A Curriculum to Improve Pediatric Residents' Telephone Triage Skills

Abstract

Introduction Telephone triage systems are frequently used due to their success in decreasing emergency department utilization, reduction of health care costs, and high levels of satisfaction among patients and providers. Despite phone triage's prevalence, few residency programs have designated curricula for residents to learn this vital skill. Methods We designed a phone triage curriculum initially piloted with senior residents at one of our continuity clinics. The curriculum consisted of a didactic session, a just-in-time simulation training session, and an experiential component of being on call during the ambulatory rotation. Retrospective pre-post self-assessments evaluated resident perceptions of their skills in taking histories and triaging care over the phone in addition to obtaining qualitative feedback from faculty and residents immediately after the curriculum and 1–2 years postgraduation. Results Of 11 eligible residents, 10 (91%) chose to participate in the pilot curriculum. Residents reported that their skills in history taking over the phone improved from 20% to 90% and their ability to triage patients over the phone improved from 0% to 80%. This led to a quality improvement initiative to increase patient calls and has continued for 5 years, with continued positive feedback from residents and attendings. Discussion Phone triage skills are a necessity for pediatric providers, but few residency programs have training curricula in place. Through an experience-based phone triage program, residents significantly improved their self-reported skills at history taking and triaging. Similar curricula could easily be adopted at other institutions.

Improving Utilization of an After-Hours Phone Triage Service: A Resident Quality Improvement Initiative

“…Next steps might include measuring further direct effects on resident education. While not specifically measured as part of this QI research, residents responded positively to this added training and experience and have requested that it continue 10…”

“…While not specifically measured as part of this QI research, residents responded positively to this added training and experience and have requested that it continue. 10 Involvement of the residents in the project not only enables sustainability but also can affect it negatively. The data show a dip in call volume in the summer after the project ended, which not only aligns with seasonality trends but also may be related to new residents starting at the practice and not having knowledge or involvement yet in the after-hours service.…”

“…To improve provider knowledge, the existing resident phone triage curriculum was expanded and changed from optional to mandatory 10. This ensured that all residents were engaged in overnight phone triage during 1 month of the year and were better able to educate patients about the service.…”

The ABCs of OTCs: A Video-Based Curriculum Regarding Over-the-Counter Pediatric Products

“…Kolb's experiential learning theory served as a conceptual framework for the educational strategies, 16 and Kirkpatrick's evaluation model of reaction, learning, and behavior guided our evaluation. 17 We aligned our design with prior successful educational interventions in telephone triage 18 , 19 and OSCEs for medical students. 20 …”