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评估旨在使医学生为撰写出院小结做准备的教育干预措施:文献快速回顾。

An evaluation of educational interventions aimed at preparing medical students for discharge summary writing: a rapid review of the literature.

机构信息

University of Exeter Medical School, Exeter, UK.

出版信息

Ir J Med Sci. 2021 May;190(2):523-530. doi: 10.1007/s11845-020-02325-0. Epub 2020 Jul 28.

Abstract

Whilst discharge summaries are important for ensuring patient continuity of care, they often lack important information. Medical students and newly qualified doctors have attributed this to insufficient teaching, thereby indicating a need to improve discharge summary education within the undergraduate medical curriculum. The aim was to review educational approaches used to prepare undergraduate medical students for discharge summary writing, and their effectiveness Medline and Scopus were systematically searched using keywords, for studies published between 2009 and 2019. Narrative synthesis was used to integrate the findings of the included studies. Study quality was appraised using the Medical Education Research Study Quality Instrument. Six studies were included in this review. Allowing students to write a discharge summary following a real patient encounter and receive written feedback was the most common educational approach used (n = 4). Three of these studies improved student attitudes towards discharge summary writing. One study described the use of a mobile application, which improved discharge summary quality. Another study utilized interprofessional learning but the effect was statistically insignificant. Medical Education Research Study Quality Instrument scores were satisfactory (mean = 12, range = 8.4-15). The literature concerning this topic is limited. The results indicate that providing written feedback to students can positively influence attitudes towards discharge summary writing. Optimisation of the quality of discharge summaries written by medical students using feedback and checklists requires further investigation, as does the use of interprofessional learning. Future studies would additionally benefit from including participant baseline data and control groups, being multicentred and measuring behavioural or patient/healthcare outcomes.

摘要

虽然出院小结对于确保患者的连续护理很重要,但它们往往缺乏重要信息。医学生和刚毕业的医生将此归因于教学不足,这表明需要在本科医学课程中加强出院小结教育。目的是回顾用于培训本科医学生撰写出院小结的教育方法及其效果。使用关键词在 Medline 和 Scopus 上进行了系统搜索,以查找 2009 年至 2019 年期间发表的研究。使用叙述性综合法综合纳入研究的结果。使用医疗教育研究研究质量工具评估研究质量。本综述纳入了 6 项研究。最常见的教育方法是让学生在真实患者就诊后撰写出院小结并获得书面反馈(n=4)。其中 3 项研究改善了学生对撰写出院小结的态度。一项研究描述了使用移动应用程序来提高出院小结质量。另一项研究则利用了跨专业学习,但效果无统计学意义。医疗教育研究研究质量工具的分数令人满意(平均 12 分,范围 8.4-15 分)。关于这个主题的文献有限。结果表明,向学生提供书面反馈可以积极影响他们对撰写出院小结的态度。使用反馈和检查表来优化医学生撰写的出院小结的质量,需要进一步调查,跨专业学习也是如此。未来的研究还将受益于纳入参与者的基线数据和对照组、多中心研究以及衡量行为或患者/医疗结果。

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