Are Discharge Summaries Teachable? The Effects of a Discharge Summary Curriculum on the Quality of Discharge Summaries in an Internal Medicine Residency Program

Abstract
Interns are often required to dictate discharge summaries without formal training. We investigated the impact of a curriculum aimed at improving the quality (i.e., complete, organized, succinct, internally consistent, and readable) of interns' discharge summaries. Fifty-nine medicine interns were randomized to a: (1) control group; (2) discharge summary curriculum; or (3) curriculum plus individualized feedback. Pre- and post-intervention, seven discharge summaries were graded using a 9-item instrument. T-tests, analysis of covariance, and effect sizes assessed group differences. There were multiple, significant within-group improvements for the intervention groups and between group differences post-intervention. The average effect size was large when the curriculum plus feedback group was compared to the control group (.70) and moderate when compared to the curriculum only group (.36). Interns who received instruction on discharge summary skills improved the quality and of their discharge summaries. Adding feedback to the curriculum provided more benefit.