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Background Orienting medical trainees to new practice environments is essential. Huddles have been shown to improve communication and safety outcomes. However, their use in orienting trainees to systems processes and changes on inpatient general medicine (GM) wards remains unexplored. Objective Implement a weekly inpatient huddle between residents and hospital leaders to improve dissemination of information around health system operations. Methods In 2019, we established "Resident Huddle," a weekly 20-minute huddle for senior internal medicine residents rotating on GM wards at a US Department of Veterans Affairs Hospital led by the site leads. Resident Huddle content included system updates, rotation updates, process reminders, performance feedback, and systems and patient safety concerns raised by trainees. Reactions to the huddle were assessed via survey. Behavioral change was assessed by rates of complete trainee admission medication reconciliation documentation before and after huddle implementation. Results Resident Huddle started in October 2019 and continues to this day. Between October 2019 and June 2022, 136 of 205 participants completed surveys (66% response rate). Respondents agreed or strongly agreed that the huddle provided useful information for care delivery (94%, 128 of 136), improved work engagement (73%, 99 of 136), provided feedback on practice patterns (90%, 121 of 135), and that issues they experienced were acknowledged and acted upon (86%, 114 of 133). Retrospective medical record analysis demonstrated improvement in admission medication reconciliation completion rate by trainees from pre-intervention (32%, 19 of 60) to post-intervention (73%, 44 of 60). Conclusions A weekly huddle between hospital leaders and residents strengthened communication and equipped trainees with operational health systems knowledge to enhance patient care outcomes while fostering a greater sense of engagement with their work environment. [ABSTRACT FROM AUTHOR]

Evidence-based medicine (EBM) has long been taught to physician trainees for critical appraisal of research manuscripts. There is no parallel or similar framework to guide trainees in the appraisal of quality improvement (QI) literature. To adapt existing guidelines of QI manuscript reporting into an educational QI-EBM appraisal tool to help residents distinguish research and QI manuscripts, assess QI designs and methodologies, and evaluate QI manuscripts' strengths and weaknesses. Between 2018 and 2021, we developed a QI-EBM critical appraisal tool (QI-EBM-CAT) and performed 3 plan-do-study-act cycles to refine the tool based on JAMA and SQUIRE 2.0 guidelines. We then surveyed residents regarding the usefulness of the tool and their confidence in evaluating QI manuscripts before and after completing a QI-EBM workshop using the QI appraisal tool. Sixty-six of 74 internal medicine postgraduate year (PGY)-1 to PGY-3 residents (89.2%) completed the workshop and assessment surveys in 2021. The workshop was found to be moderately to very useful by 85.1% (63 of 74) of residents as a framework for QI manuscript critical analysis. The summary confidence score in QI manuscript critical appraisal improved from a 64% rating of moderately to very confident in the pre-period to 94.6% in the post-period (P<.001) with statistical improvements in all 5 confidence areas assessed (P<.001). The QI-EBM-CAT, designed to teach residents how to critically assess QI manuscripts using EBM principles, resulted in subjective improvements in confidence of QI manuscript analysis. [ABSTRACT FROM AUTHOR]