Monroe Carell Jr Children's Hospital at Vanderbilt, Nashville, Tennessee
Monroe Carell Jr Children's Hospital at Vanderbilt, Nashville, Tennessee.
Hosp Pediatr. 2020 Dec;10(12):1102-1106. doi: 10.1542/hpeds.2020-0048. Epub 2020 Nov 9.
Conferences are an essential component to resident education. Work hour requirements have led to night rotations, causing residents to miss this important educational experience. To fill this void, many institutions have created night curricula, but few have studied how to implement and sustain it. Our aim was to increase formal nighttime teaching led by upper level residents from 0 to ≥3 times weekly by December of 2018.
After a needs-assessment survey was completed by upper level residents, pediatric night education sessions were established. Upper level residents on wards were responsible for teaching and recording whether nighttime teaching occurred. Data were collected by using this form, and a run chart was used to analyze the data over time. A team of hospitalists, pediatric residency program leadership, and a second-year resident met throughout the project and used the model for improvement.
Data were collected for 84 weeks. Introduction of the education sessions increased teaching occurrences from a baseline of 0 to a median of 1. After several plan, do, study, act cycles, most notably after implementing upper level feedback, special cause variation was achieved and median teaching occurrences increased to 3 times weekly. This was sustained for 32 weeks.
Focused quality improvement methodologies can be used to improve new residency program education. These methods can inform other residency programs how to successfully weave a teaching expectation into their night shifts to provide more learning opportunities in the era of duty hour requirements.
会议是住院医师教育的重要组成部分。工作时间要求导致夜间轮班，使住院医师错过了这一重要的学习机会。为了弥补这一空白，许多机构都开设了夜间课程，但很少有研究如何实施和维持这些课程。我们的目标是在 2018 年 12 月前，将由上级住院医师主导的正式夜间教学增加到每周≥3 次。
在上级住院医师完成需求评估调查后，开设了儿科夜间教育课程。值班的上级住院医师负责教学并记录是否进行了夜间教学。通过使用这种表格收集数据，并使用运行图来分析随时间变化的数据。一组医院医生、儿科住院医师项目领导和一名第二年住院医师在整个项目中合作，并使用改进模型。
收集了 84 周的数据。教育课程的引入使教学次数从基线的 0 次增加到中位数 1 次。在经过几个计划、执行、研究、行动循环后，特别是在实施上级反馈后，特殊原因的变化得到了实现，中位数教学次数增加到每周 3 次。这一情况持续了 32 周。
可以使用集中的质量改进方法来改进新的住院医师项目教育。这些方法可以为其他住院医师项目提供信息，了解如何在工作时间要求的时代，成功地将教学期望融入夜班，为学习提供更多机会。
