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学术半天制提高住院医师对教育的认知,同时不影响患者安全。

Academic Half Day Improves Resident Perception of Education Without Compromising Patient Safety.

机构信息

Department of Pediatrics, Albert Einstein College of Medicine, Children's Hospital at Montefiore, New York, NY.

Department of Pediatrics, Albert Einstein College of Medicine, Children's Hospital at Montefiore, New York, NY.

出版信息

Acad Pediatr. 2024 Aug;24(6):1010-1016. doi: 10.1016/j.acap.2024.02.007. Epub 2024 Feb 17.

Abstract

BACKGROUND

Residency programs are required to offer a didactic curriculum and protect resident time for education. Our institution implemented an academic half day (AHD) in the 2021-2022 academic year to address issues related to the standard noon conference series.

OBJECTIVE

Determine the impact of AHD implementation on education, patient safety, and workflow.

METHODS

This was a prospective, single-site educational intervention study. Pre- and post-implementation surveys and Accreditation Council for Graduate Medical Education (ACGME) surveys assessed changes in trainee and faculty attitudes and behaviors. Patient safety and workflow were evaluated by comparing the number of safety event reports, rapid response team activations, time to admission from the ED, and time of discharge on AHD days compared to other weekdays.

RESULTS

Survey response rates were: residents 68%/48%, fellows 42%/35%, and faculty 59%/29%. AHD was associated with a significant, positive change in resident attitudes and experiences and on ACGME survey items. On AHDs compared with other weekdays, there were no significant differences in safety event report rates (P = .98), nor in rapid response team activation rates (P = .99). There was not a clinically meaningful difference in median admission time from the ED on AHD weekdays (125 minutes) compared to other weekdays (130 minutes, P = .04). There was no significant difference in median discharge time on AHD vs other weekdays (P = .13).

CONCLUSIONS

This study suggests that there is no significant difference in patient safety or workflow with the implementation of AHD. This study supports prior studies that residents strongly prefer AHD. AHD may be a useful framework for resident education without compromising patient care.

摘要

背景

住院医师培训计划必须提供理论课程并保障住院医师的教育时间。为了解决与标准午休会议系列相关的问题,我们机构在 2021-2022 学年实施了半天学术日程(AHD)。

目的

确定实施 AHD 对教育、患者安全和工作流程的影响。

方法

这是一项前瞻性、单站点教育干预研究。在实施前后进行调查和住院医师医学教育认证委员会(ACGME)调查,评估学员和教师态度和行为的变化。通过比较 AHD 日与其他工作日的安全事件报告数量、快速反应团队激活次数、从急诊到入院的时间以及出院时间,评估患者安全和工作流程。

结果

调查的回复率分别为:住院医师 68%/48%,研究员 42%/35%,教师 59%/29%。AHD 与住院医师态度和经验以及 ACGME 调查项目的显著积极变化相关。与其他工作日相比,AHD 日的安全事件报告率(P=0.98)和快速反应团队激活率(P=0.99)没有显著差异。AHD 日和其他工作日的 ED 入院时间中位数(125 分钟)没有明显差异(P=0.04)。AHD 日和其他工作日的出院时间中位数没有显著差异(P=0.13)。

结论

本研究表明,实施 AHD 对患者安全或工作流程没有显著影响。本研究支持先前的研究,即住院医师强烈倾向于 AHD。AHD 可能是一种有用的住院医师教育框架,而不会影响患者护理。

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