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内科-儿科住院医师培训项目中“Y”排班制的量化结果:第一年数据

Quantitative Outcomes of "Y" Scheduling in an Internal Medicine-Pediatrics Residency Program: First Year Data.

作者信息

Friedland Allen R, Divatia Himani, Eldridge Justin, Maguire Michael, Hastry Chelsea, Chua Alex, Nichols Justin, Anttila Ashley, Donnelly John

机构信息

Internal Medicine-Pediatrics, ChristianaCare, Newark, USA.

Pediatrics, Nemours Children's Health, Wilmington, USA.

出版信息

Cureus. 2025 Jan 19;17(1):e77675. doi: 10.7759/cureus.77675. eCollection 2025 Jan.

Abstract

Introduction Scheduling resident continuity clinic sessions and outpatient education in Internal Medicine-Pediatrics (Med-Peds) residency programs pose challenges. A minority of Med-Peds programs have switched to an "X + Y" schedule (each in weeks) specifically to separate inpatient rotations and other experiences ("X" schedule) from resident continuity clinics and other outpatient longitudinal clinical and educational experiences ("Y" schedule). Outside of focus groups, quantitative data from Med-Peds residents on overall and specific satisfaction with an outpatient "Y" schedule and its specific components have not been published. We analyzed our inception year (2022-2023) Med-Peds residents' satisfaction after transitioning to a new "Y" block of outpatient education and clinical experiences in an average-sized Med-Peds program. Methods In July 2022, the "X + Y" schedule was introduced into both our Med-Peds and Pediatrics residency programs with a "6 + 2" (each in weeks) frequency upon an existing "4 + 2" (each in weeks) frequency for Internal Medicine. All Med-Peds residents (n=18) were electronically surveyed at the end of the academic year on the general "Y" schedule, continuity clinics, other outpatient clinical experiences, academic half days, administrative time, patient management skills, and the ability to make personal appointments to support wellness. Results All Med-Peds residents (n=18) were highly satisfied/satisfied with their new "Y" schedule (4.7/5) and 92% (12/13) of the postgraduate year (PGY) 2-4 felt much better/slightly better with this schedule template compared to their previous outpatient education design (4.8/5). Clinical outpatient experiences (including continuity clinic), comfort in roles/responsibilities, interest in primary care, administrative time, desktop management, and the ability to make personal appointments to support wellness were highest rated (≥ 4.0/5.0). The Med-Peds residents' favorite "Y" session was "Cohort Time", an Academic Half Day with their Med-Peds "Y" cohort colleagues for group learning and socialization. Conclusions Despite its complexities, the introduction of the "X + Y" schedule with "Y" continuity clinics and outpatient education dissociated from inpatient and other rotations in our Med-Peds residency program has been widely accepted and highly rated by residents. There has only been the need for minimal modifications for subsequent years.

摘要

引言

在内科 - 儿科(Med - Peds)住院医师培训项目中安排住院医师连续性门诊课程和门诊教育存在挑战。少数Med - Peds项目已转向“X + Y”时间表(各以周计),专门将住院轮转和其他经历(“X”时间表)与住院医师连续性门诊以及其他门诊纵向临床和教育经历(“Y”时间表)分开。除了焦点小组讨论外,尚未发表来自Med - Peds住院医师关于对门诊“Y”时间表及其具体组成部分的总体和特定满意度的定量数据。我们分析了我们项目起始年(2022 - 2023年)Med - Peds住院医师在一个中等规模的Med - Peds项目中过渡到新的门诊教育和临床经历的“Y”模块后的满意度。

方法

2022年7月,“X + Y”时间表被引入我们的Med - Peds和儿科住院医师培训项目,内科在现有的“4 + 2”(各以周计)频率基础上变为“6 + 2”(各以周计)频率。在学年结束时,对所有Med - Peds住院医师(n = 18)进行电子调查,内容涉及一般的“Y”时间表、连续性门诊、其他门诊临床经历、学术半天、行政时间、患者管理技能以及安排个人预约以促进健康的能力。

结果

所有Med - Peds住院医师(n = 18)对他们新的“Y”时间表高度满意/满意(4.7/5),并且与之前的门诊教育设计相比,92%(12/13)的二年级至四年级住院医师(PGY)觉得采用这个时间表模板后感觉好多了/稍微好些(4.8/5)。临床门诊经历(包括连续性门诊)、角色/职责的舒适度、对初级保健的兴趣、行政时间、桌面管理以及安排个人预约以促进健康的能力获得的评分最高(≥ 4.0/5.0)。Med - Peds住院医师最喜欢的“Y”时段是“群组时间”,即与他们的Med - Peds“Y”群组同事一起进行小组学习和社交的学术半天。

结论

尽管存在复杂性,但在我们的Med - Peds住院医师培训项目中引入将“Y”连续性门诊和门诊教育与住院及其他轮转分开的“X + Y”时间表已被住院医师广泛接受并获得高度评价。后续年份只需进行最少的修改。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/abec/11835468/55b899c399d0/cureus-0017-00000077675-i01.jpg

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