Shah Manish N, Heppard Brian, Medina-Walpole Annette, Clark Nancy S, McCann Robert
Family Medicine, School of Medicine and Dentistry, University of Rochester, Rochester, New York, USA.
J Am Geriatr Soc. 2005 Jan;53(1):141-5. doi: 10.1111/j.1532-5415.2005.53024.x.
This article describes the experience of fourth-year medical students participating in a geriatric education program integrated into a 4-week emergency medicine student clerkship. Between July 2002 and April 2003, all students in this required clerkship participated in a geriatric educational program consisting of a small group discussion of medical and psychosocial issues of older adult emergency department (ED) patients. Students used learned skills to evaluate older adult ED patients for medical and psychosocial issues and later followed up with these patients by telephoning them at their homes or visiting them in the hospital. Students tracked their evaluations of the medical problems, functional abilities, and social supports of patients in the ED. Students also noted when their assessments resulted in the acquisition of new skills or knowledge and when their evaluation of geriatric syndromes resulted in a change of the patient care plan. Seventy-seven students evaluated 217 patients in the ED, of whom 167 (77%) received a follow-up visit or phone call. Students documented learning new skills while caring for 80 (48%) of the older adult patients. Qualitative survey responses from students indicated that students had increased understanding of the importance of assessing functional status and social supports and providing interdisciplinary care. Integrating geriatric education modules into existing emergency medicine clerkships is an effective method to expand the geriatric curriculum in medical schools and to emphasize the importance of geriatric assessment and syndromes in emergency care.
本文描述了四年级医学生参与一项老年医学教育项目的经历,该项目融入了为期4周的急诊医学学生临床实习。在2002年7月至2003年4月期间,所有参加此次必修临床实习的学生都参与了一个老年医学教育项目,该项目包括对老年急诊科患者的医学和社会心理问题进行小组讨论。学生们运用所学技能对老年急诊科患者的医学和社会心理问题进行评估,随后通过电话家访或到医院探访对这些患者进行随访。学生们跟踪他们对急诊科患者的医疗问题、功能能力和社会支持的评估。学生们还记录了他们的评估何时带来了新技能或知识的获得,以及他们对老年综合征的评估何时导致了患者护理计划的改变。77名学生对急诊科的217名患者进行了评估,其中167名(77%)接受了随访或电话回访。学生们记录了在照顾80名(48%)老年患者时学到了新技能。学生们的定性调查反馈表明,他们对评估功能状态和社会支持以及提供跨学科护理的重要性有了更多的理解。将老年医学教育模块融入现有的急诊医学临床实习是一种有效的方法,可以扩展医学院校的老年医学课程,并强调老年医学评估和综合征在急诊护理中的重要性。