Block Robert C, Tran Bill, McIntosh Scott
Department of Community and Preventive Medicine, University of Rochester School of Medicine and Dentistry, 601 Elmwood Avenue, Rochester, New York 14642.
Health Educ J. 2011 Mar;70(1):39-47. doi: 10.1177/0017896910367955.
To determine if integration of the Chronic Care Model into undergraduate medical education is associated with anticipated use of the Model and if student perceptions match actual integration of the Model into their community projects. DESIGN: This was a cross-sectional study using qualitative and quantitative data. SETTING: A novel fourth-year medical student community health improvement course. METHOD: The study included 45 students who had enrolled in the course before introduction of the Model and 32 formally introduced to the Model through a lecture. Perceptions were measured through a survey and a focus group with data analyzed amongst and between cohorts. Projects were reviewed for actual integration of Model elements and these data were compared with reported student perceptions. RESULTS: Although they were in general utilizing most elements of the Model, student perceptions of their use of Model elements significantly differed from actual use of particular elements (p<0.001). For instance, whereas the majority believed that their projects focused on the element of Community Resources, most projects actually focused on Self-Management Support. Students formally introduced to the Model trended toward the belief that it would enhance their ability to care for patients more than students without formal exposure to it (p=0.0516). CONCLUSIONS: Although medical students may not recognize it, they may already focus their actions and thinking regarding health improvement toward patient self-management of their chronic disease. Although students require education and training if the Model is to be widely used, they may be naturally attracted to it.
确定将慢性病照护模式融入本科医学教育是否与该模式的预期应用相关,以及学生的认知是否与该模式在其社区项目中的实际融入情况相符。
这是一项使用定性和定量数据的横断面研究。
一门新颖的四年级医学生社区健康改善课程。
该研究纳入了45名在引入该模式之前就已注册该课程的学生,以及32名通过讲座正式接触该模式的学生。通过一项调查和一次焦点小组来衡量认知情况,并对不同群组之间和群组内部的数据进行分析。对项目进行审查以确定慢性病照护模式要素的实际融入情况,并将这些数据与学生报告的认知情况进行比较。
尽管学生总体上在使用该模式的大多数要素,但他们对自身使用模式要素的认知与特定要素的实际使用情况存在显著差异(p<0.001)。例如,虽然大多数人认为他们的项目侧重于社区资源要素,但实际上大多数项目侧重于自我管理支持。与未正式接触该模式的学生相比,正式接触该模式的学生更倾向于认为它会增强他们照顾患者的能力(p=0.0516)。
尽管医学生可能并未意识到,但他们在改善健康方面的行动和思维可能已经朝着患者对慢性病的自我管理方向发展。如果要广泛应用该模式,学生需要接受教育和培训,但他们可能会自然而然地被其吸引。