Presentation Description
Sreedhar Radhika1
Ananya Gangopadhyaya1, Asra Khan1, Ana Mauro1, Angie Fanuke1 and Yoon Soo Park1
1 University of Illinois College of Medicine
Ananya Gangopadhyaya1, Asra Khan1, Ana Mauro1, Angie Fanuke1 and Yoon Soo Park1
1 University of Illinois College of Medicine
Background:
One in five patients report adverse events after discharge from the hospital, resulting in greater healthcare utilization. Teaching physicians to safely discharge patients is critical to improve patient safety.
One in five patients report adverse events after discharge from the hospital, resulting in greater healthcare utilization. Teaching physicians to safely discharge patients is critical to improve patient safety.
Summary of Work:
We evaluate an Entrustable Professional Activity (EPA) aligned patient discharge curriculum for fourth-year medical students in internal medicine, administered across three academic years (2020-23). The curriculum integrates self-study didactics, direct observation of discharge, student-led post-discharge phone calls to patients and preceptor-led small group debrief activity.
We evaluate an Entrustable Professional Activity (EPA) aligned patient discharge curriculum for fourth-year medical students in internal medicine, administered across three academic years (2020-23). The curriculum integrates self-study didactics, direct observation of discharge, student-led post-discharge phone calls to patients and preceptor-led small group debrief activity.
Results:
294 students completed the pre- and post-assessments demonstrating significant improvements in knowledge (Cohen’s d = 1.41), skills (Cohen’s d = 1.45), and attitudes (Cohen’s d = 1.16) related to discharge, all P < .001.
294 students completed the pre- and post-assessments demonstrating significant improvements in knowledge (Cohen’s d = 1.41), skills (Cohen’s d = 1.45), and attitudes (Cohen’s d = 1.16) related to discharge, all P < .001.
An EPA-grounded workplace-based assessment tool was used to provide real time feedback on discharge tasks for 291/294 students. Over 75% of students were able to do the following tasks independently: explain major diagnosis, explain alarm symptoms requiring return to hospital (EPA8),elicitconcernsaboutdischargeandhomesupport,andassesspatients’ability to safely take medications (EPA 4).
145/294 students completed post-discharge phone calls and a questionnaire that showed that 95% of patients knew their admitting diagnosis (EPA 8), 93% of patients had a follow up appointment (EPA 9) and 99% patients/caregivers knew what to do if a problem arose (EPA 8).
Discussion
The curriculum demonstrates improved student performance in key areas related to discharge and helps identify student readiness to perform patient care tasks.
Conclusion
A patient-discharge curriculum improves entrustability for fourth-year students in key areas related to patient discharge, which can enhance improvements toward patient safety outcomes.
Take-home messages / implications for further research or practice
Assessing medical student readiness and entrustability for discharge is an important skill which spans several EPAs and is a critical area of assessment to consider for student competence.
References (maximum three)
- Forster, A. J., H. J. Murff, J. F. Peterson, T. K. Gandhi, and D. W. Bates (2003). "The incidence and severity of adverse events affecting patients after discharge from the hospital." Ann Intern Med 138(3): 161-167.
- Forster, A. J., H. D. Clark, A. Menard, N. Dupuis, R. Chernish, N. Chandok, A. Khan, and C. van Walraven (2004). "Adverse events among medical patients after discharge from hospital." CMAJ 170(3): 345-349.