A Paging Training Program for a Fourth-Year Internship Readiness Course

Abstract

Introduction New medical interns face a steep learning curve as they must manage complex medical scenarios, many of which they have only seen before in a classroom setting. To ameliorate these challenges, medical schools are increasingly including courses designed to address the transition from student to doctor. One of the biggest challenges for new interns is learning to triage and manage nursing pages, so we designed a mock paging program incorporated within our fourth-year transitions course. Methods We developed a database of clinical scenarios to occur via telephone between a nurse and a medicine intern. Throughout the 2-week course, these cases were administered to 40 fourth-year medical students by Master's level nursing students and nurse evaluators. The nurses used checklists to evaluate medical student management and communication, and at the end of the phone encounter students received immediate feedback. We used an observational prospective design, using a within subjects method with repeated measures. Results Data from a total of 216 phone calls were analyzed for 36 students. No statistically significant improvement of checklist scores was observed. Substantial interrater reliability was observed for the four observed cases with a Fleiss-Kappa of .76. Student comments indicated the activity was helpful for preparing them to answer pages. Discussion Our paging program offered students the chance to simulate being on call, as well as the opportunity to receive immediate feedback. It did not show improvement in checklists across time. Limitations included a small sample size and few common variables across the cases.

A scoping review of remote facilitation during simulation-based healthcare education

“…There was one qualitative study [ 4 ]. Among others, seven articles used a mixed methods design, including a quantitative design as a major approach with qualitative data collection such as a focus group interview [ 14 , 29 ], survey comments [ 7 , 30 – 32 ], and audiovisual recorded comments [ 33 ]. Reviewers evaluated the quality of these mixed methods articles using a JBI checklist for quantitative designs if the primary technique was quantitative.…”

“…The number of learners varied by type of simulation and the duration of the curriculum, from 11 [ 29 ] in an avatar-based virtual continuing medical education (CME) workshop to 305 [ 5 ] in a statewide mandatory course offered year-round. The most common areas of professional expertise among learners were medical [ 6 , 7 , 10 , 14 , 17 – 19 , 29 , 33 – 42 ], nursing [ 11 , 31 , 43 ], multi-professional [ 4 , 5 , 13 , 44 ], interprofessional [ 30 , 32 ], and dental [ 45 ]. One study [ 46 ] reported on an educational intervention for research coordinators.…”

“…One study [ 46 ] reported on an educational intervention for research coordinators. The most common learner levels were students [ 5 – 7 , 10 , 11 , 14 , 17 , 31 – 33 , 37 , 38 , 41 , 42 ], while other learners were professionals who had completed professional school or other higher education and had practical experience, such as medical specialists [ 18 , 19 , 29 , 30 , 35 ], medical residents [ 34 , 39 , 40 ], nursing staff [ 43 , 44 ], research coordinators [ 46 ], or post-graduate students [ 4 , 5 , 13 ].…”

“…Simulation topics for which remote facilitation was applied were very diverse. There were simulations for skills training [ 10 , 13 , 17 , 18 , 34 , 35 , 38 , 39 , 41 , 44 , 45 ], scenario-based simulations that included all or part of patient evaluation, diagnosis, and treatment [ 4 – 7 , 11 , 31 , 37 , 40 , 42 ], In addition, there were simulations for interviewing patients or family members [ 29 , 46 ], answering pages [ 33 , 36 ], telehealth practice [ 31 ], medical records documentation [ 14 ], and interprofessional team training [ 30 , 32 ]. Simulations focused on technical skills only [ 13 , 17 , 19 , 34 , 38 , 39 , 41 , 47 ] (n = 8), non-technical skills (NTS), such as leadership, communication, teamwork, situation awareness and decision making, only [ 4 – 6 , 10 , 11 , 30 – 33 , 36 , 40 , 42 , 46 ] (n = 13), and mixed (technical and non-technical) domains [ 7 , 14 , 18 , 29 , 35 , 37 , 44 ] (n = 8).…”

Preparing Interns as Teachers: Teaching Fourth-Year Medical Students the Tenets of the One-Minute Preceptor Model

“…These courses often focus on discrete clinical skills such as answering pages, postacute care, handoff, end-of-life care, and so on. 2 – 7 As these courses have grown nationally, a TTR Compendium began in 2023 to house TTR resources used in different courses. 8 As with the other TTR content currently published, the compendium focuses on clinical skills like cross-cover, informed consent, and delivering serious news.…”