Interdisciplinary Shadowing and Case Discussion Improve Medical Students’ Self-Efficacy and Attitude Toward Discharge Planning

Abstract

Background

The Discharge Planning Curriculum (DPC) is a 4-hour course for penultimate-year medical students at a tertiary teaching hospital in Taiwan. The course begins with a 30-minute introduction, followed by the students shadowing discharge planning case managers as they visit patients on the wards. After patient visits, the students engaged in a 1-hour case discussion. Our research assessed the effectiveness of the DPC for medical students.

Methods

This mixed methods study recruited medical students participating in family medicine rotations between October 2017 and May 2018. To determine the impact of the DPC, we quantitatively analyzed questionnaire responses to measure changes in self-efficacy, attitude toward discharge planning, and course satisfaction before and after completing the DPC. Additionally, we conducted qualitative focus group interviews to gain insight into the students’ learning experiences and applied thematic analysis to the interview data.

Results

Our study found two quantitative results: 1) The DPC significantly improved self-efficacy and attitude toward discharge planning (p < 0.001). 2) The medical students acquired knowledge about home care, assistive device application, long-term care facility referral, home rehabilitation, and home care services, and more than 95% of the students reported being satisfied with the course. In addition, the focus group interviews revealed that medical students learned several aspects of discharge planning through the curriculum, including an understanding of various aspects of discharge planning through the curriculum, the importance of early discharge planning, the roles of doctors and case managers, and the challenges faced in the process.

Conclusion

The DPC helped medical students understand different team members’ roles in discharge planning and appreciate the challenges that case managers face in this process. The DPC improved medical students’ attitudes toward discharge planning. The curriculum can be a valuable tool in training future healthcare providers in effective transitional care.

Keywords:

• continuity of patient care
• curriculum evaluation
• interdisciplinary training
• patient discharge
• undergraduate medical education

Abbreviations

DPC, discharge planning curriculum.

Data Sharing Statement

The datasets generated and/or analyzed during the current study are available from the corresponding author on reasonable request.

Ethics Approval and Consent to Participate

This study was approved by the Institutional Review Board of the Tri-Service General Hospital, Taipei, Taiwan (TSGHIRB 1-107-05-007). Written informed consent including publication of anonymized responses was obtained from all participants.

Acknowledgments

The authors would like to thank the study participants for their time.

Author Contributions

All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

Disclosure

The authors report no conflicts of interest in this work. The authors alone are responsible for the content and writing of this article.

Additional information

Funding

This study is sponsored by the Ministry of Science and Technology, Taiwan (MOST 106-2511-S-016-001-MY2). The funder had no role in this study.