Oregon Health and Science University, Portland, OR 97239-3098, USA.
J Gen Intern Med. 2010 Sep;25 Suppl 4(Suppl 4):S593-609. doi: 10.1007/s11606-010-1385-y.
Recent Breakthrough Series Collaboratives have focused on improving chronic illness care, but few have included academic practices, and none have specifically targeted residency education in parallel with improving clinical care. Tools are available for assessing progress with clinical improvements, but no similar instruments have been developed for monitoring educational improvements for chronic care education.
To design a survey to assist teaching practices with identifying curricular gaps in chronic care education and monitor efforts to address those gaps.
During a national academic chronic care collaborative, we used an iterative method to develop and pilot test a survey instrument modeled after the Assessing Chronic Illness Care (ACIC). We implemented this instrument, the ACIC-Education, in a second collaborative and assessed the relationship of survey results with reported educational measures.
A combined 57 self-selected teams from 37 teaching hospitals enrolled in one of two collaboratives.
We used descriptive statistics to report mean ACIC-E scores and educational measurement results, and Pearson's test for correlation between the final ACIC-E score and reported educational measures.
A total of 29 teams from the national collaborative and 15 teams from the second collaborative in California completed the final ACIC-E. The instrument measured progress on all sub-scales of the Chronic Care Model. Fourteen California teams (70%) reported using two to six education measures (mean 4.3). The relationship between the final survey results and the number of educational measures reported was weak (R(2) = 0.06, p = 0.376), but improved when a single outlier was removed (R(2) = 0.37, p = 0.022).
The ACIC-E instrument proved feasible to complete. Participating teams, on average, recorded modest improvement in all areas measured by the instrument over the duration of the collaboratives. The relationship between the final ACIC-E score and the number of educational measures was weak. Further research on its utility and validity is required.
最近的突破性系列合作专注于改善慢性病护理,但很少有合作包括学术实践,也没有专门针对居住教育,同时改善临床护理。有工具可用于评估临床改善的进展,但没有类似的工具来监测慢性病教育的教育改进。
设计一项调查,以帮助教学实践确定慢性病教育中的课程差距,并监测解决这些差距的努力。
在全国性学术慢性护理合作中,我们使用迭代方法开发并试点测试了一种基于评估慢性病护理(ACIC)的调查工具。我们在第二个合作中实施了这个工具,即 ACIC-Education,并评估了调查结果与报告的教育措施之间的关系。
来自 37 家教学医院的 57 个自我选择的团队参加了两个合作中的一个。
我们使用描述性统计来报告平均 ACIC-E 得分和教育测量结果,并使用 Pearson 检验来评估最终 ACIC-E 得分与报告的教育措施之间的相关性。
来自全国合作的 29 个团队和来自加利福尼亚的第二个合作的 15 个团队完成了最终的 ACIC-E。该工具测量了慢性病模型所有子量表的进展。加利福尼亚的 14 个团队(70%)报告使用了两到六个教育措施(平均 4.3 个)。最终调查结果与报告的教育措施数量之间的关系较弱(R²=0.06,p=0.376),但当去除一个异常值时,关系得到改善(R²=0.37,p=0.022)。
ACIC-E 工具被证明是可行的。在合作期间,参与团队平均在仪器测量的所有领域都记录了适度的改善。最终 ACIC-E 得分与教育措施数量之间的关系较弱。需要进一步研究其效用和有效性。