Discharge summary training curriculum: a novel approach to training medical students how to write effective discharge summaries

Ming, David; Zietlow, Kahli; Song, Yao; Lee, Hui‐Jie; Clay, Alison S.

doi:10.1111/tct.12960

Cited by 12 publications

(8 citation statements)

References 12 publications

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“…Medical student education about discharge documentation was recently investigated. 26 This study found that students felt more prepared and confident in their abilities to write discharge summaries, and that they would alter the way they write discharge summaries when they graduated. To expand on this, a PDSA-designed survey completed by junior doctors at induction found that a minority had any formal discharge summary teaching and felt that teaching would be of benefit to them.…”

Section: Discussionmentioning

confidence: 81%

Improving the quality of discharge summaries through a direct feedback system

Earnshaw

Pedersen

Evans

et al. 2020

Future Healthcare Journal

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Introduction There is a recognised need to improve the quality of discharge documentation to facilitate the safe and effective ongoing care of patients once they leave hospital. Previous studies have focused on individual interventions, such as teaching or feedback. Our continuous quality improvement project aims to improve the quality of discharge documentation at our hospital by providing a comprehensive overhaul of the education and feedback around discharge documentation. Methods We designed a comprehensive data analysis tool to analyse the performance of our discharge summaries. We presented at clinical governance sessions and arranged numerous teaching sessions for junior doctors. We developed a livefeedback system based on the content of a sample set of the previous month's summaries, which included poster-based feedback and group teaching. Results Our interventions have significantly improved the quality of our discharge documentation across a broad range of categories, including the summary of the stay, actions for general practitioners and information given to patients in lay terminology. Conclusion Our comprehensive quality improvement project has improved the quality of our discharge documentation. Further work aims to expand this project into a regional setting, as well as designing a strategy to maintain engagement of key stakeholders to ensure continued progress.

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Section: Discussionmentioning

confidence: 81%

Improving the quality of discharge summaries through a direct feedback system

Earnshaw

Pedersen

Evans

et al. 2020

Future Healthcare Journal

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“…Students tended to overestimate their achieved performance level in comparison to the rating given by experts. One study that compared expert ratings for one EPA did not show significant differences between entrustment ratings of experts [48].…”

Section: Entrustment Ratings and Summative Assessmentsmentioning

confidence: 96%

“…There was an overall heterogeneity with regard to reported educational outcome measures for EPA-based clinical curricula. Assessment methods included written knowledge-based tests [41,48], a combination of these tests with workplace-based assessments [42], and summative and time-variable entrustment and progression decisions [30]. The articles we found addressed the assessment of EPAs primarily within a clinical rotation.…”

Section: Epa Assessment In Clinical Rotations In Umementioning

confidence: 99%

Working with entrustable professional activities in clinical education in undergraduate medical education: a scoping review

et al. 2021

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Background Entrustable professional activities (EPAs) are increasingly used in undergraduate medical education (UME). We conducted a scoping review to summarize the evidence for the use of EPAs in clinical rotations in UME. Methods We searched multiple databases for scoping reviews based on the PRISMA guidelines for articles reporting qualitative and quantitative research, as well as conceptual and curriculum development reports, on EPAs in UME clinical rotations. Results We identified 3309 records by searching through multiple databases. After the removal of duplicates, 1858 reports were screened. A total of 36 articles were used for data extraction. Of these, 47% reported on EPA and EPA-based curriculum development for clerkships, 50% reported on implementation strategies, and 53% reported on assessment methods and tools used in clerkships. Validity frameworks for developing EPAs in the context of clerkships were inconsistent. Several specialties reported feasible implementation strategies for EPA-based clerkship curricula, however, these required additional faculty time and resources. Limited exposure to clinical activities was identified as a barrier to relevant learning experiences. Educators used nationally defined, or specialty-specific EPAs, and a range of entrustability and supervision scales. We found only one study that used an empirical research approach for EPA assessment. One article reported on the earlier advancement of trainees from UME to graduate medical education based on summative entrustment decisions. Conclusions There is emerging evidence concerning how EPAs can be effectively introduced to clinical training in UME. Specialty-specific, nested EPAs with context-adapted, entrustment-supervision scales might be helpful in better leveraging their formative assessment potential.

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“…IPPs were also unable to undergo formal training on the use of the evaluation tool; therefore, IPP ratings may be prone to greater variability when compared to advisors. Furthermore, senior internal medicine residents were eligible to provide feedback, and they themselves may not have received formal training on authoring discharge summaries, further contributing to variability [6]. In the future, limiting participating IPPs to supervisory attending physicians and PAs, as well as providing standardized training for IPPs, will help to standardize feedback, although there are many logistical barriers to overcome.…”

Section: Limitationsmentioning

confidence: 99%

“…In physician education, there is limited literature describing efforts to train medical students and/or house staff to write discharge summaries. In our previous work, we found that discharge summaries prepared by fourth-year medical students demonstrated frequent errors and omissions, emphasizing the need for early, standardized education [6]. Published curricula have been feasible to implement and improved trainees' competence; however, programs have struggled with sustainability and delivery of personalized feedback [6][7][8][9].…”

Section: Introductionmentioning

confidence: 99%

A novel curriculum to train physician assistant students how to write effective discharge summaries

Zietlow

Gillum²,

Stouder

et al. 2019

Medical Education Online

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Background: Physician assistants (PAs) are an integral part of inpatient care teams, but many PAs do not receive formal education on authoring discharge summaries. High-quality discharge summaries can mitigate patient risk during transitions of care by improving interprovider communication. Objective: To understand the current state of discharge summary education at our institution, and describe a novel curriculum to teach PA students to write effective discharge summaries. Design: Students completed a pre-survey to assess both knowledge and comfort levels regarding discharge summaries. They wrote a discharge summary and received feedback from two evaluators, an inpatient provider (IPP) familiar with the described patient and a simulated primary care provider (PCP). Students completed a post-survey reassessing knowledge and comfort. Results: Prior to instituting this curriculum, the majority of students (92.9%) reported rarely or never receiving feedback on discharge summaries. Eighty-four of 88 (95.5%) eligible students participated. There was discordance between IPP and simulated PCP feedback on their assessment of the quality of discharge summaries; simulated PCPs gave significantly lower global quality ratings (7.9 versus 8.5 out of 10, p = 0.006). Key elements were missing from >10% of discharge summaries. Student response was favorable. Conclusion: Clinically relevant deficiencies were common in students' discharge summaries, highlighting the need for earlier, structured training. IPPs and simulated PCPs gave discordant feedback, emphasizing differing needs of different providers during transitions of care. This novel curriculum improved students' knowledge and confidence.

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Discharge summary training curriculum: a novel approach to training medical students how to write effective discharge summaries

Cited by 12 publications

References 12 publications

Improving the quality of discharge summaries through a direct feedback system

Improving the quality of discharge summaries through a direct feedback system

Working with entrustable professional activities in clinical education in undergraduate medical education: a scoping review

A novel curriculum to train physician assistant students how to write effective discharge summaries

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