Lyman Jason A, Schorling John, Nadkarni Mohan, May Natalie, Scully Ken, Voss John
Department of Public Health Sciences, University of Virginia Health System, Charlottesville, VA 22908, USA.
J Gen Intern Med. 2008 Apr;23(4):485-8. doi: 10.1007/s11606-007-0467-y.
Multiple factors are driving residency programs to explicitly address practice-based learning and improvement (PBLI), yet few information systems exist to facilitate such training. We developed, implemented, and evaluated a Web-based tool that provides Internal Medicine residents at the University of Virginia Health System with population-based reports about their ambulatory clinical experiences. Residents use Systems and Practice Analysis for Resident Competencies (SPARC) to identify potential areas for practice improvement. Thirty-three (65%) of 51 residents completed a survey assessing SPARC's usefulness, with 94% agreeing that it was a useful educational tool. Twenty-six residents (51%) completed a before-after study indicating increased agreement (5-point Likert scale, with 5=strongly agree) with statements regarding confidence in ability to access population-based data about chronic disease management (mean [SD] 2.5 [1.2] vs. 4.5 [0.5], p < .001, sign test) and information comparing their practice style to that of their peers (2.2 [1.2] vs. 4.6 [0.5], p < .001).
多种因素促使住院医师培训项目明确关注基于实践的学习与改进(PBLI),但用于促进此类培训的信息系统却很少。我们开发、实施并评估了一个基于网络的工具,该工具为弗吉尼亚大学健康系统的内科住院医师提供有关其门诊临床经验的基于人群的报告。住院医师使用住院医师能力系统与实践分析(SPARC)来确定实践改进的潜在领域。51名住院医师中有33名(65%)完成了一项评估SPARC实用性的调查,94%的人认为它是一种有用的教育工具。26名住院医师(51%)完成了一项前后对比研究,结果显示他们对获取有关慢性病管理的基于人群的数据的能力(平均[标准差]2.5[1.2]对4.5[0.5],p<.001,符号检验)以及将自己的实践风格与同行进行比较的信息的信心(2.2[1.2]对4.6[0.5],p<.001)方面的陈述的认同度(5点李克特量表,5=强烈同意)有所提高。