Pincavage Amber T, Razi Rabia R, Arora Vineet M, Oyler Julie, Woodruff James N
J Grad Med Educ. 2013 Jun;5(2):327-31. doi: 10.4300/JGME-D-12-00127.1.
Most internal medicine (IM) residency programs provide ambulatory training in academic medical centers. Community-based ambulatory training has been suggested to improve ambulatory and primary care education. Free clinics offer another potential training setting, but there have been few reports about the experience of IM residents in free clinics.
We assessed the feasibility and acceptability of inclusion of an ambulatory rotation in a free clinic and IM residency curriculum and the advantages of the free clinic setting over the traditional ambulatory clinic model.
In 2010, the University of Chicago Internal Medicine Residency Program partnered with a free clinic in order to establish a community-based continuity clinic experience. To assess the feasibility of this innovation, 16 residents were surveyed 9 months after implementation of the clinic to determine satisfaction, perceived preparation to address common medical conditions, and attitudes toward the underserved care population. A subset of these responses was compared to responses from residents in the traditional clinic model.
Residents in the free clinic rotation were more satisfied and perceived they were more prepared to work in low-resource settings and reported similar levels of preparation regarding common outpatient conditions than residents in a traditional continuity clinic format. They reported increased future likelihood of working in an underserved clinic.
Our exploratory study suggests free clinics may be an effective platform for community-based continuity clinic training.
大多数内科住院医师培训项目在学术医疗中心提供门诊培训。有人建议开展基于社区的门诊培训，以改善门诊和初级保健教育。免费诊所提供了另一种潜在的培训环境，但关于内科住院医师在免费诊所的经历的报道很少。
我们评估了将免费诊所门诊轮转纳入内科住院医师培训课程的可行性和可接受性，以及免费诊所环境相对于传统门诊模式的优势。
2010年，芝加哥大学内科住院医师培训项目与一家免费诊所合作，以建立基于社区的连续性诊所体验。为评估这一创新举措的可行性，在诊所实施9个月后，对16名住院医师进行了调查，以确定他们的满意度、应对常见医疗状况的准备程度以及对服务欠缺人群的态度。将这些回答中的一部分与传统诊所模式下住院医师的回答进行了比较。
与传统连续性诊所模式下的住院医师相比，参与免费诊所轮转的住院医师更满意，认为自己更有准备在资源匮乏的环境中工作，并且在常见门诊疾病方面的准备程度相当。他们表示未来在服务欠缺诊所工作的可能性增加。
我们的探索性研究表明，免费诊所可能是基于社区的连续性诊所培训的有效平台。
