Division of Hematology-Oncology, Department of Medicine, Indiana University School of Medicine, 535 Barnhill Dr., RT 473, Indianapolis, IN, 46202, USA.
Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA.
J Cancer Educ. 2022 Dec;37(6):1768-1772. doi: 10.1007/s13187-021-02025-y. Epub 2021 May 14.
Interest in an oncology career has decreased among internal medicine residents completing an inpatient hematology-oncology rotation. Over years, our institutional data at Indiana University School of Medicine reflected lower satisfaction with the oncology inpatient ward rotation as compared to other rotations. We hypothesized that a switch from an inpatient ward rotation to a hybrid model of inpatient consultations and outpatient clinics would improve resident satisfaction with their educational experience in oncology. Over the 6-month periods preceding and following the change in rotation format, residents were asked to complete anonymous rotation evaluations and rate their experiences on a 5-point Likert scale (poor 1 to excellent 5). Areas assessed included patient load, educational value of patient mix, quality of didactics and teaching, quality of patient care delivery, adequacy of time for reading, and overall rotation quality. The hybrid oncology rotation was rated as significantly superior to the traditional ward format in six out of eight areas including patient load, educational value of patient mix, time for study, teaching quality, relevance of material, and overall rating. Improvements in the perceived quality of patient care delivery (p = 0.139) and quality of didactics (p = 0.058) were also observed without reaching statistical significance. The balance of inpatient and outpatient experiences with the hybrid rotation was highly rated (4.5 ± 0.5). The implementation of a hybrid oncology rotation was associated with perceived improvement in educational value, patient mix, and time for reflection and study without apparent compromise in the quality of patient care delivery.
对肿瘤学职业的兴趣在内科住院医师完成血液学-肿瘤学住院轮转后有所下降。多年来，我们在印第安纳大学医学院的机构数据反映出，与其他轮转相比，住院肿瘤病房轮转的满意度较低。我们假设，将住院病房轮转改为住院会诊和门诊相结合的混合模式，将提高住院医师对肿瘤学教育体验的满意度。在轮转模式改变前后的 6 个月期间，住院医师被要求完成匿名轮转评估，并对他们的体验在 5 分制的李克特量表上进行评分（差 1 到优秀 5）。评估的领域包括患者负荷、患者组合的教育价值、教学质量和教学、患者护理交付质量、阅读时间的充足性以及整体轮转质量。混合肿瘤学轮转在六个方面中的六个方面被评为明显优于传统病房模式，包括患者负荷、患者组合的教育价值、学习时间、教学质量、材料相关性和整体评分。在感知到的患者护理交付质量（p=0.139）和教学质量（p=0.058）方面也观察到了改善，但没有达到统计学意义。混合轮转中患者护理交付质量（p=0.139）和教学质量（p=0.058）的感知质量的改善也得到了观察，但没有达到统计学意义。混合轮转中住院和门诊体验的平衡得到了高度评价（4.5±0.5）。混合肿瘤学轮转的实施与教育价值、患者组合以及反思和学习时间的感知改善相关，而患者护理交付质量似乎没有受到影响。
