Medicine, University of Washington School of Medicine, Seattle, Washington, USA
Medicine, Veterans Affairs Puget Sound Heathcare System, Seattle, Washington, USA.
BMJ Open Qual. 2023 Mar;12(1). doi: 10.1136/bmjoq-2022-002176.
The COVID-19 pandemic necessitated increased synchronous distance education (SDE) in graduate medical education, presenting challenges for Quality Improvement and Patient Safety (QIPS) best practices, which call for integration with daily clinical care and investigation of real patient safety events.
To evaluate educational outcomes for QIPS training after conversion of a mature, in-person curriculum to SDE.
68 postgraduate year (PGY)-1 residents were surveyed before and after the SDE Culture of Patient Safety training in June 2020, and 59 PGY-2s were administered the Quality Improvement Knowledge Application Tool-Revised (QIKAT-R) before and after the SDE QIPS seminar series in July-August 2020. Values before and after training were compared using sign tests for matched pairs (PGY-1) and Wilcoxon signed-rank tests (PGY-2).
100% (68 of 68) of PGY-1s and 46% (27 of 59) of PGY-2s completed precourse and postcourse surveys. Before the course, 55 PGY-1s (81%) strongly agreed that submitting patient safety event reports are a physician's responsibility, and 63 (93%) did so after (15% increase, p=). For PGY-2s, the median composite QIKAT-R score was 17 (IQR 14.5-20) before and 22.5 (IQR 20-24.5) after the seminars, with a median difference of 4.5 (IQR 1.5-7), a 32% increase in QIPS competency (p=0.001).
Patient safety attitudes and quality improvement knowledge increased after SDE QIPS training at comparable levels to previously published results for in-person training, supporting SDE use in future hybrid curricula to optimise educational value and reach.
COVID-19 大流行促使研究生医学教育中增加同步远程教学(SDE),这给质量改进和患者安全(QIPS)最佳实践带来了挑战,这些实践需要将其与日常临床护理相结合,并调查真实的患者安全事件。
评估将成熟的面对面课程转换为 SDE 后,QIPS 培训的教育效果。
2020 年 6 月,在 SDE 患者安全文化培训前后,对 68 名住院医师-1 级(PGY-1)学员进行了调查;2020 年 7-8 月,在 SDE QIPS 研讨会系列前后,对 59 名住院医师-2 级(PGY-2)学员进行了质量改进知识应用工具修订版(QIKAT-R)的测试。使用配对符号检验(PGY-1)和 Wilcoxon 符号秩检验(PGY-2)比较培训前后的数值。
100%(68/68)的 PGY-1 级学员和 46%(27/59)的 PGY-2 级学员完成了课前和课后调查。在课程开始前,55 名 PGY-1 级学员(81%)强烈认为提交患者安全事件报告是医生的责任,而在课程结束后,有 63 名(93%)学员这样做(增加了 15%,p=)。对于 PGY-2 级学员,课前 QIKAT-R 综合评分中位数为 17(IQR 14.5-20),课后为 22.5(IQR 20-24.5),中位数差值为 4.5(IQR 1.5-7),QIPS 能力提高了 32%(p=0.001)。
SDE QIPS 培训后,患者安全态度和质量改进知识有所提高,与之前面对面培训的结果相当,支持在未来的混合课程中使用 SDE,以优化教育价值和覆盖面。