Real World Training for the Next Generation: A curriculum for resident education focused on system-based non-clinical patient care topics
Background: Modern healthcare is increasingly driven by data, with healthcare systems and individual physicians being evaluated on patient safety, quality, and performance metrics, all of which impact regulatory compliance and reimbursement¹. During inpatient rotations residents learn through direct experience, gaining insight into non-clinical aspects of patient care, including clinical documentation improvement, admission status, discharge planning, and quality metrics. The Accreditation Council for Graduate Medical Education (ACGME) designates systems-based practice (SBP) as one of the core competencies² for physicians to develop during residency training. However, teaching and assessing the specific skills required to meet this competency presents a significant challenge for both medical educators³ and learners. Objectives: Develop a curriculum to educate resident physicians on key system-based non-clinical topics that are often not included in traditional residency training, referred to as “Real World Teaching”. The curriculum will cover essential concepts such as clinical documentation improvement (CDI), discharge planning, Diagnosis-Related Groups (DRG), Relative Weight (RW), Case Mix Index (CMI), observation vs. inpatient admission status, and quality metrics. The primary goal is to help resident physicians understand how their clinical work and documentation impact patient care, quality metrics, and the broader healthcare system. Methods: A weekly resident huddle was implemented at Duke Regional Hospital (DRH), where residents from the Internal and Family Medicine inpatient teams convene to address operational challenges and review provider metrics. Four hospitalist physicians developed a curriculum consisting of four 10-minute mini-lectures, which are presented on a rotating weekly basis by DRH internal medicine faculty. In addition, a 45-minute teaching module was created and is delivered to second-year residents during their scheduled didactic time. To assess baseline knowledge and workflow, residents completed a preliminary survey before the teaching sessions, and faculty completed a similar survey to assess their perceptions of resident knowledge. Both surveys will be repeated at the end of the curriculum to assess knowledge growth. Results/Evaluation: Evaluation of improvements in knowledge and application of the various 'real-world' non-clinical topics is based on pre- and post-curriculum surveys of both residents and faculty, assessing resident competency (or perceived competency) in these areas. The project is currently underway, with initial survey data available; however, post-curriculum data is yet to be collected. Preliminary results indicate an opportunity for growth in these areas, and the first cohort of second-year residents who participated in the curriculum reported that it is likely to influence their documentation practices. Updated survey data will be presented upon completion. Significance/Relevance: This project aims to address a gap in resident medical education by providing structured instruction on systems-based practice, clinical documentation improvement, coding and quality metrics. We seek to replace the current haphazard and informal teaching methods for real world topics with a well-organized, concise curriculum called “Real World Teaching”. The successful implementation of this new curriculum and validation of its effectiveness for both residents and faculty will facilitate its full integration into residency education, aligning the academic mission of residency training more closely with the systems-based practice knowledge essential for the modern physician. References: 1. Centers for Medicare & Medicaid Services. (2024). Electronic clinical quality improvement overview. Retrieved from https://www.cms.gov/medicare/regulations-guidance/promoting-interoperability-programs/electronic-clinical-quality-measures-basics#:~:text=CMS%20has%20finalized%20the%20Electronic,Clinical%20Process/Effectiveness. 2. Accrediting Council for Graduate Medical Education. (2023). Common Program Requirements for Graduate Medical Education (Systems-Based Practice). Retrieved from https://www.acgme.org/What-We-Do/Accreditation/Common-Program-Requirements 3. Lurie, S. J., Mooney, C. J., & Lyness, J. M. (2009). Measurement of the general competencies of the Accreditation Council for Graduate Medical Education: A systematic review. Academic Medicine, 84(3), 301–309. https://doi.org/10.1097/ACM.0b013e3181971f08
- 2025
- En Collection:
| Miniatura | Título | Fecha de subida | Visibilidad | Acciones |
|---|---|---|---|---|
|
|
Real_World_Duke_Ahead_final.pptx | Descargar |