Northwestern University Feinberg School of Medicine Patient Follow-Up Logs: Current Approaches and...
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Transcript of Northwestern University Feinberg School of Medicine Patient Follow-Up Logs: Current Approaches and...
Northwestern University Feinberg School of Medicine
Patient Follow-Up Logs: Current Approaches and Innovating the Format to Encourage Self-Directed Learning
David Salzman, MDAssistant Program DirectorAssistant ProfessorDepartment of Emergency MedicineFaculty: Center for Simulation Technology and Immersive LearningNorthwestern University, Feinberg School of Medicine
Collaborators:Nicholas Hartman, MD, Melissa Marinelli, MD, Nathan Olson, MD, Matthew Patton, MD, Amer Aldeen, MD & Michael Gisondi, MD
Disclosures
No financial relationships to disclose
Introduction “The program must assure that the residents follow-up on a representative sample of patients so as to learn about the results of diagnostic studies, the outcome of interventions, and the final patient diagnosis.”
“Physician must be able to investigate and evaluate their patient care practices, appraise and assimilate scientific evidence and improve their practice of medicine.”
http://www.acgme.org/acWebsite/RRC_110/110_pdChecklist.pdfhttp://www.abms.org/Maintenance_of_Certification/ABMS_MOC.aspx
Nationwide Follow-up Trends158 Allopathic PD’s Invited
87 Completed Survey
80 Responses
99 Started Survey
7 Duplicates Removed
Survey Completed By:PD (81.25%) APD (13.75%)
CR (2.5%) PC (2.5%)
Distribution of Results:3 Year 61 (76.25%)4 year 19 (23.75%)
Method of Completion
Frequency of CompletionEvery Shift 3Every Week 1Every EM “Month” 45Calendar Month 64 times per year 2Once per Year 2Other 15
Assessment of COMPLETIONProgram Director 55Asst/Assoc PD 38Program Coordinator 38Chief Resident 5Nobody 1Other 5
Assessment of CONTENTProgram Director 45Asst/Assoc PD 32Program Coordinator 4Chief Resident 3Nobody 17Other 13
Overall SatisfactionStrongly
AgreeAgree Neutral Disagree Strongly
Disagree
System isEASY to use 35.14% 52.70% 8.11% 4.05% 0.00%
System is an EFFECTIVE Learning Tool
17.57% 31.08% 43.24% 8.11% 0.00%
Current System is an EFFICIENTLearning Tool
13.51% 29.73% 37.84% 16.22% 2.70%
Would use different system 6.76% 29.73% 33.78% 14.86% 14.86%
Multi-residency Collaboration 16.67% 30.56% 26.39% 12.50% 13.89%
Innovating the Approach
Content EvaluationImages 1.22/post
Learning Points 1.04/post
References 1.38/post
Longitudinal Follow-up 138/283 Posts = 53%
Main Content
Follow-Up Blog Utilization
Version 1.0 Version 2.0
Initial 150 day totals (7/6/11-12/2/11):1978 Visits 33.3 Views/day
Creating Posts
Developing novel posts
•July - 59.41 min •February – 44.29 min
Commenting on other posts
•July – 11.05 min•February – 9.71 min
Compliance for Block 1-4
Overall – 74.3%
PGY 1 – 95.6%PGY 2 – 85.8%PGY 3 – 56.7%PGY 4 – 54.5%
Site UsabilityStrongly Disagree
Disagree Unsure/Neutral
Agree Strongly Agree
N/A
Easy to Navigate 0.0% 4.3% 4.3% 56.5% 34.8% 0.0%
Easy to Post entry
4.3% 8.7% 8.7% 26.1% 43.5% 8.7%
Easy to Search 4.3% 17.4% 4.3% 39.1% 34.8% 0.0%
Collaboration 0.0% 0.0% 4.3% 60.9% 34.8% 0.0%
Strongly Disagree
Disagree Unsure/Neutral
Agree Strongly Agree
N/A
Easy to Navigate 0.0% 0.0% 0.0% 57.1% 42.9% 0.0%
Easy to Post entry
0.0% 0.0% 0.0% 28.6% 57.1% 14.3%
Easy to Search 0.0% 0.0% 14.3% 42.9% 42.9% 0.0%
Collaboration 0.0% 14.3% 0.0% 57.1% 28.6% 0.0%
ResultsInitial Implementation - Do they like it?
I complete the follow-up logs because I find them a useful and beneficial activity for my learning
Entirely Agree 21.7%Agree 43.5%Unsure / Neutral 17.4%Disagree 8.7%Entirely Disagree 0.0%
How have they used the information?
•Changed treatment•Changed diagnostic strategies•Different dispositions
Mobile Devices
Version 3.0 Use
Version 3.0 day totals (1/9/12-2/22/12):996 Visits = 22.13 Visits/Day
Version 1.0 Version 2.0
Version 3.0
Lessons LearnedKeywords
Security
Implementation
Software Compatibility
Version 1.0 Version 2.0
Future Directions
Integration of technology & learning theory to allow individual approach to accomplishing requirements
Transition from competency to outcomes
Long term compliance
Northwestern University EM ResidencyCollaborators:
Nicholas Hartman, MD, Melissa Marinelli, MD, Nathan Olson, MD, Matthew Patton, MD, Amer Aldeen, MD & Michael Gisondi, MD
Special Thanks for Mentorship and IT support:
John Vozenilek, MD, Kadriye Lewis, Ed.D, Lanty O’Connor, Andrew BoehmContact: [email protected]