医学学生在临床轮换期间模拟的高价值和潜在的浪费性护理行为的观察
Amanda Wade1, Meher Kalkat2, Colin Uyeki3
1Oregon Health & Science University School of Medicine, Portland, OR, USA.
Journal of general internal medicine
|January 21, 2025
概括
医学学生在临床轮换期间观察到不同程度的高价值护理 (HVC) 角色建模. 临床医生比住院医生更频繁地表现出HVC,一般外科医生表现出较少的HVC建模.
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
- 职业身份的形成 职业身份的形成
背景情况:
- 接触高价值护理 (HVC) 角色建模影响医学学生的专业身份和未来的实践.
- 了解HVC角色建模的频率和性质对于塑造未来医生行为至关重要.
研究的目的:
- 量化医学学生目睹的HVC角色模拟行为发生率和特征.
- 在不同临床轮换和各种教育工作者之间识别HVC角色建模的变化.
主要方法:
- 一项涉及11所美国医学院的医学学生的横截面调查研究.
- 一项经过验证的13项调查评估了学生对成本意识和潜在浪费角色模拟行为的看法.
- 该调查被修改,以捕捉教育工作者的角色 (与会者 vs. 住院医生/研究员) 和临床轮换背景.
主要成果:
- 在大多数轮换中,经常观察到成本意识的角色建模 (52.9-70.5%),除了赞扬成本有效的工作组 (25.7%).
- 潜在的浪费行为较少 (5-14.3%),但包括提前订购众多测试 (45.1%) 和重复测试 (32.2%).
- 内部医疗护理人员最常模拟HVC (67.7%),而一般外科护理人员最少模拟 (47.3%). 与会者通常比居民/同学更像模拟HVC.
结论:
- 在医学学生的核心临床轮换期间,教育工作者不一致地展示了高价值的护理角色建模.
- 临床医生是HVC比住院医生更一致的榜样,一般外科比其他专业更低的HVC建模.
- 需要进一步的研究来确定在临床环境中促进或阻碍HVC角色建模的具体因素.
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