Khan Erin K, Liptzin Deborah R, Baker Joyce, Meier Maxene, Baker Christopher D, Lockspeiser Tai M
Fellow, Department of Pediatrics, Section of Pulmonology and Sleep Medicine, University of Colorado School of Medicine.
Assistant Professor, Department of Pediatrics, Section of Pulmonology and Sleep Medicine, University of Colorado School of Medicine.
MedEdPORTAL. 2021 Jan 7;17:11066. doi: 10.15766/mep_2374-8265.11066.
Medical errors can occur any time resident physicians transition between rotations, especially to unfamiliar areas such as subspecialty pediatrics. To combat this, we created and implemented the pediatric resident education in pulmonary (PREP) boot camp using Kern's six-step approach to curriculum development.
PREP was a 5-hour session with multiple high-yield components held on the first day of each new rotation, aimed to prepare residents to care for complex pulmonary inpatients, including those with tracheostomy and ventilator dependence, asthma, and cystic fibrosis. The curriculum was evaluated at multiple time points through surveys of residents and faculty and two formal resident focus group sessions.
PREP was successfully implemented in July 2018 with continued monthly sessions held. Thirty-five residents participated in the first year. Resident perceived preparedness and confidence in taking call duties increased significantly following PREP. All residents rated PREP as or , the highest ratings possible. Overall, residents preferred active learning strategies. All qualitative data revealed positive effects of PREP. Clinical faculty in the pulmonology division found PREP similarly helpful and felt that PREP better prepared residents to provide care to pulmonary inpatients than our previous model.
Our monthly preparatory boot camp on the first day of residents' inpatient pulmonary rotation has improved resident experience, preparedness, and ability to care for complex pulmonary patients. The curriculum was adjusted in response to feedback to increase hands-on time and interactive sessions. Protected time for residents and active learning strategies were key to success of PREP.
住院医师在不同轮转之间转换时随时可能发生医疗差错，尤其是转到小儿亚专科等不熟悉的领域。为应对这一情况，我们采用克恩的课程开发六步法创建并实施了肺部疾病住院医师培训（PREP）训练营。
PREP是在每次新轮转的第一天举办的为期5小时的课程，包含多个高收益内容，旨在让住院医师为护理复杂的肺部住院患者做好准备，包括那些有气管造口术和呼吸机依赖、哮喘和囊性纤维化的患者。通过对住院医师和教员的调查以及两次正式的住院医师焦点小组会议，在多个时间点对该课程进行了评估。
PREP于2018年7月成功实施，并持续每月举办。第一年有35名住院医师参加。参加PREP后，住院医师对承担值班职责的准备程度和信心显著提高。所有住院医师对PREP的评分均为“优秀”或“良好”，这是可能的最高评分。总体而言，住院医师更喜欢主动学习策略。所有定性数据都显示了PREP的积极效果。肺科临床教员也认为PREP同样有帮助，并觉得与我们之前的模式相比，PREP能让住院医师更好地为肺部住院患者提供护理。
我们在住院医师肺部疾病住院轮转第一天每月举办的预备训练营改善了住院医师的体验、准备程度以及护理复杂肺部患者的能力。根据反馈对课程进行了调整，以增加实践时间和互动环节。为住院医师预留的时间以及主动学习策略是PREP成功的关键。
