Ambalavanan Manoj, Love James S, Lv Nan, Goodman Colin, Olsen Conner M, Mikolajczyk Adam E
Department of Internal Medicine, University of Illinois Chicago.
Department of Medicine, University of Illinois Chicago.
Am J Med Open. 2025 Mar 18;14:100099. doi: 10.1016/j.ajmo.2025.100099. eCollection 2025 Dec.
The transition from a postgraduate year (PGY)-1 resident to a PGY-2 resident is often stressful for trainees. Despite various preparatory efforts, the lack of hands-on experiences remains a challenge. In response, we developed the "Step-Up" curriculum, allowing PGY-1 residents to assume the senior resident role in a supervised environment.
During the final blocks of the 2021-2023 academic years, categorical PGY-1 residents divided into eligible and ineligible groups for the "Step-Up" curriculum. Preliminary, off-service and transition-year residents were excluded from the study. Eligible participants were those who rotated on inpatient or specialty wards and received a rubric outlining senior residents' best practices to encourage self-reflection and feedback from supervising attendings and senior residents. The ineligible group were residents that rotated on critical care or outpatient rotations and served as the control group. Pre- and postcurriculum surveys, with 19 Likert-scale questions (rated 1 [strongly disagree] to 5 [strongly agree]), were administered. Two-sample Wilcoxon rank-sum tests compared ordinal measures between the intervention and control groups.
Of 76 residents, 49 (64.5%) were in the intervention group and 27 (35.5%) were in the control group. No significant differences in survey responses were noted before the curriculum. Following it, participants displayed increased confidence in various competencies compared to nonparticipants. "Step-Up" participants also felt significantly more confident transitioning to the senior resident role. Of the 42 completing the curriculum, 39 (93%) agreed that the curriculum facilitated their transition.
Our study highlights the effectiveness of a hands-on curriculum where PGY-1 residents assume the senior resident role, offering a satisfying experience and enhancing comfort with the role and specific competencies. This novel approach addresses challenges in the PGY-1 to PGY-2 transition, providing valuable insights for medical education programs.
从第一年住院医师（PGY-1）过渡到第二年住院医师（PGY-2）对实习生来说往往压力很大。尽管做出了各种准备努力，但缺乏实践经验仍然是一个挑战。作为回应，我们开发了“逐步提升”课程，让PGY-1住院医师在监督环境中承担高级住院医师的角色。
在2021 - 2023学年的最后几个阶段，分类的PGY-1住院医师被分为符合和不符合“逐步提升”课程资格的两组。初步住院医师、非在职住院医师和过渡年住院医师被排除在研究之外。符合条件的参与者是那些在内科或专科病房轮转并收到一份概述高级住院医师最佳实践的评分标准的人，以鼓励自我反思以及来自指导主治医师和高级住院医师的反馈。不符合条件的组是在重症监护或门诊轮转的住院医师，作为对照组。进行了课程前和课程后的调查，有19个李克特量表问题（评分从1[强烈不同意]到5[强烈同意]）。两样本Wilcoxon秩和检验比较了干预组和对照组之间的有序测量值。
76名住院医师中，49名（64.5%）在干预组，27名（35.5%）在对照组。课程前在调查回复中未发现显著差异。课程结束后，与未参与者相比，参与者在各种能力方面表现出更高的信心。“逐步提升”课程的参与者在过渡到高级住院医师角色时也明显更有信心。在完成课程的42人中，39人（93%）同意该课程促进了他们的过渡。
我们的研究强调了让PGY-1住院医师承担高级住院医师角色的实践课程的有效性，提供了令人满意的体验，并增强了对该角色和特定能力的舒适度。这种新颖的方法解决了PGY-1到PGY-2过渡中的挑战，为医学教育项目提供了有价值的见解。
