Bautista Miho K, Meuleman John R, Shorr Ron I, Beyth Rebecca J
Geriatric Research, Education and Clinical Center, North Florida/South Georgia Veterans Health System, Gainesville, Florida, USA.
J Am Geriatr Soc. 2009 Sep;57(9):1685-91. doi: 10.1111/j.1532-5415.2009.02399.x. Epub 2009 Aug 13.
This article describes medical students' evaluation of a geriatric clerkship in postacute rehabilitative care settings. This was a cross-sectional study of fourth-year medical students who completed a mandatory 2-week rotation at a postacute care facility. Students were provided with three instructional methods: Web-based interactive learning modules; small-group sessions with geriatric faculty; and Geriatric Interdisciplinary Care Summary (GICS), a grid that students used to formulate comprehensive interdisciplinary care plans for their own patients. After the rotation, students evaluated the overall clerkship, patient care activities, and usefulness of the three instructional methods using a 5-point Likert scale (1=poor to 5=excellent) and listed their area of future specialty. Of 156 students who completed the rotation, 117 (75%) completed the evaluation. Thirty (26%) chose specialties providing chronic disease management such as family, internal medicine, and psychiatry; 34 (29%) chose specialties providing primarily procedural services such as surgery, radiology, anesthesiology, pathology, and radiation oncology. Students rated the usefulness of the GICS as good to very good (mean+/-standard deviation 3.3+/-1.0). Similarly, they rated overall clerkship as good to excellent (3.8+/-1.0). Analysis of variance revealed no significant group difference in any of the responses from students with the overall clerkship (F(112, 4)=1.7, P=.20). Students rated the geriatric clerkship favorably and found the multimodal instruction to be useful. Even for students whose career choice was not primary care, geriatrics was a good model for interdisciplinary care training and could serve as a model for other disciplines.
本文描述了医学生对急性后期康复护理环境中老年医学实习的评价。这是一项对四年级医学生的横断面研究，这些学生在一家急性后期护理机构完成了为期两周的强制轮转。学生们接受了三种教学方法：基于网络的交互式学习模块；与老年医学教员的小组会议；以及老年医学跨学科护理总结（GICS），这是一个学生用来为自己的患者制定全面跨学科护理计划的表格。轮转结束后，学生们使用5点李克特量表（1=差至5=优）对整体实习、患者护理活动以及三种教学方法的有用性进行了评价，并列出了他们未来的专业领域。在完成轮转的156名学生中，117名（75%）完成了评价。30名（26%）学生选择了提供慢性病管理的专业，如家庭医学、内科和精神病学；34名（29%）学生选择了主要提供程序性服务的专业，如外科、放射科、麻醉科、病理科和放射肿瘤学。学生们对GICS有用性的评价为良好至非常好（均值±标准差为3.3±1.0）。同样，他们对整体实习的评价为良好至优秀（3.8±1.0）。方差分析显示，在整体实习方面，学生的任何一项回答在各小组之间均无显著差异（F(112, 4)=1.7，P=0.20）。学生们对老年医学实习评价良好，并发现多模式教学很有用。即使对于那些职业选择不是初级保健的学生来说，老年医学也是跨学科护理培训的良好模式，并且可以作为其他学科的典范。
