Integrated Curriculum for Anthroposophic Medicine (ICURAM), Center for Integrative Medicine, Integrative and Anthroposophic Medicine, Faculty of Health, Witten/Herdecke University, School of Medicine, Alfred-Herrhausen-StraBe 50, 58448 Witten, Germany ; Center for Educational Research, Faculty of Health, Witten/Herdecke University, 58448 Witten, Germany ; Department of Internal Medicine, Clinical Education Ward for Integrative Medicine (CEWIM), Gemeinschaftskrankenhaus Herdecke, 58313 Herdecke, Germany.
Evid Based Complement Alternat Med. 2013;2013:743832. doi: 10.1155/2013/743832. Epub 2013 Mar 19.
Objectives. To examine the impact of active student participation on quality of care in an integrative inpatient setting. Methods. Over a two-year period, we surveyed all patients treated on the Clinical Education Ward for Integrative Medicine (CEWIM), where final-year medical students are integrated into an internal medicine ward complementing conventional medicine with anthroposophic medicine. Patients treated on the regular wards of the same internal medicine department served as the control group (CG). General quality of care was studied with the Picker Inpatient Questionnaire, physician empathy with the Consultation and Relational Empathy measure, and patient enablement with the Patient Enablement Index. ANCOVA was used to control for covariates while examining significant differences between both patient groups. Results. Comparison of the CG wards and the CEWIM revealed no significant differences in medical treatment success. The CEWIM, however, achieved better results for physician-patient interaction, physician empathy, and patient enablement. Eighty Percent of the CEWIM patients rated student participation as positively impacting quality of care. Conclusion. Our results indicate that incorporating students in an integrative healthcare setting may result in greater patient centeredness. Further studies are needed to determine whether this is due to organizational advantages, students' empathic activity, the impact of teaching, or learner-teacher interaction.
目的。考察在综合住院环境中,学生积极参与对护理质量的影响。
方法。在两年的时间里,我们调查了在综合医学临床教育病房(CEWIM)接受治疗的所有患者,在该病房中,医学生被整合到内科病房中,将人智学医学与传统医学相结合。内科同一病房的常规病房接受治疗的患者作为对照组(CG)。使用 Picker 住院病人问卷研究一般护理质量,使用咨询和关系同理心量表研究医生同理心,使用病人赋权指数研究病人赋权。使用协方差分析(ANCOVA)在考察两个病人组之间的显著差异时,控制了协变量。
结果。CG 病房和 CEWIM 的比较显示,医疗治疗成功率没有显著差异。然而,CEWIM 在医患互动、医生同理心和病人赋权方面取得了更好的结果。80%的 CEWIM 患者认为学生参与对提高护理质量有积极影响。
结论。我们的结果表明,在综合医疗保健环境中纳入学生可能会使患者更加以患者为中心。需要进一步研究,以确定这是由于组织优势、学生的同理心活动、教学的影响还是师生互动的影响。