Found in transition: Applying milestones to three unique discharge curricula
A peer-reviewed article of this Preprint also exists.
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Abstract
Introduction: A safe and effective transition from hospital to post acute care is a complex and important physician competency. Milestones and Entrustable Professional Activities (EPA) form the new educational rubric in Graduate Medical Education Training. ‘A safe and effective discharge from the hospital’ is an EPA ripe for educational innovation. Methods: The authors collaborated in a qualitative process called, mapping, to develop a Q-sort exercise to be distributed to participants at an Association for Program Directors in Internal Medicine (APDIM) workshop on milestones for transition of care. We analyzed the Q-sort results to rank the milestones in order of priority. We then applied this ranking to 3 innovative transitions of care curricula: Simulation (S), Discharge Clinic Feedback (DCF) and TRACER (T). Results: We collected 55 game boards from faculty units at the APDIM workshop. We report the prioritized milestones by Q-sort from the APDIM workshop. From the total 22 milestones, the simulation innovation identified 5/22 milestones, discharge clinic 9/22 milestones and tracer 7/22 milestones related to the EPA. Milestones identified in each innovation related back to one of the top eight prioritized milestones 75% of the time; thus more frequently than the milestones with lower priority. Discussion: We demonstrated that three unique innovations in transitions of care map to the top prioritized Q-sort milestones related to that EPA. Milestones for competency based assessment can be used to guide the development of innovative curricula in transition of care medicine.
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2014. Found in transition: Applying milestones to three unique discharge curricula. PeerJ PrePrints 2:e746v1 https://doi.org/10.7287/peerj.preprints.746v1note This preprint is not peer-reviewed. You may wish to reference the subsequent peer-reviewed version of this article.
Author comment
Summary points for this medical educational scholarship: 1. The Entrustable Professional Activity (EPA), a safe and effective discharge from the hospital, is ripe for educational innovation and collaboration. 2. Using Q-sort methodology to prioritize curricular milestones for this discharge EPA, we compare and contrast three unique discharge curricula: simulation, discharge clinic and tracer. 3. We demonstrate that the three unique discharge curricula, Simulation, Discharge Clinic Feedback and Tracer, in aggregate capture all of the highest prioritized milestones for this discharge EPA.This is a submission to PeerJ for review.
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Competing Interests
The authors declare they have no competing interests.
Author Contributions
Lauren Meade conceived and designed the experiments, performed the experiments, analyzed the data, contributed reagents/materials/analysis tools, wrote the paper, prepared figures and/or tables, reviewed drafts of the paper.
Christine Y Todd conceived and designed the experiments, performed the experiments, analyzed the data, contributed reagents/materials/analysis tools, wrote the paper, reviewed drafts of the paper.
Meghan M Walsh conceived and designed the experiments, performed the experiments, analyzed the data, contributed reagents/materials/analysis tools, wrote the paper, reviewed drafts of the paper.
Human Ethics
The following information was supplied relating to ethical approvals (i.e., approving body and any reference numbers):
This is medical education evaluation not requiring IRB.
Funding
The authors declare there was no funding for this work.
