Found in transition: Applying milestones to three unique discharge curricula

Abstract

Found in transition: Applying milestones to three unique discharge curriculaIntroduction: A safe and effective transition from hospital to post acute care is a complex and important physician competency. Milestones and Entrustable Professional Activities (EPA) form the new educational rubric in Graduate Medical Education Training. 'A safe and effective discharge from the hospital' is an EPA ripe for educational innovation. Methods: The authors collaborated in a qualitative process called, mapping, to develop a Q-sort exercise to be distributed to participants at an Association for Program Directors in Internal Medicine (APDIM) workshop on milestones for transition of care. We analyzed the Qsort results to rank the milestones in order of priority. We then applied this ranking to 3 innovative transitions of care curricula: Simulation (S), Discharge Clinic Feedback (DCF) and TRACER (T). Results: We collected 55 game boards from faculty units at the APDIM workshop. We report the prioritized milestones by Q-sort from the APDIM workshop. From the total 22 milestones, the simulation innovation identified 5/22 milestones, discharge clinic 9/22 milestones and tracer 7/22 milestones related to the EPA. Milestones identified in each innovation related back to one of the top eight prioritized milestones 75% of the time; thus more frequently than the milestones with lower priority. Discussion: We demonstrated that three unique innovations in transitions of care map to the top prioritized Q-sort milestones related to that EPA. Milestones for competency based assessment can be used to guide the development of innovative curricula in transition of care medicine.

Pediatricians’ perspectives on introducing transitional care into handover between pediatric intensive care units and general wards

“…As such, learning to manage transitions is an essential skill for doctors to master. Previous interventions have taught transitions from hospital to home to a range of learners, from preclinical medical students to attending physicians and allied health professionals [18,[20][21][22] . Most of them found that a clinically oriented curriculum for medical students improved their interdisciplinary collaboration and transitional care knowledge [21,22] .…”

Found in transition: applying milestones to three unique discharge curricula

“…In 2011, the authors presented an Association for Program Directors of Internal Medicine (APDIM) workshop on the transition of care ( Meade, Walsh & Todd, 2011 ) both to describe the individual transitions of care at our institutions and to discuss and collect data on workshop participants’ prioritization of milestones for transitions of care and specifically the EPA, “A safe and effective discharge from the hospital.” After analyzing the Q-sort data, we reflected on our original curricula, using the prioritized milestones as a gold standard to compare and contrast our transition of care program curriculum. This report describes three curricula in the transition of care, the results of the group Q-sort, and the application of the prioritized milestones back to the curricula as a way to compare and contrast curriculum in for training in an EPA.…”