Internal medicine residency training and outcomes

Journal of General Internal Medicine
C H GriffithJ F Wilson

Abstract

To review the impact of the clinical education of internal medicine residents on patients' outcomes. English-language studies of the relation between internal medicine housestaff training and patients' outcomes were systematically identified by a MEDLINE search and from bibliographies and reference lists of recently published articles. We hypothesized that the primary impact of internal medicine residency training on patients' outcomes would be the result of: (1) the inexperience of the residents; (2) the heavy workload these inexperienced residents are expected to manage: or (3) some structural feature of the internal medicine teaching services, such as the discontinuity of patient care inherent in night float systems and the fact that residents rotate to different services each month. We also hypothesized that residents may in may ways provide superior care, and many actually improve certain patient outcomes. Housestaff inexperience, workload, and structural features that promote discontinuity have been shown to affect especially outcomes of resource utilization, length of stay, and patient satisfaction. No study has demonstrated that internal medicine residents contribute to excess patient morbidity or mortality. However, th...Continue Reading

Citations

Jun 1, 1997·Journal of General Internal Medicine·L Bellini, J Ende
Aug 5, 2009·BMC Medical Education·Harish JastiMichael Elnicki
May 2, 2014·Journal of Evaluation in Clinical Practice·Jussi SipiläPäivi Rautava
Feb 5, 2011·Journal of Surgical Education·Clancy J ClarkRichard P Koehler
Sep 1, 2009·Journal of the American College of Surgeons·Thomas J SchroeppelTimothy C Fabian
Jun 13, 2001·Academic Medicine : Journal of the Association of American Medical Colleges·D W RudyJ F Wilson
Sep 27, 2006·Academic Medicine : Journal of the Association of American Medical Colleges·Adam D PeetsChristopher J Doig

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