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关于在学术环境中使用远程医疗来预防和教学的定性研究

Brittany J Raffa¹, Kimberly A Muellers², Katerina Andreadis³

¹B.J. Raffa is clinical instructor and NRSA Primary Care Research Fellow, Department of Pediatrics, Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.

Academic medicine : journal of the Association of American Medical Colleges

|June 6, 2023

概括

在COVID-19大流行期间,远程医疗的使用影响了医疗教育,医疗服务提供者和患者注意到在教学和处方方面存在挑战. 改善远程医疗技能和流程对于将其纳入医疗培训至关重要.

科学领域:

医学教育医学教育
医疗保健服务研究医疗服务研究
数字健康数字健康

背景情况:

随着COVID-19的流行,医疗保健机构的远程医疗的采用加速了.
远程医疗为医学教育,特别是临床培训和监督提供了独特的挑战和机会.
了解预防者和患者的经验对于有效地将远程医疗纳入教学至关重要.

研究的目的:

调查远程医疗在COVID-19大流行期间对教学和教学过程的影响.
从提供者和患者的角度确定与基于远程医疗的临床教育相关的挑战和好处.
为优化远程医疗在本科和研究生医学教育中的战略提供信息.

主要方法:

一项定性研究的二次分析,涉及86次采访,涉及65名患者和21名医疗服务提供者在4个学术医疗中心.
对采访数据进行主题分析,重点关注教学和预测中对远程医疗的经验和态度.
绘图确定了2009年实施研究综合框架 (CFIR) 领域的主题.

主要成果:

缺乏先前的远程医疗经验和不充分的流程阻碍了有效的教学和规范,影响了学习环境和感知到的护理质量.
远程医疗的使用加剧了维持住院连续性的挑战,并改变了学员和学员之间的沟通动态.
提供者在远程医疗监督中发现了挑战 (例如,戴口罩,摄像机接近) 和好处 (例如,观察摄像机关闭的学员).
鉴定到的大部分主题 (八个中的六个) 属于CFIR的个人特征,流程和干预特征领域.

结论:

提高医疗保健专业人员的远程医疗技能对于有效的临床教学至关重要.
在学术卫生中心优化远程医疗实施流程对于成功融入医疗课程至关重要.
远程医疗被认为是医疗教育的永久固定装置,需要结构化的方法来利用它.

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