设计驱动实践变革:住院医师临床经验的自动提取

Alexander Fidel, Mark V. Mai, Naveen Muthu, Adam C. Dziorny
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引用次数: 0

摘要

接触病人和临床诊断驱动研究生医学教育(GME)的学习。然而,经验的广度存在差异。测量这种差异将提供实践数据,以告知居民对其患者经验广度的理解。我们开发了一个自动化系统来识别住院医生与患者的互动(rppi),并在单一机构中证明了准确的归属。本研究的目的是了解受训人员计划学习的情况,并迭代地设计一个工具来实现这一目标。为了在两家新加入AMA“推进变革”倡议的机构中实现这些目标,我们使用混合方法来开发和评估患者遭遇的“中点报告”。定性结果包括对有用性、可用性和使用意图的指导探索,以及理解受训者将用于学习的资源以及我们的系统如何交付这些资源。中点报告总结性可用性测试的定量结果将包括任务完成时间、任务完成率以及认为报告有助于识别临床经验差距和指导学习的受训者比例。
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Designing to Drive Practice Change: Automated Extraction of Resident Clinical Experiences
Exposure to patients and clinical diagnoses drives learning in graduate medical education (GME). However, variation exists in the breadth of experiences. Measuring such variation would provide practice data to inform residents’ understanding of the breadth of their patient experiences. We have developed an automated system to identify resident provider-patient interactions (rPPIs) and demonstrated accurate attribution at a single institution. The objective of this study was to understand the landscape of trainee planned learning, and iteratively design a tool to be used for this goal. To achieve these objectives at two institutions new to the AMA “Advancing Change” initiative, we used a mixed-methods approach to develop and evaluate a “mid-point report” of patients encounters. Qualitative outcomes include a guided exploration of usefulness, usability, and intent to use, as well as understanding the resources trainees would use for learning and how our system may deliver these resources. Quantitative outcomes from a summative usability test of the midpoint report will include time on task, task completion rate, and proportion of trainees who perceive the report to be useful to identify gaps in clinical experiences and guide learning.
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