在研究生医学教育中实施共享决策的障碍:以疾病为中心的信念的作用
Laura Alexandra van der Woude1, Gera A Welker1, Paul L P Brand2,3
1University Medical Center Groningen (UMCG), Hanzeplein 1, 9713 GZ Groningen, The Netherlands.
Perspectives on medical education
|July 28, 2025
概括
共享决策 (SDM) 得到广泛支持,但由于医生之间根深蒂固的以疾病为中心的信念,很少实施. 克服这些信念对于将SDM纳入医学教育和实践至关重要.
科学领域:
- 医学教育 医学教育
- 卫生专业 卫生专业 卫生专业
- 以患者为中心的护理
背景情况:
- 共享决策 (SDM) 提供了显著的患者益处,但面临着实施挑战.
- 医生对SDM的行为改变通常是有限的,可能是由于潜在的信念.
- 在研究生医学教育中集成SDM的障碍需要探索.
研究的目的:
- 调查荷兰居民和医疗专家关于SDM的看法,信仰和行为.
- 识别阻碍SDM融入研究生医学教育的障碍.
主要方法:
- 混合方法研究,结合调查 (控制偏好量表,iSHARE) 和重点小组访谈.
- 参与者包括来自七家荷兰教学医院的住院医生和医疗专家.
- 专题分析用于重点小组的定性数据.
主要成果:
- 对SDM (93%) 和将其纳入教育 (89%) 的高度认可.
- 居民 (6%) 和专家 (18%) 报告的SDM培训率较低.
- 四个以疾病为中心的信念被确定为SDM实施的主要障碍.
结论:
- 尽管得到了广泛的支持,但以疾病为中心的思维阻碍了SDM的实际实施.
- 可持续的SDM整合需要意识到并从以疾病为中心的方法转向以人为中心的方法.
- 为了有效采用SDM,培训和教育必须解决这些基本信念.
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