医生的分配不当与住院医生的核心临床能力之间的关联:全国性的横截面研究
Kiyoshi Shikino1,2, Yuji Nishizaki3, Koshi Kataoka4
1Department of Community-Oriented Medical Education, Chiba University Graduate School of Medicine, Chiba, Japan kshikino@gmail.com ynishiza@juntendo.ac.jp.
BMJ open
|October 18, 2024
概括
日本 日本 日本 日本 日本.
科学领域:
- 医学教育 医学教育
- 卫生政策 卫生政策
- 医生分发 医生分发
背景情况:
- 医生分配不当是影响医疗保健获取的全球性挑战.
- 日本利用医生不均分布 (PUD) 指数来解决区域差异.
- 在医生分布多样化的领域中,缺乏对临床能力的客观评估.
研究的目的:
- 客观地评估住院医生在受医生分配不良影响的地区的核心临床能力.
- 探索医生不均分布指数 (PUD) 和住院医生的临床能力之间的关系.
主要方法:
- 采用2023年1月通用医学培训考试 (GM-ITE) 调查数据的横截面研究.
- 包括日本医院的研究生第一年和第二年住院医生.
- 进行了多变量线性回归分析,以比较高和低PUD指数组之间的GM-ITE得分.
主要成果:
- 总共有3723名住院医生参与 (2143名在高PUD指数组,1580名在低PUD指数组).
- 低PUD指数组 (表明医疗供应短缺) 的居民显示GM-ITE得分明显更高.
- 经调整后的分析显示了统计学上显著的差异 (调整系数:1.14;p<0.001).
结论:
- 在不同医生分布的地区的居民之间没有发现GM-ITE得分的临床显著差异.
- 除了医生不均分布 (PUD) 指数之外的因素可能会影响临床能力.
- 调查结果表明,需要重新评估当前的评估方法和教育框架在不同的社区环境.
相关概念视频
01:29Bias in Epidemiological Studies
161
Biases can arise at various stages of research, from study design and data collection to analysis and interpretation. Recognizing and addressing these biases is essential to ensure the validity and reliability of epidemiological findings.Broadly speaking, biases in epidemiology fall into three main categories: selection bias, information bias, and confounding. A more detailed description of possible biases is:
161
01:08Obedience
32.8K
According to obedience research, we may harm others under the forceful pressures of an authority figure (Milgram, 1974). How about if the inappropriate orders were delivered with less force? The increasing interdependence between nurses and physicians compelled Hofling and his colleagues to explore nurses’ reactions to a potentially harmful medical request made by the perceived authority figure, the doctor (Hofling, Brotzman, Dalrymple, Graves, & Pierce, 1966). In this situation,...
32.8K
01:29Issues And Trends In Healthcare Delivery System
5.6K
The issues and trends in healthcare delivery are constantly changing. The COVID-19 pandemic is one recent issue that wreaked havoc on healthcare systems, causing a shortage of healthcare workers, high demand for medicines and supplies, and increased medical expenditure due to a lack of insurance. Other issues include rising healthcare costs and care fragmentation.
Cost Containment
Payment for healthcare services has historically promoted adoption of costly and often unnecessary or inefficient...
Cost Containment
Payment for healthcare services has historically promoted adoption of costly and often unnecessary or inefficient...
5.6K
01:27Confounding in Epidemiological Studies
145
Confounding in statistical epidemiology represents a pivotal challenge, referring to the distortion in the perceived relationship between an exposure and an outcome due to the presence of a third variable, known as a confounder. This variable is associated with both the exposure and the outcome but is not a direct link in their causal chain. Its presence can lead to erroneous interpretations of the exposure's effect, either exaggerating or underestimating the true association. This...
145
01:13Patient-centered Care
2.0K
Patient-centered care involves delivering care beyond inpatient hospitalization. Reflective practice can enhance a patient-centered approach. Reflective practice is a process of reasoning that considers all aspects of the present situation, including practicalities, learning from personal practice, and consideration of patient needs. Patients appreciate care decisions made while considering their input. Involving the patient in their care provides the patient with a sense of contribution rather...
2.0K
01:26Methods of Documentation II: POMR
917
The Problem-Oriented Medical Record (POMR) revolutionized medical record-keeping by introducing a systematic approach focusing on the patient's problems rather than merely listing symptoms. Dr. Lawrence Weed's introduction of this method in the 1960s marked a significant advancement in medical documentation. The POMR framework consists of four key components: the database, problem list, plan of care, and progress notes.
917