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平行会诊对地区全科医疗会诊质量的影响。

The effect of parallel consulting on the quality of consultations in regional general practice.

作者信息

Tran Peter Duy, Laurence Jerome Martin, Weston Kathryn M, McLennan Peter L

机构信息

Liverpool Hospital, Sydney NSW, Australia.

出版信息

Educ Prim Care. 2012 May;23(3):153-7. doi: 10.1080/14739879.2012.11494098.

Abstract

OBJECTIVE

The sustainability of community-based medical education relies on maintaining consultation quality as perceived by patients. This study aims to investigate the effect of an alternative model (parallel consultation) of teaching on patients' views of consultation quality as compared to the conventional consultation model in a general practice setting.

DESIGN

A cross-sectional questionnaire study.

SETTING AND PARTICIPANTS

Patients attending a regional general practice in the Southern Highlands of New South Wales between February and May 2010, who consented to student involvement in their consultation.

MAIN OUTCOME MEASURES

Instruments to measure 'empathy' (CARE score) and 'enablement' (PEI score) as markers for consultation quality were administered after patient consultations.

RESULTS

There was no difference in consultation length between the two groups. There was a small increase in the level of empathy experienced by patients attending parallel consultations compared to conventional consultations (P<0.05). The level of enablement did not differ between the groups. Although generally encouraging towards student involvement, patients' attitudes were significantly more positive towards students involved in the parallel consultation group (P<0.01).

CONCLUSIONS

There is no loss in consultation quality, as experienced by the patient, when using the parallel consulting model. Parallel consulting does not change the length of time a patient spends with their doctor, and patients have a positive perception of the students involved in this model of clinical teaching.

摘要

目的

基于社区的医学教育的可持续性依赖于维持患者所感知的咨询质量。本研究旨在调查在全科医疗环境中,与传统咨询模式相比,一种替代性教学模式(平行咨询)对患者咨询质量看法的影响。

设计

一项横断面问卷调查研究。

地点与参与者

2010年2月至5月期间在新南威尔士州南部高地一家地区全科诊所就诊且同意学生参与其咨询的患者。

主要观察指标

在患者咨询后,使用测量“同理心”(关怀得分)和“赋能”(患者赋能指数得分)的工具作为咨询质量的标志物。

结果

两组的咨询时长无差异。与传统咨询相比,参与平行咨询的患者所体验到的同理心水平略有提高(P<0.05)。两组间的赋能水平无差异。尽管患者总体上对学生参与持鼓励态度,但患者对参与平行咨询组的学生态度明显更为积极(P<0.01)。

结论

使用平行咨询模式时,患者所体验到的咨询质量没有下降。平行咨询不会改变患者与医生相处的时长,并且患者对参与这种临床教学模式的学生有积极的看法。

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