Regenstrief Institute, Indiana University School of Medicine, Indianapolis, Indiana, USA.
Acad Med. 2011 Apr;86(4):445-52. doi: 10.1097/ACM.0b013e31820e7e6e.
In the report "Crossing the Quality Chasm," the Institute of Medicine asserted that patient-centered care is one of the six domains of quality. In this article, the authors consider how the patient- and relationship-centered components of quality can be achieved in all aspects of medical care. They suggest that faculty development in three key areas-mindful practice, formation, and training in communication skills-is necessary to achieve patient- and relationship-centeredness.The authors first review the philosophical and scientific foundations of patient-centered and relationship-centered care. They next describe and provide concrete examples to illustrate the underlying theory and practices associated with each of the three faculty development areas. They then propose five key areas for faculty development in patient- and relationship-centered care: (1) making it a central competency in all health care interactions, (2) developing a national curriculum framework, (3) requiring performance metrics for professional development, (4) partnering with national health care organizations to disseminate the curriculum framework, and (5) preserving face-to-face educational methods for delivering key elements of the curriculum. Finally, the authors consider the issues faced in faculty development today in light of the medical education issues Abraham Flexner identified more than a century ago.
在《跨越质量鸿沟》的报告中，美国国家医学院断言以患者为中心的医疗照护是质量的六个范畴之一。本文作者探讨了如何在医疗照护的各个层面实现以患者和关系为中心的质量组成部分。他们认为，在三个关键领域——正念实践、形成和沟通技巧训练——进行教师发展，对于实现以患者和关系为中心是必要的。作者首先回顾了以患者和关系为中心的医疗照护的哲学和科学基础。然后，他们描述并提供了具体的例子来说明与三个教师发展领域相关的基础理论和实践。接着，作者提出了五个以患者和关系为中心的医疗照护教师发展的关键领域：（1）将其作为所有医疗互动的核心能力，（2）制定国家课程框架，（3）为专业发展制定绩效指标，（4）与国家医疗保健组织合作传播课程框架，以及（5）保留面对面的教育方法来传授课程的关键要素。最后，作者根据一个多世纪前 Abraham Flexner 确定的医学教育问题，考虑了当今教师发展所面临的问题。
