凭证考试中的临床和沟通技能的分数是否预测了可能不适当的抗生素处方?
Robyn Tamblyn1,2,3, Teresa Moraga4, Nadyne Girard4
1Department of Epidemiology, Biostatistics and Occupational Health, McGill University, 2001 McGill College Avenue, H3A 1G1, Montreal, QC, Canada. robyn.tamblyn@mcgill.ca.
BMC medical education
|November 2, 2023
概括
具有较强的人际交往技能的医生对呼吸道感染的抗生素处方较少. 提高这些技能可能会减少不必要的抗生素使用.
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
- 抗生素管理局 抗生素管理局
背景情况:
- 不适当的抗生素处方在医生之间有所不同,与诊断不确定性和沟通问题有关.
- 医生沟通和临床技能可能会影响常见感染的抗生素处方.
研究的目的:
- 评估医生临床和沟通技巧与对上呼吸道感染 (URIs) 和鼻炎的抗生素处方之间的关联.
主要方法:
- 一项队列研究分析了2526名国际医学毕业生和48394名医疗保险患者.
- 用临床技能评估 (CSA) 考试评估临床和沟通技巧.
- 抗生素分发数据来自医疗保险D部分,医生特征来自ECFMG和AMA数据库.
主要成果:
- 抗生素在71.1%的鼻炎和50.5%的URI遭遇中被处方.
- 改进的人际交往技能得分显著降低了抗生素处方几率 (或每十分之一的0.93).
- 临床技能熟练程度和英语熟练程度与处方率无关;女性医生和内科或美国南部地区的医生更有可能开处方抗生素.
结论:
- 显示出卓越的人际交往技能的医生不太可能为URI和鼻炎开处方抗生素.
- 针对人际交往技能的有针对性的培训可以通过更好地管理患者的期望来减少不必要的抗生素处方.
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