior to instituting this curriculum, the majority of students (92.9%) reported rarely or never receiving feedback on discharge summaries. Eighty-four of 88 (95.5%) eligible students participated. There was discordance between IPP and simulated PCP feedback on their assessment of the quality of discharge summaries; simulated PCPs gave significantly lower global quality ratings (7.9 versus 8.5 out of 10, p = 0.006). Key elements were missing from >10% of discharge summaries. Student response was favorable. : Clinically relevant deficiencies were common in students' discharge summaries, highlighting the need for earlier, structured training. IPPs and simulated PCPs gave discordant feedback, emphasizing differing needs of different providers during transitions of care. This novel curriculum improved students' knowledge and confidence.
: 医师助理（PAs）是住院患者护理团队的重要组成部分，但许多 PAs 并未接受过撰写出院小结的正规教育。高质量的出院小结可以通过改善医护人员之间的沟通来降低患者在转院过程中的风险。: 为了了解我们机构中出院小结教育的现状，并描述一种新颖的课程，以教授 PA 学生撰写有效的出院小结。: 学生们完成了一项预调查，以评估他们在出院小结方面的知识和舒适度。他们写了一份出院小结，并从两位评估者那里得到了反馈，一位是熟悉所描述患者的住院提供者（IPP），另一位是模拟的初级保健提供者（PCP）。学生们在完成调查后再次评估了他们的知识和舒适度。: 在实施本课程之前，大多数学生（92.9%）报告很少或从未收到过出院小结的反馈。88 名符合条件的学生中有 84 名（95.5%）参与了课程。IPP 和模拟 PCP 对出院小结质量的评估存在分歧；模拟 PCP 给出的总体质量评分明显较低（10 分制下分别为 7.9 分和 8.5 分，p = 0.006）。超过 10%的出院小结中存在关键内容缺失。学生的反应是积极的。: 学生的出院小结中存在明显的临床相关缺陷，这凸显了早期进行结构化培训的必要性。IPP 和模拟 PCP 提供了不一致的反馈，强调了在转院过程中不同提供者的不同需求。这种新颖的课程提高了学生的知识和信心。
