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Discharge summary training curriculum: a novel approach to training medical students how to write effective discharge summaries.

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Title: Discharge summary training curriculum: a novel approach to training medical students how to write effective discharge summaries.
Authors: Ming, David1 (AUTHOR) david.ming@duke.edu, Zietlow, Kahli2 (AUTHOR), Song, Yao3 (AUTHOR), Lee, Hui‐Jie3 (AUTHOR), Clay, Alison4 (AUTHOR)
Source: Clinical Teacher. Oct2019, Vol. 16 Issue 5, p507-512. 6p.
Subject Terms: *Medical students, *Medical school curriculum, *Teaching hospitals, *Curriculum, Hospital admission & discharge, Patient safety
Abstract: Summary: Background: Resident physicians at teaching hospitals write many discharge summaries (DCSs), but receive little formal training or feedback. Poor DCS quality poses a potential patient safety risk. Methods: We developed a curriculum to train fourth‐year medical students (MS4s) how to write DCSs and integrated this curriculum into a transition‐to‐residency course. An inpatient attending physician (IPA) and non‐inpatient physician (coach) used structured tools to assess for the presence of key elements within the DCS, evaluate the overall quality of the DCS, and judge the student's progression towards entrustable professional activities and transitional year milestones. We identified overall areas of weakness and correlated scores between IPAs and coaches. Improvements in student knowledge and DCS writing confidence were determined using pre‐ and post‐curriculum surveys. Results: Of 102 eligible students, 78 completed the assignment, 61 wrote a new DCS and 17 reviewed previously written DCSs. Patient condition at discharge was missing in more than 20.0% of DCSs. Coaches were less likely than IPAs to assess students as entrustable (58.3% versus 95.8%; p = 0.0027). IPAs assigned higher overall quality ratings than coaches (8.0 versus 6.0 out of 10.0, p< 0.0001). Post‐intervention, 82.2% of students reported they learned how to write high‐quality DCSs and 93.3% of students reported they would change the way they write DCSs. Conclusions: Graduating medical students have limited skill and comfort in writing DCSs. Structured training on how to write DCSs before postgraduate residency training is a key step towards ultimately improving transitions of care. Training should teach learners to write high‐quality DCSs that serve the needs of both inpatient and outpatient providers. Resident physicians at teaching hospitals are expected to independently author [discharge summaries] DCSs, yet few receive formal training [ABSTRACT FROM AUTHOR]
Copyright of Clinical Teacher is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Data: Discharge summary training curriculum: a novel approach to training medical students how to write effective discharge summaries.
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  Data: &lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Ming%2C+David%22&quot;&gt;Ming, David&lt;/searchLink&gt;&lt;relatesTo&gt;1&lt;/relatesTo&gt; (AUTHOR)&lt;i&gt; david.ming@duke.edu&lt;/i&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Zietlow%2C+Kahli%22&quot;&gt;Zietlow, Kahli&lt;/searchLink&gt;&lt;relatesTo&gt;2&lt;/relatesTo&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Song%2C+Yao%22&quot;&gt;Song, Yao&lt;/searchLink&gt;&lt;relatesTo&gt;3&lt;/relatesTo&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Lee%2C+Hui‐Jie%22&quot;&gt;Lee, Hui‐Jie&lt;/searchLink&gt;&lt;relatesTo&gt;3&lt;/relatesTo&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Clay%2C+Alison%22&quot;&gt;Clay, Alison&lt;/searchLink&gt;&lt;relatesTo&gt;4&lt;/relatesTo&gt; (AUTHOR)
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  Data: &lt;searchLink fieldCode=&quot;JN&quot; term=&quot;%22Clinical+Teacher%22&quot;&gt;Clinical Teacher&lt;/searchLink&gt;. Oct2019, Vol. 16 Issue 5, p507-512. 6p.
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  Data: *&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Medical+students%22&quot;&gt;Medical students&lt;/searchLink&gt;&lt;br /&gt;*&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Medical+school+curriculum%22&quot;&gt;Medical school curriculum&lt;/searchLink&gt;&lt;br /&gt;*&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Teaching+hospitals%22&quot;&gt;Teaching hospitals&lt;/searchLink&gt;&lt;br /&gt;*&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Curriculum%22&quot;&gt;Curriculum&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Hospital+admission+%26+discharge%22&quot;&gt;Hospital admission &amp; discharge&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Patient+safety%22&quot;&gt;Patient safety&lt;/searchLink&gt;
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  Data: Summary: Background: Resident physicians at teaching hospitals write many discharge summaries (DCSs), but receive little formal training or feedback. Poor DCS quality poses a potential patient safety risk. Methods: We developed a curriculum to train fourth‐year medical students (MS4s) how to write DCSs and integrated this curriculum into a transition‐to‐residency course. An inpatient attending physician (IPA) and non‐inpatient physician (coach) used structured tools to assess for the presence of key elements within the DCS, evaluate the overall quality of the DCS, and judge the student&#39;s progression towards entrustable professional activities and transitional year milestones. We identified overall areas of weakness and correlated scores between IPAs and coaches. Improvements in student knowledge and DCS writing confidence were determined using pre‐ and post‐curriculum surveys. Results: Of 102 eligible students, 78 completed the assignment, 61 wrote a new DCS and 17 reviewed previously written DCSs. Patient condition at discharge was missing in more than 20.0% of DCSs. Coaches were less likely than IPAs to assess students as entrustable (58.3% versus 95.8%; p = 0.0027). IPAs assigned higher overall quality ratings than coaches (8.0 versus 6.0 out of 10.0, p&lt; 0.0001). Post‐intervention, 82.2% of students reported they learned how to write high‐quality DCSs and 93.3% of students reported they would change the way they write DCSs. Conclusions: Graduating medical students have limited skill and comfort in writing DCSs. Structured training on how to write DCSs before postgraduate residency training is a key step towards ultimately improving transitions of care. Training should teach learners to write high‐quality DCSs that serve the needs of both inpatient and outpatient providers. Resident physicians at teaching hospitals are expected to independently author [discharge summaries] DCSs, yet few receive formal training [ABSTRACT FROM AUTHOR]
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  Data: &lt;i&gt;Copyright of Clinical Teacher is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder&#39;s express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.&lt;/i&gt; (Copyright applies to all Abstracts.)
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RecordInfo BibRecord:
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      – Type: doi
        Value: 10.1111/tct.12960
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      – Code: eng
        Text: English
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        PageCount: 6
        StartPage: 507
    Subjects:
      – SubjectFull: Medical students
        Type: general
      – SubjectFull: Medical school curriculum
        Type: general
      – SubjectFull: Teaching hospitals
        Type: general
      – SubjectFull: Curriculum
        Type: general
      – SubjectFull: Hospital admission & discharge
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      – SubjectFull: Patient safety
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      – TitleFull: Discharge summary training curriculum: a novel approach to training medical students how to write effective discharge summaries.
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              Text: Oct2019
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              Y: 2019
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