A systematic review of evidence-based practices for clinical education and health care delivery in the clinical teaching unit

Abstract

Background: The clinical teaching unit using the Grading of Recommendations is a widespread clinical training model Assessment, Development and Evaluathat requires reform to prepare phystion Confidence in the Evidence from icians for practice in the 21st century. In Reviews of Qualitative Research (GRADEthis systematic review, we aimed to CERQual) methodology. identify evidencebased practices in internal medicine clinical teaching units Results: We included 107 studies of that contribute to improved clinical internal medicine clinical teaching education and health care delivery. units, of which 93 (87%) were conducted in North America. Surveys Methods: We searched several data(n = 31, 29%), trials (n = 17, 16%) and bases from 1993 until Apr. 5, 2021, to narrative studies (n = 15, 14%) were the identify published studies in inpatient most prevalent study designs. Pracclinical teaching units that involved medtices identified as contributing to ical trainees and reported outcomes improved clinical education or health related to trainee education or health care delivery included purposeful care delivery. We identified emergent rounding (high confidence), bedside themes using a narrative approach and rounding (moderate confidence), determined confidence in review findings resource stewardship interventions (high confidence), interprofessional rounds (moderate confidence), geographic wards (moderate confidence), allocating more trainee time to patient care or educational activities (moderate confidence), “drip” continuous models of admission (moderate confidence), limiting duty hours (moderate confidence) and limiting clinical workload (moderate confidence).