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住院医师同行评审过程:内科住院医师培训项目中的一种创新教学模式。

Resident Peer Review Process: An Innovative Teaching Model in an Internal Medicine Residency Program.

作者信息

Malayala Srikrishna V, Qazi Khalid, Vasireddy Deepa, Atluri Paavani

机构信息

Internal Medicine, Temple University Hospital, Philadelphia, USA.

Internal Medicine, State University of New York (SUNY) Buffalo, Buffalo, USA.

出版信息

Cureus. 2021 Mar 21;13(3):e14017. doi: 10.7759/cureus.14017.

Abstract

Introduction Medical peer review is an integral part of the performance improvement process in any hospital. The very first exposure to the peer review process in a physician's career is typically after graduation and when they start practicing as an attending physician. We implemented a "Resident Peer Review Process" training module in our Internal Medicine residency program with an intention to familiarize the residents about peer review. Methods The resident peer review process was implemented over a period of four weeks with the "resident peer review committee" having representation from all three Postgraduate Year (PGY) levels. The committee reviews the cases referred to them over a period of four weeks through a process of weekly meetings and adjudicates the cases. If any deficiency is identified, the committee will provide feedback to the residents involved in the case and presents the educational points identified from the adjudication at the end of the module as a morning report. Results Eighty-nine (89) cases were reviewed through this process over a span of two years. About 77.5% of the cases were identified to have a deficiency. Teaching points were identified and presented in Week 4 meetings in 80.9% of the cases that had a deficiency. The residents provided a positive response and said that the process improved their quality of patient care (98%), professionalism (95%), systems-based practice, practice-based learning (90%), medical knowledge (88%), and interpersonal and communications skills (87%).  Discussion This resident-driven, novel, and innovative model can be a successful teaching methodology for Internal Medicine residents to augment Patient Safety and Quality Improvement and could be implemented in residency programs irrespective of the size and specialty.

摘要

引言

医学同行评审是任何医院绩效改进过程中不可或缺的一部分。医生职业生涯中首次接触同行评审过程通常是在毕业后开始担任主治医师之时。我们在内科住院医师培训项目中实施了一个“住院医师同行评审流程”培训模块,旨在让住院医师熟悉同行评审。

方法

住院医师同行评审流程在四周内实施,“住院医师同行评审委员会”由所有三个研究生年级(PGY)的代表组成。该委员会通过每周会议的流程,在四周时间内对提交给他们的病例进行评审并裁决。如果发现任何不足之处,委员会会向参与该病例的住院医师提供反馈,并在模块结束时将评审中确定的教育要点作为早间报告呈现出来。

结果

在两年时间里,通过这个流程共评审了89个病例。约77.5%的病例被发现存在不足。在80.9%存在不足的病例中,在第4周的会议上确定并呈现了教学要点。住院医师给出了积极反馈,并表示该流程提高了他们的患者护理质量(98%)、专业素养(95%)、基于系统的实践、基于实践的学习(90%)、医学知识(88%)以及人际和沟通技能(87%)。

讨论

这种由住院医师驱动的新颖创新模式可以成为内科住院医师增强患者安全和质量改进的一种成功教学方法,并且可以在住院医师培训项目中实施,无论其规模和专业如何。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b56a/8057285/7d98a21fdc65/cureus-0013-00000014017-i01.jpg

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