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X+Y 排班对儿科住院医师和教师对教育和患者护理的看法的影响。

Impact of X+Y Scheduling on Pediatric Resident and Faculty Perceptions of Education and Patient Care.

机构信息

Department of Pediatrics (RE Myers), Rainbow Babies and Children's Hospital and Case Western Reserve University School of Medicine, Cleveland, Ohio.

Department of Pediatrics (L Thoreson), The University of Texas at Austin Dell Medical School and Dell Children's Medical Center, Austin, Tex.

出版信息

Acad Pediatr. 2021 Sep-Oct;21(7):1273-1280. doi: 10.1016/j.acap.2021.02.018. Epub 2021 Mar 11.

Abstract

PURPOSE

Traditional half-day per week continuity clinic experiences can lead to fragmented education in both the inpatient and outpatient arenas. Five pediatric residency programs were granted the ability from the ACGME to create X+Y scheduling where residents have continuity clinic in "blocks" rather than half-day per week experiences. The aim of this study is to assess the impact X+Y scheduling has on pediatric resident and faculty perceptions of patient care and other educational experiences.

METHODS

Electronic surveys were sent to residents and faculty of the participating programs both prior to and 12 months after implementing X+Y scheduling. Survey questions measured resident and faculty perception of continuity clinic schedule satisfaction and the impact of continuity clinic schedules on inpatient and subspecialty rotation experiences using a 5-point Likert Scale. Data were analyzed using z-tests for proportion differences for those answering Agree or Strongly Agree between baseline and post-implementation respondents.

RESULTS

Hundred and twenty-six out of 186 residents (68%) responded preimplementation and 120 out of 259 residents (47%) responded post-implementation. 384 faculty members were sent the survey with 51% response pre-implementation and 26% response at 12 months. Statistically significant (P < .05) improvements were noted in resident and faculty perceptions of ability to have continuity with patients and inpatient workflow affected by clinic scheduling.

CONCLUSIONS

From both resident and faculty perspectives, X+Y scheduling may improve several aspects of patient care and education. X+Y scheduling could be considered as a potential option by pediatric residency programs, especially if validated with more objective data.

摘要

目的

传统的每周半天连续性诊所体验可能导致住院和门诊领域的教育碎片化。五个儿科住院医师培训计划获得了 ACGME 的授权,可以创建 X+Y 时间表,让居民以“块”而不是每周半天的方式进行连续性诊所。本研究旨在评估 X+Y 时间表对儿科住院医师和教师对患者护理和其他教育体验的看法的影响。

方法

在实施 X+Y 时间表之前和之后 12 个月,向参与计划的居民和教师发送电子调查。调查问题使用 5 分李克特量表衡量居民和教师对连续性诊所时间表满意度的看法,以及连续性诊所时间表对住院和亚专科轮转体验的影响。对于在基线和实施后回答“同意”或“强烈同意”的回答者,使用 z 检验比较比例差异进行数据分析。

结果

186 名居民中有 126 名(68%)在实施前做出了回应,259 名居民中有 120 名(47%)在实施后做出了回应。向 384 名教师发送了调查,实施前的回应率为 51%,12 个月时的回应率为 26%。居民和教师对能够与患者保持连续性以及诊所排班对住院工作流程的影响的看法都有显著改善(P<.05)。

结论

从住院医师和教师的角度来看,X+Y 时间表可能会改善患者护理和教育的几个方面。X+Y 时间表可能是儿科住院医师培训计划的一个潜在选择,特别是如果有更客观的数据验证。

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