Design and Evaluation of a Pediatric Resident Health Care Transition Curriculum

儿科住院医师医疗保健过渡课程的设计与评估

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Abstract

INTRODUCTION: In 2011, the American Academy of Pediatrics developed a consensus statement urging physicians who provide care to youth with special health care needs to acquire the knowledge and skills to facilitate well-timed transitions to adult-oriented care. However, a minority of these youth receive the services necessary to make appropriate transitions. Two potential barriers to supporting well-planned transitions are minimal provider training and gaps in medical records. METHODS: We designed an adaptable health care transition (HCT) curriculum combinings asynchronous didactic modules and a synchronous portable medical summary (PMS) critique exercise to improve resident knowledge, skills, and behavior. Residents completed pre- and posttests to assess knowledge prior to and after viewing animated video didactic modules. Residents attempted to create a PMS, received feedback and instruction on how to create a well-written PMS, and then reattempted this activity. Residents evaluated both the didactic modules and the PMS critique exercise following delivery of the curriculum. RESULTS: Over 21 months, 20 pediatric residents and hospital medicine fellows completed the curriculum during an elective complex care block rotation. Pre- and posttests revealed statistically significant (p < .001) improvement in knowledge. Learners included an average of 46% of 18 recommended PMS elements before and 98% of elements after the PMS critique exercise (p < .001). Evaluations demonstrated overwhelmingly positive learner responses. DISCUSSION: Our adaptable HCT curriculum improves pediatric residents' knowledge, skills, and behavior in transition processes and addresses a significant gap in pediatric graduate medical education.

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