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儿科住院医师对以家庭为中心的查房的看法:两家儿童医院的定性研究

Pediatrics Residents' Perspectives on Family-Centered Rounds: A Qualitative Study at 2 Children's Hospitals.

作者信息

Mittal Vineeta, Krieger Evelina, Lee Benjamin C, Kind Terry, McCavit Timothy, Campbell Joyce, Ottolini Mary C, Flores Glenn

出版信息

J Grad Med Educ. 2013 Mar;5(1):81-7. doi: 10.4300/JGME-D-11-00314.1.

Abstract

BACKGROUND

Many academic hospitals have incorporated family-centered rounds, yet little is known about pediatrics residents' perspectives on the educational impact of these rounds.

OBJECTIVE

To identify pediatrics residents' knowledge, attitudes, and beliefs about family-centered rounds, including perceived benefits and barriers.

METHODS

We conducted focus groups of residents exposed to family-centered rounds at 2 university-affiliated, freestanding children's hospitals. Focus group data were analyzed using grounded theory.

RESULTS

A total of 24 residents participated in 4 focus groups. Residents reported that family-centered rounds enhance education by increasing patient encounters and improving physical exam skills, direct observation, real-time feedback, and attending role modeling; improve parent satisfaction, interpersonal and communication skills, and safety; and reduce length of stay. Physical constraints (large teams and small rooms), lack of uniform approaches to family-centered rounds, variable attending teaching styles, and specific conditions (child abuse, patients on isolation) were cited barriers.

CONCLUSIONS

Pediatrics residents report that well-conducted family-centered rounds improve their education and the quality of patient care, including parent satisfaction, communication with families, and patients' length of stay. Standardizing family-centered rounds and reducing attending variability in teaching style might further enhance residents' educational experiences.

摘要

背景

许多学术型医院已采用以家庭为中心的查房模式,但对于儿科住院医师对这些查房模式的教育影响的看法却知之甚少。

目的

确定儿科住院医师对以家庭为中心的查房模式的知识、态度和信念,包括感知到的益处和障碍。

方法

我们在两家大学附属的独立儿童医院对接触过以家庭为中心的查房模式的住院医师进行了焦点小组访谈。焦点小组数据采用扎根理论进行分析。

结果

共有24名住院医师参加了4个焦点小组。住院医师报告称,以家庭为中心的查房模式通过增加患者接触机会、提高体格检查技能、直接观察、实时反馈以及上级医师的榜样作用来加强教育;提高家长满意度、人际沟通技能和安全性;并缩短住院时间。身体限制(团队规模大且房间小)、缺乏统一的以家庭为中心的查房模式、上级医师教学风格各异以及特定情况(虐待儿童、隔离患者)被认为是障碍。

结论

儿科住院医师报告称,开展良好的以家庭为中心的查房模式可改善他们的教育以及患者护理质量,包括家长满意度、与家庭的沟通以及患者的住院时间。规范以家庭为中心的查房模式并减少上级医师教学风格的差异可能会进一步提升住院医师的教育体验。

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