Addressing medial student knowledge deficits in 'hospital-to-home' transitions of care using a constructivism theory-based workshop intervention.

Abstract

Effective teaching and learning initiatives on transitions of patient care, especially from hospital to home, are frequently lacking within medical school curricula. We trialled an integrated test-enhanced active learning strategy to prepare students for the safe management of these patient transitions. This randomised, prospective, single blinded, interventional study assessed medical students' knowledge, regarding patients' hospital-to-home transition. The intervention was a purpose-designed transitions of care workshop, the assessment tool was a multiple-choice assessment based on prior studies. Students were randomly allocated to the application of the assessment both pre- and post-workshop or to assessment solely post-workshop to determine the potential for the assessment to prime student learning. Sixteen students enrolled for the workshops. Significant knowledge gaps were identified. No student identified that medication errors were the most common source of post-discharge adverse events. Only 42% of participants knew that age >65 contributes to medication non-adherence, with 50% knowing that the medical reconciliation process should include discontinued medications. The workshop increased student knowledge, addressing identified knowledge gaps (74% pre-workshop versus 87% post-workshop, p < 0.005). Students self-perceived level of competency after completing the workshop intervention was increased (5.5 pre-workshop versus 15 post-workshop, p < 0.001). All aspects of student self-assessed competency increased significantly from the pre-workshop scores. There was no priming effect of the pre-workshop assessment on student knowledge scores or perceived competency. Important gaps in student knowledge skills and attitudes exist regarding the hospital to home transition. Our active learning strategy addressed these gaps, enhancing student understanding and confidence around transitions of patient care.