A patient follow-up intervention to improve medical decision making at an internal medicine residency program

Leela Chockalingam*, Angela Keniston, Lauren McBeth, Marina Mutter

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Objectives: Practice-based learning and improvement (PBLI) is an ACGME (Accreditation Council for Graduate Medical Education) core competency. Learning and reflecting on patients through follow-up is one method to help achieve this competency. We therefore designed a study evaluating a structured patient follow-up intervention for senior internal medicine (IM) residents at the University of Colorado Hospital (UCH). Methods: Trainees completed structured reflections after performing chart review of prior patients during protected educational time. Two-month follow-up surveys evaluated the exercise's potential influence on clinical and reflective practices. Results: Forty out of 108 (37 %) eligible residents participated in the exercise. Despite 62.5 % of participants lacking specific questions about patient outcomes before chart review, 81.2 % found the exercise at least moderately helpful. 48.4 % of participants believed that the review would change their practice, and 60.9 % felt it reinforced their existing clinical practices. In our qualitative data, residents learned lessons related to challenging clinical decisions, improving transitions of care, the significance of early goals of care conversations, and diagnostic errors/strategies. Conclusions: Our results indicate that IM residents found a structured patient follow-up intervention educational, even when they lacked specific patient outcomes questions. Our results underscore the importance of structured self-reflection in the continuous learning process of trainees and suggest the benefit of dedicated educational time for this process.

Original languageEnglish (US)
Pages (from-to)142-150
Number of pages9
Issue number2
StatePublished - May 1 2024


  • clinical reasoning
  • diagnostic errors
  • medical education
  • practice-based learning and improvement
  • qualitative research

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Biochemistry, medical
  • Health Policy
  • Clinical Biochemistry
  • Medicine (miscellaneous)


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