Dang Nathan V, Pon Tiffany K, Hellier Yvette M
University of California, San Francisco, CA, USA.
University of California, Davis Health, Sacramento, CA, USA.
Hosp Pharm. 2022 Aug;57(4):425-434. doi: 10.1177/00185787211066458. Epub 2022 Jan 19.
To describe pharmacy resident perspectives on the layered learning practice model (LLPM) at large academic medical centers in the United States and identify the types of training residents receive to prepare for the LLPM. This was a cross-sectional, mixed methods study that surveyed pharmacy residents completing training at large, academic medical centers on their perspectives of the LLPM. Residents with at least 4 weeks of precepting experience were eligible to complete an online survey. Descriptive statistics were generated for demographic and Likert data while themes were identified from narrative free responses. Twenty-seven resident responses from 10 institutions were included. Likert data showed generally positive perspectives toward overall experience with the LLPM and perceived LLPM impact on clinical knowledge and professional practice, with 100.0% of respondents agreeing they enjoyed precepting under the LLPM. However, 44.4% also agreed that precepting was stressful. LLPM impact on resident behavior received positive to neutral responses; 63.0% neither agreed nor disagreed that the LLPM changed their approach to patient care. Written comments revealed themes such as sources of stress within the LLPM, increased depth of learning, improved comprehensive patient care, and improved professional growth. The most common forms of LLPM training occurred through preceptor and student evaluations (73.1% and 61.5%, respectively) and orientation (50.0%). These findings identified a variety of resident perspectives on the LLPM ranging from positive to negative and revealed possible areas of improvement related to LLPM implementation. Residency programs may consider exploring stressors on the resident role in the LLPM to better structure resident precepting training and maximize their clinical learning experience.
描述美国大型学术医疗中心药学住院医师对分层学习实践模式(LLPM)的看法,并确定住院医师为准备LLPM所接受的培训类型。这是一项横断面混合方法研究,调查了在大型学术医疗中心完成培训的药学住院医师对LLPM的看法。有至少4周带教经验的住院医师有资格完成在线调查。对人口统计学和李克特数据进行描述性统计,同时从无叙述性回复中确定主题。纳入了来自10个机构的27名住院医师的回复。李克特数据显示,对LLPM的总体体验以及LLPM对临床知识和专业实践的感知影响普遍持积极态度,100.0%的受访者表示他们喜欢在LLPM下带教。然而,44.4%的人也认为带教压力很大。LLPM对住院医师行为的影响得到了积极到中性的回应;63.0%的人既不同意也不反对LLPM改变了他们的患者护理方法。书面评论揭示了诸如LLPM内部的压力源、学习深度增加、综合患者护理改善和职业成长改善等主题。LLPM培训最常见的形式是通过带教老师和学生评估(分别为73.1%和61.5%)以及入职培训(50.0%)。这些发现确定了住院医师对LLPM的各种看法,从积极到消极,并揭示了与LLPM实施相关的可能改进领域。住院医师培训项目可能会考虑探索LLPM中住院医师角色的压力源,以更好地构建住院医师带教培训并最大化他们的临床学习体验。