Implementation of a Peer-to-Peer Teaching Intervention Improved Electronic Discharge Summary Documentation by New Internal Medicine Residents

Abstract

The early months of residency training (EMCT) from July to September can be overwhelming for interns, or post-graduate year one (PGY1) residents. Traditional orientation may not be sufficient to ensure a smooth transition to residency. Interns are responsible for completing discharge summaries in most training hospitals but receive little or no prior training. The objective of this study was to determine the effectiveness of a peer-to-peer orientation of new (incoming) PGY1 internal medicine residents by present (outgoing) PGY1 residents. This was an observational, analytical (cohort), single-center study. The intervention group, new (incoming) 2016 internal medicine, or PGY1, residents were exposed to a 2-h peer-to-peer orientation, in addition to the traditional orientation process. The internal medicine residents from the previous year (2015 PGY1 residents), exposed to only the traditional orientation process (TOP) prior to their commencement of residency, served as the control group. A comparison between the groups’ discharge summary documentation (DC summary) was performed using an independent two-sample t test; linear regression analysis was applied to control for potential confounders. Statistically significant differences were found in mean discharge summary scores between the intervention and control group. The intervention group had a higher average score (mean 73.6; standard deviation (SD) 12.3; 95% confidence interval (CI) 68.0–79.1) than the control group (mean 65.7; SD 7.9; 95% CI 62.5–69.0). Using a two-tailed independent t test, the mean difference between both groups was found to be 7.8, or 12% (95% CI 1.8–13.8; p = 0.012). This highly portable intervention may improve discharge summary documentations by new PGY1 residents during EMCT if implemented nationwide.