Admission Clinical Diagnosis and Assessment: An Innovative Curriculum and Experiential Learning Opportunity

Initial clinical assessment, diagnostic workup and triage of patients newly admitted to the hospital are essential clinical skills gained during internal medicine residency training. However, increasing external pressures across the health care system have made teaching and practicing these skills with resident learners more challenging. A focus on hospital bed flow, length of stay, and early discharge, in combination with nurse and ancillary staffing shortages have shifted focus away from clinical assessment and more towards patient throughput and disposition. In addition, emergency department boarding of admitted patients has led to fractured and inefficient healthcare delivery. Our workshop will detail how we applied Kern's 6-step curriculum development methodology to the creation of an innovative admitting and triage general internal medicine (GIM) service geographically located in the emergency department. Residents on this rotation work directly with GIM faculty on the triage, initial workup, and assessment of newly admitted patients. We will discuss the entire curriculum development process from needs assessment to curriculum evaluation. Additionally, we will share the content of the didactic curriculum created for this rotation that focuses on clinical assessment, interdisciplinary care team communication, and healthcare system navigation. We will also show our resident evaluation process, which is mapped to the ACGME milestones. Finally, we will share preliminary assessment and evaluation data, including resident attitudes and confidence in the selected subset of ACGME milestones.

Speakers

• Danielle Baek
• Christina Koch, MD
• Bernadette Siaton, MD, MEdHP
• Kathyrn Silva, MD

Additional Information

Year Published: 2023 - APDIM Fall Meeting