Catalanotti Jillian, Popiel David, Johansson Patrik, Talib Zohray
J Grad Med Educ. 2013 Dec;5(4):674-7. doi: 10.4300/JGME-D-12-00354.1.
Public health training has become an important aspect of residency education. The Institute of Medicine recommends public health training for all resident physicians, and internal medicine educational milestones include general public health skills.
We sought to integrate community health into internal medicine residency training by developing a community health elective (CHE) curriculum.
We developed a 2-week CHE curriculum for internal medicine residents, featuring facilitated discussion sessions, clinical experience at health centers targeting medically underserved populations, and a culminating presentation. We evaluated our pilot curriculum using pre-elective and postelective course surveys with Likert-type questions.
Of 150 eligible residents, 32 (21%) enrolled in the elective. Nearly all participants (30 of 32, 94%) strongly agreed that learning about community health was an important part of their residency training. Residents' perceived competence at discharging hospital patients with follow-up at community health sites increased 13-fold after taking the elective (P < .001). There was no increase in reported likelihood to practice in an underserved community or in primary care.
The CHE addresses several Accreditation Council for Graduate Medical Education competencies and internal medicine Milestones and could be a replicable model for internal medicine residency programs that seek to provide community health training.
公共卫生培训已成为住院医师教育的一个重要方面。医学研究所建议对所有住院医师进行公共卫生培训，内科教育里程碑包括一般公共卫生技能。
我们试图通过开发一门社区健康选修课程（CHE），将社区健康纳入内科住院医师培训。
我们为内科住院医师开发了一门为期2周的CHE课程，其特色包括促进讨论环节、在针对医疗服务不足人群的健康中心的临床经验以及一场总结汇报。我们使用带有李克特式问题的选修前和选修后课程调查问卷对我们的试点课程进行了评估。
在150名符合条件的住院医师中，32人（21%）报名参加了该选修课程。几乎所有参与者（32人中有30人，94%）强烈同意了解社区健康是他们住院医师培训的重要组成部分。参加选修课程后，住院医师在将医院患者转至社区健康机构进行随访方面的感知能力提高了13倍（P < 0.001）。在医疗服务不足社区或初级保健领域执业的报告可能性没有增加。
CHE满足了研究生医学教育认证委员会的多项能力要求和内科里程碑要求，对于寻求提供社区健康培训的内科住院医师项目而言，可能是一个可复制的模式。
