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Care transitions curricula at emory. Manuel A. Eskildsen, MD, MPH, CMD. “Use of a Virtual Classroom in Training Fourth-Year Medical Students on Care Transitions”. J Hosp Med 2011 Fourth-year medical students at Emory Part of “Senior Medicine” rotation
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Care transitions curricula at emory Manuel A. Eskildsen, MD, MPH, CMD
“Use of a Virtual Classroom in Training Fourth-Year Medical Students on Care Transitions” • J Hosp Med 2011 • Fourth-year medical students at Emory • Part of “Senior Medicine” rotation • All medical students taking rotation between August 2009 and April 2010
Course Description • Mix of in-person lectures, online activities, and patient care • Activities are complementary to their medicine subinternship • Two in-person meetings: one at beginning, other at end of rotation
Result Highlights • Confidence and knowledge improved from pre- to post-test • Attitudes did not change • 90% of students met criteria for appropriateness of discharge summaries • 97.5% of students rated course “good” or better
Lessons Learned • Students were most appreciative of learning real-life skills, like discharge summaries • Minimized daily interruption for students on busy clinical rotation • One way of introducing “stealth geriatrics” • Measuring impact on patient care will need to wait
Internal Medicine Resident Curriculum • Started in July 2010 • Charged by the Dept. of Medicine to create a curriculum by creating a “Care Transitions Task Force” • 7 members: • 5 general internists (mostly hospitalists) • 2 geriatricians • Focused not just on discharge transitions, but also on handovers
Curricular content • Started with intern orientation • Plenary talk • Small group workshops • Plenary presentation to residents • Development of pocket card for residents
Ongoing training • Training on discharge summaries (Emory Hospital) • Two meetings with residents • Feedback on their discharge summaries • Training on Hospital Handovers (VA, EUH Midtown) • Residents observed at least once doing handover • Receive feedback
Challenges – Work Remaining • So far, pilots at individual hospitals • By including residents, we are changing clinical practice • Faculty buy-in is key • Work for other types of transitions: • ER to floor • Discharges to Post-acute care