Web-Based Module to Train and Assess Competency in Systems-Based Practice (Out of Print)

Abstract

Abstract Introduction The Accreditation Council for Graduate Medical Education defines systems-based practice as a residents' understanding of the health care system and their ability to efficiently and effectively utilize resources within this system. We developed this module to train medical residents in the delivery of optimal care to patients by helping them navigate the complex maze of health care resources and to make transitions of care more seamless. Methods We created an interactive, web-based 30-minute module based on the story of an older patient who presents to an emergency room with focal weakness after a recent hospital stay. The key curricular components of this training module are: (1) the basic elements of Medicare and Medicaid, (2) the various levels of post-acute hospital care for older patients, and (3) the role of provider-to-provider and provider-to-patient communication in patient transitions of care, including the critical elements of an effective discharge summary. The vignette has been tailored to be applicable to multidisciplinary trainees. Interactive questions are embedded within the case to emphasize key teaching points while continuing to engage the learners. Results We piloted this web-based module on trainees of the Harvard Geriatric Medicine Fellowship. Among the 10 fellows who participated, there was an average increase in score between pre- and posttests of 10.6% (from 79% to 90%). The module was well-received by the trainees, and we anticipate a greater improvement in performance among trainees who have never been trained in geriatric medicine. Discussion Systems-based practice is difficult to teach. By creating and piloting this web-based module we hope to offer residency directors an effective and entertaining interactive tool which may be used in either a didactic or an individual setting. Geriatric medicine offers an ideal forum for such teaching.

Keywords

• Delivery of Healthcare
• United States Centers for Medicare and Medicaid Services
• Discharge Summary
• Computer-Based Learning
• Web-Based Module