一种质量改进方法,将健康目标的社会决定因素纳入儿科模拟中
Megan Feick1, Ammarah U Iqbal1, Henna Boolchandani1
1Yale University School of Medicine New Haven Connecticut USA.
AEM education and training
|October 4, 2023
概括
将健康的社会决定因素 (SDH) 整合到儿科紧急情况模拟中,显著增加了其包含率,从5%增加到57%. 实习生压倒性地批准了这些增强的模拟,强调了它们在解决健康差异方面的价值.
科学领域:
- 医学教育 医学教育
- 健康 公平 卫生 公平
- 基于模拟的学习
背景情况:
- 健康差异和不平等的社会资源分配对健康结果产生负面影响.
- 健康的社会决定因素 (SDH) 对整体和公平的患者护理至关重要.
- 时间限制和缺乏理解等障碍阻碍了提供者解决SDH的问题.
研究的目的:
- 增加SDH目标在儿科紧急情况模拟中的整合.
- 主要目标:在12个月内将SDH含量从5%提高到50%.
- 二级目标:评估实习生对SDH整合的认可.
主要方法:
- 采用改善模式框架,包括与居民和辅导员的采访.
- 确定了关键驱动因素,并开发了嵌入SDH目标的模拟案例 (例如,无家可归,种族主义).
- 利用计划-做-研究-行动循环进行代测试,改进和实施干预措施.
主要成果:
- 在质量改进倡议之前,SDH很少被纳入儿科紧急模拟.
- 在研究期间,包括SDH主题的模拟比例每月上升到57%.
- 绝大多数受训者 (94%) 赞成将SDH目标纳入.
结论:
- 改进模式有效地将SDH目标集成到儿科紧急住院模拟中.
- 未来的方向包括评估课程的有效性,更广泛的传播和评估长期可持续性.
- 模拟课程有望提高学习者在实践中解决SDH的能力.
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