Nelson Brett D, Lee Anne Cc, Newby P K, Chamberlin M Robert, Huang Chi-Cheng
Department of Pediatrics, Boston Medical Center, Boston, Massachusetts, USA.
Pediatrics. 2008 Jul;122(1):28-33. doi: 10.1542/peds.2007-2178.
Our goal was to describe current resident interest, participation, curricula, resources, and obstacles related to global health training within pediatric residency programs.
We conducted a cross-sectional survey of the 201 accredited pediatric residency programs in the United States, Puerto Rico, and the Caribbean from October 2006 to January 2007. Survey topics included resident interest and participation in electives, training opportunities, program support, and educational curricular content related to global health.
Of the 201 surveyed pediatric residency programs, 106 (53%) responded. Fifteen percent of responding programs reported that a majority of their residents were interested in global health. Fifty-two percent offered a global health elective within the previous year, and 47% had formally incorporated global health into their training curricula. Six percent of the programs reported a formalized track or certificate in global health. The median number of residents per program participating in global health electives within the previous year was 0 during postgraduate year 1, 1 during postgraduate year 2, and 2 during postgraduate year 3. The median number of all residents per program participating in a global health elective in the previous year was 3 (7.4% of program size). Among programs that offered a global health elective, support to participating residents included prerequisite clinical training (36%), cultural orientation (36%), language training (15%), faculty mentorship (82%), and post-elective debriefing (77%). Fourteen percent of the programs provided full funding for resident electives. Characteristics of pediatric residency programs that were significantly associated with higher resident participation in a global health elective were larger program size, university affiliation, greater reported resident interest, and faculty involvement in global health.
More than half of the pediatric residency programs surveyed offered a global health elective in the previous year. An American Academy of Pediatrics survey 10 years earlier had shown 1 of 4 programs with global health electives. Observance of American Academy of Pediatrics consensus guidelines for global health electives varied widely among programs, and additional efforts should focus on resident preparation, mentorship, and funding.
我们的目标是描述当前儿科住院医师培训项目中住院医师对全球健康培训的兴趣、参与情况、课程设置、资源及障碍。
2006年10月至2007年1月,我们对美国、波多黎各及加勒比地区的201个经认可的儿科住院医师培训项目进行了横断面调查。调查主题包括住院医师对选修课程的兴趣和参与情况、培训机会、项目支持以及与全球健康相关的教育课程内容。
在201个接受调查的儿科住院医师培训项目中,106个(53%)做出了回应。15%做出回应的项目报告称,其大多数住院医师对全球健康感兴趣。52%的项目在前一年提供了全球健康选修课程,47%的项目已将全球健康正式纳入其培训课程。6%的项目报告有全球健康方面的正规培训方向或证书。每个项目中,前一年参加全球健康选修课程的住院医师人数中位数在研究生一年级时为0,二年级时为1,三年级时为2。每个项目中,前一年参加全球健康选修课程的所有住院医师人数中位数为3(占项目规模的7.4%)。在提供全球健康选修课程的项目中,对参与的住院医师的支持包括临床预培训(36%)、文化培训(36%)、语言培训(15%)、教师指导(82%)以及选修课后汇报(77%)。14%的项目为住院医师选修课程提供全额资助。与住院医师更高比例参与全球健康选修课程显著相关的儿科住院医师培训项目特征包括项目规模更大、隶属于大学、住院医师兴趣更高以及教师参与全球健康工作。
超过一半接受调查的儿科住院医师培训项目在前一年提供了全球健康选修课程。10年前美国儿科学会的一项调查显示,四分之一的项目设有全球健康选修课程。各项目对美国儿科学会全球健康选修课程共识指南的遵守情况差异很大,应进一步努力关注住院医师的准备、指导和资金问题。