Garber Adam M, Ownby Allison R, Trimble Gregory, Aiyer Meenakshy K, Brown David R, Grbic Douglas
Department of Internal Medicine, Virginia Commonwealth University School of Medicine, 1200 East Broad Street, PO Box 980102, Richmond, VA 23298-0102 USA.
Office of Educational Programs, McGovern Medical School at UTHealth, Houston, TX USA.
Med Sci Educ. 2022 Jul 16;32(4):855-864. doi: 10.1007/s40670-022-01578-x. eCollection 2022 Aug.
"Giving or receiving a patient handover to transition patient care responsibility" is one of the thirteen Core Entrustable Professional Activities (Core EPAs) for Entering Residency. However, implementing a patient handover curriculum in undergraduate medical education (UME) remains challenging. Educational leaders in the multi-institutional Core EPA8 pilot workgroup developed a longitudinal patient handover UME curriculum that was implemented at two pilot institutions.
We utilized multi-school graduation questionnaire data to assess the association of our patient handover curriculum on self-reported frequency of observation/feedback and skill acquisition by comparing data from the shared curriculum schools to data from other Core EPA pilot schools (three schools with school-specific curriculum; five without a dedicated handover curriculum). Questionnaire data from 1,278 graduating medical students of the class of 2020 from all ten Core EPA pilot schools were analyzed.
Graduates from the two medical schools that implemented the shared patient handover curriculum reported significantly greater frequency of handover observation/feedback compared to graduates at the other schools (school-specific curriculum ( < .05) and those without a handover curriculum ( < .05)). Graduates from the two shared approach schools also more strongly agreed that they possessed the skill to perform handovers compared to graduates from the other eight pilot schools that did not implement this curriculum.
The findings of this study suggest that the implementation of a multi-institutional Core EPA-based curricular model for teaching and assessing patient handovers was successful and could be implemented at other UME institutions.
“进行患者交接以转移患者护理责任”是进入住院医师阶段的十三项核心可托付专业活动(核心EPA)之一。然而,在本科医学教育(UME)中实施患者交接课程仍然具有挑战性。多机构核心EPA8试点工作组的教育领导者制定了一项纵向患者交接UME课程,并在两个试点机构实施。
我们利用多所学校的毕业调查问卷数据,通过比较共享课程学校的数据与其他核心EPA试点学校(三所具有学校特定课程的学校;五所没有专门交接课程的学校)的数据,来评估我们的患者交接课程与自我报告的观察/反馈频率和技能获取之间的关联。对来自所有十所核心EPA试点学校的2020届1278名毕业医学生的问卷数据进行了分析。
与其他学校(学校特定课程(<0.05)和没有交接课程的学校(<0.05))的毕业生相比,实施共享患者交接课程的两所医学院的毕业生报告的交接观察/反馈频率显著更高。与未实施该课程的其他八所试点学校的毕业生相比,来自两所采用共享方法学校的毕业生也更强烈地认同他们具备进行交接的技能。
本研究结果表明,基于多机构核心EPA的课程模型用于教学和评估患者交接的实施是成功的,并且可以在其他UME机构实施。