Levine Sharon A, Chao Serena H, Brett Belle, Jackson Angela H, Burrows Adam B, Goldman Laura N, Caruso Lisa B
Department of Medicine, School of Medicine, Boston University, Boston, Massachusetts 02118, USA.
J Am Geriatr Soc. 2008 Jun;56(6):1140-5. doi: 10.1111/j.1532-5415.2008.01710.x. Epub 2008 Apr 10.
Chief residents (CRs) play a crucial role in training residents and students but may have limited geriatrics training or formal preparation for their CR role. A 2-day off-site chief resident immersion training (CRIT) addressed these challenges. Objectives were to foster collaboration between disciplines in the management of complex older patients, increase knowledge of geriatrics principles to incorporate into teaching, enhance leadership skills, and help CRs develop an achievable project for implementation in their CR year. Three cohorts totaling 47 trainees and 18 faculty mentors from 13 medical and surgical disciplines participated over 3 successive years. The curriculum, developed and taught by a multidisciplinary team, featured an interactive surgical case, mini-lectures on geriatrics topics, seminars to enhance teaching and leadership skills, and one-on-one mentoring to develop a project in geriatric care or education. Evaluation included pre- and postprogram tests and self-report surveys and two follow-up surveys or interviews. In 2006 and 2007, scores on a 12-item objective knowledge test increased significantly (P<.001) from before to immediately after CRIT. Self-report knowledge and confidence in teaching geriatrics also increased significantly (P<.05) in all formally covered topics. Mean enhancement of CR skills was 4.3 (1=not at all, 5=very much). Eleven months after CRIT, all but five CRs had implemented at least part of their action projects. CRs reported improved care of older patients, better leadership skills, more and better geriatrics teaching, and more collaboration between disciplines. A 2-day interactive program for CRs can increase institutional capacity regarding geriatrics teaching and care of elderly patients across medical specialties.
住院总医师(CRs)在培训住院医师和医学生方面发挥着关键作用,但他们接受的老年医学培训可能有限,或者对其住院总医师角色缺乏正式的准备。为期两天的异地住院总医师沉浸式培训(CRIT)解决了这些挑战。其目标是促进各学科在复杂老年患者管理中的协作,增加将老年医学原则纳入教学的知识,提高领导技能,并帮助住院总医师制定一个在其住院总医师年度可实施的项目。在连续三年中,来自13个内科和外科专业的三个学员组,共47名学员和18名教员导师参加了培训。该课程由一个多学科团队开发和授课,包括一个交互式外科病例、关于老年医学主题的小型讲座、提高教学和领导技能的研讨会,以及一对一指导以制定老年护理或教育项目。评估包括项目前后测试、自我报告调查以及两次后续调查或访谈。在2006年和2007年,12项客观知识测试的分数在CRIT前后显著提高(P<.001)。在所有正式涵盖的主题中,自我报告的老年医学教学知识和信心也显著提高(P<.05)。住院总医师技能的平均提升为4.3(1=完全没有,5=非常多)。CRIT结束11个月后,除了五名住院总医师外,其他所有住院总医师都至少实施了他们行动项目的一部分。住院总医师报告称,老年患者的护理得到改善,领导技能提高,老年医学教学更多且更好,各学科之间的协作也更多。为期两天的住院总医师互动项目可以提高机构在跨医学专业的老年医学教学和老年患者护理方面的能力。