Background: Resident physicians at teaching hospitals write many discharge summaries (DCSs), but receive little formal training or feedback. Poor DCS quality poses a potential patient safety risk. Methods: We developed a curriculum to train fourth-year medical students (MS4s) how to write DCSs and integrated this curriculum into a transition-to-residency course. An inpatient attending physician (IPA) and non-inpatient physician (coach) used structured tools to assess for the presence of key elements within the DCS, evaluate the overall quality of the DCS, and Resident physicians at teaching hospitals are expected to independently author [discharge summaries] DCSs, yet few receive formal training *Drs Ming and Zietlow are co-first authors.
This study explored employees behavior flexibility, status, and independence value as vital factors of employee creativity. Based on the theory of interaction creativity, we theorize the core factors, synergistic effects, and substitution effects of employee creativity. This paper adopted a qualitative approach using a self-administrated survey to collect data. Data were collected from 380 Chinese employees via an online and offline survey. The results contribute to creativity literature and expand the study on employee’s creativity performance. Moreover, it opens the black box of employee creativity from a new insight by exploring the effects of human resource flexibility and work values. The paper suggests that to obtain innovation and organizational sustainability, companies should not only advocate human resource flexibility management but also combine the work values of employees.
Background
Clinical education across the professions is challenged by a lack of recognition for faculty and pressure for patient throughput and revenue generation. These pressures may reduce direct observation of patient care provided by students, a requirement for both billing student-involved services and assessing competence. These same pressures may also limit opportunities for interprofessional education and collaboration.
Methods
An interprofessional group of faculty collaborated in a sequential quality improvement project to identify the best patients and physical location for a student teaching clinic. Patient chief complaint, use of resources, length of stay, estimated severity of illness and student participation and evaluation of the clinic was tracked.
Results
Clinic Optimization and Patient Care: Five hundred and thirty-two emergency department (ED) patients were seen in the first 19 months of the clinic. A clinic located near the ED allowed for patients with higher emergency severity index and greater utilization of imaging. Patients had similar or lower lengths of stay and higher satisfaction than patients who remained in the ED (p < 0.0001). In the second clinic location, from October 2016–June 2019, 644 patients were seen with a total of 667 concerns; the most common concern was musculoskeletal (50.1%).
Student Interprofessional Experience: A total of 991 students participated in the clinic: 68.3% (n = 677) medical students, 10.1% (n = 100) physician assistant students, 9.7% (n = 96) undergraduate nursing students, 9.1% (n = 90) physical therapy students, and 2.8% (n = 28) nurse practitioner students. The majority (74.5%, n = 738) of student participants worked with students from other professions. More than 90% of students reported that faculty set a positive learning environment respectful of students. However, 20% of students reported that faculty could improve provision of constructive feedback.
Direct Observation: Direct observation of core entrustable professional activities for medical students was possible. Senior medical students were more likely to be observed generating a differential diagnosis or management plan than first year medical students.
Conclusions
Creation of a DOCENT clinic in the emergency department provided opportunities for interprofessional education and observation of student clinical skills, enriching student experience without compromising patient care.
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