在军事内科住院计划中实施"健康公平轮"课程:试点研究
Veronica Wright1, William Hirschfeld2, Erika Walker2
1Combined Internal Medicine/Psychiatry Residency Program, National Capital Consortium, Walter Reed National Military Medical Center, Bethesda, MD 20889, USA.
Military medicine
|May 21, 2024
概括
这项研究表明,基于案例的学习有效地培训军事医疗学员识别健康差异. 该课程提高了识别军事卫生系统 (MHS) 内偏见和歧视的技能.
科学领域:
- 医学教育 医学教育
- 健康 公平 卫生 公平
- 军事卫生系统 军事卫生系统
背景情况:
- 尽管在军事卫生系统 (MHS) 获得平等的护理,但健康差异仍然存在.
- 健康的社会决定因素和医疗保健因素,如提供者偏见,推动了这些差异.
- 基于案例的学习有效地教授健康公平术语,但在诊断临床病例中的差异识别方面的技能发展仍然是一个差距.
研究的目的:
- 确定基于案例的学习是否可以为学员提供技能,以识别导致MHS健康差异的因素.
- 评估基于案例的新课程在提高学员识别偏见和歧视的能力方面的有效性.
主要方法:
- 一个纵向的基于案例的课程",健康公平轮",在国家资本财团内科住院计划中实施.
- 实习生分析了临床病例,以寻找医疗保健提供者偏见和小组系统歧视的证据.
- 一个追溯的测试前后测试调查评估了学员的信心和对课程的反应,并使用对的样本分析数据 t-test.
主要成果:
- 该调查的响应率为60.8% (14/23名实习生).
- 93%的实习生发现案例有吸引力,技能实践变化,教育价值良好至优秀.
- 在识别偏见/歧视 (P<.001),减轻个人偏见 (P<.001) 和参与/领导这些话题的讨论 (P=.001,P=.002) 中,观察到自我报告的信心有显著的增加.
结论:
- 医疗公平轮,利用基于案例的学习,显示承诺作为军事内部医学学员的最佳教学方法.
- 该课程有效地提高了学员在识别和识别医疗保健提供者偏见和MHS内部系统歧视的影响方面的技能.
- 解决健康差异需要军事医生熟练识别MHS内的他们的司机.
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