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为健康公平工作:在医学研究生教育中模拟和空间反思
Kamna S Balhara1,2, Sean Tackett3, Jessica Bienstock4
1Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, MD.
概括
这项研究为居民开发了基于模拟的健康公平教育,提高了文化谦卑和对解决偏见和健康结构决定因素 (SDOH) 的信心. 对患者相互作用的积极影响持续了很长一段时间.
科学领域:
- 医学教育 医学教育
- 健康 公平 研究 健康 公平 研究
- 基于模拟的学习
背景情况:
- 推进健康公平需要临床医生解决结构差异和减轻偏见.
- 现有的健康公平教育往往缺乏经验组成部分和跨学科融合.
- 需要有效的纵向干预措施,为住院人员准备应对复杂的临床挑战.
研究的目的:
- 描述一所机构范围的,基于纵向模拟的健康公平教育干预措施,用于第一年居民.
- 评估体验式学习对健康结构决定因素 (SDOH) 和偏见缓解的影响.
- 评估居民文化谦卑,沟通技巧和解决健康差异的信心的变化.
主要方法:
- 一年级住院医生参与了与标准化患者 (SPs) 模拟的患者接触.
- 干预包括SP反,叙事反思,使用视觉艺术进行小组汇报,以及3-6个月后续的元认知活动.
- 调查测量了自我报告对临床决策,沟通,SDOH理解和文化谦卑的影响.
主要成果:
- 在模拟后立即观察到文化谦卑和信心的统计学显著改善.
- 居民报告说,在患者接触期间,他们提高了处理污名化语言,偏见和SDOH的技能.
- 大多数改善,包括对患者相互作用的积极影响,在3-6个月的随访中持续存在.
结论:
- 基于模拟的健康公平教育可以有效地提高居民在解决差异方面的技能.
- 该干预表明了跨学科,体验式学习的健康公平模式.
- 用特定场所的案例进行复制可以促进组织对患者需求和公平的承诺.
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