1
|
Friedes BD, McRae AE, Abdul-Raheem J, Balighian E, Golden W, Pahwa AK. Medical Student Note Quality on a Pediatrics Core Clerkship Differs by Service. Cureus 2023; 15:e44740. [PMID: 37809116 PMCID: PMC10557370 DOI: 10.7759/cureus.44740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/03/2023] [Indexed: 10/10/2023] Open
Abstract
Introduction Medical students rotate on various clinical disciplines with the same professional goal of learning medical documentation. This study investigated differences between medical student notes on inpatient general and subspecialty pediatric services by comparing note quality, length, and file time. Methods In a single-site, observational cohort study, medical students in the Core Clerkship in Pediatrics (CCP) from July 2020 to June 2021 participated in a note-writing didactic course. We compared notes from medical students completing their inpatient assignment on a general pediatric service to those who completed it on a pediatric subspecialty service. Primary outcomes were note quality measured by Physician Documentation Quality Instrument-9 (PDQI9), note length (measured by line count), and file time (measured by hours to completion since 6 AM on the morning of note initiation). Results We evaluated 84 notes from 84 medical students on the general pediatric services and 50 notes from 49 medical students on the pediatric subspecialty services. Note quality measured by PDQI9 was significantly higher for general pediatric service notes compared to pediatric subspecialty service notes (p = 0.03). General pediatric service notes were significantly shorter (p < 0.001). We found no difference in file time (p = 0.23). Conclusion Medical student notes on pediatric subspecialty services scored significantly lower in quality and were longer compared to general pediatric services, demonstrating the need for a more tailored note-writing curriculum and note template based on service.
Collapse
Affiliation(s)
| | - Ashlyn E McRae
- Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, USA
| | | | | | | | - Amit K Pahwa
- Internal Medicine - Pediatrics, Johns Hopkins University, Baltimore, USA
| |
Collapse
|
2
|
McRae AE, Rowe JT, Friedes BD, Abdul-Raheem J, Balighian ED, Bertram A, Huang V, McFarland SR, McDaniel LM, Kumra T, Christopher Golden W, Pahwa AK. Assessing the Impact of a Note-Writing Session and Standardized Note Template on Medical Student Note Length and Quality. Acad Pediatr 2023; 23:1454-1458. [PMID: 36907434 DOI: 10.1016/j.acap.2023.02.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 02/09/2023] [Accepted: 02/27/2023] [Indexed: 03/14/2023]
Abstract
PURPOSE To determine whether a formal note-writing session and note template for medical students (MS) during the Core Clerkship in Pediatrics (CCP) increase note quality, shortens note length, and decreases time of documentation. METHODS In this single site, prospective study, MS participating in an 8-week CCP received a didactic session on note-writing in the electronic health record (EHR) and utilized EHR template developed for the study. We assessed note quality (measured by Physician Documentation Quality Instrument-9 [PDQI-9]), note length and note documentation time in this group compared to MS notes on the CCP in the prior academic year. We used descriptive statistics and Kruskal-Wallis tests for analysis. RESULTS We analyzed 121 notes written by 40 students in the control group and 92 notes writing by 41 students in the intervention group. Notes from the intervention group were more "up to date," "accurate," "organized," and "comprehensible" compared to the control group (P = 0.02, P = 0.04, P = 0.01, and P = 0.02, respectively). Intervention group notes received higher cumulative PDQI-9 scores compared to the control group (median score 38 (IQR 34-42) versus 36 (IQR 32-40) out of 45 total, P = 0.04). Intervention group notes were approximately 35% shorter than the control group notes (median 68.5 lines vs 105 lines, P < 0.0001) and were signed earlier than control group notes (median file time 316 minute vs 352 minute, P = 0.02). CONCLUSIONS The intervention successfully decreased note length, improved note quality based on standardized metrics, and reduced time to completion of note documentation.
Collapse
Affiliation(s)
- Ashlyn E McRae
- Johns Hopkins University School of Medicine (AE McRae, JT Rowe, BD Friedes, J Abdul-Raheem, and A Bertram), Baltimore, Md.
| | - Julian T Rowe
- Johns Hopkins University School of Medicine (AE McRae, JT Rowe, BD Friedes, J Abdul-Raheem, and A Bertram), Baltimore, Md
| | - Barbara D Friedes
- Johns Hopkins University School of Medicine (AE McRae, JT Rowe, BD Friedes, J Abdul-Raheem, and A Bertram), Baltimore, Md
| | - Jareatha Abdul-Raheem
- Johns Hopkins University School of Medicine (AE McRae, JT Rowe, BD Friedes, J Abdul-Raheem, and A Bertram), Baltimore, Md
| | - Eric D Balighian
- Department of Pediatrics (ED Balighian, SR McFarland, T Kumra, and W. Christopher Golden), Johns Hopkins University School of Medicine, Baltimore, Md
| | - Amanda Bertram
- Johns Hopkins University School of Medicine (AE McRae, JT Rowe, BD Friedes, J Abdul-Raheem, and A Bertram), Baltimore, Md
| | - Victoria Huang
- Department of Anesthesia and Critical Care Medicine (V Huang), Johns Hopkins University School of Medicine, Baltimore, Md
| | - Susan R McFarland
- Department of Pediatrics (ED Balighian, SR McFarland, T Kumra, and W. Christopher Golden), Johns Hopkins University School of Medicine, Baltimore, Md
| | - Lauren M McDaniel
- Department of Pediatrics (LM McDaniel), University of Washington School of Medicine, Seattle, Wash
| | - Tina Kumra
- Department of Pediatrics (ED Balighian, SR McFarland, T Kumra, and W. Christopher Golden), Johns Hopkins University School of Medicine, Baltimore, Md
| | - William Christopher Golden
- Department of Pediatrics (ED Balighian, SR McFarland, T Kumra, and W. Christopher Golden), Johns Hopkins University School of Medicine, Baltimore, Md
| | - Amit K Pahwa
- Departments of Internal Medicine and Pediatrics (A Pahwa), The Johns Hopkins University School of Medicine, Baltimore, Md
| |
Collapse
|