Fishman Claire E, Sommers Thomas, Bennett Nadia L, Cohen Margot E
Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
Department of Medicine, Massachusetts General Hospital, Boston, MA, USA.
Med Teach. 2024 Apr;46(4):486-488. doi: 10.1080/0142159X.2023.2292980. Epub 2023 Dec 17.
Frequent transitions between core clinical rotations in medical school increase anxiety and cognitive load. Few formalized programs exist to ease these transitions. Our institutional needs-assessment found that approximately 85% of students believed that additional rotation-specific information prior to starting a new rotation would reduce anxiety and increase success.
We developed a novel web-based peer-to-peer handoff tool available to all clerkship students at a single, large academic institution. The tool contains the names and contact information of students who most recently completed rotations on each service for all clerkships. A handoff checklist was also created with suggested discussion points for handoffs. Students were encouraged to schedule a handoff 1-2 weeks before starting a new rotation.
Overall, 83 students (66%) utilized the handoff tool, with use and efficacy decreasing with time during the clinical year. Of tool users, 65% expressed that having access to the tool prior to starting a new rotation helped to reduce anxiety, and 74% felt that the information gained helped to ease transitions. Our peer-to-peer handoff tool may help students feel more prepared to start a new rotation, decrease anxiety during clerkship year, and ease transitions.
This low-resource intervention may be implemented at other institutions to provide students with equal opportunities to receive valuable information prior to starting new rotations, regardless of pre-existing peer connections. An automated update system, which we are implementing at our institution, could greatly decrease the time required to maintain a handoff tool and improve sustainability.
医学院核心临床轮转之间频繁转换会增加焦虑和认知负担。很少有正式的项目来缓解这些过渡。我们的机构需求评估发现,大约 85%的学生认为,在开始新的轮转之前提供额外的特定轮转信息,会减轻焦虑并提高成功率。
我们为单一大型学术机构的所有实习学生开发了一种新颖的基于网络的、点对点的交接工具。该工具包含了最近完成每个服务轮转的学生的姓名和联系方式,涵盖了所有实习科室。还创建了一份交接清单,其中包含了交接的建议讨论要点。学生们被鼓励在开始新的轮转前 1-2 周安排交接。
总体而言,有 83 名学生(66%)使用了交接工具,随着临床学年的推移,使用和效果逐渐减少。在工具使用者中,65%表示在开始新的轮转之前可以访问该工具,这有助于减轻焦虑,74%的人认为获得的信息有助于顺利过渡。我们的点对点交接工具可能有助于学生在开始新的轮转时感到更有准备,减轻实习年的焦虑,并顺利过渡。
这个低资源的干预措施可以在其他机构实施,为学生在开始新的轮转之前提供获得有价值信息的平等机会,而不受预先存在的同伴关系的影响。我们机构正在实施的自动更新系统可以大大减少维护交接工具所需的时间,并提高可持续性。