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耳鼻喉科门诊的医学生:预约时间、患者满意度和学生满意度。

Medical students in ENT outpatient clinics: appointment times, patient satisfaction and student satisfaction.

作者信息

Hajioff D, Birchall M

机构信息

Southmead Hospital, Bristol, UK.

出版信息

Med Educ. 1999 Sep;33(9):669-73. doi: 10.1046/j.1365-2923.1999.00422.x.

Abstract

OBJECTIVES

Outpatient clinics are increasingly important in medical education. The effect of students on clinic times and patient satisfaction, as well as their own satisfaction, were studied.

DESIGN

A prospective, non-randomized, controlled study using adult patient questionnaires, medical student questionnaires and clinic time sheets.

SETTING

Two teaching hospital ENT clinics.

SUBJECTS

Medical students and adult patients.

RESULTS

Three hundred and twenty-five patient questionnaires were collected (77% response), including 135 student encounters. Students did not affect appointment durations (19 min +/- 0.48 (standard error)) except at centre B (35 min +/- 1.1, P < 0.0001) where patient numbers were cut for teaching. Patient satisfaction, generally high, was not affected by students, appointment duration or gender of doctor or patient. It was slightly higher in the lower social classes (rs = 0.20, P = 0. 003) and older patients (rs = 0.17, P = 0.002). Student acceptability scores were not affected by student numbers (up to four), social class or time spent alone with students. They were higher if time was spent alone with the doctor (75.3% +/- 4.9) than not (63.0% +/- 1.8, P = 0.024). Thirty-six per cent of patients preferred to have a student present; only 9% preferred not. Student satisfaction was higher at centre B (73.7% +/- 2.3) where appointments were longer and students spent more time alone with patients than centre A (64.3% +/- 2.3, P = 0.0052).

CONCLUSIONS

Clinic appointments are not necessarily longer in the presence of students. When students have the chance to see patients alone during longer consultations, student satisfaction is higher. Patient satisfaction, generally high, is not altered by the presence of students, but patients given time alone with their doctor are more accepting of students. These findings have resource implications for the planning of NHS clinics in teaching hospitals.

摘要

目的

门诊诊所在医学教育中日益重要。本研究探讨了学生对门诊时间及患者满意度的影响,以及学生自身的满意度。

设计

一项前瞻性、非随机对照研究,采用成人患者问卷、医学生问卷及门诊时间表。

地点

两家教学医院的耳鼻喉科门诊。

研究对象

医学生和成年患者。

结果

共收集到325份患者问卷(回复率77%),其中包括135次学生参与的诊疗。除了在B中心(35分钟±1.1,P<0.0001),由于教学而减少了患者数量,学生并未影响预约时长(19分钟±0.48(标准误))。总体较高的患者满意度不受学生、预约时长、医生或患者性别的影响。在社会阶层较低者(rs=0.20,P=0.003)和老年患者(rs=0.17,P=0.002)中,满意度略高。学生接受度得分不受学生人数(最多4人)、社会阶层或与学生单独相处时间的影响。与未与医生单独相处(63.0%±1.8)相比,与医生单独相处时得分更高(75.3%±4.9,P=0.024)。36%的患者希望有学生在场;只有9%的患者不希望有。B中心的学生满意度更高(73.7%±2.3),该中心的预约时间更长,学生与患者单独相处的时间比A中心更多(64.3%±2.3,P=0.0052)。

结论

有学生在场时,门诊预约时间不一定会更长。当学生有机会在较长的会诊中单独诊治患者时,学生满意度更高。总体较高的患者满意度不会因学生在场而改变,但有时间与医生单独相处的患者更能接受学生。这些研究结果对教学医院国民保健服务门诊的规划具有资源方面的启示。

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