Practice Improvement Module research at the American Board of Internal Medicine, Philadelphia, Pennsylvania, USA.
Health Aff (Millwood). 2012 Jan;31(1):150-8. doi: 10.1377/hlthaff.2011.0907.
To ensure that medical residents will be prepared to deliver consistently high-quality care, they should be trained in settings that provide such care. Residents in internal medicine, particularly, need to learn good care habits in order to meet the needs of patients with diabetes and other common chronic and high-impact illnesses. To assess the strength of such training, we compared the quality of medical care provided in sixty-seven US internal medicine residency ambulatory clinics with the quality of care provided by 703 practicing general internists. We found significant quality gaps in process, intermediate outcome, and patient-experience measures. These inadequacies in ambulatory training for internal medicine residents must be addressed by policy makers and educators-for example, by accelerating the movement toward new residency curricula that emphasize competency-based training.
为确保住院医师能够始终提供高质量的医疗服务，他们应该在提供此类服务的环境中接受培训。内科住院医师尤其需要养成良好的医疗习惯，以满足患有糖尿病和其他常见慢性病及高影响力疾病患者的需求。为了评估这种培训的效果，我们比较了 67 家美国内科住院医师实习门诊提供的医疗服务质量与 703 名普通内科医生提供的医疗服务质量。我们发现，在流程、中间结果和患者体验措施方面存在显著的质量差距。对于内科住院医师的这种门诊培训不足，政策制定者和教育工作者必须加以解决；例如，加快推动新的住院医师课程，强调基于能力的培训。
