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A systematic review of evidence-based practices for clinical education and health care delivery in the clinical teaching unit

Canadian Medical Association journal (CMAJ), 2022-02, Vol.194 (6), p.E186-E194 [Peer Reviewed Journal]

2022 CMA Impact Inc. or its licensors. ;COPYRIGHT 2022 CMA Joule Inc. ;Copyright Joule Inc Feb 14, 2022 ;2022 CMA Impact Inc. or its licensors 2022 ;ISSN: 0820-3946 ;EISSN: 1488-2329 ;DOI: 10.1503/cmaj.202400 ;PMID: 35165130

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Title:
A systematic review of evidence-based practices for clinical education and health care delivery in the clinical teaching unit
Author: Tang, Brandon ; Sandarage, Ryan ; Chai, Jocelyn ; Dawson, Kristin Anne ; Dutkiewicz, Katrina Rose ; Saad, Stephan ; Kitchin, Vanessa ; Hatala, Rose ; McCormick, Iain ; Kassen, Barry
Subjects: Care and treatment ; Clinical Trials as Topic ; Data analysis ; Delivery of Health Care - methods ; Education reform ; Education, Medical - methods ; Educational aspects ; Evidence-based medicine ; Evidence-based practice ; Evidence-Based Practice - methods ; Health aspects ; Health care delivery ; Health care reform ; Humans ; Internal medicine ; Internal Medicine - education ; Medical education ; Medical research ; Medical students ; Medicine ; Medicine, Experimental ; North America ; Patients ; Physicians ; Practice ; Qualitative Research ; Surveys and Questionnaires ; Systematic review
Is Part Of: Canadian Medical Association journal (CMAJ), 2022-02, Vol.194 (6), p.E186-E194
Description: The clinical teaching unit is a widespread clinical training model that requires reform to prepare physicians for practice in the 21st century. In this systematic review, we aimed to identify evidence-based practices in internal medicine clinical teaching units that contribute to improved clinical education and health care delivery. We searched several databases from 1993 until Apr. 5, 2021, to identify published studies in inpatient clinical teaching units that involved medical trainees and reported outcomes related to trainee education or health care delivery. We identified emergent themes using a narrative approach and determined confidence in review findings using the Grading of Recommendations Assessment, Development and Evaluation Confidence in the Evidence from Reviews of Qualitative Research (GRADE-CERQual) methodology. We included 107 studies of internal medicine clinical teaching units, of which 93 (87%) were conducted in North America. Surveys ( = 31, 29%), trials ( = 17, 16%) and narrative studies ( = 15, 14%) were the most prevalent study designs. Practices identified as contributing to improved clinical education or health care delivery included purposeful rounding (high confidence), bedside rounding (moderate confidence), resource stewardship interventions (high confidence), interprofessional rounds (moderate confidence), geographic wards (moderate confidence), allocating more trainee time to patient care or educational activities (moderate confidence), "drip" continuous models of admission (moderate confidence), limiting duty hours (moderate confidence) and limiting clinical workload (moderate confidence). In this review, we identified several evidence-based practices that may contribute to improved educational and health care outcomes in clinical teaching unit settings. These findings may offer guidance for policies, resource allocation and staffing of teaching hospitals.
Publisher: Canada: CMA Joule Inc
Language: English
Identifier: ISSN: 0820-3946
EISSN: 1488-2329
DOI: 10.1503/cmaj.202400
PMID: 35165130
Source: ProQuest One Psychology
Open Access: DOAJ Directory of Open Access Journals
Open Access: PubMed Central
Geneva Foundation Free Medical Journals at publisher websites
AUTh Library subscriptions: ProQuest Central
MEDLINE
Alma/SFX Local Collection

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A systematic review of evidence-based practices for clinical education and health care delivery in the clinical teaching unit

2022 CMA Impact Inc. or its licensors. ;COPYRIGHT 2022 CMA Joule Inc. ;Copyright Joule Inc Feb 14, 2022 ;2022 CMA Impact Inc. or its licensors 2022 ;ISSN: 0820-3946 ;EISSN: 1488-2329 ;DOI: 10.1503/cmaj.202400 ;PMID: 35165130

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