Adult literature has demonstrated that patient preferences and understanding of discharge instructions can impact success of discharge and even predict return ER visits. There is very little data in pediatric literature describing what information should be discussed with families when providing discharge instructions, and most pediatric residents do not receive formal education on the topic. This curriculum is designed as a brief educational intervention that can improve residents’ comfort and skills in providing discharge education to families. The materials include both how to present the curriculum and tools to assess resident knowledge, behaviors and attitudes regarding discharge education as well as an objective checklist to evaluate their skills. The curriculum is designed to be presented in small group, open discussion format while residents are rotating on the inpatient pediatric ward months.
This curriculum has been taught to pediatric interns, family medicine residents and psychiatry residents rotating on the inpatient pediatric wards at two large, free-standing children’s hospitals and demonstrated reproducible, statistically significant improvement in resident comfort and performance in providing discharge education. When evaluating the curriculum, resident free text comments included “it made me think of considerations I hadn’t previously thought of” and “this has made me make an effort to be present, rather than just give written instructions for the nurse to go over."
The curriculum is significant because it is a brief educational intervention that can have an impact on trainee comfort and skills as well as patient care. Although not well demonstrated in pediatric literature, adult literature has shown that a patients’ preparedness for discharge can predict the risk of a return ER visit, making this an important topic to address in pediatric inpatient medicine, as improvement in the quality of discharge counseling likely impacts patient safety and overall understanding and adherence to the outpatient treatment plan. There were slight variations in the way the curriculum was executed at each institution, yet both had favorable results, demonstrating the flexibility of the curriculum and the potential for interdisciplinary collaboration in the shared goal of improving the patient experience and safety at the time of discharge. In addition, it allows for objective observation of a trainee providing direct patient care. Providing thorough discharge counseling to a family should address all 6 ACGME core competencies, and this curriculum provides for an additional way to evaluate performance.
AAMC MedEdPORTAL publication ID 10079. Link to original
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Widmer K, Bhansali P, Noffsinger J. Discharge education curriculum for residents rotating on an inpatient pediatric ward. MedEdPORTAL Publications. 2015;11:10079. http://doi.org/10.15766/mep_2374-8265.10079
Instructor's Guide-Discharge Education Curriculum
Introductory Handout.doc (28 kB)
Pre-curriculum Survey.doc (49 kB)
Observation Checklist.docx (16 kB)
Discharge Mnemonic Handout.docx (13 kB)
Discharge Mnemonic Handout
Post-curriculum Survey.doc (51 kB)
Copyright License.pdf (64 kB)