Mapping hospital data to characterize residents' educational experiences.

Area of Science:

• Medical Education
• Internal Medicine Training
• Clinical Informatics

Background:

• Experiential learning is crucial for graduate medical education, but the clinical content trainees encounter is poorly understood.
• Quantifying patient care activities is essential to define residents' educational experiences.
• There's a need to characterize the diversity of clinical cases encountered by residents.

Purpose of the Study:

• To characterize and compare the clinical educational experiences of Internal Medicine residents across four training hospitals.
• To identify variations in patient diagnoses encountered by residents.
• To inform curricular changes aimed at enriching resident training.

Main Methods:

• A crosswalk tool mapped International Classification of Diseases, 10th Revision (ICD-10) discharge diagnoses to American Board of Internal Medicine (ABIM) content.
• Data were collected from four hospitals within a single Internal Medicine Residency Program over one academic year.
• Frequencies of diagnosis categories were compared across sites to profile inpatient clinical experiences.

Main Results:

• Over 18,600 discharges were analyzed, with the crosswalk tool capturing over 95% of cases.
• Infectious Disease and Cardiovascular Disease were the most common diagnoses across all sites.
• Significant underrepresentation of certain specialties (e.g., Allergy/Immunology, Dermatology) and notable site-specific differences in condition frequencies were observed.

Conclusions:

• Substantial variations exist in the clinical content experienced by residents across different hospital training sites.
• These findings highlight the need for programmatic and curricular adjustments.
• Changes were implemented to enhance the hospital-based educational experiences of residents.