Enhancing hospital discharge summary writing skills: a pilot study on a competency-based training model

Discharge summary (DS) is an essential clinical document for hospitalized patients. Writing effective DS is a core competency of intern doctors upon entering clinical practice. However, this skill is often underdeveloped due to its exclusion from most medical school curricula, resulting in suboptimal DS quality and communication breakdowns.

We conducted a one-day, in-person DS writing workshop in June 2025 for 58 final year medical students prior to hospital internship. The workshop comprised of pre-workshop assessments, didactic lectures on DS writing skills, small-group appraisals, and post-workshop assessments with tutor feedback. Pre- and post-workshop surveys assessed participants' perceptions of DS writing and workshop effectiveness using a 5-point Likert scale. DS samples from pre- and post-workshop assessments were graded by three blinded specialist doctors using a 10-component rubric (maximum score: 30, 3 in each component).

98.2% of participants agreed that the workshop improved their DS writing skills and would recommend it to others. Survey reponses showed significant post-workshop improvements in understanding purposes and structure of DS (p<0.001), the requirements for an effective DS (p<0.001), confidence in writing an effective DS (p<0.001), and completing it within 10 minutes (p=0.002). Objective assessment scores also improved significantly across most DS key components and for the total score (20.53 ± 2.86 vs 15.54 ± 3.86, p<0.001).

This is the first report in the literature describing a DS writing educational intervention for orthopedics, as previous reports focused mainly on internal medicine and were not tailored to the specifics of an orthopedic or surgical admission such as procedures, complications, and post-operative instructions. This pilot program improved students' performance and confidence in DS writing. It highlights the importance in incorporating competency-based, hands-on DS training as a routine component in medical education to better prepare interns for inpatient clinical practice.