Postdischarge follow‐up visits for medical and pharmacy students on an inpatient medicine clerkship

Abstract

BACKGROUND Teaching medical and pharmacy students to collaborate on discharge planning for chronically ill patients may facilitate their ability to provide quality care. OBJECTIVE To determine whether a discharge curriculum would improve students' attitudes and self‐assessed skills in interdisciplinary collaboration and transitional care for chronically ill patients. DESIGN The discharge curriculum of an inpatient medicine clerkship focused on safe patient transitions after hospitalization. Curricular components included an interdisciplinary workshop, follow‐up visits with discharged patients, a final group debriefing, and letters to patients' primary care providers. Preassigned medical and pharmacy student partners coordinated discharges and conducted postdischarge visits. The change in students' attitudes and skills in interdisciplinary collaboration and discharge planning was assessed using a 5‐point Likert‐scaled survey given before and after the curriculum, and students reported their satisfaction using additional Likert‐scaled and open‐ended questions. RESULTS The program was completed by 97% of students (37 of 39 medical, 22 of 22 pharmacy). The postcurriculum survey response rates were 92% and 86%, respectively; matched response rates were 58% and 59%. The attitudes and self‐assessed skills of both medical and pharmacy students significantly improved for most survey items after the curriculum. Students also reported that the curriculum had a favorable impact on their learning about interdisciplinary care (4.3, SD 0.72), humanism (4.3, SD 0.63), and discharge planning (4.4, SD 0.70). Ninety‐three percent reported that the curriculum was valuable to their education. CONCLUSIONS A clinically oriented curriculum with postdischarge visits improved students' attitudes and self‐assessed skills in interdisciplinary collaboration and transitional care and fostered a patient‐centered approach to care. Journal of Hospital Medicine 2008;3:20–27. © 2008 Society of Hospital Medicine.

“Learning by Doing”—Resident Perspectives on Developing Competency in High-Quality Discharge Care

“…Comprehensive approaches to teaching discharge care as part of a more formal curriculum have been previously described, but these efforts have focused on medical students. 29,30 Although medical school may be an ideal time to introduce the topic of high-quality discharge care, such training should be continued and further developed during residency.…”

Getting Out of Silos: An Innovative Transitional Care Curriculum for Internal Medicine Residents Through Experiential Interdisciplinary Learning

“…27 The results correspond to the Kolb cycle of experiential learning, suggesting integration of experiences (abstract conceptualization) and incorporation of learning into practice (active experimentation). 26 Published transitional care curricula in internal medicine and family medicine rarely describe use of experiential learning (eg, direct patient contact, real-life experience with different care systems and disciplines) in diverse care systems, 10,[28][29][30][31][32] whereas residency curricula in home or nursing home settings or interdisciplinary teams do not focus on transitional care. [11][12][13][14][15][16][17][18][19][20][21][22][23][24][25] For example, nursing home curricula do not focus on how the complex care structure of postacute care affects transitions, or how transitional care to and from the nursing home can be optimized at an individual patient and system level.…”

Found in transition: Applying milestones to three unique discharge curricula

“…A medical student 67 curriculum using experiential learning that follows a patient through the transition improved 68 confidence (Lai 2008) and was found to be both feasible and effective (Bray-Hall 2010). behaviors that demonstrate the competence (Green 2009).…”