Found in transition: Applying milestones to three unique discharge curricula
- Published
- Accepted
- Subject Areas
- Science and Medical Education
- Keywords
- Transition of care, Medical Education, Milestones, Entrustable Professional Activities, Discharge, Q-sort
- Copyright
- © 2014 Meade et al.
- Licence
- This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, reproduction and adaptation in any medium and for any purpose provided that it is properly attributed. For attribution, the original author(s), title, publication source (PeerJ PrePrints) and either DOI or URL of the article must be cited.
- Cite this article
- 2014. Found in transition: Applying milestones to three unique discharge curricula. PeerJ PrePrints 2:e746v1 https://doi.org/10.7287/peerj.preprints.746v1
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.
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.