直接观察涉及医学学生的基于社区的门诊接触
S H Frank1, K C Stange, D Langa
1Department of Family Medicine, Case Western Reserve University, Cleveland, OH 44106-4950, USA. shf2@po.cwru.edu
JAMA
|September 3, 1997
概括
门诊护理机构的医学学生改变了医生讨论期望和病史的方法,但不会影响整体访问长度或患者满意度. 它们的存在不会对患者护理的质量产生负面影响.
科学领域:
- 医学教育 医学教育
- 健行护理服务提供者
- 医疗保健服务研究 医疗服务研究
背景情况:
- 医学教育从住院到社区出院的转变引发了人们对医学学生对患者护理的影响的担忧.
- 评估医学学生对临床接触的影响对于优化培训和患者结果至关重要.
研究的目的:
- 评估医学学生对临床时间利用和在门诊期间患者满意度的影响.
- 量化医生与患者互动模式的变化,有或没有学生参与.
主要方法:
- 在16个基于社区的家庭实践办公室中进行了一项横截面的多方法研究.
- 通过受过研究培训的护士进行直接观察和验证的患者满意度调查 (医疗结果研究9项访问评级尺度) 得到了使用.
- 从452次门诊访问中收集了数据,比较了学生参与和不参与的患者.
主要成果:
- 当学生在场时,医生花了更多的时间在访问期望上,而在历史记录和评估上花了更少的时间.
- 总的来说,医生与患者的互动时间保持一致 (大约10分钟),患者满意度没有显著差异.
- 医生更有可能讨论其他家庭成员的问题,学生不成比例地被分配给少数民族患者.
结论:
- 医学学生的参与改变了门诊接触的内容,但并没有改变其持续时间.
- 患者的满意度和满足患者的期望不会受到医学学生的存在的影响.
- 该研究强调需要解决学生分配中的潜在偏见,并进一步调查改变交互动态的影响.
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