Are discharge summaries teachable? The effects of a discharge summary curriculum on the quality of discharge summaries in an internal medicine residency program.

Overview

BACKGROUND: Interns are often required to dictate discharge summaries without formal training. We investigated the impact of a curriculum aimed at improving the quality (i.e., complete, organized, succinct, internally consistent, and readable) of interns' discharge summaries. METHOD: Fifty-nine medicine interns were randomized to a: (1) control group; (2) discharge summary curriculum; or (3) curriculum plus individualized feedback. Pre- and post-intervention, seven discharge summaries were graded using a 9-item instrument. T-tests, analysis of covariance, and effect sizes assessed group differences. RESULTS: There were multiple, significant within-group improvements for the intervention groups and between group differences post-intervention. The average effect size was large when the curriculum plus feedback group was compared to the control group (.70) and moderate when compared to the curriculum only group (.36). CONCLUSIONS: Interns who received instruction on discharge summary skills improved the quality and of their discharge summaries. Adding feedback to the curriculum provided more benefit.