Department of Medicine, Veteran's Administration, Greater Los Angeles, CA.
School of Nursing, University of California, Los Angeles, CA.
J Am Assoc Nurse Pract. 2024 Sep 1;36(9):491-500. doi: 10.1097/JXX.0000000000001029.
The One-Minute Preceptor (OMP) model to teach diagnostic reasoning and Reporter, Interpreter, Manager, and Educator (RIME) framework to measure progress are used in physician training. Little is known about the use of these tools in nurse practitioner (NP) training.
Precepting NP trainees at the Veterans Affairs (VA) is not standardized. A standardized approach to precepting NP residency trainees using the OMP model and RIME scoring was evaluated for improvement and helpfulness.
A quality-improvement project with two Plan-Do-Study-Act (PDSA) cycles were conducted over a 12-week period. Mean RIME scores, preceptor self-efficacy, and use of teaching skills were measured preintervention and postintervention. Data were analyzed using a paired sample t -test and descriptive statistics.
A convenience sample of preceptors and trainees was recruited from a large VA medical center. A 1-hour workshop educated preceptors with role playing and return demonstrations on OMP techniques and RIME scoring. The teachings were applied to standardize precepting and assess diagnostic reasoning. Trainee self-scoring and results triggered conversations to fulfil the identified gaps.
Mean RIME scores improved (1.62 [0.17] vs. 2.23 [0.38], p < .001) post 12-week intervention. Mean RIME scores improved between PDSA cycle 1 and cycle 2 (2.07 [0.25] vs. 2.48 [0.39], p < .001). Preceptors (91%) and trainees (100%) found the OMP model and RIME framework helpful.
Use of the OMP improved diagnostic reasoning in NP trainees. The OMP and RIME framework provided standardization of precepting and trainee discussions on improvements.
一分钟导师（OMP）模型用于教授诊断推理，记者、解释者、管理者和教育者（RIME）框架用于衡量进展，这些模型和框架被用于医生培训。然而，关于这些工具在护士从业者（NP）培训中的应用，我们知之甚少。
在退伍军人事务部（VA），对 NP 实习生的指导没有标准化。本研究评估了使用 OMP 模型和 RIME 评分对 NP 住院医师培训进行标准化指导的方法，以提高指导效果并衡量其有用性。
在 12 周的时间内进行了一项包含两个计划-执行-研究-行动（PDSA）周期的质量改进项目。在干预前和干预后测量 RIME 评分、导师自我效能感和教学技能的使用情况。使用配对样本 t 检验和描述性统计分析数据。
从一家大型退伍军人医疗中心招募了便利样本的导师和学员。一个 1 小时的研讨会通过角色扮演和示范 OMP 技术和 RIME 评分，对导师进行了教育。这些教学方法被应用于标准化指导和评估诊断推理。学员自我评分和结果触发了对话，以填补已识别的差距。
干预 12 周后，RIME 评分均值提高（1.62[0.17] vs. 2.23[0.38]，p<.001）。在 PDSA 循环 1 和循环 2 之间，RIME 评分均值提高（2.07[0.25] vs. 2.48[0.39]，p<.001）。91%的导师和 100%的学员认为 OMP 模型和 RIME 框架很有帮助。
使用 OMP 提高了 NP 学员的诊断推理能力。OMP 和 RIME 框架为指导的标准化以及学员讨论改进提供了框架。
