Seaberg D C, Godwin S A, Perry S J
Department of Emergency Medicine, University of Florida Health Science Center, Jacksonville, FL, USA.
Acad Emerg Med. 2000 Dec;7(12):1433-6. doi: 10.1111/j.1553-2712.2000.tb00504.x.
Residency programs only are not challenged with developing competent emergency clinicians, but should strive to develop caring, empathetic, and community-minded physicians. An exercise was designed to help residents experience emergency department (ED) visits from the patient's perspective.
This study occurred in emergency medicine residency program at an urban teaching institution with an annual ED census of 94,000. On the first day of residency orientation, each resident was given a clinical scenario and registered through triage into the ED. Nurses were blinded to the study. The study concluded when the examining physician entered the exam room. Residents were then presented with a simulated bill based on their scenario. Residents completed a survey initially and at six months. Survey ratings were measured using a 100-mm visual analog scale (VAS) (0 = not at all; 100 = a great deal).
Twenty-five residents participated over two years. Sixty-four percent had never been an ED patient before. Median length of stay was 139 minutes. This exercise was found to improve resident empathy for patients on initial survey, 66 mm (range 16-71), and at follow-up, 66 mm (range 23-91). Residents found the exercise useful both initially, 50 mm (range 4-86), and at follow-up, 49 mm (range 15-81). Ninety-two percent of the residents thought the goals of the exercise had been met. Residents also stated the study changed their approach to patient care (45 mm, range 4-76) and made them a better physician (49 mm, range 5-80).
The ED visit study enhanced patient empathy within residents and was useful in improving patient care attitude.
培养胜任的急诊临床医生并非住院医师培训项目面临的唯一挑战,还应努力培养有爱心、有同理心且具有社区意识的医生。设计了一项活动,以帮助住院医师从患者的角度体验急诊就诊过程。
本研究在一所城市教学机构的急诊医学住院医师培训项目中进行,该机构急诊科年接诊量为94000人次。在住院医师入职培训的第一天,给每位住院医师一个临床病例,并通过分诊登记进入急诊科。护士对该研究不知情。当检查医师进入检查室时,研究结束。然后根据他们的病例给住院医师提供一份模拟账单。住院医师在最初和六个月时完成一份调查问卷。调查评分采用100毫米视觉模拟量表(VAS)(0 = 一点也不;100 = 非常)进行测量。
两年内共有25名住院医师参与。64%的人之前从未作为急诊患者就诊过。中位住院时间为139分钟。结果发现,这项活动在初始调查时提高了住院医师对患者的同理心,评分为66毫米(范围16 - 71),在随访时为66毫米(范围23 - 91)。住院医师发现该活动在最初(评分为50毫米,范围4 - 86)和随访时(评分为49毫米,范围15 - 81)都很有用。92%的住院医师认为该活动达到了目标。住院医师还表示,该研究改变了他们对患者护理的方式(评分为45毫米,范围4 - 76),并使他们成为更好的医生(评分为49毫米,范围5 - 80)。
急诊就诊研究增强了住院医师对患者的同理心,有助于改善患者护理态度。