Mulligan Matthew J, Breviu Amanda B, Hall Sarah K, Stenehjem Karen E, Cioletti Anne C
Associate Professor, Division of General Internal Medicine at the Spencer Fox Eccles School of Medicine at the University of Utah.
Associate Professor, Intermountain Healthcare; Adjunct Assistant Professor, Division of General Internal Medicine, Spencer Fox Eccles School of Medicine at the University of Utah.
MedEdPORTAL. 2024 Dec 31;20:11479. doi: 10.15766/mep_2374-8265.11479. eCollection 2024.
Intervisit care, asynchronous care provided between patient visits, represents an essential part of patient care. Despite the importance of intervisit care, residency programs have not traditionally taught residents how to effectively manage intervisit care within the formal curriculum. We aimed to improve resident preparedness in providing intervisit care with an intervisit workshop.
We developed a 2-hour, small-group, interactive workshop on intervisit care for categorical internal medicine interns at the University of Utah in Fall of 2023. The workshop consisted of a didactic session introducing a novel framework for intervisit care medical decision-making, case-based application, and practical site-specific applications using the electronic health record. We evaluated the workshop with an electronic survey following the session.
Thirty-two internal medicine residents (100% participation rate) participated in the workshop and 26/32 (81%) completed the survey. Residents felt intervisit care education was extremely important (median = 5, interquartile range [IQR] = 1). Residents felt more prepared to provide intervisit care after the workshop (median = 2, IQR = 2, vs. median = 4, IQR = 0; < .001). Residents felt the framework for medical decision-making was helpful (median = 4, IQR = 1).
By employing a framework to guide medical decision-making and guided application, our intervisit care workshop improved residents' perceived preparedness in providing intervisit care for their patients. This workshop addresses a major gap in medical education and can be adapted by other institutions and specialties. Further work is needed to reinforce content and develop metrics of intervisit care.
就诊间隔期护理是患者护理的重要组成部分，指在患者就诊期间提供的非同步护理。尽管就诊间隔期护理很重要，但传统上住院医师培训项目并未在正式课程中教授住院医师如何有效管理就诊间隔期护理。我们旨在通过举办一次就诊间隔期护理工作坊，提高住院医师在提供就诊间隔期护理方面的准备程度。
2023年秋季，我们为犹他大学的内科分类实习生举办了一次为时2小时的小组互动式就诊间隔期护理工作坊。该工作坊包括一个讲授环节，介绍一种用于就诊间隔期护理医疗决策的新颖框架、基于案例的应用以及使用电子健康记录的特定场所实际应用。课程结束后，我们通过电子调查对该工作坊进行了评估。
32名内科住院医师（参与率100%）参加了该工作坊，26/32（81%）完成了调查。住院医师认为就诊间隔期护理教育极其重要（中位数 = 5，四分位间距[IQR] = 1）。工作坊结束后，住院医师感觉自己在提供就诊间隔期护理方面更有准备（中位数 = 2，IQR = 2，而之前中位数 = 4，IQR = 0；P <.001）。住院医师认为医疗决策框架很有帮助（中位数 = 4，IQR = 1）。
通过采用一个框架来指导医疗决策和引导应用，我们的就诊间隔期护理工作坊提高了住院医师为患者提供就诊间隔期护理的感知准备程度。该工作坊弥补了医学教育中的一个重大空白，其他机构和专业可对其进行改编。需要进一步开展工作以强化相关内容并制定就诊间隔期护理的衡量指标。
