scholarly journals Improving Handoffs: Implementing a Training Program for Incoming Internal Medicine Residents

2018 ◽  
Vol 10 (6) ◽  
pp. 698-701 ◽  
Author(s):  
Erica Lescinskas ◽  
Diana Stewart ◽  
Chirayu Shah
2021 ◽  
Author(s):  
Andrew James Caddell ◽  
Edwin Moses Bamwoya ◽  
Andrew Donald Moeller

Abstract Background There has been a paradigm shift in residency training over the last several years wherein Competency by Design (CBD) is being integrated to replace more traditional time-based models of training. The Residency Program Committee (RPC) for the Cardiology training program at Dalhousie University in Halifax, Canada addressed the Transition to Practice stage by approving a trial of adjusting the resident call responsibilities to reflect the transition to CBD curriculum. The goal of this adjustment was three-fold: i. Gradually increase accountability of the senior cardiology resident as they transition to practice; ii. Address a gap in training that allows the senior resident to have a gradual transition to the role of a practicing cardiologist while on call; iii. Allows further evolution of skills and abilities. Methods A survey was administered to the practitioners involved in this competency-based change to the call responsibilities. Surveys were distributed to the final year Cardiology Residents, Staff Cardiologists, and Senior Internal Medicine residents to assess their experience and opinions of the current, competency-based change of the on-call curriculum. The survey consisted of eleven questions, of which, four were assessed on a Likert scale and 3 were yes/no questions. Results Four PGY6 cardiology residents, five senior internal medicine residents and eleven staff cardiologists completed the survey. Amongst those who completed the survey there was agreement that the change to the on-call responsibilities improved cardiology residents’ skills, accountability and preparedness to practice. All groups felt the changes were useful for the cardiology training program. There was mild negative effect of perceived accountability by the internal medicine residents. Conclusion Overall the change in call structure led to improved perceived preparedness to practice amongst the cardiology residents and addressed a gap in the Transition to Practice phase of CBD training. This study provides some evidence to the potential benefit of CBD and specifically in the benefits towards transitioning to practice.


2019 ◽  
Vol 11 (4s) ◽  
pp. 146-151 ◽  
Author(s):  
Simon Ritter ◽  
Jerome Stirnemann ◽  
Jan Breckwoldt ◽  
Hans Stocker ◽  
Manuel Fischler ◽  
...  

ABSTRACT Background Research shows that when patients and health care providers share responsibility for clinical decisions, both patient satisfaction and quality of care increase, and resource use decreases. Yet few studies have assessed how to train residents to use shared decision-making (SDM) in their practice. Objective We developed and evaluated a SDM training program in internal medicine. Methods Senior internal medicine residents from 3 hospitals in Switzerland were assessed shortly before and 2 months after completing a program that included a 2-hour workshop and pocket card use in clinical practice. Encounters with standardized patients (SPs) were recorded and SDM performance was assessed using a SDM completeness rating scale (scores ranging from 0 to 100), a self-reported questionnaire, and SPs rating the residents. Results Of 39 eligible residents, 27 (69%) participated. The mean (SD) score improved from 65 (SD 13) to 71 (SD 12; effect size [ES] 0.53; P = .011). After training, participants were more comfortable with their SDM-related knowledge (ES 1.42, P < .001) and skills (ES 0.91, P < .001), and with practicing SDM (ES 0.96, P < .001). Physicians applied SDM concepts more often in practice (ES 0.71, P = .001), and SPs felt more comfortable with how participants discussed their care (ES 0.44, P = .031). Conclusions The SDM training program improved the competencies of internal medicine residents and promoted the use of SDM in clinical practice. The approach may be of interest for teaching SDM to residents in other disciplines and to medical students.


MedEdPORTAL ◽  
2015 ◽  
Vol 11 (1) ◽  
Author(s):  
Laura Rock ◽  
Nina Gadmer ◽  
Robert Arnold ◽  
David Roberts ◽  
Asha Anandaiah ◽  
...  

2007 ◽  
Vol 30 (4) ◽  
pp. 56
Author(s):  
I. Rigby ◽  
I. Walker ◽  
T. Donnon ◽  
D. Howes ◽  
J. Lord

We sought to assess the impact of procedural skills simulation training on residents’ competence in performing critical resuscitation skills. Our study was a prospective, cross-sectional study of residents from three residency training programs (Family Medicine, Emergency Medicine and Internal Medicine) at the University of Calgary. Participants completed a survey measuring competence in the performance of the procedural skills required to manage hemodynamic instability. The study intervention was an 8 hour simulation based training program focused on resuscitation procedure psychomotor skill acquisition. Competence was criterion validated at the Right Internal Jugular Central Venous Catheter Insertion station by an expert observer using a standardized checklist (Observed Structured Clinical Examination (OSCE) format). At the completion of the simulation course participants repeated the self-assessment survey. Descriptive Statistics, Cronbach’s alpha, Pearson’s correlation coefficient and Paired Sample t-test statistical tools were applied to the analyze the data. Thirty-five of 37 residents (9 FRCPC Emergency Medicine, 4 CCFP-Emergency Medicine, 17 CCFP, and 5 Internal Medicine) completed both survey instruments and the eight hour course. Seventy-two percent of participants were PGY-1 or 2. Mean age was 30.7 years of age. Cronbach’s alpha for the survey instrument was 0.944. Pearson’s Correlation Coefficient was 0.69 (p < 0.001) for relationship between Expert Assessment and Self-Assessment. The mean improvement in competence score pre- to post-intervention was 6.77 (p < 0.01, 95% CI 5.23-8.32). Residents from a variety of training programs (Internal Medicine, Emergency Medicine and Family Medicine) demonstrated a statistically significant improvement in competence with critical resuscitation procedural skills following an intensive simulation based training program. Self-assessment of competence was validated using correlation data based on expert assessments. Dawson S. Procedural simulation: a primer. J Vasc Interv Radiol. 2006; 17(2.1):205-13. Vozenilek J, Huff JS, Reznek M, Gordon JA. See one, do one, teach one: advanced technology in medical education. Acad Emerg Med. 2004; 11(11):1149-54. Ziv A, Wolpe PR, Small SD, Glick S. Simulation-based medical education: an ethical imperative. Acad Med. 2003; 78(8):783-8.


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