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医学教育交接信内容:从医学院到外科住院医师实习——混合方法分析。

Content of an Educational Handover Letter From Medical Schools to Surgery Residencies: A Mixed Method Analysis.

机构信息

J.M. Lipman is professor of surgery, Department of Colorectal Surgery, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio; ORCID: https://orcid.org/0000-0001-6165-0304 .

Y.S. Park is associate professor, Harvard Medical School, and director of health professions education research, Massachusetts General Hospital, Boston, Massachusetts.

出版信息

Acad Med. 2021 Nov 1;96(11S):S136-S143. doi: 10.1097/ACM.0000000000004325.

Abstract

PURPOSE

To identify the content of an educational handover letter from undergraduate to graduate education in General Surgery.

METHOD

Expert consensus was attained on the content of an educational handover letter. A 3-stage Delphi technique was employed with 8 experts in each of 4 stakeholder groups: program directors in general surgery, medical student surgical acting internship or prep course directors, authors of medical student performance evaluations, and current categorical General Surgery residents. Data were collected from April through July 2019. A mixed method analysis was performed to quantitatively assess items selected for inclusion and qualitatively provide guidance for the implantation of such a letter.

RESULTS

All 32 experts participated in at least one round. Of the 285 initially identified individual items, 22 were ultimately selected for inclusion in the letter. All but one expert agreed that the list represents what the content of an educational handover letter in General Surgery should be. Qualitative analysis was performed on 395 comments and identified 4 themes to guide the implementation of the letter: "minimize redundancy, optimize impact, use appropriate assessments, and mitigate risk."

CONCLUSIONS

A framework and proposed template are provided for an educational handover letter from undergraduate to graduate medical education in General Surgery based on the quantitative and qualitative analysis of expert consensus of major stakeholders. This letter holds promise to enhance the transition from undergraduate to graduate medical education by allowing programs to capitalize on strengths and efficiently address knowledge gaps in new trainees.

摘要

目的

确定普通外科本科到研究生教育交接信的内容。

方法

专家就交接信的内容达成共识。采用 3 阶段 Delphi 技术,共有 4 个利益相关者群体的 8 名专家参与:普通外科项目主任、医学生外科实习或预备课程主任、医学生绩效评估作者和现任普通外科住院医师。数据收集于 2019 年 4 月至 7 月。采用混合方法分析,对入选的项目进行定量评估,并为该信的实施提供定性指导。

结果

所有 32 名专家至少参加了一轮。在最初确定的 285 项单独项目中,最终有 22 项被选中纳入信函。除一位专家外,所有专家都认为该清单代表了普通外科交接信的内容。对 395 条评论进行了定性分析,确定了 4 个主题来指导该信的实施:“尽量减少冗余,优化影响,使用适当的评估方法,降低风险”。

结论

基于主要利益相关者的专家共识的定量和定性分析,为普通外科本科到研究生医学教育的交接信提供了框架和建议模板。该信有望通过允许项目利用优势并有效解决新学员的知识差距,促进从本科到研究生医学教育的过渡。

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