Organization: Parkland Health

Program: New Resident Physician Training

Design Objective: Curriculum Redesign & Launch

Learning Objective:

Background & Impetus for Change: Annually, Parkland’s New Physician Training Residency trains and onboards approximately 500-600 physicians. These physicians range in experience from new graduate physicians to fellows. From an inpatient perspective, the previous curriculum attempted to address the multiple aspects of a patient's story, including admission, rounding, transferring, and discharging a patient. The patient build in MST was not truly reflective of a patient’s story and needed to be updated to align with a more true-to-life experience, as it only reflected one phase of care.

Learning Theories and Methods:

• ADDIE

• Phasic Patient MST Build

Attributes:

• MST (Master Train in Epic) - Role limited to support, research, data mining, and patient design

• Adobe Illustrator

• Adobe InDesign

Overview:

Given MST’s limited availability at Parkland to adequately provided a patient in different phases of care (i.e. transport a patient through “time”), the redesign for this class focused on building a robust patient in different phases of inpatient care. These phases included:

• Admission

• Rounding and Transferring

• Discharge

Creating a patient in this manner allows the provider to experience different aspects of their role regarding patient care. There are many nuances to the different phases, and providing a rich patient build allows the provider to experience and learn about these different features.

During the admission, the provider learns to admit a patient through the necessary organizational steps, including reviewing the patient chart, notes, and completing an admission and order set. Throughout the patient rounding phase, the provider learns to appropriately update progress notes and learns the process for customizing a Smart Text template and the utilization of Smart Phrases, in addition to transferring a patient in accordance with organizational standards. Finally, the provider experiences the discharging of a patient and their appropriate disposition, including any follow-up orders, such as discharge medications and referrals.

The provider is given a quick start guide, in addition to direct instruction, which allows them to complete tasks at their own pace, and also to be given reinforcement by the instructor.

Outcomes:

Broadly speaking, the new provider training is a standard introduction to Epic documentation and is an improvement over prior year trainings. It does not dial into specifics within disciplines and service lines and requires oversight and support by upper-level residents and fellows. Additionally, the New Resident Training availability is limited to four hours for Inpatient, Ambulatory, and InBasket training, and is in the process of expanding to meet the continued needs and requests of new providers to encourage more positive entry-level support. Additional resources such as Artificial Intelligence-driven simulations have been entertained, but have been met with some operational barriers such as cost and time availability.