Use of a virtual classroom in training fourth-year medical students on care transitions

BACKGROUND: Transferring complex patients between settings can be fraught with poor communication and adverse outcomes, yet few medical students nationwide are trained in specific skills to improve care transitions. OBJECTIVE: To give medical students the fund of knowledge and skills to develop and implement a safe discharge plan. DESIGN: A new care transitions curriculum imparted to all fourth-year medical students from August 2009 to April 2010 during their internal medicine sub-internship. SETTING: Emory University School of Medicine. INTERVENTION: Activities included: 1) discussion of an online case highlighting care transitions issues; 2) preparation of a discharge summary based on online templates; and 3) a postdischarge phone call to one of their patients. MEASUREMENTS: We evaluated the curriculum using questionnaires measuring changes in pretest to posttest confidence in performing discharge tasks, attitudes toward the care transitions process, and performance on a knowledge quiz. We also assessed course satisfaction and the quality of students' discharge summaries and postdischarge call reports performed during the module. RESULTS: Students' confidence in their ability to perform discharge tasks improved from 16.5 to 20.8 on a 25-point scale (P < 0.001). Knowledge quiz scores improved from 68 to 82 out of 100 (P < 0.001); 90.1% (109/121) of discharge summaries and 90.1% (109/121) of postdischarge call reports met all quality criteria. CONCLUSIONS: This curriculum showed that students could acquire the needed skills to prepare quality discharge summaries and communicate well with patients at discharge, as well as improve their overall knowledge surrounding care transitions. Journal of Hospital Medicine 2012;7:14-21. (C) 2011 Society of Hospital Medicine