Colbert Colleen Y, Mirkes Curtis, Cable Christian T, Sibbitt Stephen J B, VanZyl Gail O, Ogden Paul E
Department of Internal Medicine, Scott & White Hospital, 2401 South 31st St., Temple, TX 76508, USA.
Acad Med. 2009 Dec;84(12):1833-9. doi: 10.1097/ACM.0b013e3181bf27db.
In 2007, the Scott & White/Texas A&M HSC College of Medicine began requiring all internal medicine residents to attend quarterly patient panel conferences, during which former Scott & White patients speak frankly about their inpatient and outpatient experiences. The main purpose of this mixed-methods pilot study was to determine whether residents' competency education could be enhanced via the conferences.
Of the 54 internal medicine residents in the residency program, 31, 39, and 41 participated in three patient panel conferences, respectively, between December 2007 and August 2008. Each resident completed an assessment that included a reflection on his or her own practice and the identification of competency issues highlighted by patients' oral narratives. Content analyses of responses to open-ended questions were performed. Consensus on themes was reached. Descriptive statistics were run on quantitative data.
Six themes were identified: improve communication with patients/families, improve patient care, improve professional behaviors, empathize with patients/families, display sensitivity to patients'/families' needs/concerns, and recognize system issues. When asked if the conference highlighted competency problems, residents answered "agree" or "strongly agree" as follows: 82% for professionalism, 82.9% for systems-based practice, 85.2% for interpersonal and communication skills, and 84.4% for patient care. The majority were able to provide examples of competency issues.
The patient panel conference experience was a powerful mechanism for enhancing competency education. The conferences were an effective means of presenting real-life examples of systems issues in the context of a hospital system.
2007年，斯科特与怀特医疗中心/德州农工大学健康科学中心医学院开始要求所有内科住院医师参加季度患者小组会议，在此会议上，曾在斯科特与怀特医疗中心就诊的患者会坦诚分享他们的住院和门诊经历。这项混合方法试点研究的主要目的是确定是否可以通过这些会议加强住院医师的能力教育。
在住院医师培训项目的54名内科住院医师中，分别有31名、39名和41名在2007年12月至2008年8月期间参加了三次患者小组会议。每位住院医师都完成了一项评估，其中包括对自己实践的反思以及确定患者口头叙述中突出的能力问题。对开放式问题的回答进行了内容分析。就主题达成了共识。对定量数据进行了描述性统计。
确定了六个主题：改善与患者/家属的沟通、改善患者护理、改善职业行为、同情患者/家属、对患者/家属的需求/担忧表现出敏感性以及认识系统问题。当被问及会议是否突出了能力问题时，住院医师的回答“同意”或“强烈同意”的比例如下：职业素养为82%，基于系统的实践为82.9%，人际和沟通技能为85.2%，患者护理为84.4%。大多数人能够提供能力问题的实例。
患者小组会议经历是加强能力教育的有力机制。这些会议是在医院系统背景下展示系统问题实际例子的有效手段。
