Are Your Learners Ready to Hold the Admission Pager? Building a Resident Rotation for Triage and Disposition Decision-Making
In the context of internal medicine , triage refers to a constellation of activities related to determining the most appropriate disposition/management plans for patients. Triaging occurs across the care continuum and represents entrustable professional activities and skills across multiple ACGME domains that internists must master for patient safety and appropriate utilization of health care resources. After ACGME implemented resident duty hour restrictions in 2003, many activities and duties transitioned from resident learners to staff physicians creating a gap in skills and knowledge in resident training. This workshop will provide a framework to tailor and implement a resident triage rotation focused on three foundational competencies: interprofessional communication, evidence-based decision making, and systems-based practice. Understanding that each institution has their own locality differences, we will include breakout sessions where we will use a triage curriculum tool to complete an institutional specific needs assessment. We will take participants through the step-by-step process of creating this rotation from recruiting and engaging faculty and formalizing a curriculum to orienting the residents and faculty to the rotation and teaching the curriculum. Then we will focus on evaluating resident acquired triage skills through the use of curriculum-based knowledge assessments and a faculty evaluation based on EPAs from ACGME's 2.0 milestones. The workshop concludes with discussions on developing a tool for residents to evaluate their triage rotations and provide feedback to faculty/program leadership for future improvements.