Assistant Professor, Department of Medicine, Baylor College of Medicine.
Associate Professor, Department of Medicine, Baylor College of Medicine; Associate Program Director, Internal Medicine Residency, Baylor College of Medicine.
MedEdPORTAL. 2020 Sep 29;16:10977. doi: 10.15766/mep_2374-8265.10977.
Hospital medicine is a growing field that focuses not only on expertise in inpatient medicine but also on knowledge of nonclinical health system topics. The traditional model for resident education does not lend itself to learning these topics. We developed a unique ward rotation with a dedicated curriculum called the Resident Inpatient Training Experience (RITE) to address this deficiency.
The RITE rotation was initially implemented in the 2013-2014 academic year. The curriculum accompanying the rotation contained four case-based modules that included content on patient safety, quality improvement, cost-conscious care, hospital metrics/reimbursement, physician billing and coding, and transitions of care. Prior to RITE, residents received an email orientation to the service. To evaluate the rotation and curriculum, residents completed a pre- and postrotation online survey. Forty-six upper PGY 2 residents each rotated on the service for 1 month. An experienced hospitalist attended on the service and facilitated a weekly discussion on each module. This publication includes an updated version of the email orientation, the four modules, and the surveys.
There was a 72% response rate for completion of the pre- and postrotation survey. Confidence in managing hospitalized patients and knowledge of module content taught during the rotation improved.
We found that implementation of a hospital medicine rotation and curriculum improved resident independence and knowledge of the module topics and was a successful way to alleviate current deficiencies in resident education.
医院医学是一个不断发展的领域,不仅注重住院医学方面的专业知识,还注重非临床卫生系统相关主题的知识。传统的住院医师教育模式并不适合学习这些主题。我们开发了一种独特的病房轮转模式,并设计了一个名为住院医师培训体验(Resident Inpatient Training Experience,RITE)的专门课程,以解决这一不足。
RITE 轮转最初于 2013-2014 学年实施。伴随轮转的课程包含四个基于案例的模块,涵盖患者安全、质量改进、成本意识护理、医院指标/报销、医生计费和编码以及医疗过渡期管理等内容。在 RITE 之前,住院医师会收到有关该服务的电子邮件介绍。为了评估轮转和课程,住院医师完成了在线预轮转和后轮转调查。46 名住院医师 2 年级的住院医师每人在该服务上轮转 1 个月。一位经验丰富的医院医师在该服务上工作,并每周对每个模块进行讨论。本出版物包括电子邮件介绍、四个模块以及调查的更新版本。
完成预轮转和后轮转调查的比例为 72%。管理住院患者的信心和对轮转期间教授的模块内容的了解有所提高。
我们发现,实施医院医学轮转和课程可以提高住院医师的独立性和对模块主题的了解,是缓解当前住院医师教育不足的成功方法。