Alhusain Rashid, Saini Astha, Minhas Hersimren, Ahmed Ahmed K, Bishop Patrick, Osman Baraa, Khan Hajra, Adam Omeralfaroug, Weinberger Jarrett J, Levine Diane L
Internal Medicine, Detroit Medical Center, Michigan, USA.
Internal Medicine, Wayne State University School of Medicine, Detroit, USA.
Cureus. 2024 Jan 11;16(1):e52126. doi: 10.7759/cureus.52126. eCollection 2024 Jan.
Interns experience challenges in their transition from medical school to residency. Orientation is traditionally delivered by faculty and administrators and often does not address practical skills needed by interns during the transition.
The objective is to address traditional orientation gaps and improve incoming interns' transition experience. Methods: We identified opportunities with our intern orientation using a quality improvement methodology. Plan Do Study Act (PDSA) cycle 1 consisted of a pilot boot camp. PDSA cycle 2 was conducted over two weeks, June 9-23, 2021, at the Detroit Medical Center, Detroit, MI. Participation was voluntary. Residents were assigned incoming interns on a 1:1 basis. Five virtual sessions were conducted addressing: daily workflow, documentation, presentation skills, and utilization of the Electronic Health Record (EHR). All participants received pre- and post-program surveys. Results: Twenty-two rising second- and third-year residents (26%) and 22 incoming interns (58%) participated. There was a significant improvement in the understanding of daily workflow (mean improvement 0.957, p=0.003), and most tasks associated with EHR including comfort with the sign-out process (mean improvement 1.21; p=0.002), accessing specific team lists (mean improvement 1.75, p=0.001), writing orders (mean improvement 1.41; p=0.002), composing documentation (mean improvement 1.23; p=0.001). Writing notes improved significantly (mean improved by 0.52; p=0.04). Nearly all (93.2%) stated the program achieved its overall goals and believed (92.9%) the program should be continued for incoming intern classes.
A targeted orientation bootcamp led by near-peers positively impacted the intern experience improving understanding of day-to-day responsibilities and comfort utilizing the electronic health record.
实习生在从医学院过渡到住院医师阶段时会遇到挑战。传统上,入职培训由教员和管理人员进行,往往没有涉及实习生过渡期间所需的实践技能。
旨在弥补传统入职培训的不足,改善新入职实习生的过渡体验。
我们采用质量改进方法确定了实习生入职培训的机会。计划-执行-研究-改进(PDSA)循环1包括一个试点新兵训练营。PDSA循环2于2021年6月9日至23日在密歇根州底特律的底特律医疗中心进行了两周。参与是自愿的。住院医师与新入职实习生按1:1分配。举办了五次虚拟课程,内容包括:日常工作流程、文档记录、演示技能以及电子健康记录(EHR)的使用。所有参与者都接受了培训前和培训后的调查。
22名即将升入二年级和三年级的住院医师(26%)和22名新入职实习生(58%)参与了培训。对日常工作流程的理解有显著改善(平均改善0.957,p = 0.003);与电子健康记录相关的大多数任务也有改善,包括对交接班流程的熟悉程度(平均改善1.21;p = 0.002)、访问特定团队列表(平均改善1.75,p = 0.001)、书写医嘱(平均改善1.41;p = 0.002)、撰写文档(平均改善1.23;p = 0.001)以及书写病历记录有显著改善(平均改善0.52;p = 0.04)。几乎所有(93.2%)参与者表示该项目实现了总体目标,并认为(92.9%)该项目应该继续面向新入职实习生班级开展。
由同龄人主导的有针对性的入职培训新兵训练营对实习生体验产生了积极影响;提高了他们对日常职责以及使用电子健康记录的熟悉程度。