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By Melanie Powell, MD, MPH
Hello! I am the inaugural fellow in Quality and Safety at the MedStar Institute for Quality and Safety. Over the next year, I’ll provide monthly insights and document my transition from Family Medicine chief resident at one of MedStar’s community-based hospitals to the administrative fellow at MIQS, an institute housed within one of the largest hospital systems in the Northeast United States.
As residents settle into the new academic year, the most common question upper levels face is: “What’s next?” My former co-residents, having figured this out and starting their new positions, now ask, “How did that go by so fast?”
Times of transition are both challenging and incredibly exciting. Trainees across the healthcare spectrum transitioning to independent practice may feel high levels of anxiety, stress, and concerns about inadequacy, isolation, confusion, and fear. This can lead to underperformance, burnout and ultimately compromise the delivery of safe, high-quality care. In response, organizations such as the American College of Surgeons and residency programs like University of Iowa Health Care Anesthesiology developed Transition to Independent Practice Programs to help fill perceived gaps in training. The National Council of State Boards of Nursing recently completed a national study to transition new nursing graduates into clinical practice. Initial results show that nursing clinical competence significantly increased after 9-12 months of participation.
What these programs have in common is mentorship. Mentorship is critical to the development of confident and clinically competent healthcare providers. Typically, it is implied and assumed by residency programs but actualized with varying degrees of value to residents and faculty. Reviewing the ACGME Milestones for Family Medicine Residents, mentorship is mentioned only once (within the description of a Level 5 achievement for professionalism) and in the context of a resident becoming a successful mentor herself. While it’s expected and vital that residents become effective mentors so they may train the next generation of leaders and support their colleagues, all health care providers require guidance to do so.
I am excited to be part of a health system that recognizes the value of mentorship and feel privileged to have been mentored by two very strong women during my Family Medicine residency at MedStar Franklin Square Medical Center. In addition to the research mentorship provided through the MedStar Health Research Institute, the MedStar Institute for Quality and Safety is generating a network of quality and safety mentors to pair with young trainees. Further, the Academy for Emerging Leaders in Patient Safety (AELPS) continues to educate an interdisciplinary group of young trainees in the US and abroad that includes medical and nursing students, connected with each other through a shared love of patient safety and dedication to culture change.
The question we must always ask ourselves going forward is: “How can we improve?” There are abundant opportunities to add to the curricula of nursing/medical schools and residency programs so that future clinicians can start building their skills as early as possible. To do this, we must identify ways to make mentorship, quality improvement, patient safety, and leadership a part of trainees’ everyday experiences. I think this includes encouraging interdisciplinary collaboration whenever possible. We grow professionally and make our patients safer when each front-line voice is heard and connected.
I hope those of you reading this post reply with your insights and share the innovative changes happening at your medical schools, nursing schools, hospitals, and elsewhere.