Stimmel Barry, Cohen Devra, Colliver Jerry, Swartz Mark
Departments of Medicine and Medical Education, Mount Sinai School of Medicine of The City University of New York.
Subst Abus. 2000 Mar;21(1):1-7. doi: 10.1080/08897070009511413.
Utilizing standardized patients (SPs), house staff knowledge of alcohol and substance abuse was assessed in residents just prior to their starting their first graduate year of training. A total of 345 residents from 13 different residencies in eight institutions participated in this program. Each resident was assigned four SP cases. The reliability of these encounters ranged from 0.63 to 0.74. Of the participating residents, 22% were United States medical graduates (USMGs) and 78% were international medical graduates (IMGs). A considerable proportion of both USMGs and IMGs failed to ask appropriate questions concerning alcohol and drug use or identify the presence of risk factors associated with such use. Residents' scores on cases primarily dealing with general medical issues, as compared to those dealing with substance abuse, were consistently higher. Knowledge of basic information concerning substance abuse and opioids was deficient in over 50% of those tested. These findings suggest that residents about to start their clinical training are not sufficiently prepared to address patients presenting with alcohol and other drug problems.
利用标准化病人（SPs），在住院医师开始其首个研究生培训年之前，对他们关于酒精和药物滥用的知识进行了评估。来自八个机构的13个不同住院医师项目的345名住院医师参与了该项目。每位住院医师被分配了四个标准化病人案例。这些问诊的信度范围为0.63至0.74。参与的住院医师中，22%是美国医学毕业生（USMGs），78%是国际医学毕业生（IMGs）。相当一部分美国医学毕业生和国际医学毕业生都未能询问关于酒精和药物使用的适当问题，也未能识别与此类使用相关的风险因素的存在。与处理药物滥用问题的案例相比，住院医师在主要处理一般医疗问题的案例上的得分始终更高。超过50%的受测者缺乏关于药物滥用和阿片类药物的基本信息。这些发现表明，即将开始临床培训的住院医师在应对出现酒精和其他药物问题的患者时准备不足。
